Search Results (4,771)

Background/Objectives: Health education plays a vital role in training health professionals and caregivers, supporting both prevention and the promotion of self-care. In this context, technology serves as a valuable ally by enabling continuous and flexible learning. Among the various domains of health education, nutrition stands out as a key element in the management of Amyotrophic Lateral Sclerosis (ALS), helping to prevent malnutrition and enhance patient well-being. Accordingly, this study aimed to evaluate the effectiveness of the teaching and learning processes within a learning pathway focused on food and nutrition in the context of ALS. Methods: This study adopted a longitudinal, quantitative design. The learning pathway, titled “Food and Nutrition in ALS,” consisted of four self-paced and self-instructional Massive Open Online Courses (MOOCs), offered through the Virtual Learning Environment of the Brazilian Health System (AVASUS). Participants included health professionals, caregivers, and patients from all five regions of Brazil. Participants had the autonomy to complete the courses in any order, with no prerequisites for enrollment. Results: Out of 14,263 participants enrolled nationwide, 182 were included in this study after signing the Informed Consent Form. Of these, 142 (78%) completed at least one course and participated in the educational intervention. A significant increase in knowledge was observed, with mean pre-test scores rising from 7.3 (SD = 1.8) to 9.6 (SD = 0.9) on the post-test across all courses (p < 0.001). Conclusions: The self-instructional, technology-mediated continuing education model proved effective in improving participants’ knowledge about nutrition in ALS. Future studies should explore knowledge retention, behavior change, and the impact of such interventions on clinical outcomes, especially in multidisciplinary care settings. Full article

Background: Thyroid eye disease (TED) is a rare autoimmune orbital disorder predominantly associated with Graves’ disease. It is characterized by orbital inflammation, tissue remodeling, and potential visual morbidity. Conventional therapies, particularly systemic glucocorticoids, offer only partial symptomatic relief, failing to reverse chronic structural changes such as proptosis and diplopia, and are associated with substantial adverse effects. This review aims to synthesize recent developments in understandings of TED pathogenesis and to critically evaluate emerging therapeutic strategies. Methods: A systematic literature review was conducted using MEDLINE, Embase, and international clinical trial registries focusing on pivotal clinical trials and investigational therapies targeting core molecular pathways involved in TED. Results: Current evidence suggests that TED pathogenesis is primarily driven by the autoimmune activation of orbital fibroblasts (OFs) through thyrotropin receptor (TSH-R) and insulin-like growth factor-1 receptor (IGF-1R) signaling. Teprotumumab, a monoclonal IGF-1R inhibitor and the first therapy approved by the U.S. Food and Drug Administration for TED, has demonstrated substantial clinical benefit, including improvements in proptosis, diplopia, and quality of life. However, concerns remain regarding relapse rates and treatment-associated adverse events, particularly hearing impairment. Investigational therapies, including next-generation IGF-1R inhibitors, small-molecule antagonists, TSH-R inhibitors, neonatal Fc receptor (FcRn) blockers, cytokine-targeting agents, and gene-based interventions, are under development. These novel approaches aim to address both inflammatory and fibrotic components of TED. Conclusions: Teprotumumab has changed TED management but sustained control and toxicity reduction remain challenges. Future therapies should focus on targeted, mechanism-based, personalized approaches to improve long-term outcomes and patient quality of life. Full article

Background/Objectives: Studies have reported that female athletes often exhibit low levels of nutritional knowledge and inadequate dietary intake to meet their nutritional needs. The aim of this study was to evaluate the effect of a nutritional education intervention on nutrition knowledge, dietary intake, and body composition in female handball players (n = 45; age, 17.6 ± 2.1 years). Methods: A quasi-experimental intervention design was implemented, consisting of a 3-week educational program delivered through six in-person sessions led by a registered dietitian. Nutrition knowledge, dietary intake, adherence to the Mediterranean diet, and anthropometric and body composition measurements were assessed. Results: Nutrition knowledge levels were significantly higher both immediately post-intervention and three months later compared to baseline (p < 0.05, ES > 0.8). A total of 36 participants completed a 3-day dietary record at baseline and at follow-up. Initial assessments revealed insufficient energy (31 kcal/kg/day) and carbohydrate intake (3.0 g/kg/day) and a high intake of total fats (1.4 g/kg/day). During follow-up, a significant decrease in the consumption of foods rich in sugar was observed (p = 0.0272). A total of 82.2% of the players needed to improve their adherence to the Mediterranean diet. No significant changes were found in Mediterranean diet adherence or body composition following the intervention. Conclusions: The nutritional education intervention significantly improved athletes’ nutritional knowledge and significantly decreased their consumption of sugary foods; however, further studies are needed to evaluate its impact on dietary intake and body composition, considering the study’s limitations. Full article

