Search Results (6,313)

Background/Objectives: Pediatric acquired brain injury (ABI) often results in persistent challenges that extend beyond motor impairments, affecting quality of life (QoL), social participation, and engagement in physical activity. Given the complexity and chronicity of these outcomes, there is a pressing need for multidimensional interventions grounded in the International Classification of Functioning, Disability and Health (ICF). Sport-based exercise interventions, when developmentally adapted and tailored to individual interests, may promote intrinsic motivation, peer connection, and sustainable engagement—factors especially relevant in pediatric ABI populations, who often experience reduced physical activity and social isolation. However, standardized, replicable protocols specifically tailored to this population remain scarce. This study presents the protocol for a randomized controlled trial evaluating the effects of a 16-week sport-based intervention on QoL, social participation, physical activity engagement, and motor functioning tailored for adolescents with pediatric ABI. Methods: Participants will be randomly assigned to an intervention group or a control group receiving usual care. The intervention consists of one weekly 60-minute session, led by trained professionals in adapted physical activity and pediatric neurorehabilitation. It combines sport-based motor skill training, cooperative games, and group activities specifically tailored to each child’s developmental level, motor abilities, and preferences. Outcomes will be assessed at baseline and following the 16-week intervention period, focusing on QoL, participation, physical activity engagement, and motor functioning. Discussion: This study introduces a structured, child-centered model that bridges clinical rehabilitation and community-based sport. By integrating motor and psychosocial targets through a group sport-based intervention, it aims to enhance recovery across ICF domains. Findings may inform interdisciplinary practice and support the development of sustainable strategies to promote long-term engagement and well-being in adolescents with ABI. Full article

Background/Objectives: Proteinuria, a marker of renal dysfunction, has been implicated in cancer risk, yet its role in gastric carcinogenesis remains underexplored in high-incidence populations. This study evaluated the association between urine dipstick proteinuria severity and gastric cancer incidence in a nationwide Korean cohort. Methods: We analyzed data from the Korean National Health Insurance Service–National Sample Cohort, including 220,941 adults aged > 40 years, without a diagnosis of cancer, who received health examinations in 2009. Proteinuria was classified by single dipstick testing as negative, 1+, or ≥2+. Participants were followed for a mean of 4.37 ± 0.49 years (965,601.2 person-years). Multivariable Cox proportional hazards models adjusted for age, sex, body mass index, systolic blood pressure, fasting glucose, LDL cholesterol, estimated glomerular filtration rate, smoking status, alcohol intake, and physical activity were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results: During follow-up, 1934 participants (0.88%) developed gastric cancer. A significant dose–response relationship emerged (p for trend = 0.037). In fully adjusted models, 1+ proteinuria conferred no significant risk increase (HR 1.10; 95% CI, 0.80–1.51), whereas ≥2+ proteinuria was associated with a 42% higher gastric cancer risk (HR 1.42; 95% CI, 1.00–2.02). Conclusions: Severe dipstick proteinuria independently predicts elevated gastric cancer risk in Korean adults. Integration of urine dipstick testing into gastric cancer screening protocols may offer a simple, cost-effective strategy for risk stratification, particularly in high-incidence settings. Full article

Background: The World Health Organization (WHO) defines health promotion as the process of enabling individuals to gain control over and improve their health. This shifts the focus from lifestyle choices to broader social determinants of health, requiring involvement from healthcare, authorities, industry, civil society, and the media. Civil society engagement in health initiatives offers benefits such as empowerment, service delivery, flexibility, policy participation, and credibility. However, identifying specific health promotion actions for civil society organizations (CSOs) is challenging. The lack of assessment tools for CSOs hinders evaluation and improvement. Objective: To develop a tool, ‘PromoACTIVA-SC’, to assess CSOs’ health promotion practice by identifying essential actions that constitute the health promotion process. Methods: ‘PromoACTIVA-SC’ was developed through documentary analysis and validated by experts. CSOs’ members participated in cognitive interviews for comprehensibility, and the tool was pilot tested for administration and Likert scale evaluation. Results: The final questionnaire, consisting of 8 phases and 40 items, demonstrated good content validity. Its use can help to map CSOs’ practices and identify areas needing improvement. CSOs can use it for self-assessment and in collaborative health promotion and disease prevention efforts. Conclusions: ‘PromoACTIVA-SC’ is the first tool designed to assess civil society’s role in the health promotion process. Its future use will reveal the extent to which civil society organizations actively participate in health promotion. It can also be used to promote CSOs’ involvement in health policy and administration, enhancing public health outcomes through collaborative, cross-sectoral efforts. Full article

