Search Results (649)

Modern lifestyles are increasingly plagued by physical inactivity, social disconnection, digital addiction, and excessive time indoors—factors that negatively impact the health and well-being of both humans and their companion dogs (Canis familiaris). Evidence shows that nature exposure, physical activity, and human–animal bond (HAB) each enhance physical, mental, and social well-being, yet these domains have rarely been examined together as an integrated therapeutic triad. We introduce a new conceptual framework of bonded green exercise, defined as shared physical activity between a bonded human and dog in natural environments. Synthesizing existing evidence across human and canine sciences into a testable conceptual integration, we posit that bonded green exercise may plausibly activate evolutionarily conserved, synergistic mechanisms of physiological, behavioural, and affective co-regulation. Four testable hypotheses are proposed: (H1) triadic synergy: combined domains produce greater benefits than additive effects; (H2) heterospecific benefit: parallel health gains occur in both species; (H3) behavioural amplification: dogs acts as catalysts to drive human participation in nature-based activity; and (H4) scalable health promotion: bonded green exercise represents a low-cost, accessible, One Health approach with population-level potential. This framework highlights how intentional, shared physical activity in nature may potentially offer a novel low-cost and accessible model for enhancing health, lifespan, welfare, and ecological stewardship across species. Full article

Background and Objectives: Bladder cancer (BC) represents a significant global health burden, ranking as the tenth most commonly diagnosed malignancy worldwide, with an incidence rate of 5.6 per 100,000 person-years annually. The research team aimed to summarize evidence on specialized nursing-led interventions for bladder cancer management across the disease continuum. Materials and Methods: This scoping review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) methodology to search four databases from January 2018 to November 2025. Results: This concise but informative scoping review of 20 studies revealed substantial clinical and patient-reported benefits from specialized nursing interventions. Enhanced recovery after surgery (ERAS) protocols incorporating structured nursing care demonstrated a 35% reduction in postoperative complications. Integrated nursing interventions during postoperative intravesical therapy significantly improved patient satisfaction, treatment compliance, and self-efficacy while reducing anxiety and depression. Digital health platforms, including internet-based and mobile applications, proved effective in reducing caregiver burden, enhancing disease knowledge, and improving coping strategies. Preoperative stoma education and postoperative ostomy care management significantly improved self-efficacy, stoma care knowledge, and overall health-related quality of life. Psychosocial interventions, including cognitive behavioral therapy and mindfulness-based approaches, demonstrated significant improvements in quality of life and reductions in fear of recurrence, depression, and anxiety. However, a critical evidence gap exists regarding bladder cancer-specific mental health interventions. Conclusions: Specialized nursing-led care plays a critical role in strengthening clinical and assistive practice in bladder cancer. Evidence from this scoping review shows that nursing-led interventions significantly improve clinical outcomes, patient satisfaction, symptom management, and quality of life across all phases of bladder cancer care while reducing caregiver burden and enhancing psychological well-being for both patients and families, reinforcing the value of integrating specialized nursing roles into routine bladder cancer management. Full article

Background/Objectives: Parental mental health challenges are associated with parenting difficulties and child mental health issues. Parenting interventions can support families; however, parents with mental health challenges face barriers to accessing parenting support, which is not consistently offered within adult mental health settings. Embedding technology-assisted parenting programs into these settings could provide accessible, holistic support. Partners in Parenting Kids (PiP Kids) is a digital parenting program designed to prevent child anxiety and depression, yet its suitability for parents with mental health challenges and fit within mental health services remains unclear. This study aimed to co-design and adapt PiP Kids for future implementation in an Australian adult mental health service. Methods: Parents who recently sought mental health support (n = 8) and service providers (n = 7) participated in co-design workshops to explore needs and preferences for a technology-assisted parenting program and iteratively develop a prototype. Parents (n = 3) trialled the online component of the prototype and participated in qualitative interviews to assess acceptability. Results: The adapted clinician-supported program was designed to facilitate (1) parent and clinician readiness for parenting support; (2) emotional and social support for parents and clinicians; (3) practical, personalised parenting knowledge; (4) parent-led empowerment; and (5) accessible, integrated support. Prototype clinician training was developed to strengthen the clinician-support component. Parents indicated initial acceptability of the online prototype while reiterating the value of including face-to-face support. Conclusions: This study co-designed an online, clinician-supported parenting program for future embedding within adult mental health settings. The findings highlight key considerations for developing and implementing technology-assisted interventions that promote family-focused care for parents seeking mental health support. Full article

