Search Results (13,234)

Objectives: The rapid digitalization of health communication has made electronic health (e-health) literacy an essential competency, while also increasing concerns about cyberchondria. This descriptive–correlational study examined perceived e-health literacy and cyberchondria among students enrolled in a Faculty of Sports Sciences and evaluated their associations with selected socio-demographic and behavioral factors. Methods: Data were collected between February and May 2025 using a Socio-Demographic Information Form, the e-Health Literacy Scale (eHEALS), and the Short-Form Cyberchondria Severity Scale (CSS-12). Quantitative data were analyzed using group comparison tests, correlation analyses, effect size estimates, and multivariable linear regression. Results: Students demonstrated eHEALS scores close to the upper end of the possible range, together with considerable cyberchondria severity scores. Cyberchondria severity was positively associated with perceived e-health literacy; this association remained statistically significant but weak after adjustment for daily internet use, gender, age, academic year, and department. Significant differences were also observed according to daily internet use, gender, academic year, and department. Conclusions: These findings highlight the dual role of digital health platforms among students engaged in health- and performance-related fields. Educational interventions should promote critical appraisal of online health information and psychologically safe digital health behaviors. Full article

Climate change perception among youth has gained increasing scholarly attention; however, immigrant youth remain underrepresented in empirical research despite navigating climate change impacts across multiple sociocultural and geopolitical contexts. This study investigates (1) immigrant youths’ beliefs about climate change, (2) how climate risks are perceived across space and time, and (3) how they construct their climate change beliefs and associated risks. Drawing on Social Constructivism, and Risk Perception Theory, the study employs a qualitative descriptive design using eight focus group discussions with 41 immigrant youth aged 14–18 in Calgary, Canada. Reflexive thematic analysis reveals that immigrant youth widely recognise climate change as real and intensifying, with beliefs shaped through lived and observed environmental experiences, social interaction, family narratives, and transnational comparisons rather than abstract scientific reasoning alone. Climate risk perception emerges as complex and relational. Participants associated climate change with impacts on health, wellbeing, food security, and everyday life; however, they often perceived its most severe consequences as temporally and spatially distant. This produces a notable “belief–risk gap,” where acceptance of climate change does not translate into a strong sense of personal vulnerability or urgency. Risk perceptions are mediated by everyday experiences, institutional trust in the host country, and comparisons with other global crises. The findings highlight the critical role of transnational experiences in shaping climate understanding and advance an integrated interpretation linking socially constructed climate knowledge with perceptions of risk and psychological distance, with implications for climate communication and public health communication strategies for immigrant youth. Full article

Objectives: Major depressive disorder (MDD) frequently co-occurs with substance use disorders, resulting in greater clinical severity and poorer outcomes. Sedative–hypnotic/anxiolytic agents (SHA) are commonly used to manage anxiety and insomnia, also in MDD. However, their long-term intake might lead to misuse and physical and cognitive complications. Trazodone, an antidepressant with sedative and anxiolytic properties, has been proposed as an option in SHA detoxification, but data on patients with comorbid MDD and SHA use disorders (MDD+SHA-UD) are limited. This study retrospectively evaluated the effects of a three-month treatment with extended-release trazodone in this population. Methods: Seventy-four outpatients with MDD+SHA-UD treated with extended-release trazodone were evaluated at baseline and after one and three months. Depressive symptoms were assessed using the Hamilton Depression Rating Scale. Secondary outcomes included anxiety (Hamilton Anxiety Rating Scale), sleep disturbances (Pittsburgh Sleep Quality Index), physical symptoms (Hamilton Depression–Anxiety subscales, 36-Item Short-Form Health Survey), cognitive functioning (Perceived Deficits Questionnaire–Depression, 5-item), and quality of life (World Health Organization-Five Well-Being Index). Results: Trazodone was associated with a significant reduction in depressive symptoms (p < 0.001), with 47.3% of the initial sample achieving remission at endpoint. Improvements were also observed in measures of anxiety, physical symptoms, subjective sleep quality, perceived cognitive functioning, and quality of life (all p < 0.001). Side effects were mild (25.7% at one month) and declined over time. Conclusions: In this uncontrolled preliminary study, extended-release trazodone was associated with significant improvements across multiple symptom domains in MDD+SHA-UD, warranting controlled investigation. Full article