Microglia and macrophages are critical immune cells within the central nervous system (CNS), with distinct roles in development, homeostasis, and disease. Once viewed as passive bystanders, these cells are now recognized for their dynamic phenotypic plasticity, which enables them to respond to a wide range of physiological and pathological stimuli. During homeostasis, microglia and CNS-resident macrophages actively participate in synaptic pruning, neuronal support, myelin regulation, and immune surveillance, contributing to CNS integrity. However, under pathological conditions, these cells can adopt neurotoxic phenotypes, exacerbating neuroinflammation, oxidative stress, and neuronal damage in diseases such as Alzheimer’s, Parkinson’s, multiple sclerosis, and glioblastoma. This review synthesizes emerging insights into the molecular, epigenetic, and metabolic mechanisms that govern the behavior of microglia and macrophages, highlighting their developmental origins, niche-specific programming, and interactions with other CNS cells. We also explore novel therapeutic strategies aimed at modulating these immune cells to restore CNS homeostasis, including nanotechnology-based approaches for selective targeting, reprogramming, and imaging. Understanding the complex roles of microglia and macrophages in both health and disease is crucial for the development of precise therapies targeting neuroimmune interfaces. Continued advances in single-cell technologies and nanomedicine are paving the way for future therapeutic interventions in neurological disorders. Full article

Excessive alcohol consumption is associated with various health complications, including liver damage and systemic inflammation. Probiotic interventions have emerged as promising strategies to mitigate alcohol-induced harm, yet their mechanisms of action remain incompletely understood. This randomized, double-blind, placebo-controlled clinical trial aimed to evaluate the protective effects of Weizmannia coagulans BC179 in chronic alcohol consumers. Seventy participants with a history of long-term alcohol intake were randomly assigned to receive either BC179 (3 g/day, 1 × 10¹⁰ CFU) or a placebo for a 30-day intervention period. Following alcohol ingestion, dynamic monitoring of blood alcohol concentration (BAC), inflammatory and oxidative stress biomarkers, and serum metabolomic profiles was conducted. BC179 supplementation significantly reduced BAC and enhanced the activities of alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH), while decreasing levels of alkaline phosphatase (ALP), high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6). Conversely, the anti-inflammatory cytokine interleukin-10 (IL-10), superoxide dismutase (SOD), and glutathione (GSH) were significantly upregulated. Levels of cytochrome P4502E1 (CYP2E1) and malondialdehyde (MDA) were also markedly reduced. Metabolomic analysis revealed significant modulation of taurine and hypotaurine metabolism, as well as downregulation of caffeine-related pathways. Collectively, these findings indicate that W. coagulans BC179 alleviates alcohol-induced discomfort by enhancing alcohol metabolism, attenuating inflammation, reducing oxidative stress, and modulating key metabolic pathways. This probiotic strain may represent a promising adjunctive strategy for managing alcohol-related health issues. Full article