Background: Eating disorders (EDs) and self-harm (SH) are both associated with distress, poor psychosocial functioning, and increased risk of mortality. Much of the literature discusses the complex interplay between SH and ED behaviours where co-occurrence is common. The onset of both is typically seen during teenage years into early adulthood. A better understanding of the functions of these behaviours is needed to guide effective prevention and treatment, particularly during the crucial developmental years. An earlier review has explored the functions of self-harm, but an equivalent review for eating disorder behaviours does not appear to have been completed. Objectives: This evidence synthesis had two objectives. First, to identify and synthesise published first-hand accounts of the reasons why people engage in eating disorder behaviours with the view to develop a broad theoretical framework of functions. Second, to draw comparisons between the functions of eating disorder behaviours and self-harm. Methods: A qualitative evidence synthesis reporting first-hand accounts of the reasons for engaging in eating disorder behaviours. A ‘best fit’ framework synthesis, using the a priori framework from the review of self-harm functions, was undertaken with thematic analysis to categorise responses. Results: Following a systematic search and rigorous screening process, 144 studies were included in the final review. The most commonly reported functions of eating disorder behaviours were distress management (affect regulation) and interpersonal influence. This review identified significant overlap in functions between self-harm and eating disorder behaviours. Gender identity, responding to food insecurity, to delay growing up and responding to weight, shape, and body ideals were identified as functions more salient to eating disorder behaviours. Similarly, some self-harm functions were not identified in the eating disorder literature. These were experimenting, averting suicide, personal language, and exploring/maintaining boundaries. Conclusions: This evidence synthesis identified a prominent overlap between psychological functions of eating disorder behaviours and self-harm, specifically in relation to distress management (affect regulation). Despite clear overlap in certain areas, some functions were found to be distinct to each behaviour. The implications for delivering and adapting targeted interventions are discussed. Full article

Background/Objectives: Military Service Members (SMs) require optimal nutrition to support health, readiness, and job performance. However, they often fall short of meeting nutrition guidelines. This study aimed to determine the impact and feasibility of implementing the U.S. Marine Corps (USMC) “Fueled to Fight^®” (F2F) nutrition program in non-appropriated fund (NAF) food venues. Objectives included evaluating changes in Military Nutrition Environment Assessment Tool (mNEAT) scores, feasibility of implementing and maintaining F2F strategies, and influence on customer purchasing patterns. Methods: Researchers conducted a pre-post interventional study from January to December 2024 at three NAF food venues across two USMC bases. F2F strategies, including identifying items using a stoplight color coding system (Green = healthy, Yellow = less healthy, Red = least healthy), menu revisions, food placement, promotion, and marketing, were implemented. Data included mNEAT assessments, sales reports, and stakeholder focus groups. Generalized Estimating Equations models were used to analyze sales data. Results: mNEAT scores increased across all venues post-intervention. Availability and sales of Green items increased, while sales of Red items decreased in some venues. Profit increased at all three food venues. Focus groups revealed feasibility and provided insights for future interventions. Conclusions: F2F interventions in NAF food venues are feasible and can positively impact the food environment and customer purchasing patterns without negatively affecting profit. This study highlights the importance of integrating nutrition programs into all military food venues, not just government-funded dining facilities, to support the nutritional fitness and readiness of SMs. Full article

