Search Results (16,566)

Mental health conditions have become an increasing concern among university students, particularly those pursuing health science disciplines such as pharmacy. Rigorous academic demands, high workloads, and sustained psychological pressure place pharmacy students at a high risk of mental health disorders, including depression, anxiety, stress, and suicidal ideation. This study aimed to systematically review and quantitatively synthesize existing evidence on the prevalence of mental health conditions among pharmacy students in Thailand and globally using a meta-analytic approach. A comprehensive literature search was conducted across the major academic databases, including PubMed, ScienceDirect, Scopus, and ThaiJo, using predefined search terms and stringent inclusion criteria to ensure methodological rigor and relevance. Data from eligible studies were extracted and analyzed using STATA software to ensure statistical precision and reliability of the pooled estimates. A total of 51 studies, comprising 17,717 pharmacy students across 16 countries, including the United States, Thailand, Brazil, Malaysia, Syria, Pakistan, Poland, France, Portugal, Nigeria, Saudi Arabia, Sudan, Lebanon, Egypt, the United Arab Emirates, and Vietnam, were included. The meta-analysis revealed pooled prevalence rates of 44.26% for depression (95% CI: 36.08–52.61), 52.01% for anxiety (95% CI: 42.86–61.09), 48.10% for stress (95% CI: 32.96–63.43), and 24.52% for suicidal ideation (95% CI: 14.10–36.70). These findings reflect a substantial mental health burden among pharmacy students, necessitating immediate and context-specific interventions. Considering these findings, academic institutions must develop and implement comprehensive mental health support strategies. Such initiatives should include early identification and screening programs, access to psychological counseling services, resilience-building interventions, and stress management workshops to effectively address the psychological needs of pharmacy students and enhance their academic and personal well-being. Full article

The number of older women imprisoned is increasing around the world, leading to an increased demand on health and social care services within prisons. Imprisoned women are considered older by age 50 as they experience a disproportionate burden of cancer and disease. Access to prison cancer screening programmes in prison should mirror access in the community; however, this is not always the case. The purpose of this scoping review is to systematically review the literature relating to enablers and barriers of cancer screening programmes in imprisoned older women. We performed a scoping review using the Arksey and O’Malley framework. Twelve studies were identified. Locations of studies varied across high-income countries. Enablers and barriers were identified within operational, personal, and accessibility categories. To improve mortality relating to cancer diagnosis it is vital that older imprisoned women are supported to access cancer screening. It was identified that older imprisoned women have different needs to other prison populations, and the barriers and enablers identified relate to staffing, communication, peer support, and processes to improve the experience of the older prison population. There is limited research in this area, and older women are a minority in a marginalized prison population. More research is needed to ensure the appropriate and effective development of cancer screening services. Full article

To understand human–machine interactions, we adopted a framework that distinguishes between stable individual differences (enduring personality/interpersonal traits), initial trust (pre-interaction expectations), and situational trust (dynamic calibration via gaze and behavior). A driving simulator experiment was conducted with 30 male participants to investigate trust calibration across three levels: manual (Level 0), semi-automated (Level 2, requiring monitoring), and fully automated (Level 4, system handles tasks). We combined eye tracking (pupillometry/fixations) with the Eysenck Personality Questionnaire (EPQ) and Interpersonal Trust Scale (ITS). Results indicated that semi-automation yielded a higher hazard detection sensitivity (d′ = 0.81) but induced greater physiological costs (pupil diameter, ηp² = 0.445) compared to manual driving. A mediation analysis confirmed that neuroticism was associated with initial trust specifically through interpersonal trust. Critically, despite lower initial trust, young male individuals with high interpersonal trust exhibited slower reaction times in the semi-automation model (B = 0.60, p = 0.035), revealing a “social complacency” effect where social faith paradoxically predicted lower behavioral readiness. Based on these findings, we propose that situational trust is a multi-layer calibration process involving dissociated attentional and behavioral mechanisms, suggesting that such “wary but complacent” drivers require adaptive HMI interventions. Full article

