Search Results (467)

Women’s health in middle age is influenced by the physical and hormonal changes associated with perimenopause and menopause, phenomena that have been extensively studied from a biological perspective. However, there remains a gap in our understanding of the sociocultural factors that affect this stage of life, especially regarding social perception, self-perception, and their consequences for social behaviour. This article presents a scoping review of the literature in the Web of Sciences and Scopus databases using PRISMA Guidelines for the period 2015–2025. Limitations include the exploration of only two databases and the inclusion of only articles, not books, theses, or other materials. The search focused on social prejudices and assessments of middle-aged women, linked to sexism and ageism, as well as the psychological, social, and cultural processes that have contributed to overcoming these issues in recent decades. Special relevance is given to the concept of attractiveness, analysing how external perception and self-perception of female attractiveness are shaped during this transition. Articles mainly centred on medical issues, or that did not include a social perspective, were excluded. The findings from 57 studies provide an understanding of the evolution of these representations and their implications for gender equality and the reduction in sexism and ageism. Full article

Chronic non-cancer pain (CNCP) is a complex and highly prevalent condition among older adults that contributes to suffering and disability. It is frequently underestimated and normalized as part of aging. This scoping review aimed to identify and describe the consequences of CNCP on the daily lives of older adults. A scoping review was conducted following the Arksey and O’Malley framework and the PRISMA-ScR reporting guidelines. Searches were performed in five databases (CINAHL, Scopus, Web of Science, Embase, and PubMed) and in grey literature between January and February 2026. The protocol was registered in the Open Science Framework (OSF). The level of evidence was appraised using the Center for Evidence-Based Medicine criteria. Forty-four articles were included that met the established inclusion criteria. CNCP exerted a multidimensional negative impact. Physically, it was associated with increased frailty, higher risk of falls, and disability in activities of daily living. Psychologically, it correlated with anxiety, depression, and sleep disturbances. Socially, it contributed to isolation and created financial barriers that limited access to health services. CNCP represents a critical barrier to older adults’ wellbeing. Nursing should prioritize early detection and avoid the normalization of pain in clinical practice. Knowledge gaps remain regarding gender perspectives and mental health outcomes. Full article

Personal protective equipment, workspaces and safety systems are engineered around assumptions about the bodies and behaviour of their users. In the maritime workforce those assumptions have historically been male: women make up fewer than two per cent of the world’s 1.9 million seafarers, and the shipboard environment they work in, including its protective equipment, machinery, accommodation and emergency systems, was overwhelmingly designed for a male population. This paper treats the resulting disadvantages as an applied human-factors and occupational-safety problem, asking how a male-default design baseline translates into measurable safety, health and equipment gaps, and how engineering methods can close them. Following the PRISMA 2020 guideline, we searched Scopus, Web of Science and PubMed, screened 516 records, and synthesised 50 sources. Five engineering-relevant clusters emerged: (i) protective equipment sized to male anthropometry; (ii) workspace and accommodation design that embeds gendered reach, force and privacy penalties; (iii) a high and persistent burden of harassment, bullying and sexual misconduct, with reported prevalence exceeding 50 per cent among women; (iv) under-addressed occupational and reproductive-health exposures; and (v) weak, non-anonymous reporting and redress systems. Across clusters the evidence is dominated by qualitative and survey research with heterogeneous, non-standardised definitions and almost no engineering-grade quantification of risk. We argue that several of these gaps are tractable design problems, namely anthropometry-driven protective-equipment specification, inclusive ergonomic standards in equipment and safety-system design, and tamper-evident digital reporting tools, and we set out a structured, engineering-oriented research agenda. Framed as an applied human-factors and safety-engineering question rather than solely a policy concern, accommodating the full user population emerges as a precondition for a safe, inclusive and resilient workforce. Full article

