Search Results (1,021)

In recent studies, public health has been considered a key stakeholder in climate mitigation and adaptation in cities since they are more exposed to the impact of climate change. Nurses represent a vast majority of public health professionals, playing a key role in health promotion that allows them to influence individuals, families, and communities in adopting healthier behaviours and decarbonized lifestyles. Therefore, the purpose of this study is to map the existing evidence on nursing interventions, which are being led or implemented to reduce the health risks related to climate change in urban areas. The present review follows the JBI methodological framework, including a search on PubMed, MEDLINE complete, CINAHL Complete, Scopus, Web of Science, SciELO (Scientific Electronic Library Online), BASE (Bielefeld Academic Search Engine), and RCAAP. Hand searched references were also considered, including quantitative, qualitative, and mixed-methods studies between January 2014 and October 2024, for a more contemporary perspective. A three-step search strategy and data extraction tool were used by two independent reviewers. Twenty-seven studies in English and Portuguese were eligible for inclusion, all targeting a population of professionals with nursing-related roles: two case studies, one Delphi panel, one descriptive study, one historical research paper, two using a methodological design format, four narrative reviews, one observational study, nine review articles, three scoping reviews, and three systematic reviews. Eight categories of nursing interventions that contribute to decarbonized lifestyles, reducing health risks in relation to climate change, were acknowledged. Nurses play a key role in empowering individuals, families, and communities, promoting climate awareness and literacy, supporting health policy change, advocating for the most vulnerable and engaging in environmental activism, using evidence-based research, and taking advantage of marketing strategies and social media. Full article

Periodontal disease is a common and serious oral disease among older adults. As the global older population increases, preventing periodontal disease is vital for healthy ageing. Poor oral hygiene, uncontrolled diabetes, and smoking are key risk factors of periodontal disease. Improving oral hygiene, diabetes management, and quitting smoking are essential health behavioural change interventions to manage periodontal disease. The objective of this study is to review the prevention of periodontal disease among older adults through health behavioural change interventions. Effective strategies to improve oral hygiene include personalised education on proper brushing and interdental cleaning. Educating caregivers is equally important as they supervise care-dependent older adults to maintain oral health. For those with diabetes, physical activity improves glycated haemoglobin levels and clinical periodontal parameters by reducing reactive oxygen species and systemic inflammation. Smoking cessation could be achieved through a multi-faceted approach. Effective smoking cessation combines brief interventions with intensive behavioural/pharmacological support for long-term success, especially in highly dependent individuals. Tailored strategies for older adults, integrated care, and expanded research improve outcomes and health equity in ageing populations. In conclusion, health behavioural change interventions are non-invasive preventive measures that include oral hygiene reinforcement, diabetic management, and smoking cessation. Prioritising these interventions empowers older adults to maintain oral health, reducing disease burden and enhancing overall well-being for healthy ageing. Full article

Generative artificial intelligence (AI) is changing higher education. Understanding students’ perceptions, usage behaviour and ethical concerns is crucial for the responsible and sustainable use of AI in the academic environment. The aim of this study was to explore the perceptions, experiences and challenges of health sciences students in relation to the use of generative AI in their academic learning. A descriptive cross-sectional survey was conducted with 397 students enrolled in four undergraduate health-related degree programmes in Slovenia, including nursing, physiotherapy, dietetics and applied kinesiology. The data was collected using a validated 27-point scale. Students were generally favourable towards AI, especially in terms of its perceived usefulness, integration into their daily study routine and ethical considerations. Regression analyses revealed that frequency of AI use, duration of use, self-reported skill level and confidence in using AI significantly predicted perceived usefulness. Gender differences were found, with male students reporting higher perceived usefulness and fewer concerns. Students recognised the potential of generative AI but emphasised the importance of ethical guidance, digital literacy and equal access. Institutions should prioritise structured training and inclusive strategies to ensure meaningful, sustainable and responsible integration of AI into health education. Full article