The rapid digitalization of healthcare has led to the widespread availability of mobile health (mHealth) applications, including those aimed at mental health and well-being. The present study followed the PRISMA guidelines and systematically reviewed English and/or German mental health apps available in the Google Play Store to evaluate their functional quality and behavior-change potential. It utilized the Mobile App Rating Scale (MARS) to assess app quality, including engagement, functionality, esthetics, and information quality, and the App Behavior Change Scale (ABACUS) to evaluate the potential for behavior change by inclusion of behavior change techniques (BCTs). A total of 77 apps were reviewed, with findings indicating an average functional quality and moderate behavior-change potential, as the reviewed apps only utilized a limited amount of BCTs. Notably, only a small fraction of apps had been evaluated in randomized controlled trials (RCTs). Further analysis showed that MARS and ABACUS scores had limited predictive power regarding app popularity as measured by stars awarded by users and number of user ratings in the Google Play Store. The study highlights the need for more rigorous testing of mHealth apps and suggests that factors beyond those measured by MARS and ABACUS may influence app popularity. In addition to the scientific value, this review provides insights for both users interested in mental health support via apps and developers aiming to enhance the quality and impact of mental health applications. Full article

For individuals with mental illness who experience multidimensional marginalization, the risks of encountering discrimination and receiving inadequate care are compounded. Artificial intelligence (AI) systems have propelled the provision of mental healthcare through the creation of digital mental health applications (DMHAs). DMHAs can be trained to identify specific markers of distress and resilience by incorporating community knowledge in machine learning algorithms. However, DMHAs that use rule-based systems and large language models (LLMs) may generate algorithmic bias. At-risk populations face challenges in accessing culturally and linguistically competent care, often exacerbating existing inequities. Creating equitable solutions in digital mental health requires AI training models that adequately represent the complex realities of marginalized people. This narrative review analyzes the current literature on digital mental health through an intersectional framework. Using an intersectional framework considers the nuanced experiences of individuals whose identities lie at the intersection of multiple stigmatized social groups. By assessing the disproportionate mental health challenges faced by these individuals, we highlight several culturally responsive strategies to improve community outcomes. Culturally responsive strategies include digital mental health technologies that incorporate the lived experience of individuals with intersecting identities while reducing the incidence of bias, harm, and exclusion. Full article

In an increasingly digitalized work environment, the expectation of perpetual work availability—constant connectivity (CC)—has become central to employees’ daily experiences, influencing productivity, well-being, and work–life balance. This study validates the Constant Connectivity Scale in the Italian organizational context, assessing its psychometric properties through exploratory and confirmatory factor analyses with 300 employees from three organizations. Reliability and validity assessments revealed the scale’s unidimensional structure, strong internal consistency, and high construct validity, demonstrating its effectiveness in measuring perceived hyperconnectivity at work. Findings reveal important relationships between constant connectivity and employee outcomes: significant associations with increased anxiety and a paradoxical moderate positive correlation with job performance, suggesting complex mechanisms whereby connectivity simultaneously activates engagement and strain processes. The weak correlation with smart working perception indicates that organizational flexibility policies have not substantially reduced connectivity expectations in Italian organizations. This study contributes to the digital work literature by providing a validated, culturally adapted instrument for as sessing constant connectivity in the Italian workforce. The validated CCS offers organizations evidence-based measurement for understanding hyperconnectivity intensity and implementing targeted strategies for building workforce resilience and promoting mental health through better management of digital connectivity demands. Full article