Chronic pain is inherently multifactorial, with biological, psychological, and social factors contributing to neuropathic pain (NP) and central sensitization (CS) syndromes. Comorbidity between functional disorders and the lack of clinical biomarkers adds to the challenge of diagnosis and treatment, leading to frustration for healthcare professionals and patients. Available treatments are limited, increasing patient suffering with personal and financial costs. This systematic review examined multisensory processing alterations in chronic pain and reviewed current pharmacological and non-pharmacological interventions. A structured search was conducted on the PubMed database using the keywords Central Sensitization, Fibromyalgia, Complex Regional Pain Syndrome, and Neuropathic Pain, combined with the keywords Vision, Audition, Olfaction, Touch, Taste, and Proprioception. Papers were then filtered to discuss current treatment approaches. Articles within the last five years, from 2018 to 2023, have been included. Papers were excluded if they were animal studies; investigated tissue damage, disease processes, or addiction; or were conference proceedings or non-English. Results were summarized in table form to allow synthesis of evidence. As this study is a systematic review of previously published research rather than a clinical trial or experimental investigation, the risk of bias was assessed independently by at least two reviewers. 138 studies were identified and analyzed. Of these, 96 focused primarily on treatment options for chronic pain and were analyzed for this systematic review. There were a few emerging themes. No one therapy is effective, so a multidisciplinary approach to diagnosis, including pharmacological, somatic, and psychological treatment, is generally predicted to achieve the best outcomes. Cranial neurovascular compromise, especially of the trigeminal, glossopharyngeal, and potentially the vestibulocochlear nerve, is being increasingly revealed with the advancement of neuroimaging. Cortical and deep brain stimulation to evoke neuroplasticity is an emerging and promising therapy and warrants further investigation. Finally, including patients in their treatment plan allows them control and offers the ability to self-manage their pain. Risk of bias limits the ability to judge the quality of evidence. Full article

Background/Objectives: Self-care is a cornerstone of healthy aging and chronic disease management; however, evidence on the most effective intervention models for improving quality of life in older adults with chronic non-communicable diseases (NCDs) remains fragmented. This review aimed to evaluate the effectiveness of self-care interventions in promoting quality of life and health outcomes in older adults with NCDs. Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO (CRD420251040613). Randomized and non-randomized clinical trials published between 2019 and 2024 were retrieved from Scopus, Web of Science, and EBSCOhost. Eligible studies included adults aged ≥60 years with NCDs receiving self-care interventions. Data extraction and risk of bias assessment were independently performed using Joanna Briggs Institute tools. Results: Twenty-nine studies involving 7241 older adults were included. Self-care interventions comprised nurse-led educational programs, digital health strategies, community- and peer-based approaches, and person-centered care models. Multicomponent and continuous interventions demonstrated consistent improvements in physical and psychological domains of quality of life, self-efficacy, autonomy, symptom management, and treatment adherence. Digital interventions enhanced monitoring and engagement, although their effectiveness varied according to sensory and health literacy limitations. Conclusions: Structured, person-centered, and nurse-led self-care interventions are effective in improving quality of life and autonomy among older adults with NCDs. These findings support their integration into primary and community-based care, reinforcing their relevance for clinical practice, care planning, and the development of assistive and educational strategies in aging care. Full article

Melanoma was once considered ‘incurable’; however, drug therapy for the condition has dramatically transformed with the advent of immune checkpoint inhibitors and molecular targeted therapies. In this review, we summarize the published literature on melanoma drug therapy, presenting the current landscape of melanoma treatments, and discuss potential future transformations in melanoma therapy. Although the prognosis of advanced-stage melanoma had been extremely poor in the past, new-age immunotherapy has made long-term survival possible. Several immunotherapies and their combinations, as well as personalized vaccines, cell therapies, and intratumoral agents, have been tested with success; however, adverse toxicities have also been detected. Therefore, patient selection and management are critical. Furthermore, new approaches to overcome the limitations of the current treatments are also being developed. To implement these therapies clinically, guideline-recommended treatment algorithms should be followed while optimizing the therapies by considering factors such as presence of BRAF mutations which may lead to treatment resistance, increased disease burden/progression rate, toxicity tolerance, and the presence of brain metastases. In practice, the choice of the initial therapy should depend on the patient, leading to personalized therapy and minimal adverse effects. Full article

