Search Results (13,070)

Traffic accidents represent a significant threat to individuals, with motorcycles frequently involved. Despite concerted efforts by organizations like the World Health Organization and governments worldwide, reducing accident rates remains a challenge. Notably, Indonesia has witnessed a surge in traffic accidents, with motorcycles being a prominent mode of transport. This study aims to evaluate situational awareness and motorcycle riders’ behavior among Indonesians, with respect to factors such as riding time and age. This study involves laboratory-based research and uses quantitative primary data collected with the Situation Awareness Global Assessment Technique (SAGAT), the Situation Present Assessment Method (SPAM), and the Motorcycle Rider Behavior Questionnaire (MRBQ). The results indicate that overall situation awareness is low, with the lowest level among young riders. Nighttime situational awareness is also lower than during the daytime. Recommendations to improve situation awareness include periodic training with scenario-based sessions for motorcycle riders, strict adherence to driving regulations, the potential integration of motorcycle simulators, and prioritizing the program to enhance young riders’ situation awareness. These recommendations aim to boost rider safety and reduce motorcycle accidents. Full article

Background: Research concerning potential resolutions to immigrants’ health care access in Canada is limited, and the viewpoint of immigrant communities regarding priorities and feasible solutions remains inadequately captured. The objective of this article is to portray a research endeavor in which grassroots community members assumed the role of priority-setters for research on primary care access concerns. Aim: This cross-sectional study aimed to identify community-prioritized primary care access research topics among Nepalese Canadian immigrants in Calgary by ranking ten predefined issues based on perceived importance. Methods: We conducted community-based participatory research (CBPR) with the Nepalese community members in Canada. Participants were recruited using snowball sampling through community networks and rated topics using a 5-point Likert scale. A self-administered survey was used to collect participants’ rankings of ten predefined primary care access challenge themes. The themes were identified through comprehensive literature reviews undertaken by the research program team. The questionnaire was pilot-tested and refined based on feedback from team members before being administered. Results: A total of 401 Nepalese immigrants completed the survey, with 50.4% self-identifying as men. Among survey participants, significant gender differences were observed in sociodemographic characteristics, including age distribution, educational attainment, extended health insurance coverage, household income, and length of stay in Canada. Overall, health care cost and lack of resources were identified as the highest research priorities. While both men and women ranked these issues highly, women assigned greater priority to transportation- and culture-related barriers, whereas men generally assigned lower priority to these issues. Conclusions: There is a growing recognition that health solution priority-setting approaches should embrace transdisciplinary collaboration, with community participation as a pivotal factor. The results underscore the value of transdisciplinary, collaborative priority-setting approaches that center community participation to inform health research and interventions aligned with the needs of immigrant communities. Full article

Introduction: Despite improved health service accessibility, neonatal mortality in Ethiopia remains high at 33 per 1000 live births. Thus, improving health facilities’ readiness across infrastructure, basic amenities, equipment, medications, laboratory services, Kangaroo Mother Care, infection prevention and control, staffing, and guidelines availability is critical for improving the quality of neonatal care and survival. Objective: The aim of this study was to evaluate the readiness of Ethiopian hospitals to provide services to small and sick newborns. Methods: This was a cross-sectional study including 208 hospitals across four regions in Ethiopia in 2021–2024, prior to the implementation of the Saving Little Lives program. Data was collected using an adapted World Health Organization’s Service Availability and Readiness Assessment tool and are presented using composite scores. Results: The mean composite readiness score for the 208 hospitals for providing services to small and sick newborns in labour and delivery wards was 59%, with domain-specific scores of 47% for basic amenities, 56% for essential neonatal care, and 74% for newborn resuscitation. Significant variation was seen across hospital levels, and basic amenities were available in 68%, 49%, and 43%, essential neonatal care in 68%, 81%, and 71%, and newborn resuscitation in 68%, 66%, and 50% of referral, general, and primary hospitals, respectively. The mean composite readiness score to provide newborn care in the neonatal care units was 57%. Scores varied by hospital levels, with scores of 73%, 64%, and 50% for referral, general, and primary hospitals, respectively. Domain-specific scores were 63% for basic amenities, 65% for equipment, 67% for medications, 63% for laboratory services, 25% for Kangaroo Mother Care, 68% for infection prevention and control, 55% for staffing, and 51% for guidelines availability. Functional bCPAP machines were available in 14% of labour and delivery wards and in 35% of neonatal care units. Conclusions: There was a substantial gap in readiness to provide care for small and sick newborns, and significant variations across hospital levels. Immediate actions must be taken to address the observed gaps to reach the sustainable development goal of reducing neonatal mortality to at least 12 per 1000 live births by 2030. Full article