Wellington, New Zealand, is highly vulnerable to disaster-induced food security crises due to its geography and geological characteristics, which can disrupt transportation and isolate the city following disasters. Urban agriculture (UA) has been proposed as a potential alternative food source for post-disaster scenarios. This study examined the potential of urban agriculture for enhancing post-disaster food security by calculating vegetable self-sufficiency rates. Specifically, it evaluated the capacity of current Wellington’s community gardens to meet post-disaster vegetable demand in terms of both weight and nutrient content. Data collection employed mixed methods with questionnaires, on-site observations and mapping, and collecting high-resolution aerial imagery. Garden yields were estimated using self-reported data supported by literature benchmarks, while cultivated areas were quantified through on-site mapping and aerial imagery analysis. Six post-disaster food demand scenarios were used based on different target populations to develop an understanding of the range of potential produce yields. Weight-based results show that community gardens currently supply only 0.42% of the vegetable demand for residents living within a five-minute walk. This rate increased to 2.07% when specifically targeting only vulnerable populations, and up to 10.41% when focusing on gardeners’ own households. However, at the city-wide level, the current capacity of community gardens to provide enough produce to feed people remained limited. Nutrient-based self-sufficiency was lower than weight-based results; however, nutrient intake is particularly critical for vulnerable populations after disasters, underscoring the greater challenge of ensuring adequate nutrition through current urban food production. Beyond self-sufficiency, this study also addressed the role of UA in promoting food diversity and acceptability, as well as its social and psychological benefits based on the questionnaires and on-site observations. The findings indicate that community gardens contribute meaningfully to post-disaster food security for gardeners and nearby residents, particularly for vulnerable groups with elevated nutritional needs. Despite the current limited capacity of community gardens to provide enough produce to feed residents, findings suggest that Wellington could enhance post-disaster food self-reliance by diversifying UA types and optimizing land-use to increase food production during and after a disaster. Realizing this potential will require strategic interventions, including supportive policies, a conducive social environment, and diversification—such as the including private yards—all aimed at improving food access, availability, and nutritional quality during crises. The primary limitation of this study is the lack of comprehensive data on urban agriculture in Wellington and the wider New Zealand context. Addressing this data gap should be a key focus for future research to enable more robust assessments and evidence-based planning. Full article

Objectives: This study aimed to evaluate the effect of nutritional education on nutritional knowledge, nutritional status, and quality of life in patients with liver cirrhosis. Methods: Thirty patients participated. At baseline, assessments were conducted to collect data on demographics, physical activity, anthropometric and biochemical measures, dietary habits, 24 h food intake, nutritional status, quality of life, and nutritional knowledge. Participants received a 30 min face-to-face nutritional education session by a registered dietitian, repeated after one month. A follow-up phone call was conducted one month later to reinforce the education. Final evaluations were completed one month after the call. Results: A significant upward trend was detected in nutritional knowledge scores after the intervention period (from 7.4 ± 2.76 to 9.2 ± 3.45). The physical component of quality of life improved, while the mental component showed a slight decline. Dietary changes included reduced energy and protein intake among females and increased protein intake in males. In both genders, fat intake increased and carbohydrate intake decreased. Biochemical improvements were observed, including significant reductions in gamma-glutamyl transferase, aspartate aminotransferase, alanine aminotransferase, and triglycerides in females and alanine aminotransferase and gamma-glutamyl transferase in males. Conclusions: Structured nutritional education may improve nutritional knowledge, dietary behavior, and biochemical markers in cirrhosis patients. Longer follow-up durations may further enhance these improvements. Full article

Honey bees are essential pollinators for the ecosystem and food crops. However, their health and survival face threats from both biotic and abiotic stresses. Fungi, microsporidia, and bacteria might significantly contribute to colony losses. Therefore, rapid and sensitive diagnostic tools are crucial for effective disease management. In this study, molecular assays were developed to quickly and efficiently detect the main honey bee pathogens: Nosema ceranae, Aspergillus flavus, Paenibacillus larvae, and Black queen cell virus. In this context, new primer pairs were designed for use in quantitative Real-time PCR (qPCR) reactions. Various protocols for extracting total nucleic acids from bee tissues were tested, indicating a CTAB-based protocol as the most efficient and cost-effective. Furthermore, excluding the head of the bee from the extraction, better results were obtained in terms of quantity and purity of extracted nucleic acids. These assays showed high specificity and sensitivity, detecting up to 250 fg of N. ceranae, 25 fg of P. larvae, and 2.5 pg of A. flavus DNA, and 5 pg of BQCV cDNA, without interference from bee DNA. These qPCR assays allowed pathogen detection within 3 h and at early stages of infection, supporting timely and efficient management interventions. Full article