While standard anti- vascular endothelial growth factor (VEGF) therapy, with or without photodynamic therapy (PDT), is effective for patients with polypoidal choroidal vasculopathy (PCV), not all achieve optimal visual outcomes. This study aimed to compare fortified (double the dose and the volume of the standard one) anti-VEGF combined with PDT versus fortified anti-VEGF monotherapy and to investigate biomolecular profiles and disease relationships among PCV, neovascular age-related macular degeneration (nvAMD), and central serous chorioretinopathy (CSCR). The goal was to identify novel pathways to inform future therapeutic strategies, including hypoxia-inducible factors (HIF)-1α inhibitors. This retrospective cohort study included 23 eyes with indocyanine green-confirmed type C PCV. One eye treated with transpupillary thermotherapy was not included in the following two groups. Patients received either combined therapy (PDT + fortified-dose anti-VEGF; n = 12) or fortified-dose anti-VEGF monotherapy (n = 10). Primary outcomes were changes in best-corrected visual acuity (BCVA) and central retinal thickness (CRT). Secondary outcomes included injection burden and recurrence. Exploratory analyses examined aqueous biomarkers, including VEGF, placental growth factor (PlGF), β-catenin, HIF-1α, and Wnt1 across PCV, CSCR, and nvAMD to identify novel therapeutic targets. Significant (p = 0.003/p = 0.005) median CRT reduction was similar (p = 0.468) between groups (combined/monotherapy: 137.5 µm/106.5 µm). BCVA (median [Q1, Q3]) change in logarithm of the minimum angle of resolution (LogMAR) was not statistically significant (p = 0.279), with 0.25 [0.00, 0.98] in the combined group versus 0.00 [−0.03, 0.28] in the monotherapy group. Treatment burden of anti-VEGFs per person per year was lower with combined therapy (1.16 ± 0.47# PDT + 2.81 ± 0.92# anti-VEGF injections) compared with monotherapy (4.61 ± 1.49# injections). Six eyes demonstrated recurrence at a mean of 15.5 months. Incomplete regression of polyps and branching vascular networks was observed in all eyes. Exploratory biomarker analysis revealed significantly (p < 0.05) higher VEGF and PlGF levels in nvAMD compared with PCV. nvAMD also demonstrated significantly (p < 0.05) higher β-catenin and lower HIF-1α levels relative to PCV and CSCR, while no significant biomarker differences were observed between PCV and CSCR. Combined therapy or monotherapy with fortified anti-VEGFs reduced treatment burden and achieved significant anatomical improvement but did not yield superior functional outcomes, highlighting the therapeutic difficulty of type C PCV. Biomarker profiling revealed shared hypoxia-related mechanisms between PCV and CSCR, with elevated HIF-1α compared to nvAMD indicating a “preliminary” possible role for HIF-1α inhibitors. Differential expression of these biomarkers highlights additional molecular pathways that may inform future targeted interventions. Full article