Background: Self-harm in young people is influenced by multiple factors, with media playing a significant role. While research has examined its harmful and protective effects, little attention has been paid to how healthcare professionals interpret and respond to media’s role in shaping young people’s experiences of self-harm. To our knowledge, no research has examined adolescent mental health professionals’ perspectives and, crucially, how these are constructed and understood. The study aimed to examine the following: (1) how mental health practitioners construct and use discourses to interpret the role of media in young people’s self-harm; and (2) how these discourses shape clinical understanding and practice. Methods: This qualitative study employed semi-structured interviews with ten clinicians from child and adolescent mental health services across England working with young people who self-harm. Data were analysed using critical discourse analysis to uncover how broader societal and institutional narratives shape clinicians’ perspectives. Results: Two dominant discourses were identified: “Media as Disruptor” and “The Hidden World of Youth”. These discourses framed media as both a risk factor and a potential intervention tool, positioning media as a powerful yet morally ambiguous force in young people’s lives. Clinicians largely framed media’s influence as negative but acknowledged its capacity for education and intervention. Conclusions: This research offers new insights into how media-related self-harm risks and benefits are framed and managed in mental health care settings. The study underscores the need for systemic changes in clinical practice, enhanced training, updated guidelines and a shift towards broader sociocultural perspectives in understanding self-harm and suicidal behaviour. Full article

Background: Antimicrobial resistance (AMR) poses a critical global health challenge, particularly in resource-limited settings. A hub-and-spoke model, decentralising expertise and distributing resources to peripheral facilities, has been proposed as a strategy to enhance the antimicrobial stewardship (AMS) capacity in low- and middle-income countries. Aim: This study sought to understand healthcare professionals’ experiences of a hub-and-spoke AMS model in the Volta Region of Ghana and its influence on clinical practice, leadership, and collaborative endeavours to address AMR. Methods: A qualitative descriptive design was adopted. In-depth interviews were conducted with 11 healthcare professionals who participated in the AMS program. Thematic analysis was used to identify key themes related to the knowledge and skills that were gained, clinical and leadership practice changes, capacity building, and challenges. Results: Participants reported an increased awareness of AMR, particularly regarding the scale and clinical implications of antimicrobial misuse. The clinical practice improvements included more judicious prescribing and enhanced adherence to infection prevention and control measures. Many respondents highlighted stronger leadership skills and a commitment to capacity building through AMS committees, multidisciplinary collaboration, and cross-organisational knowledge exchange. Despite resource constraints and logistical hurdles, participants expressed optimism, citing data-driven approaches such as point prevalence surveys to track progress and inform policy. Engagement with hospital management and public outreach were viewed as essential to sustaining AMS efforts and curbing over-the-counter antibiotic misuse. Conclusions: The hub-and-spoke model caused observable improvements in AMS knowledge, clinical practice, and leadership capacity among healthcare professionals in Ghana. While challenges remain, particularly in securing sustainable resources and shifting community behaviours, these findings underscore the potential of network-based programs to catalyse systemic changes in tackling AMR. Future research should explore long-term outcomes and strategies for embedding AMS practices more deeply within healthcare systems and communities. Full article

Walking and cycling, as active modes of transportation, play a vital role in advancing sustainable urban mobility by reducing emissions and improving public health. However, widespread adoption faces challenges such as inadequate infrastructure, safety concerns, socio-cultural barriers, and policy limitations. This study systematically reviewed 56 peer-reviewed articles from 2004 to 2024, across 30 countries across five continents, employing the Capability, Opportunity and Motivation-Behaviour (COM-B) framework to identify the main drivers of walking and cycling behaviours. Findings highlight that the lack of dedicated infrastructure, inadequate enforcement of road safety measures, personal and traffic safety concerns, and social stigmas collectively hinder active mobility. Strategic interventions such as developing integrated cycling networks, financial incentives, urban planning initiatives, and behavioural change programs have promoted increased engagement in walking and cycling. Enhancing urban mobility further requires investment in pedestrian and cycling infrastructure, improved integration with public transportation, the implementation of traffic-calming measures, and public education campaigns. Post-pandemic initiatives to establish new pedestrian and cycling spaces offer a unique opportunity to establish enduring changes that support active transportation. The study suggests expanding protected cycling lanes and integrating pedestrian pathways with public transit systems to strengthen safety and accessibility. Additionally, leveraging digital tools can enhance mobility planning and coordination. Future research is needed to explore the potential of artificial intelligence in enhancing mobility analysis, supporting the development of climate-resilient infrastructure, and informing transport policies that integrate gender perspectives to better understand long-term behavioural changes. Coordinated policy efforts and targeted investments can lead to more equitable transportation access, support sustainability goals, and alleviate urban traffic congestion. Full article