Social media addiction (SMA) and social phobia (SP) are significant adolescent mental health concerns. In Saudi Arabia, despite high social media penetration, the association between these two constructs remains under-researched, particularly in the Aseer region. This cross-sectional study, conducted from January to March 2025, recruited 384 Saudi adolescents aged 11–19 from schools in the Aseer region using multistage cluster sampling. Participants completed validated self-report measures, including the Social Phobia Inventory (SPIN) and the Al-Menayes Social Media Addiction Scale. A refined “Core SMA” subscale was created based on expert consensus criteria to enhance measurement precision. The prevalence of moderate-to-severe social phobia was 15.6%. A significant, moderate positive correlation emerged between SP and SMA (Spearman’s ρ = 0.294, p < 0.001). After adjusting for age, gender, and family income, adolescents with moderate social phobia had 2.15 times the odds of probable SMA compared to those with no SP (adjusted odds ratio [AOR] = 2.15, 95% CI: 1.15–4.04, p < 0.05), and this effect was more pronounced for those with severe social phobia (AOR = 2.56, 95% CI: 1.04–6.30, p < 0.05). This study demonstrates a clear relationship between social phobia severity and social media addiction among Saudi adolescents in the Aseer region. These findings support the urgent need for integrated mental health and digital literacy interventions that proactively screen for both conditions. Full article

Mobile Global Positioning System (GPS) data offer a promising approach to inferring mental health status through behavioural analysis. Whilst previous research has explored location-based behavioural indicators including location clusters, entropy, and variance, persistent GPS measurement errors have compromised data reliability, limiting the practical deployment of smartphone-based digital phenotyping systems. This study develops and validates an algorithmic preprocessing method designed to mitigate inherent GPS measurement limitations in mobile health applications. We conducted comprehensive evaluation through controlled experimental protocols and naturalistic field assessments involving 38 participants over a seven-day period, capturing GPS data across diverse environmental contexts on both Android and iOS platforms. The proposed preprocessing algorithm demonstrated exceptional precision, consistently detecting major activity centres within an average 50-metre margin of error across both platforms. In naturalistic settings, the algorithm yielded robust location detection capabilities, producing spatial patterns that reflected plausible and behaviourally meaningful traits at the individual level. Cross-platform analysis revealed consistent performance regardless of operating system, with no significant differences in accuracy metrics between Android and iOS devices. These findings substantiate the potential of mobile GPS data as a reliable, objective source of behavioural information for mental health monitoring systems, contingent upon implementing sophisticated error-mitigation techniques. The validated algorithm addresses a critical technical barrier to the practical implementation of GPS-based digital phenotyping, enabling the more accurate assessment of mobility-related behavioural markers across diverse mental health conditions. This research contributes to the growing field of mobile health technology by providing a robust algorithmic framework for leveraging smartphone sensing capabilities in healthcare applications. Full article

Objective: To conduct a scoping review of the global trends of adolescent health inequities and their social determinants from 2000 to 2024 and establish an evidence base for developing targeted intervention strategies. Methods: Guided by the rainbow model, we conducted a bibliometric analysis of 171 peer-reviewed articles related to adolescent health inequalities and their social determinants from the Web of Science Core Collection using CiteSpace 6.3.1 to summarize empirical evidence on how social determinants of health (SDOH) influence adolescents’ health behaviors (e.g., drinking) and health outcomes (e.g., overweight). Results: First, results showed a progressive increase in publications addressing social determinants of adolescent health from 2000 to 2024. Journals in public health and preventive medicine accounted for the highest proportion of articles, with the United States contributing the largest national share (21.05% of global output). Second, an analysis of keywords showed that previous studies mostly focused on the effects of socioeconomic status, family affluence on adolescent health (e.g., physical activity, mental health, and overweight). Third, inequalities in adolescent health were prevalent globally. Health behaviors (e.g., diet, oral health, and smoking) have received widespread attention and are influenced by socioeconomic status, family environment, and gender, whereas various indicators of adolescent health outcomes (e.g., obesity, mental health, and suicide) were highly correlated with family socioeconomic status. Conclusions: To reduce adolescent health disparities, it is important to deepen interdisciplinary research, consider the impact of emerging societal (e.g., digital environments) and environmental factors (e.g., climate change), and develop systematic and comprehensive intervention strategies that encompass the individual, family, school, community, and national levels. Full article