Purpose: The purpose of this preliminary study was to investigate the prevalence of Charles Bonnet Syndrome (CBS) among patients attending the National Centre of Service and Research for the Prevention of Blindness and Vision Rehabilitation of the Visually Impaired, Rome, Italy. Furthermore, the research aimed to delineate the psychological profile of these individuals to determine whether significant differences exist compared with visually impaired patients who do not experience hallucinatory phenomena and to identify likely predictors. Methods: A preliminary cross-sectional analysis was conducted on a convenience sample of patients recruited between January 2025 and December 2025. Prevalence was calculated based on structured clinical interviews, while the psychological profile was assessed by comparing the CBS group with a control group (non-CBS) matched for visual acuity. Participants underwent comprehensive ophthalmological and psychological assessments, including best-corrected visual acuity (BCVA), reading acuity (RA), contrast sensitivity (CS), fixation stability, and retinal sensitivity (RS). Psychological status was evaluated using the Symptom Check List-90-Revised (SCL-90-R), the Patient Health Questionnaire (PHQ-9), and the Generalized Anxiety Disorder Questionnaire (GAD-7). Patients experiencing CBS were further interviewed regarding the specific characteristics and patterns of their hallucinations. The association between CBS and both psychological profiles and visual function parameters was evaluated using regression analysis. Results: Out of 385 individuals screened, 120 participants (58% women; mean age 55.4 ± 18.8 years) were included; CBS was detected in 19%. No significant differences were observed between participants with and without CBS in demographic variables or psychological questionnaire scores (p > 0.05). Mean SCL-90-R, PHQ-9, and GAD-7 scores indicated mild psychological distress, depression, and anxiety, with no significant group differences (p > 0.05). Using standard cut-off values, depressive and anxiety symptoms were prevalent in 65% and 88% of participants, respectively, but were not significantly associated with CBS in chi-square or logistic regression analyses (p > 0.05). Logistic regression analysis of SCL-90 scores showed that only anxiety was significantly associated with hallucination occurrence among the visually impaired participants (OR = 0.27; 95% CI = 0.08–0.87; p < 0.05). Among the visual function parameters, poorer RA in the worse eye was significantly associated with CBS (p < 0.05). Conclusions: This study confirms that CBS is a prevalent, yet frequently under-reported, condition within rehabilitation settings. While overall visual function did not differ significantly between patients with and without CBS, reduced reading acuity (RA) in the worse eye emerged as a potential specific risk factor. Characterizing the psychological profile of these patients is essential to differentiate the syndrome from psychiatric disorders and to develop tailored support pathways. Despite its preliminary nature, this research underscores the necessity of systematic screening to enhance clinical management and the emotional well-being of visually impaired individuals. Consequently, integrating psychological support into visual rehabilitation programs is vital to addressing the high prevalence of comorbid anxiety and depression. Full article

Background: This structured narrative review summarizes and critically appraises evaluated childhood obesity prevention programs implemented in European countries and published between 2015 and 2024. Methods: Systematic searches for PubMed, EBSCOhost, and Google Scholar, complemented by research registries, were conducted year-by-year and independently screened by two reviewers. Results: Five multinational/international programs were identified alongside multiple national initiatives delivered in family, school, community, healthcare, and digital settings. Overall, interventions consistently improved intermediate outcomes—such as selected dietary behaviors, physical activity participation, knowledge, and parental self-efficacy—more than anthropometric endpoints. Effects on BMI/BMI z-score or overweight/obesity prevalence were heterogeneous and frequently small or non-significant, especially for short-duration, single-setting educational interventions. More favorable anthropometric outcomes were commonly reported in long-term, population-scaled physical activity or community-based programs as well as in multidisciplinary healthcare-supported approaches; however, these strategies were typically resource-intensive and sometimes showed differential effectiveness across socioeconomic or cultural groups. Conclusions: The evidence indicates that single-setting or short-term interventions may improve selected behavioral outcomes but are generally insufficient to produce sustained effects on anthropometric measures without integration into broader, multi-level strategies. It is needed to integrate families, schools, communities, and health services with explicit attention to sustainability and equity. Technology-supported tools may strengthen reach and continuity when embedded within comprehensive prevention frameworks. Full article

Cancer center infusion departments are often challenged with scheduling a large number of patients while having a limited number of nurses available to administer the infusions. Cancer patients have different acuity levels depending on many factors, such as treatment plans, drug side effects, and health status. Thus, several factors need to be considered when assigning patients to nurses, as unbalanced nurse-to-patient assignments affect patient flow and nurse workload. This study introduces a mixed-integer programming model for nurse–patient assignments that minimizes patient wait times while ensuring workload balance among oncology nurses, while addressing the limited attention in existing studies to jointly modeling patient acuity and nurse continuity. The model also explores the effects of maintaining nurse continuity for patients desiring the same nurse throughout their treatments. Because the mixed-integer programming model can become difficult to solve when there are many cancer patients, an alternative nurse–patient assignment heuristic is proposed and evaluated. Numerical examples based on data from a regional cancer center compare the effectiveness and performance of the exact and heuristic methods. The results show that patient wait time and workload variation among nurses increase when there is a stronger requirement to maintain nurse continuity, which could negatively affect both patient and nurse satisfaction. This study provides valuable insights into the nurse–patient assignment problem and helps cancer infusion centers determine the impacts of maintaining different levels of nurse continuity in their settings. Full article