Background/Objectives: The COVID-19 pandemic exposed global weaknesses in healthcare preparedness and highlighted the pivotal role of the World Health Organization (WHO) in coordinating responses and issuing technical guidance. Among these, the document “Rational use of personal protective equipment (PPE) for COVID-19 and considerations during severe shortages” (December 2020) aimed to standardize PPE use amid global scarcity. This study assessed the awareness, implementation, and perceived usefulness of this WHO guidance among Polish healthcare personnel and evaluated discrepancies between the WHO expectations and workplace realities. Methods: A cross-sectional, anonymous online survey was conducted between July and September 2025 among employees of 243 randomly selected healthcare facilities in Poland (constituting 20% of all hospitals). The original 24-item questionnaire covered the demographics, awareness and implementation of the WHO PPE guidelines, and perceptions of their effectiveness during and after the pandemic. Data were analyzed descriptively. Results: A total of 542 healthcare workers participated, predominantly nurses (56.8%) and physicians (12.2%), with 86.8% being female and 59.3% having over 20 years of experience. Most respondents (76.5%) reported familiarity with the WHO PPE document, and 63.1% confirmed its implementation in their institutions. Over two-thirds (68.0%) reported that the guidelines improved their sense of safety at work. The main barriers to implementation included staff shortages (52.9%) and insufficient local guidance (20.6%). In 2025, 52.3% continue to apply the WHO recommendations, and 70.8% believe they remain relevant in current practice. However, 80.2% indicated that the WHO guidance should be more closely adapted to local conditions. Conclusions: The WHO PPE guidance was widely recognized and reported as implemented by respondents from participating healthcare facilities, contributing to improved preparedness. Nonetheless, limited institutional support and inadequate local adaptation reduced implementation effectiveness. Future WHO recommendations should better align with national healthcare contexts to enhance preparedness for future crises. Full article

Objective: This study aimed to design and clinically evaluate a bespoke cosmetic formulation tailored to individual skin characteristics and user preferences, focusing on hydration and barrier recovery in mature, therapy-affected skin. In addition, this study aimed to explore the feasibility and short-term outcomes of a structured, biometry-driven personalization approach applied within a single-subject case study design. Materials and Methods: A personalized dermato-cosmetic formulation incorporating melatonin, astaxanthin, low-molecular-weight hyaluronic acid, allantoin, yarrow oil (Achillea millefolium), lecithin, cholesterol, and arginine was developed based on objective biophysical assessment of the skin. A clinical case evaluation was conducted in a male subject over 55 years of age (Fitzpatrick phototype III) presenting persistent xerosis and dehydration following completed oncologic therapy. Quantitative skin biometry was performed at baseline and after 28 days of daily application, assessing hydration at six anatomical sites, sebum secretion, pigmentation and erythema indices, elasticity, and stratum corneum turnover and scaling. Results: After 28 days, sebum secretion increased by more than 100%, indicating partial restoration of the lipid barrier. Hyperpigmented areas decreased from 7.2% to 2.3%, while skin elasticity improved from 25% to 44%. A reduction of 8% in the erythema index suggested decreased vascular reactivity. Hydration levels improved consistently across all evaluated sites, and epidermal renewal was enhanced, as evidenced by reduced scaling and smoother skin surface. The melanin index remained stable throughout the study period. Conclusions: This pilot evaluation shows that bespoke cosmetic formulations, customized to individual skin biometry and preferences, can yield measurable improvements in hydration, barrier repair, elasticity, pigmentation uniformity, and epidermal renewal within 28 days, even in skin compromised by previous oncologic therapy. Given the single-subject nature of this pilot evaluation, these findings cannot be generalized to broader populations but rather highlight the importance of personalization and objective skin assessment in guiding individualized dermato-cosmetic formulation strategies. Personalized dermato-cosmetology using objective biophysical assessment may be a promising future strategy for effective, consumer-centered skincare. Full article

Background: Large language models (LLMs) are becoming progressively integrated into clinical practice; however, their role in cardiovascular (CV) prevention remains unclear. This review synthesizes current evidence on LLM applications in preventive cardiology and proposes a governance framework for their safe translation into practice. Methods: We conducted a comprehensive narrative review of literature published between January 2015 and November 2025. Evidence was synthesized across three functional domains: (1) patient applications for health literacy and behavior change; (2) clinician applications for decision support and workflow efficiency; and (3) system applications for automated data extraction, registry construction, and quality surveillance. Results: Evidence suggests that while LLMs generate empathetic, guideline-concordant patient education, they lack the nuance required for unsupervised, personalized advice. For clinicians, LLMs effectively summarize clinical notes and draft documentation but remain unreliable for deterministic risk calculations and autonomous decision-making. System-facing applications demonstrate potential for automated phenotyping and multimodal risk prediction. However, safe deployment is constrained by hallucinations, temporal obsolescence, automation bias, and data privacy concerns. Conclusions: LLMs could help mitigate structural barriers in CV prevention but should presently be deployed only as supervised “reasoning engines” that augment, rather than replace, clinician judgment. To guide the transition from in silico performance to bedside practice, we propose the C.A.R.D.I.O. framework (Clinical validation, Auditability, Risk stratification, Data privacy, Integration, and Ongoing vigilance) as a roadmap for responsible integration. Full article