Background/Objectives: Lebanon is undergoing a rapid demographic transition, with older adults projected to exceed one-fifth of the population by 2050. Supporting healthy and independent aging requires a robust evidence base that extends beyond clinical care to encompass community, environmental, psychosocial, and policy dimensions of aging in place. This bibliometric review maps the landscape of gerontology and geriatrics research in Lebanon to identify research trends, gaps, and future priorities for advancing holistic approaches to aging. Methods: A bibliometric review was conducted of gerontology and geriatrics research published between 2015 and 2026. Publications were retrieved from the Scopus database and screened according to predefined eligibility criteria. Results: A total of 403 publications met the inclusion criteria. Research productivity increased steadily over the study period, reaching its highest level in 2025, although publications remained concentrated among a relatively small number of authors and institutions. The literature was predominantly oriented toward clinical, epidemiological, and public health aspects of aging, with comparatively limited attention to community-based aging, psychosocial well-being, age-friendly environments, policy, social participation, and other determinants that support older adults’ ability to age safely and independently within their communities. Research evaluating interventions outside tertiary healthcare settings was particularly scarce. Conclusions: This review provides the first bibliometric mapping of gerontology and geriatrics research in Lebanon and indicates that, despite substantial growth in scientific output, the identified literature is largely centered on diseases and institutional healthcare. Future research should adopt more holistic and multidisciplinary perspectives to promote psychosocial well-being and aging well in one’s community. These priorities may guide researchers, practitioners, and policymakers in developing strategies for aging well in Lebanon. Full article

Background: In recent decades, doctoral education has undergone a profound transformation. As a result, PhD students have become an increasingly vulnerable population, facing greater risk of mental health problems than the general population. A particularly important subgroup comprises PhD students in medicine and health sciences, who often combine doctoral training with clinical work. Their dual roles expose them to additional pressures, with an increased risk of burnout. Given that their context differs considerably from the typical university environment, in this systematic review, we aim to synthesize the current evidence on burnout, impostor syndrome, and research engagement, along with related indicators of psychological distress, among PhD students in medicine and health sciences, as well as identify key risk and protective factors and highlight gaps for future research. Methods: A systematic literature search was conducted in March 2026 across the Web of Science, Scopus, and Ovid MEDLINE databases. Following a screening process based on PRISMA guidelines, 27 studies were included; due to substantial heterogeneity, findings were synthesized narratively. Results: Psychological difficulties appeared to be more strongly associated with institutional factors rather than personal traits. Burnout was highly prevalent and linked to professional isolation and poor relationships with supervisors. Impostor syndrome emerged as a recurrent theme in qualitative accounts, though it was formally assessed with a validated instrument in only one study. Moreover, research engagement did not appear to protect students from burnout. Conclusion: Burnout and psychological distress are widespread among PhD students in medicine and health sciences, and impostor feelings emerged as a recurrent theme, although formally measured in only one study. These findings highlight the need for structural and institutional changes rather than relying solely on individual psychological support. Full article