Pregnancy and birth are biological processes shaped by social factors, requiring sociological approaches to explain reproductive behaviour. This narrative review outlines the importance of health sociology against the background that health and illness behaviour is influenced by the social environment. The aim of this paper is to summarize the current state of research on the influence of social systems and social milieu behaviour on reproduction, pregnancy, and childbirth in order to make it easier for midwives and doctors to take these factors into account in their everyday clinical and outpatient work. First, the paper lays out the basics of how health and illness are socially constructed, looking at it from both a structural and action-oriented perspective. It then goes on to explain what this means for pregnancy and childbirth as social processes, how women’s health is related to the social construction of gender roles, that breastfeeding is also a social process, and what conclusions can be drawn for the work of midwives. Pregnancy and birth are social processes based on norms and role attributions: “Decisions” regarding one’s own reproductivity are usually only “self-determined” to a limited extent and tend to occur in the context of social norms and milieu-specific role expectations. The promotion of women’s health depends on how milieu-specific norms and logics of action are understood. For all the professions involved in obstetrics, this results in the need for a critical examination of the sociological aspects of health. This implies the necessity for all obstetric professions to critically examine aspects of the sociology of health in order to provide women and their families with appropriate, evidence-based and client-centred care in the context of pregnancy, birth and the postpartum period, against the background of constant social change. Full article

Background/Objectives: The EAT-Lancet Commission proposed a healthy and sustainable ‘planetary health diet’ (PHD) based on the nutritional needs of adults, but recommended for all population groups over the age of two years. This study investigated the extent to which UK adolescent diets meet these recommendations, and the association between meeting recommendations and nutritional intake. Methods: Dietary intake data collected from students aged 11–15 years between 2019 and 2022 as part of the Food provision, cUlture and Environment in secondary schooLs (FUEL) study was used. Specifically, 24 h intakes of food groups and key nutrients were summarised for each participant, and micronutrient intake was expressed as a percentage of the reference nutrient intake (RNI). The proportion of participants meeting each PHD recommendation was calculated. A PHD index score was developed to measure the overall adherence to recommendations. Multilevel linear regression models were fitted to explore the association between the PHD score and intake of each nutrient. Results: No participants fully met the recommendations. The mean PHD score was 14.2 (3.3) out of 39. Adherence was low for the emphasised foods, and lowest for nuts (1.3%) and unsaturated oils (0.2%). Higher PHD index scores were associated with lower intakes of all micronutrients, with the largest association for vitamin B12 [regression coefficient: −12.9% (95% CI: −16.3, −9.4) of RNI] and the smallest for vitamin D [regression coefficient: −0.4 (95% CI: −0.7, −0.2) of RNI]. Conclusions: Substantial dietary changes are needed for this population group to meet the PHD guidelines. Further research should focus on why these recommendations may lead to the inadequate intake of some nutrients in this age group. We propose that the PHD guidance needs to be reviewed and potentially adapted for this specific population, with consideration of the typical dietary behaviours of this age group. Full article