Background: The skin microbiome plays a key role in maintaining skin health, and its composition can be influenced by cosmetic treatments. This study aimed to investigate the effects of SMART DNA Therapy treatment on facial skin microbiome composition, with specific focus on changes in commensal and pathogenic bacterial populations following multi-component anti-aging intervention. Methods: This clinical study included 10 Caucasian female participants aged 28–50 years (Clinical trial registration number: 0406/2023). Each participant received three Retix.C SMART DNA THERAPY treatments at 14-day intervals over 6 weeks. The protocol included three phases: chemical peeling with ferulic acid, peptide microinjections for DNA repair, and home-care products with antioxidants. Bacterial samples were collected from forehead and cheek skin before treatment and 2 weeks after the final treatment. Samples were analyzed using bacterial culture and PCR methods. Results: After treatment, the skin microbiome showed beneficial changes with increased numbers of helpful bacteria and elimination of harmful bacteria: complete removal of Cutibacterium acnes and Staphylococcus aureus was observed, Staphylococcus epidermidis and other beneficial bacteria increased on both forehead and cheek areas. Overall bacterial diversity decreased, and participants exhibited more similar microbiome patterns after treatment. Conclusions: SMART DNA Therapy treatment successfully modified the skin microbiome by increasing protective bacteria and eliminating pathogenic species. The treatment may support skin health through microbiome modulation and the potential antioxidant effects of its active ingredients, although these were not directly assessed in this study. Full article

A greater understanding of health-promoting factors, such as hope, is crucial for preventing and enhancing the mental health of higher education students. The Herth Hope Index (HHI) is a 12-item tool that has been widely used to assess a comprehensive, non-temporal perception of hope. While this instrument has been used extensively in adult populations, most studies focus on clinical populations. Additionally, the HHI reveals inconsistencies in terms of scale dimensionality and items to be retained. Therefore, this study sought to assess the HHI’s psychometric characteristics in a sample of Portuguese Higher Education students. The person response validity, internal scale validity, unidimensionality, and uniform differential item functioning were assessed using a Rasch rating scale model. A total of 2227 higher education students participated during the e-survey activation period (spring semester of 2020). The mean age of the sample was 22.5 ± 6.2 years (range 18–59 years). Three of the twelve items (#3, #5, and #6) failed to satisfy the established criterion for goodness of fit. Following the elimination of these three items, the resultant nine-item scale exhibited satisfactory item fit to the model, appropriate unidimensionality (52.4% of the variance explained), enough person goodness of fit, sufficient separation, and the absence of differential item functioning. The 9-item version of the HHI had psychometric properties comparable to the original 12-item version. This study also underscores the importance of validated instruments for assessing hope-based interventions in academic contexts. Further research is necessary to explore the potential dimensions inherent to the hope concept and to identify variations in hope profiles among items influenced by cultural attributes. Full article

Approximately one-third of cancer survivors report a need for professional help to cope with Fear of Cancer Recurrence (FCR). In the REMOTE trial, we aim to investigate the efficacy of two internet-based mind-body techniques to address this currently unmet medical need. Cancer survivors, screened using the Cancer Worry Scale (CWS), are randomly assigned to one of the three study groups: (1) internet-based emotional freedom techniques (iEFT) (n = 113), (2) an active control condition internet-based mindfulness meditation intervention (iMMI) (n = 113), or (3) a wait-list control group (WLC) (n = 113). The interventions iEFT and iMMI are conducted remotely using Microsoft Teams (Microsoft, Redmond, WA), and participants have access to an online platform via the MyNexuzHealth application (nexuzhealth NV, Hasselt, Belgium). The primary endpoint is the level of FCR. Secondary outcomes are emotional distress and quality of life (QoL). If iEFT and/or iMMI appear to be effective in reducing FCR, they could be readily implemented in clinical practice. Full article