The integration of occupational safety and health protection with workplace efforts to promote worker health and well-being is a well-established concept, progressively formalized through the CDC-NIOSH Total Worker Health^® (TWH) program. This scoping review aimed to map and describe the implementation and evaluation methods used in TWH approaches across occupational settings. Scopus, Web of Science, and PubMed were searched using predefined search strings based on “Total Worker Health” and “Total Worker Health approach”. The original search was conducted in January 2023 and was updated in July 2026 using the same databases and search strategies. Eligible studies were peer-reviewed articles written in English that addressed the application, implementation, assessment, or evaluation of TWH approaches in occupational settings. Sixty studies identified in the original search were fully charted and summarized using descriptive frequency tables. The updated search retained eight additional recent studies, which were reported separately and additionally charted across a focused set of core methodological domains. Across the original corpus and the updated studies, substantial heterogeneity was observed in occupational sectors, study aims, intervention components, assessment methods, analytical approaches, and reporting formats. The main tools used to evaluate TWH aspects and interventions were surveys, questionnaires, interviews, meetings, focus groups, training activities, and mixed-methods evaluations. No single standardized model for implementing or evaluating TWH approaches emerged from the mapped literature; however, more consistent reporting of implementation processes, assessment tools, study populations, and analytical approaches may improve comparability, reproducibility, and transferability across occupational settings. Full article

Background/Objectives: Schools constitute the principal setting for the identification of children’s psychosocial risk and the delivery of preventive support, and school-health surveillance therefore depends on informant reports. Selection of the reporting informant is constrained by feasibility, cost, and questionnaire length, which frequently preclude multi-informant assessments, and the question of whether adult and child reports index a common property has predominantly been examined in single-country designs. The present study estimated the criterion-related validity of child, teacher, and principal reports of school safety across multiple education systems, against outcomes spanning children’s experience, institutional functioning, and externally assessed achievements; the estimand was thus informant-specific validity rather than cross-informant agreement. Methods: TIMSS 2023 Grade 4 data from 12,955 schools in 63 education systems (395,961 children, 27,100 teacher records) were analyzed, with child, teacher, and principal reports modeled as separate informants. Students were randomly split within schools so that no student contributed both a predictor and an outcome; the split was replicated 50 times and averaged. Convergence was evaluated with a multitrait–multi-informant model, with ceiling effects and differential unreliability specified as rival explanations; informant contributions were estimated by an exact relative-importance (LMG) variance decomposition, with response surface analysis reported as a secondary characterization of directional discrepancy. Results: Median school-level cross-informant correlations were below 0.10 and were not attributable to ceiling effects or to unreliability. With all three informants retained, the child report accounted for 95% (95% CI 92–97) of the informant-explained variance in school belonging and 75% (65–82) in peer victimization, but 44% (28–59) in mathematics, where the three contributions were approximately equal. These proportions were computed on a modest total: the three informant scores jointly explained between 1% and 13% of between-school variance. The pattern was robust to informant, item, covariate, and weighting specifications, and to correction for differential predictor unreliability. Conclusions: Criterion-related informant validity in school safety measurement was domain-specific. For outcomes describing children’s experience, adult reports contributed substantially lesser than child reports and cannot be regarded as interchangeable substitutes for children’s reports of experienced safety. Because school-health surveillance, risk identification, preventive targeting, and resource allocation depend on these inputs, valid monitoring requires student self-reports rather than adult proxy reports alone. Full article

Introduction: Dating violence is an early form of intimate partner violence characterized by controlling behaviors, psychological and sexual abuse, and digital coercion. Despite its high prevalence among adolescents and young adults, it remains underrecognized and insufficiently addressed in healthcare settings. Nurses are strategically positioned to identify and respond to dating violence due to their close contact with patients and holistic approach to care. However, important gaps remain between existing protocols and their implementation in clinical practice. Methods: An exploratory qualitative study was conducted within a constructivist paradigm as part of a multicenter research project on dating violence among health sciences university students. Twelve experts, including nurses, healthcare professionals, and representatives of survivor-led organizations, participated in focus groups and reflective journals between September and December 2025 at the University of Barcelona. Data were analyzed using an interpretative phenomenological approach, with inductive thematic analysis guiding coding and theme development. Methodological rigor was ensured following the Consolidated Criteria for Reporting Qualitative Research (COREQ). Ethical approval was obtained. Results: Four themes emerged: (1) barriers to identification, including the normalization of controlling behaviors, myths of romantic love, and limited recognition of psychological and digital violence; (2) challenges in nursing responses, such as insufficient training, clinical uncertainty, organizational barriers, and lack of screening tools; (3) identification strategies, including systematic screening, relationship-centered interviewing, emotional education, and recognition of subtle warning signs; and (4) actions following identification, focused on validation, confidentiality, risk assessment, interdisciplinary referral, and ongoing support. Conclusions: Findings highlight the need to update protocols to explicitly address digital violence and strengthen nursing-led interventions. Participants emphasized the need for enhanced professional training, context-appropriate screening tools, and intersectoral collaboration as potential strategies to improve the identification and response to dating violence. Full article