Background: To examine the association between allostatic load and the progression of multimorbidity and the role of socioeconomic factors among older Americans. Methods: Data from the Health and Retirement Study (HRS), a longitudinal study of older American adults, were used. Data were included from waves 8 (2006), 10 (2010), 11 (2012), and 13 (2016). Self-reported diagnoses of five chronic conditions (diabetes, heart disease, lung diseases, cancer, and stroke) indicated multimorbidity and were dichotomised to reflect having two or more conditions versus one or fewer. Multimorbidity in 2006 was subtracted from that in 2016 to calculate ten-year change in multimorbidity. Sociodemographic data (age, gender, education, and wealth) were from wave 8 (2006). Behaviours (physical activity and smoking) were from wave 10 (2010). Allostatic load, indicated by five biomarkers (waist circumference, high blood pressure, glycosylated haemoglobin, high-density lipoprotein, and c-reactive protein), was from wave 11 (2012). Structural Equation Modelling (SEM) was used to assess the longitudinal association between the aforementioned factors and the incidence of multimorbidity in 2016. Results: Given that allostatic load was assessed in a subsample of HRS, 8222 were excluded for lack of relevant data. A total of 3336 participants were included in the final analysis. The incidence of multimorbidity in 2016 was 19%. Allostatic load in 2012 was significantly associated with the incidence of multimorbidity in 2016 (estimate 0.10, 95% Confidence Interval (CI) 0.07, 0.14); in other words, for an additional marker of allostatic load, there was an average 0.1 change in the incidence of multimorbidity. Wealth and education (2006) were indirectly associated with multimorbidity through allostatic load and behaviours. Smoking (2010) was positively associated with multimorbidity in 2016, while physical activity showed a negative association. Conclusions: Biological markers of stress indicated by allostatic load were associated with multimorbidity. Adverse socioeconomic conditions appear to induce allostatic load and risk behaviours, which impact the progression of multimorbidity. Full article

Globally, unhealthy dietary behaviours are consistently seen to significantly contribute to the burden caused by diet-related diseases (DRDs). This is particularly evident among adolescents, a demographic that are at a critical stage of development for lifelong eating habits. This study aims to map the efficacy of post-primary school-based nutritional education (NE) interventions in the modification of adolescent dietary behaviours. A scoping review methodology was implemented, following the Joanna Briggs Institute framework, and adhering to PRISMA-ScR guidelines. Peer-reviewed research from 2015 to 2024 was thoroughly searched using the PubMed and Scopus databases, with inclusion criteria centred on school-based NE interventions aimed at changing post-primary students’ eating habits. In total, 50 studies were selected for analysis, which were then further categorised into five key intervention approaches: knowledge and behaviour-focused programmes, DRD-specific interventions, gamified or interactive learning methods, peer-led or externally facilitated programmes, and school food environment modifications. The findings indicate that structured NE interventions, particularly those incorporating behavioural theories, show positive outcomes in enhancing adolescent dietary knowledge and self-efficacy. The gamified interventions and interactive approaches demonstrated high engagement among participants, but the success of long-term changes was varied. The interventions addressing DRDs, especially obesity, showed significant impacts when combining educational components with structural modifications to school food environments. Peer-led models improved relatability and participation rates but faced challenges in terms of standardisation and repeatability. While school-based NE interventions effectively improve adolescent nutritional knowledge and behaviours, future research should focus on long-term follow-up assessments to determine the sustainability of these changes. These findings offer valuable insights for educators designing curricula, policymakers developing school health strategies, and practitioners seeking to implement feasible, evidence-based nutrition programmes in diverse educational settings. Full article

Air pollution poses a serious threat to both public health and the environment, contributing to millions of premature deaths worldwide each year. The integration of augmented reality (AR), blockchain, and the Internet of Things (IoT) technologies can provide a transformative approach to collaborative air quality monitoring (AQM), enabling real-time, transparent, and intuitive access to environmental data for community awareness, behavioural change, informed decision-making, and proactive responses to pollution challenges. This article presents a unified vision of the key elements and technologies to consider when designing such AQM systems, allowing dynamic and user-friendly immersive air quality data visualization interfaces, secure and trusted data storage, fine-grained data collection through crowdsourcing, and active community learning and participation. It serves as a conceptual basis for any design and implementation of such systems. Full article