Autism Spectrum Disorder (ASD) is frequently accompanied by gastrointestinal disturbances, dietary selectivity, and altered stress responses, with growing evidence pointing to gut–brain axis involvement. While intestinal microbiota has been extensively studied, the role of the oral microbiota remains underexplored. This study investigates the associations between oral microbiota composition and behavioral, gastrointestinal, dietary, and neuroendocrine parameters in children with ASD. A total of 45 children aged 2–18 years comprised the study group. Data collection included oral swabs for 16S rRNA gene sequencing, salivary cortisol sampling, dietary records, and standardized behavioral assessments using the Vineland Adaptive Behavior Scale. A total of 363 microbial species across 11 phyla were identified. Significant correlations were observed between specific bacterial taxa and functional gastrointestinal disorders (FGIDs), dietary patterns, salivary cortisol rhythms, and functioning. Children with FGIDs, food selectivity, or macronutrient imbalances exhibited enriched pro-inflammatory taxa (e.g., Selenomonas, Megasphaera), whereas those with typical cortisol secretion or higher adaptive functioning showed greater microbial diversity and abundance of health-associated genera (e.g., Bifidobacterium dentium). These findings suggest that oral microbiota profiles may reflect systemic physiological and neurobehavioral traits in children with ASD. Further longitudinal studies are needed to clarify causal relationships and support the development of microbiota-targeted interventions. Full article

Background/Objectives: Dietary patterns have changed over time, characterising a process of nutritional transition that reflects socioeconomic and demographic inequalities among different populations. This study assessed changes in dietary consumption patterns and the associated social determinants, comparing two time periods in a sample of individuals from a state in the Northeast Region of Brazil. Methods: Data from the 2008–2009 and 2017–2018 Household Budget Survey for the state of Paraíba were analysed, totalling 951 and 1456 individuals, respectively. Foods were categorised according to the NOVA classification and compared based on sociodemographic and economic variables. To determine the factors that most strongly explain the contribution of each NOVA food group to the diet, beta regression analysis was conducted. Results: Differences were observed between the two periods regarding the dietary contribution of the NOVA food groups, with a decrease in consumption of unprocessed foods and an increase in ultra-processed foods. Living in urban areas, being an adolescent, and having an income above the minimum wage were associated with reduced intake of unprocessed foods in both periods. Additionally, being an adolescent and having more than eight years of schooling were associated with higher consumption of ultra-processed foods. Conclusions: The population under study showed changes in food consumption, reflecting a transition process that is occurring unevenly across socioeconomic and demographic groups, thereby reinforcing social inequalities. These findings can guide priorities in food and nutrition policies, highlighting the need for intervention studies to evaluate the effectiveness of such actions. Full article

Urban wildlife conservation is emerging as a critical component of sustainable city ecosystems. Rather than simply increasing tree abundance or species richness, conservation management should focus on key species. In this research, Xishan Forest Park in Beijing was chosen as a case study. Our aim was to identify keystone taxa critical for avian foraging and nesting during the breeding season. We performed a network analysis linking bird species, their diets, and nest plants. Dietary components were detected using DNA metabarcoding conducted with avian fecal samples. Nest plants were identified via transect surveys. Two indices of the network, degree and weighted mean degree, were calculated to evaluate the importance of the dietary and nest plant species. We identified 13 bird host species from 107 fecal samples and 14 bird species from 107 nest observations. Based on the degree indices, fruit trees Morus and Prunus were detected as key food sources, exhibiting both the highest degree (degree = 9, 9) and weighted mean degree (lnwMD = 5.21, 4.63). Robinia pseudoacacia provided predominant nesting sites, with a predominant degree of 7. A few taxa, such as Styphnolobium japonicum and Rhamnus parvifolia, served dual ecological significance as both essential food sources and nesting substrates. Scrublands, as a unique habitat type, provided nesting sites and food for small-bodied birds. Therefore, targeted management interventions are recommended to sustain or enhance these keystone resource species and to maintain the multi-layered vertical vegetation structure to preserve the diverse habitats of birds. Full article

Introduction: The wellbeing of humans and the planet is negatively impacted by unhealthy eating behaviors and excessive food waste. Mindfulness approaches have the potential to help people modify their behavior to achieve healthier outcomes. Pilot testing methods to sustainably support healthy eating and reduce food waste are essential for identifying effective ways to promote human and planetary health. Methods: A pilot study was conducted to test a virtual mindful eating program to improve eating behaviors and reduce food waste among a small sample of U.S. adults. Mixed-methods approaches were used to identify the efficacy of the piloted intervention on mindfulness, eating behaviors, and food waste while identifying participant perspectives of the mindful eating program. Results: Quantitative study outcomes indicated positive intervention effects on hunger/satiety cues and food appreciation. No significant intervention effects were detected on mindfulness or food waste. Qualitative findings highlighted participant reports of experiencing greater self-awareness, an improved relationship with food, and a sense of creativity with meal preparation. Conclusions: This pilot study tested a novel mindful eating program that improved eating behaviors related to hunger/satiety and increased food appreciation. The program was accepted by participants, but it did not increase mindfulness or reduce food waste. Future iterations of this mindful eating program will require modifications to test different approaches for increasing mindfulness and reducing food waste while expanding the positive effects on healthy eating. Full article