Patient activation enhances self-management of chronic illnesses, and sleep quality is vital for health. The link between activation and sleep quality and the mediating role of chronic diseases remain underexplored. This study examined the association between patient activation and sleep quality, variations across chronic disease groups, and whether chronic diseases mediate this relationship. A population-based cross-sectional survey in South Tyrol (Italy) included 2090 adults (55.0% response rate). Patient activation was measured using the Patient Activation Measure (PAM-10), and sleep quality was measured using the Brief Pittsburgh Sleep Quality Index (B-PSQI). The presence and number of chronic diseases were self-reported. Bivariate analyses, multiple linear regression, and mediation analyses (PROCESS) were performed. Among the participants, 918 (44%) reported at least one chronic disease. These individuals had poorer sleep (B-PSQI mean: 5.05 ± 3.26 vs. 3.66 ± 2.65; p < 0.001) and lower patient activation (PAM-10: 54.4 ± 12.7 vs. 57.2 ± 12.5; p < 0.001) than those without. A negative correlation between PAM-10 and B-PSQI was observed (r = −0.12, p < 0.001), with stronger associations in patients with hypertension and mental illness. In adjusted regressions, chronic disease, female sex, and older age predicted poorer sleep, whereas higher PAM-10 scores predicted better sleep. Mediation analyses showed that chronic disease partially mediated the relationship between patient activation and sleep quality, accounting for 4.7% to 6.3% of the total effect. Conclusions: Higher patient activation correlates with better sleep quality, although this relationship is partly mediated by the chronic disease burden. Sleep disturbances persist across chronic conditions, despite good self-management. These findings highlight the importance of adopting strategies to manage chronic diseases and sleep disturbances, acknowledging that while patient activation is statistically associated with sleep quality, the strength of this relationship is limited. Full article

Background: Emotion regulation (ER) plays a vital role in mental health, spanning mood, anxiety, and personality disorders. Cognitive reappraisal (CR) is one of the most common ER strategies and depends on prefrontal brain areas, but its success varies, and its neural basis is not fully clear. Interest is growing in using transcranial direct current stimulation (tDCS) to support ER, yet most studies have focused only on the dorsolateral prefrontal cortex (dlPFC) and used simple tasks. Objective: This study explored whether tDCS applied to either the dlPFC or the ventromedial prefrontal cortex (vmPFC) could shape autonomic responses during CR while people watched emotionally engaging film clips. Methods: Participants were randomly assigned to receive either active or sham tDCS over the dlPFC or vmPFC. While stimulated, they used CR strategies (positive reappraisal, fictional reappraisal, or distancing) to manage their reactions to negative film scenes. Heart rate (HR), skin conductance (SC), and respiratory rate (RR) were tracked throughout as physiological indicators. Results: Active dlPFC tDCS combined with CR led to significantly greater reductions in HR toward the end of emotional exposure, compared to sham or non-CR conditions. dlPFC stimulation also lowered HR even without explicit CR, pointing to possible effects on automatic regulation. vmPFC effects were inconsistent, and no reliable effects were observed for SC or RR. Conclusions: These results suggest that tDCS effects on autonomic ER depend on the brain region and timing. dlPFC stimulation may strengthen both intentional and automatic emotion regulation, especially when combined with reappraisal, highlighting the value of realistic emotional tasks in neuromodulation studies. Full article

This study investigated youth’s empowerment through EU-funded climate change projects (CCPs) and the role that social research and public engagement play in that process. The importance of considering youth empowerment in a time of climate change is increasingly recognized. Youth are exposed to interrelated health, socioeconomic, and political vulnerabilities caused by climate change, but they often lack resources to address and navigate these changes. To help address these issues, youth empowerment holds the potential to give youth a greater influence over their lives in the context of an evolving climate. EU-funded CCPs play a crucial role in EU’s climate mitigation and adaptation policies, and the implementation of these projects can have widespread implications for youth across the EU. However, there is little research exploring the local youth implications of EU-funded CCPs. In this paper, we want to start addressing this knowledge gap by exploring how youth empowerment was facilitated, shaped, and restrained over a year-long collaboration with students from a Greek school as part of a Horizon 2020 project on the social acceptance of Carbon Capture and Utilization (CCUS) technologies. The findings indicate that the activities provided the students with opportunities to explore and express different types of concerns, knowledge, and perspectives on issues related to climate change, social acceptance, and CCUS. However, the empowering potential of these activities was also shaped by power differentials and contestations around the validity of different knowledge sources. For meaningful youth engagement through Horizon 2020 initiatives, more longitudinal and meaningful participation is needed. Full article