Background: The rising prevalence and enduring impact of mental health problems in youth have intensified the call for population-level prevention. Low positive and high negative affect in childhood are vulnerability factors for mental health problems in adolescence. Supporting youth in managing affect during early adolescence may foster mental health preventively. Self-regulation training has shown promise in this regard. Moreover, its parallels with Behavioral Activation (BA) align with the recommendation to adapt evidence-based clinical interventions into scalable, accessible formats for prevention. Methods: This study examined whether a 12-day mobile-based self-regulation training, consistent with BA principles and delivered in an innovative digital format, could increase positive and decrease negative affect in a sample of 156 youths (M_age = 10.0). Results: No significant group differences emerged in affect change over time, and neither baseline levels of self-control nor emotion regulation strategies moderated the effects. Conclusions: The findings suggest that low-intensity mobile-based interventions may be insufficient to produce meaningful affect change in youth. The potential need to shift from universal prevention strategies to more selective approaches targeting at-risk youth is discussed. Full article

Objectives: Lifestyle behaviors such as physical activity, cognitive engagement, social interaction, diet, sleep, and vascular risk management are increasingly recognized as contributors to cognitive aging and dementia risk. Although many middle-aged and older adults express interest in maintaining brain health, less is known about their beliefs about brain-healthy behaviors or their preferences for receiving multicomponent brain health interventions. This study examined adults’ ratings of the usefulness of a wide range of lifestyle activities for brain health and their preferred formats for receiving support. Methods: A 60-item online survey was administered to compensated volunteers aged 40 years and older through a commercial provider. The questionnaire assessed perceived usefulness of lifestyle-based brain health activities and preferred intervention delivery formats. The analytic sample included 761 respondents. Descriptive statistics were computed for all ratings and differences by age group and gender were tested using MANOVA with post hoc comparisons adjusted for multiple testing. Results: Participants endorsed many lifestyle activities as helpful for brain health. Mentally stimulating activities, good sleep, stress management, and creative activities received the highest ratings, whereas strength training, meditation, language learning, and computer-based cognitive training were rated lower. Aerobic exercise and mentally stimulating activities were most frequently selected as the single most important activity. Significant effects of age, gender, and their interaction were observed, with younger men and older women generally rating activities more favorably. With respect to desire for services, over half of participants preferred receiving a cognitive assessment, and many favored online education or app-based tools. Conclusions: Middle-aged and older adults recognize a wide range of lifestyle factors as potentially beneficial for brain health and express strong interest in structured support, particularly assessments and digital resources. These findings can inform the design of flexible, multicomponent brain health interventions aligned with adults’ preferences and priorities. Full article

Cyberbullying generally reveals two leading players: the attacker side (perpetrator) and the victim side; each side has its distinctive social and psychological dynamics. In most prior empirical studies, the victim side is pivotal, as it bears the direct psychological and emotional consequences of online aggression. Recently, cyberbullying victimisation has been elevated as a main psychological concern among university students. Nevertheless, the moderating role of family support remained untested, particularly in a collectivist cultural context such as the Kingdom of Saudi Arabia (KSA). This study tested the impacts of cyberbullying victimisation on mental health consequences (anxiety, stress, and depression) among KSA university students. The study further tested family support as a moderator in these relationships. Data was collected from 650 students employing a self-structured survey. The data obtained was analyzed using “Partial Least Squares Structural Equation Modelling” (PLS-SEM). The findings revealed that cyberbullying-victimization can significantly raise students’ anxiety, stress, and depressive signs, supporting its place as a critical psychological risk factor. Contrary to the “traditional stress-buffering theory”, family support failed to alleviate the influence of cyberbullying-victimization on anxiety and stress, and unexpectedly, higher levels of family support were related to higher depressive levels, suggesting a reverse-buffering impact. These results highlighted the complicated relationships between family support and emotional outcomes in the context of digital threats. The study stressed the urgent need for culturally delicate mediations, such as training sessions for digital resilience, and colleague-based supportive systems to successfully deal with the mental health consequences of cybervictimization. Full article