Indigenous youth in Canada experience disproportionate mental health challenges, highlighting the need to better understand behavioural and contextual factors that influence wellbeing. This study examined associations between lifetime alcohol use and self-reported mental health among Indigenous adolescents, with attention to gender and age differences. Cross-sectional data from 64 participants in the Smart Indigenous Youth (SIY) study were analyzed using Fisher’s exact tests, stratified analyses, and logistic regression. In bivariate analyses, lifetime alcohol use was associated with lower odds of positive self-reported mental health (OR = 0.31, 95% CI [0.09–0.96], p = 0.042); however, this association attenuated after adjustment for gender (OR = 0.64, p = 0.631). Male youth had higher odds of positive mental health than female youth (OR = 4.99, 95% CI [1.65–15.10], p = 0.004). Although male participants reported greater land-based activity participation, land-based activity was not independently associated with mental health. Findings highlight the importance of considering gender alongside behavioural and contextual factors and support larger longitudinal studies using culturally relevant measures. Full article

Depressive symptoms are a prevalent mental health concern among older adults. This study examined whether the frequency of receptive arts engagement was associated with depressive symptom scores through leisure-related relaxation and subjective well-being in a specified serial mediation model. Using cross-sectional data from the 2023 Chinese General Social Survey (CGSS), we analyzed 2332 adults aged 60 years or older. Hierarchical regression and bias-corrected bootstrap mediation analyses with 5000 resamples were conducted to examine the proposed model. We found that more frequent art activities were significantly associated with fewer depressive symptoms. Three indirect associations were examined. The indirect association through leisure and relaxation alone was not significant, whereas the association through subjective well-being was the largest of the three tested pathways. A small serial indirect association through leisure and relaxation and subjective well-being was also identified. This model-specific pathway should not be interpreted as causal or as the primary mechanism of arts engagement. These findings describe one possible pathway linking receptive arts engagement to depressive symptoms among older adults. Further research should examine this pathway alongside other psychological, biological, social, and behavioral processes. Full article

Adolescence is a critical developmental period in which epilepsy can affect both health behaviors and psychological well-being. However, clinical indicators alone do not fully capture adolescents’ lived experience. Grounded in Self-Determination Theory, this study examined the cross-sectional associations among autonomy-supportive healthcare (ASH) environments, medication adherence, and life satisfaction in adolescents with epilepsy. A cross-sectional design was used with 1219 Italian adolescents with epilepsy (M age = 15.58, SD = 1.72), recruited through pediatric neurology clinics and national patient support organizations. Participants completed validated self-report measures: the Health Care Climate Questionnaire (HCCQ) for ASH, the Medication Adherence Report Scale (MARS) for medication adherence, and the Satisfaction With Life Scale (SWLS) for life satisfaction. A mediation model was tested to evaluate the indirectly associated paths among the variables. The mediation model showed a good fit to the data (χ²/df = 2.45, CFI = 0.994, RMSEA = 0.034, SRMR = 0.029). ASH was positively associated with both medication adherence (β = 0.40, p < 0.001) and life satisfaction (β = 0.23, p < 0.001), while medication adherence was positively associated with life satisfaction (β = 0.35, p < 0.001). The indirect statistical path from ASH to life satisfaction through medication adherence was also significant (β = 0.08, p < 0.001), indicating partial mediation. Overall, these findings highlight positive cross-sectional links between ASH environments, medication adherence, and psychological well-being in adolescents with epilepsy, underscoring the potential relevance of relational aspects of care in chronic disease management. Full article