Background/Objectives: Empowerment strategies promoting healthy behaviors are important for preventing chronic diseases and cancer, while individual health responsibility (IHR) plays a significant role. Although widely discussed in the literature, the concept of IHR does not have clearly defined domains or a validated instrument for assessment. Its overlap with locus of control theory, self-motivation, and personality type creates further difficulties. Meanwhile, perception of one’s own responsibility for health is an intuitive, simple item to answer, reflecting a person’s belief related to this topic. Moreover, for ethical reasons, this concept cannot be separated from personal beliefs and should not be adjusted according to strict scales and externally imposed definitions. Therefore, this study aimed to: (1) explore whether there is an association between self-perception of IHR and preventive/risk-taking behaviors; and (2) examine socio-demographic factors associated with the IHR score and three self-perceived characteristics, namely self-perceived locus of control, health literacy, and health status. Methods: A cross-sectional study with 968 healthcare workers was conducted in a large, multidisciplinary hospital covering several behaviors (smoking, alcohol consumption, diet, and participation in a screening program for hepatitis C). IHR was evaluated on a scale from 1 to 10, where 1 meant “to very little extent” and 10 meant “to a great extent”. Results: The average IHR score was 8.80 (SD = 1.88). In the univariate analysis, the IHR score was significantly related to gender, age, education, marital status, and all three personal characteristics. In the multivariate analysis, the socio-demographic associations lost statistical significance. IHR maintained its association with the healthy diet score in the multivariable model (B = 0.113, p = 0.036). In the unadjusted analyses, the distribution of IHR differed between participants who declared alcohol consumption and those who declared abstinence (χ² = 17.157, p = 0.002). However, this association was not retained in the multivariable model. Self-perceived internal locus of control was negatively associated with screening acceptance, but not with IHR. The OR of 0.927 refers to a one-point increase on the 1–10 scale. Across the full observed scale range, this corresponds to an OR of 0.51 (95% CI: 0.29–0.89), indicating lower odds of screening acceptance among participants with higher perceived internal control. Because this estimate assumes linearity across the entire scale, it should be interpreted cautiously. Conclusions: The gap between perceived responsibility and actual behavior suggests that IHR messaging alone is unlikely to be sufficient. Future research should consider social desirability and external locus of control when analyzing IHR and health behaviors. Full article

Curriculum-based programs are one of the most common and effective strategies for preventing intimate partner violence (IPV) in low- and middle-income countries (LMICs). Yet relatively little is known about how curricula and their implementation compare across programs, limiting learning and innovation. This scoping review examined the design, content, and implementation of 55 curricula from 42 programs implemented in 23 LMICs between 2001 and 2024. Curricula were identified through screening systematic reviews, grey literature, donor reports, and professional contacts. Data on program characteristics, subject matter, methodologies, and implementation were extracted, synthesized, and analyzed. We found curricula employed similar participatory methodologies and content, and violence, gender, relationships, power, and communication emerged as core topics. Adaptation of earlier programming was widespread: only five curricula did not cite content adapted from an earlier program. Key gaps included the relatively limited use of evidence-based strategies to build relationship skills and content addressing alcohol use and poor mental health, important IPV risk factors. Implementation varied considerably in terms of intensity, frequency, duration, group size, facilitators and their training, and information on some features was sparse. The findings highlight several opportunities for strengthening and innovation, for which we present six recommendations to guide future IPV prevention programming. Full article

Social activity is considered a primary factor in prolonging health and independence in later life, alongside physical activity. While population ageing reflects increasing life expectancy, the risk of living longer in poor health remains. In response to this risk, the United Kingdom developed extra-care schemes, introducing a housing and care model that combines social activities with flexible support to promote healthy and independent living in later life. Despite these potential benefits, observations that male tenants engage less with social opportunities than female tenants highlight a gap in understanding the social needs of men in care environments. This study explores how male social engagement is understood and influenced in extra-care schemes through a dual-perspective approach, combining service–user and service–provider viewpoints. Semi-structured interviews were conducted with six male tenants (mean age = 84 years) and five scheme managers across four extra-care schemes. Reflexive Thematic Analysis revealed barriers to male social engagement related to gender imbalanced environments, poor health, social identity disruption, and widowhood. Conversely, group membership and reliable family involvement function as protective resources that sustain identity roles and support networks for men living in a care environment. Developing male-oriented community links and peer support initiatives within extra-care, alongside appropriate training and psychoeducation for staff and tenants, may be effective when supporting men in care settings. Future research would benefit from broader multi-stakeholder samples to address the limitations of this study. Full article