COVID-19 significantly disrupted the progress of the SDGs globally, including in Saudi Arabia. This study explores the progression of SDGs in Saudi Arabia during and after COVID-19, focusing on four dimensions: financial, socioeconomic, health, and environmental. A qualitative approach was employed, involving 19 semi-structured interviews conducted in two rounds (during and post COVID-19). Thematic analysis, conducted using NVivo 14.0, identified four main themes and 16 subthemes, which align with the SDG dimensions. The study revealed significant disruptions across four SDG dimensions during the pandemic. These included economic downturns, increased poverty, strained healthcare systems, and environmental changes. Guided by systems theory as an analytical lens, the study findings indicate that while COVID-19 caused disruptions across SDGs, it also acted as a catalyst for transformational shifts across interconnected SDG domains. The post-pandemic period has shown recovery, including economic growth, enhanced gender equality, improved mental health services, and a renewed focus on sustainability. Six cross-thematic themes emerged: (1) economic recovery and employment, (2) gender equity and education, (3) mental health and healthcare, (4) poverty reduction and food security, (5) environmental sustainability, and (6) digital transformation resilience. Based on these insights, the study provides recommendations for Saudi policymakers to align SDG progress with Saudi Vision 2030 in line with pragmatic sustainability. Full article

Mental health disorders affect large numbers of people worldwide and are a major cause of long-term disability. Digital health technologies such as mobile apps and wearable devices now generate rich behavioural data that could support earlier detection and more personalised care. However, these data are highly sensitive and distributed across devices and platforms, which makes privacy protection and scalable analysis challenging; federated learning offers a way to train models across devices while keeping raw data local. When combined with edge, fog, or cloud computing, federated learning offers a way to support near-real-time mental health analysis while keeping raw data local. This review screened 1104 records, assessed 31 full-text articles using a five-question quality checklist, and retained 17 empirical studies that achieved a score of at least 7/10 for synthesis. The included studies were compared in terms of their FL and edge/cloud architectures, data sources, privacy and security techniques, and evidence for operation in real-world settings. The synthesis highlights innovative but fragmented progress, with limited work on comorbidity modelling, deployment evaluation, and common benchmarks, and identifies priorities for the development of scalable, practical, and ethically robust FL systems for digital mental health. Full article

Background: Better understanding factors leading to suicide and prevention opportunities is a global public health priority. This qualitative pilot study tested whether reviewing inquest recordings could generate insights during COVID-19 and inform public health prevention programmes across a predominantly rural and coastal area where there are significant health inequalities. Methods: Fifty-five inquest recordings reached a suicide conclusion between March 2020 and January 2021. Stratified sampling was used to obtain two samples from each month. Template analysis was employed to thematically analyse data from 30 inquests. Results: Risk factors during this period were social isolation, anxiety, difficulty in routine creation and maintenance, low mood and economic impact. Remote working in a more rural/coastal area impacted both healthcare service users and staff. Lockdown and other multiple risk factors impacted those at increased risk of poor mental health and suicide. Conclusions: There is a need to identify those at risk and with deteriorating mental health. All age trauma-informed approaches are needed to prevent individuals from reaching crisis along with more equitable services and community support due to the complex nature of suicide. This requires consideration of digital access/exclusion, training, continuity of care and enhanced care of those with additional needs and multiple vulnerabilities. Full article