Background: Dementia is a syndrome with a high global prevalence that includes a number of progressive diseases of the brain affecting various cognitive domains such as memory and thinking and the performance of daily activities. It manifests as symptoms which often include significant mood and behaviour changes that are highly varied. Changed moods and behaviours due to dementia may reflect distress and may be stressful for both the person living with dementia and their informal and formal carers. To provide dementia care support specific to mood and behaviour changes, the Behaviours in Dementia Toolkit website (BiDT) was developed using human-centred design principles. The BiDT houses a user-friendly, digital library of over 300 free, practical, and evidence-informed resources to help all care partners better understand and compassionately respond to behaviours in dementia so they can support people with dementia to live well. Objective: (1) To characterize the users that visited the BiDT; and (2) to understand the platform’s early impact on these users. Methods: A multi-method, descriptive study was conducted in the early post-website launch period. Outcomes and measures examined included the following: (1) reach: unique visitors, region, unique visits, return visits, bounce rate; (2) engagement: engaged users, engaged sessions, session duration, pages viewed, engagement rate per webpage, search terms, resources accessed; (3) knowledge change; (4) behaviour change; and (5) website impact: relevance, feasibility, intention to use, improving access and use of dementia guidance, recommend to others. Data was collected using Google Analytics and an electronic survey of website users. Results: From 4 February to 31 March 2024, there were 76,890 unique visitors to the BiDT from 109 countries. Of 76,890 unique visitors to the BiDT during this period, 16,626 were engaged users as defined by Google Analytics (22%) from 80 countries. The highest number of unique engaged users were from Canada (n = 8124) with an engagement rate of 38%. From 5 March 2024 to 31 March 2024, 100 electronic surveys were completed by website users and included in the analysis. Website users indicated that the BiDT validated or increased their dementia care knowledge, beliefs, and activities (82%) and they reported that the website validated their current care approaches or increased their ability to provide care (78%). Further, 77% of respondents indicated that they intend to continue using the BiDT and 81.6% said that they would recommend it to others to review and adopt. Conclusions: The BiDT is a promising tool for sharing practical and evidence-informed information resources to support people experiencing dementia-related mood and behaviour changes. Early evaluation of the website has demonstrated significant reach and engagement with users in Canada and internationally. Survey data also demonstrated high ratings of website relevance, feasibility, intention to use, knowledge change, practice support, and its contribution to dementia guidance. Full article

Background: The rise in antimicrobial-resistant (AMR) strains of Neisseria gonorrhoeae is internationally recognised as a critical public health concern, with limited treatment options available. The urgency of this issue prompted the European Centre for Disease Prevention and Control to establish ‘EURO-GASP’ to monitor trends in resistance and address developments. Comprehensive data on AMR strains in people living with HIV (PLHIV) is limited, especially in Cyprus. Objectives: To analyse trends in rates of resistant N. gonorrhoeae infections and identify any correlations between patient factors that may contribute to such in PLHIV in The Republic of Cyprus. Methods: We conducted a retrospective chart review study on N. gonorrhoea resistance among PLHIV from the Gregorios HIV reference clinic in Larnaca, Cyprus, between 2015 and 2023. Antimicrobial susceptibility was assessed via disc diffusion or gradient strip method on GC II agar against a non-homogenous panel of antibiotic preparations, based on standard laboratory practice variation. Demographic and clinical data, including antibiograms, treatments and test of cure, were recorded. Statistical analysis was performed using Stata v16, with significance set at p < 0.05. The study received approval from the Cyprus National Bioethics Committee. Results: A total of 45 isolates from 39 patients were analysed, with 62% of these demonstrating resistance to at least one antibiotic. Resistance rates were not shown to change over time. We identified a statistically significant linear association between a person having a history of an STI and the number of antibiotics which the isolate is resistant to (β = 1.2; p: 0.004). Notably, a single isolate demonstrated resistance to ceftriaxone, the first-line treatment currently recommended in both Europe and the United States. This finding is particularly alarming given the critical role of ceftriaxone in the management of gonorrhoea. Conclusions: Whilst there has been no increase in resistance rates over time, the detection of ceftriaxone-resistant N. gonorrhoeae is a significant public health concern. Given that having a history of an STI makes a person more likely to develop a resistant infection, PLHIV or those who engage in risky sexual behaviours are particularly vulnerable. There is a pressing need to enhance surveillance and implement routine susceptibility testing in Cyprus, given the country’s role as a major international hub for travel and migration. Molecular analysis can further improve our understanding. Additionally, the global public health community must urgently prioritise the development of novel therapeutic agents for the treatment of gonorrhoea. Full article