Background: Diabetic kidney disease (DKD) is the leading cause of chronic kidney disease and end-stage renal disease worldwide. Despite robust evidence-based guidelines, real-world adherence to recommended preventive care remains inadequate. Most prior evaluations have focused on individual care components rather than comprehensive composite care delivery. Methods: A retrospective cross-sectional study of 1010 adult patients with diabetes attending outpatient clinics at King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNGHA), Jeddah, Saudi Arabia. Full guideline-concordant care (GCC) was defined as composite completion of HbA1c monitoring, albuminuria screening using the urine albumin-to-creatinine ratio (ACR), and renin–angiotensin–aldosterone system inhibitor (RAASi) use among patients with detected albuminuria. Multivariable logistic regression (n = 1007) identified independent predictors of full GCC. Results: Only 22.7% (95% CI: 20.1–25.3%) of patients achieved full GCC. Partial care was the most common pattern (46.2%), followed by no care (20.7%) and near-complete care (10.4%). HbA1c testing was performed in 55.0% and albuminuria screening in 49.3% of patients. Among those with detected albuminuria, RAASi therapy was prescribed in 78.9%. Primary care management (OR 4.79, 95% CI 3.45–6.66; p < 0.001) and hypertension (OR 2.00, 95% CI 1.33–3.00; p = 0.001) were independently associated with full GCC. Age, gender, kidney function, and cardiac disease were not significant predictors. Conclusions: Substantial gaps exist in guideline-recommended DKD care, driven primarily by screening deficiencies rather than treatment failures. Care delivery is influenced more by healthcare setting than by patient characteristics, highlighting the need for system-level interventions targeting detection infrastructure across all care settings. Full article

Context: Child-focused healthcare professionals serve as primary providers of both physical and psychosocial care to pediatric patients and their families. Consequently, they are exposed to substantial occupational and emotional challenges in the course of their practice. Objectives: This study examined the levels and multidimensional aspects of occupational stress, coping strategies, and resilience among healthcare professionals providing care to pediatric patients and their families in Greece. Methods: Socio-demographic characteristics, perceived occupational stress, coping strategies (WCQ), and resilience were assessed in a sample of 202 child-focused healthcare (physicians and nurses) and social care professionals (social workers, psychologists, and special education professionals) employed across a range of health and psychosocial services in Greece. Multiple linear regression analyses using the enter method were performed to examine the associations among resilience, occupational stress, and coping strategies while controlling for relevant demographic and occupational variables. Results: Social support was significantly associated with gender. Positive coping was associated with age, work experience, and the WCQ subscales Social Support, Daydreaming, and Avoidance. Avoidance coping was positively associated with profession and Daydreaming. Significant differences were also observed according to age, occupational stress, positive coping, social support, and resilience. Hierarchical multiple regression analysis demonstrated that, positive coping was independently and most strongly associated with resilience (p < 0.001), whereas work stress was independently and negatively associated with resilience (p = 0.001), with higher perceived stress corresponding to lower levels of resilience. Conclusions: The findings highlight the central role of positive coping in relation to resilience among child-focused healthcare professionals, while demonstrating the negative association between occupational stress and resilience. These results underscore the need for interventions that strengthen effective coping strategies, reduce work-related stress, and enhance resilience among healthcare professionals. They also identify important knowledge gaps and support the need for future research examining occupational stress, its long-term consequences, and the coping mechanisms and resilience among professionals working with children and families. Full article

Background/Objectives: Individuals with marginalized sexual and gender identities experience mental health disparities arising from chronic minority stress and systemic barriers within healthcare settings. Mental health professionals occupy a central role in addressing these inequities; however, persistent deficits in professional preparation and cultural knowledge continue to undermine affirming, identity-inclusive care. This study explored the cultural knowledge of Italian mental health professionals regarding LGBTQIA+ health needs, focusing on how such knowledge is conceptualized, enacted, and constrained in clinical practice, using the Culturally Competent Compassion Model as a theoretical framework. Methods: A qualitative study was conducted using semi-structured interviews with 14 Italian mental health professionals (psychologists, psychotherapists, and psychiatrists), purposively selected from a broader qualitative dataset of 33 professionals based on clinical specialization in mental health. Data were analyzed using reflexive thematic analysis. Results: Four themes were identified: (1) training as absent structure; (2) knowing without knowing; (3) the paralysis of partial competence; and (4) stigma as institutional climate. Findings showed that professionals often rely on partial and informal knowledge, experience uncertainty in clinical interactions, and encounter difficulties in translating knowledge into practice. Participants demonstrated awareness of explicit and subtle forms of stigma affecting LGBTQIA+ individuals within healthcare settings. Conclusions: The findings highlight a gap between declarative awareness and self-reported preparedness for clinical practice, underscoring the need for structured training programs integrating theoretical knowledge and clinical skill development. Cultivating cultural knowledge and cultural humility among mental health professionals represents a systemic investment in reducing mental health inequities and improving affirming care for LGBTQIA+ populations. Full article