Background/Objectives: Identifying consistent patterns across empathy domains can help clinicians understand how empathy relates to burnout, covert narcissism, and other personality traits, thereby enhancing the effectiveness of clinical training. We examined empathy and assessed whether burnout, covert narcissism, and other personality traits show consistent associations across empathy domains. Methods: This cross-sectional study included 213 medical residents from a teaching and public tertiary care facility in Mexico. The Jefferson Scale of Empathy, the Maslach Burnout Inventory, the Hypersensitive Narcissism Scale, and the Zuckerman–Kuhlman Personality Questionnaire were applied. Nonparametric partial correlations were calculated, controlling for sex, age, specialty, year of residency, and psychological well-being. Results: On a 7-point Likert scale, the mean scores for perspective-taking, compassionate care, and the ability to stand in the patient’s shoes were 6.0 ± 0.8, 6.0 ± 1.0, and 4.1 ± 1.2, respectively. Depersonalization was negatively correlated with all empathy domains: perspective-taking (Spearman’s ρ = −0.20, p = 0.04), compassionate care (Spearman’s ρ = −0.30, p < 0.0001), and the ability to stand in the patient’s shoes (Spearman’s ρ = −0.25, p < 0.0001). The associations between other components of burnout, covert narcissism, and the remaining personality traits varied according to the domain of empathy. Conclusions: Depersonalization showed consistent, albeit modest, negative associations with all empathy domains, whereas the remaining psychological factors showed domain-specific relationships. Differentiating between empathy domains is essential, as it allows medical educators and clinicians to tailor interventions to specific components rather than treating empathy as a unitary construct. Full article

Background: Hygiene and food-safety training is a critical public health strategy for preventing contamination and promoting safe food-handling practices in community settings. This study evaluated the long-term effectiveness of In-person, Online, and Hybrid instructional modes in enhancing hygiene and food-safety competencies among trainees in Ilocos Norte, Philippines. Methods: Using a longitudinal quasi-experimental design, performance was measured at 12, 24, and 36 months across four domains: Personal Health & Hygiene, Food Hazards, Cleaning and Sanitation, and Good Manufacturing Practices. A total of 384 students met all inclusion criteria and completed the full series of evaluations. Descriptive and inferential statistical analyses were employed. Results: Competency scores increased significantly over time in all instructional modes (p < 0.001). Hybrid learners demonstrated the highest early longitudinal gains at 12 months (mean score, M = 20.88), compared with In-person (M = 10.28) and Online (M = 10.57). At 36 months, Online learners achieved the highest performance (M = 19.50), indicating stronger long-term retention. Effect size analysis using eta squared (η²) showed large effects for Cleaning and Sanitation (η² = 0.196), Good Manufacturing Practices (η² = 0.115), and overall performance (η² = 0.138). Standardized Mean Change (SMC) indicated substantial improvement across modes, with Hybrid showing the greatest early change (SMC = 41.76 at 12 months) and Online exhibiting the strongest long-term improvement (SMC = 38.80 at 36 months). Training Efficiency Index (TEI) identified In-person instruction as most efficient (TEI = 30.55), followed by Online (29.49) and Hybrid (19.56). Linear Mixed-Effects Regression confirmed significant main effects of Time (β = 4.82, p < 0.001) and Mode (β = 3.97, p < 0.001), as well as a significant Time × Mode interaction (β = −1.42, p < 0.01). Conclusions: The findings indicate that Hybrid instruction supports rapid early competency gains, while Online instruction yields superior long-term mastery of hygiene and food-safety competencies. These results provide evidence-based guidance for optimizing hygiene training programs in community and public health contexts. Full article