Introduction: Children living in low- and middle-income countries (LMICs) are at increased risk of emotional and behavioural challenges, often linked to caregiver stress and harsh parenting practices. Strengthening family functioning through parenting interventions is a critical strategy for improving child mental health in these settings. The Strong Families programme was developed as a light-touch family skills intervention for high-stress, low-resource environments. Methods: A multisite pilot feasibility and acceptability study was conducted in Cambodia with 40 families. Caregivers and children (aged 8–15) participated in a 3-week intervention, with one session per week. Data were collected using the Parenting and Family Adjustment Scales (PAFAS), the Strengths and Difficulties Questionnaire (SDQ), and the Child and Youth Resilience Measure (CYRM-R) at baseline, two weeks, and six weeks post-intervention. Repeated measures ANOVA and Friedman’s ANOVA were used to assess changes over time. Results: Caregivers showed statistically significant improvements across all PAFAS subscales. For example, coercive parenting scores decreased from 8.13 at baseline to 4.00 post-intervention and 2.33 at follow-up (F(2,78) = 59.76, p < 0.001). Positive encouragement improved from 2.60 to 1.00 and 0.33, respectively (F(2,78) = 27.05, p < 0.001). In terms of child outcomes, SDQ total difficulty scores declined from 20.68 to 16.55 over time (F(2,78) = 7.58, p = 0.001). Emotional problems dropped from 5.60 to 2.38 (χ²(2) = 21.17, p < 0.001), and conduct problems from 4.33 to 2.68 (F(2,78) = 11.35, p < 0.001). Prosocial behaviours increased from 5.60 to 9.45 (F(2,78) = 69.93, p < 0.001). Personal resilience scores rose from 32.70 at baseline to 47.48 at follow-up (χ²(2) = 62.42, p < 0.001), while caregiver resilience improved from 23.63 to 33.63 (χ²(2) = 61.83, p < 0.001). Improvements were particularly pronounced among families with the highest baseline challenges. Conclusions: Findings indicate that the Strong Families programme is feasible and effective in improving parenting skills, family adjustment, child mental health, and resilience in a Cambodian LMIC context. These results reinforce the programme’s potential for integration into broader national strategies to improve psychosocial outcomes for families in high-stress, low-resource environments. Full article

Urban environments and climate-related challenges impact older adults’ health and well-being. To address these challenges, climate adaptation strategies and urban design guidelines should be tailored to older adults’ needs. Ethnographic studies can help identify these needs by involving them directly in the research process. This study uses ethnographic research to explore older adults’ perceptions and behaviours regarding climate change risks and impacts, health, and mobility challenges in a vulnerable urban area—São Roque da Lameira, Porto, Portugal. It studies the applicability and complementarity of four participatory methods that can inform urban design: (I) semi-structured interviews, (II) ‘go-along’ interviews, (III) user observations, and (IV) emotional mapping. The qualitative data collected were analysed through thematic and spatial analysis. Common themes emerged between the four methods, including concerns about accessibility, safety, and comfort, such as uneven pavements, lack of seating, and poor infrastructure for people with reduced mobility. Participants recommended improvements, such as more green spaces and better pedestrian infrastructure quality. Notably, each method uncovered distinct dimensions, highlighting the added value of a multi-method approach. This study demonstrates that combining participatory methods offers deeper, context-specific insights to inform age-friendly and climate-resilient urban design. Future research should take climate-focused methods and a multidisciplinary approach into consideration. Full article