Participation in organized sports has been shown to enhance youths’ development, improve mental health symptoms, and maintain overall well-being. Research on the outcomes of bullying in the youth population shows the opposite. Youth from marginalized communities in particular—specifically sexual and gender minority or lesbian, gay, bisexual, transgender, queer, intersex, asexual (LGBTQIA+) youth—are at an increased risk of being victims of bullying than their counterparts. However, there is a gap in the literature on the relationship between the three variables. Thus, this review explored the relationship between bullying among sexual and gender minority youth and its impact on the level of engagement in organized sports participation. Psychosocial risk factors and responses are identified, and suggestions for sports programs are proposed. A total of 16 articles, categorized by sexual and gender identity groups to further highlight the current literature on specific groups, were included in the final synthesis of this review. The findings revealed a range in the experiences of bullying and levels of sports participation among LGBTQIA+ youth, highlighting individual differences and impacts of various factors. The findings also emphasized the importance of involvement from schools, administrators, and policymakers in creating a safer, inclusive environment for LGBTQIA+ youth to increase engagement in sports, ultimately improving overall well-being and development. Full article

Objective: The objective of this study is to analyze trends in global research on vitamin D deficiency and mental health outcomes among women using bibliometric methods, focusing on publication output, citation patterns, collaboration structures, thematic research clusters, and key gaps in the existing literature. Methods: A structured bibliometric search of the Scopus database identified 1124 English-language, peer-reviewed articles published between 2000 and 2024 on vitamin D deficiency and mental health in women. Data were analyzed using VOSviewer-Version 1.6.20 to visualize publication trends, citation impact, co-authorship networks, and thematic clusters. Basic statistics were used to explain the publication patterns, while the analysis of networks revealed new research themes and connections across different areas of study. Results: Research output increased steadily, reaching a peak in 2024. Annweiler, C. was the most prolific author. Leading institutions included the University of Western Ontario, Harvard T.H. Chan School of Public Health, and Monash University based on citation impact. The United States contributed the most publications, followed by the United Kingdom and China. Thematic analysis showed strong links between vitamin D deficiency and depression, anxiety, neurodegenerative disorders, and metabolic conditions. Conclusions: This bibliometric analysis highlights the growing academic interest in vitamin D deficiency and its association with mental health outcomes among women. The findings reflect patterns in research activity, collaboration, and thematic focus rather than evidence of clinical effectiveness or causal relationships. While significant progress has been made, gaps remain in gender-specific research, life stage analysis, and representation from low- and middle-income countries. Full article

Chosen family caregivers assume caregiving roles by choice rather than by blood or legal relation. Chosen family caregivers play a critical yet often invisible role in supporting older adults living with HIV. Unlike traditional family caregivers, many chosen family members are themselves living with HIV or other chronic health conditions, creating unique dynamics of mutual support, resilience, and vulnerability. Older LGBTQ adults are disproportionately reliant on chosen family, often due to stigma, estrangement from biological family, or social marginalization, highlighting distinct challenges in caregiving relationships. Women in chosen family roles frequently experience compounded burdens, balancing emotional, physical, and logistical care responsibilities alongside broader social and structural pressures. Despite their essential contributions, chosen family caregivers remain largely unrecognized within healthcare systems, limiting their access to formal support, respite, and decision-making authority. This commentary synthesizes the existing literature and conceptual perspectives to examine the social, gendered, and health-related dimensions that distinguish chosen family caregiving. It highlights key gaps in recognition and support and outlines implications for policy, research, and practice aimed at strengthening care for older adults living with HIV. Full article