This study examines the impact of role overload on female hoteliers’ intention to quit, highlighting the mediating role of work–family conflict and the moderating role of co-worker support. Drawing on Conservation of Resources (COR) theory, the research conceptualizes role overload as a key job demand that depletes employees’ personal and emotional resources, triggering strain and turnover intentions. Data were collected from 255 full-time female employees working in five-star hotels in Egypt and analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM) via WarpPLS software version 8. The findings reveal that role overload significantly increases both work–family conflict and intention to quit, while work–family conflict partially mediates the relationship between role overload and turnover intentions. Moreover, co-worker support plays a crucial buffering role, weakening the positive effects of both role overload and work–family conflict on intention to quit. The study contributes to hospitality research by providing a gender-sensitive understanding of how high-demand hotel environments affect female employees’ retention and highlights the importance of co-worker support as a practical intervention to mitigate turnover among women employees. These insights offer valuable guidance for hotel managers aiming to enhance employee well-being and reduce attrition in luxury hotel settings. Full article

Objectives: Personalized medicine is gaining rapid attention over the current drug prescription approach of ‘one-size-fits-all’. Three-dimensional (3D) printing is one such product development technique that has the potential to transform the pharmaceutical and biomedical sectors. Methods: To establish the future of 3D printing in mainstream pharmacy practice, initially, pharmaceutical preclinical and clinical scientific databases (peer-reviewed articles, patents, and marketed products) over the past 10 years were critically scrutinized. Additionally, to provide context, we developed a hypothetical case study illustrating the capabilities of the 3D printing super-compounding pharmacy in personalized patient care, emphasizing the critical role of pharmacists in this process. Results: Acknowledging the potential of 3D printing in pharmacy practice, this review effectively summarizes the advances and opportunities of pharmaceutically feasible 3D printing methods, as well as the challenges in translating this technology into a future super-compounding pharmacy facility. Furthermore, the review highlights the promising capabilities of such pharmaceutical 3D printers in enabling on-site printing of 3D medicines tailored to individual needs, which may range from dose adjustments to multidrug single tablets (polypills). Conclusions: We believe that 3D printing technology has the potential to revolutionize precision and personalized medication approaches in pharmacy practice, which will significantly benefit patient healthcare outcomes. Additionally, the adoption of such technology in pharmacies will lead to a reinvention of the role of pharmacists, thereby creating more job opportunities. Ultimately, 3D printing will create a new paradigm of super-compounding pharmacy practice, providing a new sense of excitement for those looking to enter the pharmacy profession. Full article

Diet plays a central role in shaping the composition and metabolic activity of the oral microbiota, thereby influencing both oral and systemic health. Disturbances in this delicate host–microbe balance, triggered by dietary factors, smoking, poor oral hygiene, or antibiotic use, can lead to microbial dysbiosis and increase the risk of oral diseases such as periodontitis, as well as chronic systemic disorders including diabetes, cardiovascular disease, Alzheimer’s disease, and certain cancers. Among dietary contaminants, exposure to toxic heavy metals such as cadmium (Cd), lead (Pb), mercury (Hg), nickel (Ni), and arsenic (As) represents an underrecognized modifier of the oral microbial ecosystem. Even at low concentrations, these elements can disrupt microbial diversity, promote inflammation, and impair metabolic homeostasis. Saliva has recently emerged as a promising, non-invasive biofluid for monitoring nutritional status and early metabolic alterations induced by diet and environmental exposures. Salivary biomarkers, including metabolites, trace elements, and microbial signatures, offer potential for assessing the combined effects of diet, microbiota, and toxicant exposure. This review synthesizes current evidence on how diet influences the oral microbiota and modulates susceptibility to heavy metal toxicity. It also examines the potential of salivary biomarkers as integrative indicators of nutritional status and metabolic health, highlights methodological challenges limiting their validation, and outlines future research directions for developing saliva-based tools in personalized nutrition and precision health. Full article