Background: In the wake of the COVID-19 pandemic, nursing students and educators are navigating an increasingly complex academic environment. The rigorous demands of nursing education, combined with diminished academic preparedness and growing mental health concerns, have heightened the need for effective wellness interventions. The SKY Happiness Retreat©, an evidence-based program incorporating breathwork, meditation, and mindfulness practices, offers a potential strategy to enhance student resilience and reduce stress. Purpose: This pilot study examined the impact of integrating the SKY Happiness Retreat© into a Bachelor of Science in Nursing (BSN) program. This study evaluated whether participation reduced perceived stress and improved students’ ability to manage stressful situations. Methods: A quasi-experimental pretest–post-test design was used with junior-level BSN students recruited through convenience sampling at a rural university. Participants completed a structured three-day retreat focused on breathwork, meditation, and mindfulness. Outcomes were measured using the Mood and Anxiety Symptom Questionnaire (Mini-MASQ), the Perceived Stress Scale (PSS), and the Brief Resilience Scale (BRS). Results: Perceived stress significantly decreased following the intervention (PSS: pre M = 18.50, SD = 4.583; post M = 17.30, SD = 5.841; t(43) = 2.072, p = 0.022). General distress also significantly improved (Mini-MASQ: pre M = 15.51, SD = 6.535; post M = 12.82, SD = 5.118; t(44) = 3.941, p < 0.001). No significant changes were observed in anxious arousal or anhedonic depression. BRS scores demonstrated a modest increase in resilience. Conclusions: The SKY Happiness Retreat© shows promise as an experiential learning strategy within undergraduate nursing education. Findings suggest participation was associated with reductions in perceived stress and general distress while promoting resilience. Integrating evidence-based wellness programs into prelicensure nursing curricula may better prepare students to manage academic and professional stress. Larger, longitudinal studies are needed to evaluate long-term effectiveness. Full article

Background: Due to the rise in Alzheimer disease (AD) and AD-related dementias (AD/ADRD) in an aging population, millions of caregivers will be at risk for physical and mental health decline. As those they care for already have physical and cognitive impairment, it is crucial that caregivers maintain health-promoting behaviors. Because regular physical activity (PA) prevents functional loss and improves physical health and well-being, understanding how to help caregivers adopt and sustain PA despite unique time, caregiving, and self-efficacy barriers is a pressing public-health priority. Existing health-promoting interventions among dementia caregivers, including PA, have demonstrated limited success. To overcome the fragmentation and slow synthesis of behavioral science evidence, the Human Behavior-Change Project advocates theoretical grounding, systematic mapping of intervention components (e.g., behavior change techniques [BCTs]) using standardized taxonomies, and explicit specification of mechanisms of behavior change (MoBCs). Objective: To examine the limited success of health-promotion interventions among dementia caregivers we aimed to conduct a narrative review to synthesize evidence from interventions that evaluated PA in dementia caregivers across three domains: (1) use of behavioral theory to inform intervention design, (2) specification of BCTs, and (3) identification and measurement of MoBCs. Methods: Two scientific databases were searched to identify representative studies and reviews, using key terms including “physical activity”, “intervention”, “dementia”, and “caregiver” from inception to July 2025. Results: Seven primary intervention trials and six reviews were selected for inclusion. Gaps across the domains were identified to inform priority areas for future research. Conclusions: There is a need to develop tailored, theory-driven PA interventions that target empirically supported BCTs and MoBCs to improve dementia caregivers’ health and well-being. Full article