Background: While the consumer experience of psychosis has received significant attention in Western research, a substantial gap exists regarding the experiences of women in the Kingdom of Saudi Arabia (KSA). In this context, religious, cultural, familial, and gender-specific factors uniquely shape the experience of psychosis, help-seeking behaviors, and recovery. This study aimed to explore the lived experiences of Saudi women with psychosis across three phases: first-episode onset, hospitalization or follow-up, and community living after discharge. Methods: This hermeneutic phenomenological study, guided by van Manen’s methodology, employed all six lifeworld existentials: lived space, lived body, lived time, lived self-other, lived thing, and lived cyborg. Semi-structured interviews were conducted with 21 women diagnosed with psychosis at two hospitals in Riyadh, KSA. Data collection included 13 audio-recorded interviews and eight documented via field notes, supplemented by creative methods such as drawings, poems, and written texts analyzed using van Manen’s vocative method. All Arabic data were professionally translated and verified for accuracy. Results: Three overarching themes emerged. First, women’s lived experiences of first-episode psychosis highlighted the process of understanding causes and developing insight during onset. Second, experiences during admission and follow-up revealed the impact of clinical encounters, nursing care, and the critical need for therapeutic healing spaces. Third, living with psychosis in the community emphasized the complexities of medication adherence, family dynamics, and the pursuit of recovery through education, employment, and religious practice. Conclusions: The participants articulated user-based recovery perspectives, including empowerment, shared decision-making, and hope, which contrasted sharply with the service-based approaches they received. Culturally specific stressors and pervasive stigma shaped every phase of their journey. To the authors’ knowledge, no prior study has examined this population using a hermeneutic phenomenological framework; these findings provide a women-focused, culturally situated evidence base for developing gender-specific recovery models and enhanced discharge planning within the KSA mental health system. Full article

Objective: To map the scientific evidence and identify knowledge gaps regarding the health of Black and Sexual and Gender Minority populations within the global context of health education. Introduction: Health education curricula should explicitly recognize, define, and address the specific needs and health disparities affecting Black and Sexual and Gender Minority populations to ensure that healthcare provision is comprehensive and inclusive in diverse settings. Eligibility criteria: Studies related to professional health training at undergraduate and graduate levels, as well as other educational modalities addressing healthcare provision for Black and Sexual and Gender Minority populations, were included. Methods: This scoping review was conducted following the JBI methodology. Studies were retrieved from Scopus, Web of Science, PubMed, Embase, MEDLINE, Virtual Health Library, CINAHL, ERIC, Cochrane Library, Brazilian Digital Library of Theses and Dissertations, ProQuest Dissertations & Theses Global, EBSCO databases, and the Networked Digital Library of Theses and Dissertations, without language or time restrictions. Two independent reviewers screened the studies and extracted data using a standardized form developed for this review. Concepts, definitions, structures, results, and applications of professional health education for the care of Black and Sexual and Gender Minority populations were systematically synthesized. The results were organized and presented in tabular and graphical formats, accompanied by a narrative summary. Results: A total of 104 studies were included. The evidence was predominantly concentrated in North America, particularly in the United States, with limited representation from other regions. Most studies were published after 2020, indicating a recent expansion of research interest. The methodological profile was characterized by a predominance of quantitative and descriptive designs, alongside qualitative and mixed-methods approaches. Thematic analysis revealed a concentration of studies addressing gender-affirming care, workforce diversity, social determinants of health, and discrimination, while intersectional approaches and long-term educational outcomes remained less explored. Conclusions: The available evidence indicates that health education has increasingly incorporated themes related to equity and diversity; however, the integration of structured and mandatory curricular approaches addressing the intersectional health needs of Black and Sexual and Gender Minority populations remains limited. The findings highlight the need for broader geographic representation, stronger methodological designs, and the development of comprehensive educational strategies capable of addressing structural inequalities within health training contexts. Full article

Background/Objectives: Inappropriate medication storage and disposal are recognized public health concerns and represent a relevant source of environmental exposure to pharmaceutical compounds, with potential implications for ecosystem and human health. Identifying population-level determinants of these behaviors is essential to support targeted interventions and risk mitigation strategies. Methods: A cross-sectional population-based study was conducted using a structured survey administered to Brazilian adults. The questionnaire assessed medication storage practices, disposal behaviors, and prior exposure to guidance on appropriate medication handling. Descriptive statistics were used to characterize the sample, and multivariate logistic regression analysis was performed to identify independent predictors of appropriate disposal practices. Results: A total of 475 participants were included in the analysis. Although awareness of the environmental impact of improper medication disposal was high, inappropriate practices remained prevalent. Multivariate logistic regression identified educational level as the primary independent determinant of appropriate disposal practices (p < 0.001), while no significant associations were observed for age or gender (p > 0.05). Lack of prior guidance was frequent and may represent a relevant population-level exposure influencing unsafe behaviors. Conclusions: The findings highlight a gap between awareness and practice and identify key sociodemographic determinants influencing medication disposal behaviors. From an environmental epidemiology perspective, improper disposal may contribute to the dissemination of pharmaceutical residues in water systems, representing an indirect but widespread exposure pathway. Targeted public health strategies focusing on high-risk groups are needed to promote safe medication handling and reduce environmental and health risks. Full article