Food security is crucial for social stability and economic development. Ensuring food security in the arid region of Northwest China presents unique challenges due to limited water and soil resources. This study addresses these challenges by integrating a comprehensive water and soil resource matching assessment with grain production forecasting. Based on data from 2000 to 2020, this research projects the food security status to 2035 using the GM(1,1) model, incorporating a comprehensive index of soil and water resource matching and regression analysis to inform production forecasts. Key assumptions include continued historical trends in population growth, urbanization, and dietary shifts towards an increased animal protein consumption. The findings revealed a consistent upward trend in grain production from 2000 to 2020, with an average annual growth rate of 3.5%. Corn and wheat emerged as the dominant grain crops. Certain provinces demonstrated comparative advantages for specific crops like rice and wheat. The most significant finding is that despite the projected growth in the total grain output by 2035 compared to 2020, the regional grain self-sufficiency rate is projected to range from 79.6% to 84.1%, falling below critical food security benchmarks set by the FAO and China. This projected shortfall carries significant implications, underscoring a serious challenge to regional food security and highlighting the region’s increasing vulnerability to external food supply fluctuations. The findings strongly signal that current trends are insufficient and necessitate urgent and proactive policy interventions. To address this, practical policy recommendations include promoting water-saving technologies, enhancing regional cooperation, and strategically utilizing the international grain trade to ensure regional food security. Full article

Situated in the southern hilly-mountain belt of China’s “Three Zones and Four Belts Strategy”, Gannan region is a critical ecological shelter belt for the Ganjiang River. Decades of intensive mineral extraction and irrational agricultural development have rendered it into an ecologically fragile area. Consequently, multiple restoration initiatives have been implemented in the region over recent decades. However, it remains unclear how relationships among ecosystem services have evolved under these interventions and how future ecosystem management should be optimized based on these changes. Thus, in this study, we simulated and assessed the spatiotemporal dynamics of five key ESs in Gannan region from 1990 to 2020. Through integrated correlation, clustering, and redundancy analyses, we quantified ES interactions, tracked the evolution of ecosystem service bundles (ESBs), and identified their socio-ecological drivers. Despite a 31% decline in water yield, ecological restoration initiatives drove substantial improvements in key regulating services: carbon storage increased by 6.9 × 10¹² gC while soil conservation rose by 4.8 × 10⁸ t. Concurrently, regional habitat quality surged by 45% in mean scores, and food production increased by 2.1 × 10⁵ t. Critically, synergistic relationships between habitat quality, soil retention, and carbon storage were progressively strengthened, whereas trade-offs between food production and habitat quality intensified. Further analysis revealed that four distinct ESBs—the Agricultural Production Bundle (APB), Urban Development Bundle (UDB), Eco-Agriculture Transition Bundle (ETB), and Ecological Protection Bundle (EPB)—were shaped by slope, forest cover ratio, population density, and GDP. Notably, 38% of the ETB transformed into the EPB, with frequent spatial interactions observed between the APB and UDB. These findings underscore that future ecological restoration and conservation efforts should implement coordinated, multi-service management mechanisms. Full article

Microplastics are pervasive environmental pollutants that pose risks to human health through ingestion and inhalation. This review synthesizes current practices to reduce exposure and toxicity by examining major exposure routes and dietary interventions. More than 130 papers were analyzed to achieve this aim. The findings show that microplastics contaminate a wide range of food products, with particular concern over seafood, drinking water, plastic-packaged foods, paper cups, and tea filter bags. Inhalation exposure is mainly linked to indoor air quality and smoking, while dermal contact poses minimal risk, though the release of additives from plastics onto the skin remains an area of concern. Recommended strategies to reduce dietary exposure include consuming only muscle parts of seafood, moderating intake of high-risk items like anchovies and mollusks, limiting canned seafood liquids, and purging mussels in clean water before consumption. Avoiding plastic containers, especially for hot food or microwaving, using wooden cutting boards, paper tea bags, and opting for tap or filtered water over bottled water are also advised. To mitigate inhalation exposure, the use of air filters with HyperHEPA systems, improved ventilation, regular vacuuming, and the reduction of smoking are recommended. While antioxidant supplementation shows potential in reducing microplastic toxicity, further research is needed to confirm its effectiveness. This review provides practical, evidence-based recommendations for minimizing daily microplastic exposure. Full article