Background: Respiratory syncytial virus (RSV) poses a significant global health threat, particularly to children and the elderly. While progress has been made in RSV vaccine development, gaps remain, especially in protecting the elderly population. BARS13, a recombinant non-glycosylated G protein-based RSV vaccine, has shown promise in preclinical and Phase 1 studies. This phase II trial sought to determine whether escalating doses of BARS13 could enhance immune responses while maintaining safety and tolerability in healthy older adults aged 60–80 years. Methods: This study employed a rigorous randomized, double-blind, placebo-controlled design involving 125 participants across two Australian centers. Participants were randomized in a 3:1 (vaccine–placebo) ratio for Cohorts 1–2 (30 active, 10 placebo each) and a 2:1 ratio for Cohort 3 (30 active, 15 placebo). Cohort 1 (low dose) received 10 µg rRSV-G + 10 µg CsA in one arm + a placebo in the other (Days 1 and 29); Cohort 2 (high dose) received 10 µg rRSV-G + 10 µg CsA in both arms (20 µg total per dose, Days 1 and 29); Cohort 3 (multi-dose) received the same dose as that of Cohort 2 but with a third dose on Day 57. The placebo groups received IM injections in both arms at matching timepoints. The primary endpoints included safety and tolerability assessments, while the secondary endpoints evaluated the RSV G protein-specific IgG antibody concentrations using enzyme-linked immunosorbent assays (ELISAs). Statistical analysis was performed on both the safety and immunogenicity populations. Results: BARS13 was well-tolerated across all cohorts, with no serious adverse events (SAEs) related to the vaccine. The most common adverse events were mild local reactions (pain and tenderness) and systemic reactions (headache and fatigue), which resolved within 24–48 h. Immunogenicity analysis demonstrated a dose-dependent increase in the RSV G protein-specific IgG geometric mean concentrations (GMCs). Cohort 3, which received multiple high-repeat dose administrations, showed the highest immune response, with the IgG GMC rising from 1195.4 IU/mL on Day 1 to 1681.5 IU/mL on Day 113. Response rates were also the highest in Cohort 3, with 86.2% of participants showing an increase in antibody levels by Day 29. Conclusions: BARS13 demonstrated a favorable safety profile and strong immunogenicity in elderly participants, with a clear dose-dependent antibody response. These results support further development of BARS13 as a potential RSV vaccine candidate for the elderly. Further studies are needed to evaluate the long-term efficacy and optimal dosing schedule. Full article

Background: This study investigated the cross-sectional associations of personal and general views on aging, number of non-communicable diseases, and their interactions as cross-sectional predictors of vigorous physical activity. Methods: Participants were 1699 individuals aged 50 years and over (Mean age = 67.79) and living in the community in the UK; 70.8% were women. Participants completed measures assessing Awareness of Age-Related Gains and Losses (AARC-Gains; AARC-Losses; indicators of personal views on aging), Expectations Regarding Aging (ERA; indicator of general views on aging), vigorous physical activity in the last month, non-communicable disease status, and sociodemographic questions. Linear regression models were used. Results: After having adjusted for age, sex, education, marital status, and working status, higher AARC-Gains, lower AARC-Losses, more positive ERA, and fewer non-communicable diseases were cross-sectionally associated with greater likelihood of engagement with vigorous physical activity (Adjusted models Odds Ratio (OR) of 1.08; 0.86; and 1.06, respectively). The interactions of AARC-Gains and AARC-Losses with number of non-communicable diseases as cross-sectional predictors of likelihood of engagement with vigorous physical activity were not statistically significant. The interaction between ERA (i.e., General Views on Aging) and number of non-communicable diseases was a statistically significant cross-sectional predictor of likelihood of engagement with vigorous physical activity (OR = 0.99; p = 0.044). Conclusions: Having more positive and less negative views on aging may prompt vigorous physical activity engagement. Moreover, positive general views of aging may be particularly important for physical activity among those who have one or more non-communicable diseases. Although we cannot infer causality, promoting positive views on aging and decreasing negative views on aging could help fostering active aging, especially among those with physical health conditions. Full article