Background: Mental health has become a fundamental component of the sports world. Although previous studies have addressed psychological aspects of women’s soccer, no comprehensive review has mapped both mental health symptoms and adaptive psychological resources and psychophysiological markers in professional, semi-professional, and competitive adolescent women’s soccer. Objective: This scoping review aimed to map recent evidence from 2020 to 2025 on mental health in professional and semi-professional women’s soccer including competitive settings for adolescents, identifying key psychological constructs, assessment instruments, and risk and protective factors within the competitive sport context. Methods: Following the methodological guidelines of the Joanna Briggs Institute (JBI) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR), a systematic search was conducted in PubMed/MEDLINE, Scopus, and Web of Science. Thirteen empirical studies that explicitly assessed mental health dimensions in professional and semi-professional women’s soccer players were included. Results: The most frequently studied constructs were psychological stress, competitive anxiety, resilience, motivation, and well-being. The main risk factors included intense competitive demands, accumulated fatigue, and performance pressure. Predominant protective factors were individual resilience, social support, team cohesion, and self-confidence. The most used instruments were validated scales including the Brunel Mood Scale (BRUMS), Sport Anxiety Scale-2 (SAS-2), Competitive State Anxiety Inventory-2 Revised (CSAI-2R), Generalized Anxiety Disorder-7 (GAD-7), Sport Mental Health Assessment Tool-1 (SMHAT-1) and qualitative interviews. Resilience emerged as a central concept; although it was measured directly in only two studies, it emerged conceptually as a central theme in the evidence, and recent qualitative studies have highlighted the influence of the institutional environment and technical support. Conclusions: The available evidence which is heterogeneous and limited to 13 studies points to a growing body of research on mental health in women’s soccer, focused primarily on stress and resilience. However, significant gaps remain, including a lack of multi-season longitudinal studies tracking players across full competitive cycles, limited representation of Latin American and Asian contexts (one study each), the absence of position-specific analyses such as studies focused on goalkeepers and insufficient attention to positive well-being. Prospective and intervention-based studies are needed to develop a comprehensive understanding of mental health in elite sports and in competitive adolescent settings. Full article

Diabetes-related hypoglycemia contributes substantially to increased morbidity, mortality, health-care utilization, and reduced quality of life. Older adults with diabetes represent a heterogeneous group of patients who need individualized blood glucose targets to avoid hypoglycemia. Since the elderly present with varying degrees of functional and cognitive status and individualized health needs, their management varies among individuals. Complicating this, the hypoglycemia risk in older adults treated with insulin also varies due to aging, renal dysfunction, cognitive impairment, and other comorbidities. The challenge for healthcare providers is in considering all aspects of care in order to avoid hypoglycemia in elderly individuals. In this review, we introduce a Patient and Function Centric Approach to the assessment and management of hypoglycemia in older adults. This holistic framework extends beyond blood glucose values to systematically evaluate the other domains of patients’ health that influence hypoglycemia risk, including biochemical, medication, timing, autonomic, cognitive, mood, renal, pancreatic, hepatic, social, and physical function. The management of hypoglycemia in older adults should also include strategies to address both fear of hypoglycemia and hypoglycemia unawareness. In addition to physical limitations, the psychosocial barriers to self-care in older individuals with hypoglycemia are also of paramount importance. Using tools that measure diabetes burden, diabetes distress, and fear of hypoglycemia provides valuable insights into patient wellbeing. The use of newer anti-hyperglycemic medications, sensor-augmented insulin pump therapy, intranasal glucagon, and continuous glucose monitoring (CGM) has significantly contributed to reduced hypoglycemia incidence in individuals with diabetes. Overall, successful management requires a collaborative approach that empowers patients, respects their individual needs and preferences and helps them face the challenges associated with diabetes management with confidence rather than fear or anxiety. Adopting a patient- and function-centric approach to hypoglycemia management allows clinicians to move beyond a one-size-fits-all model and adopt individualized glycemic targets that improve overall diabetes control and mental well-being. Full article