The increasing migration phenomenon and its impact on sexual health highlight the urgency of improving access to preventive services and developing responsive surveillance mechanisms. This study aims to describe the context and define the implementation circuits of a Community-Based Surveillance System (CBSS) focused on social epidemiological aspects related to sexual health in Chile’s migrant population. A two-phase qualitative design was employed: Phase 1 involved formative research, and Phase 2 focused on the design of CBSS implementation circuits. The formative phase led to the selection and characterization of three community-based organizations (CBOs)—two in Santiago and one in Antofagasta—and two primary healthcare centers (PHCs). Findings revealed heterogeneity in institutional capacities, limited coordination between CBOs and the health system, and a high level of willingness to participate. PHCs showed comparable profiles. Based on this, differentiated operational circuits were co-designed and adapted with stakeholders, and formalized through site-specific implementation manuals. This pre-implementation evaluation helped identify critical contextual barriers and generate tailored strategies for CBSS deployment. The active involvement of local actors is essential to ensuring the contextual relevance, institutional acceptability, and future sustainability of the proposed model. These insights offer transferable learning for the design of health interventions in underserved and structurally constrained settings. Full article

Introduction: Chronic primary low back pain (CPLBP) is a prevalent condition in primary care and a leading cause of disability and absenteeism worldwide. Multidimensional approaches may be necessary to achieve physical and mental health benefits in individuals with CPLBP. Objective: The BACKFIT randomized controlled trial aims to evaluate the effectiveness of a multidimensional intervention—combining supervised exercise and mindfulness—on pain, physical fitness, mental health, and functional outcomes in individuals with CPLBP. Hypothesis: Both the supervised exercise program focused on motor control and trunk muscle strength (IG1) and the multidimensional intervention combining supervised exercise with mindfulness training (IG2) are expected to produce significant health improvements in individuals with CPLBP. It is further hypothesized that IG2 will yield greater improvements compared to IG1, both immediately post-intervention and at the two-month follow-up. Design: Randomized controlled trial. Setting: Virgen de las Nieves University Hospital, Granada (Spain). Participants: 105 individuals. Inclusion criteria: Previously diagnosed with CPLBP, aged ≥18 and ≤65 years, able to read and understand the informed consent, and able to walk, move, and communicate without external assistance. Exclusion criteria: serious lumbar structural disorders, acute or terminal illness, physical injury, mental illness, and medical prescriptions that prevent participation in the study. Intervention: Individuals will be randomly assigned to a supervised physical exercise group (2 days per week, 45 min per session), a multidimensional intervention group (same as supervised physical exercise group, and mindfulness 1 day per week, 2.5 h per session) or an active control group (usual care, 2 days per week, 45 min per session). The intervention will last 8 weeks. Main Outcome Measures: Primary outcome: pain threshold, perceived acute pain, and disability due to pain. Secondary measures: body composition, muscular fitness, gait parameters, device-measured physical activity and sedentary behavior, self-reported sedentary behavior, quality of life, pain catastrophizing, mental health, sleep duration and quality, and central sensitization. The groups will undergo pre-intervention, post-intervention, and a 2-month follow-up after a detraining period. Statistical Analysis: Both per-protocol and intention-to-treat approaches (≥70% attendance) will be used. Program effects will be assessed via one-way ANCOVA for between-group changes in primary and secondary outcomes. Conclusions: Given the complex nature of CPLBP, multidimensional approaches are recommended. If effective, this intervention may provide low-cost alternatives for health professionals. Full article