Tuberculosis (TB) remains a major public health challenge in Peru, where interindividual variability in treatment response and drug-induced hepatotoxicity may be influenced by host genetic background. This study aimed to characterize clinically relevant polymorphisms in NAT2, CYP2E1, and SLCO1B1 in a cohort of TB patients from Southern Peru, a genetically underrepresented Andean population. Thirty-five adults receiving first-line therapy (isoniazid and rifampicin) underwent targeted Sanger sequencing of key functional variants among these three genes. NAT2 acetylator phenotypes were predominantly intermediate (68.6%), followed by rapid (20%) and slow (11.4%) profiles, with high minor allele frequencies for rs1041983 and rs1801280. CYP2E1 functional promoter variants were infrequent, whereas SLCO1B1 exhibited notable allelic heterogeneity, suggesting potential variability in rifampicin transport. Comparative analysis with previously reported Peruvian data revealed regional differences in acetylator distribution, supporting population-specific pharmacogenomic stratification. Although clinical toxicity outcomes were not evaluated, the high prevalence of reduced acetylation genotypes suggests a substantial proportion of patients may benefit from genotype-informed isoniazid dosing strategies. These findings provide foundational data for implementing precision medicine approaches using affordable and targeted technologies in TB management within Andean populations and support the integration of pharmacogenomics into national TB control programs. Full article

Background: The first 1000 days of life represent a critical window for developmental programming, during which specific nutritional exposures, such as vitamin D levels, may influence long-term health trajectories. Vitamin D plays a central role in skeletal development, but increasing evidence also supports its possible involvement in immune, metabolic, and neurodevelopmental processes during early life. In this narrative review, we summarize current evidence on the biological functions of vitamin D across the first 1000 days, focusing on its roles in skeletal, immune, metabolic, and neurodevelopmental processes, and its potential role as a programming factor. Methods: We conducted our research using the PubMed, Scopus, and Cochrane databases. We included systematic reviews, randomized controlled trials, and high-quality observational studies published from 2015 onward, focusing on pregnancy, neonatal life, and early childhood. Results: Vitamin D acts through placental, epigenetic, skeletal, immune, metabolic, and neurodevelopmental pathways that are particularly active during early development. Low maternal or early-life vitamin D status has been associated with adverse birth outcomes and impaired bone health. It has also been linked to increased susceptibility to infections and allergic diseases, altered metabolic trajectories, and mild neurodevelopmental differences. Evidence from supplementation trials remains heterogeneous, with benefits appearing more consistent in populations with baseline deficiency. Conclusions: Vitamin D fulfills several biological plausibility criteria for a potential early-life programming factor, although current human evidence remains heterogeneous. Full article

Background/Objectives: The Positive Parenting Program (Triple P) is an evidence-based intervention for families including young children with neurodevelopmental disorders. Because establishing a definitive diagnosis in early childhood takes time, especially for 1–3-year-olds who have only recently shown early signs, parents often experience substantial stress. This study examines the effectiveness of the Group Triple P (GTP) program for mothers of 1–3-year-old children without a confirmed diagnosis who spent time at a community parenting support center. Methods: The participants were 41 mothers of children aged 1–3 who did not confirmed neurodevelopmental diagnosis but showed behavioral, emotional, or developmental concerns, or whose mothers reported parenting difficulties. To reflect real community practices, a non-randomized pre–post test design without a control group was adopted. Assessments were conducted at baseline, postintervention, and at a 12 weeks follow-up using the Strengths and Difficulties Questionnaire, Parenting Scale, Parenting Experience Scale, and Depression Anxiety Stress Scale. Results: GTP improved the mothers’ assessments of positive behaviors in children who may have neurodevelopmental disorders, with a medium effect size. GTP reduced dysfunctional parenting styles in mothers with a large effect size. It also enhanced mothers’ confidence and fulfilling sense in parenting, and decreased depression and stress with a medium effect size. Perceived access to parenting support improved, contributing to better parenting adaptation with a medium effect size. Conclusion: GTP may serve as an early public health intervention for mothers of young children who may have neurodevelopmental disorders by supporting maternal mental health and promoting adaptive parenting. Full article

On 9–10 December 2025, the Coalition for Epidemic Preparedness Innovations (CEPI) and the International Vaccine Institute (IVI) convened a workshop in Seoul under CEPI’s Disease X Program. The primary objective was to identify existing gaps needing to be filled and streamline vaccine development and preparedness for Severe Fever with Thrombocytopenia Syndrome (SFTS). CEPI’s partners and experts discussed a multifaceted agenda, ranging from understanding the evolving epidemiology to the refinement of animal models and immunological assay harmonization. Key outcomes included the refinement of Target Product Profiles (TPPs) specifying use cases for both peacetime and outbreak contexts, alongside a recommendation for a core immunoassay panel aimed at harmonizing evaluation frameworks and mitigating the challenges posed by low SFTS prevalence. Integration of the One Health approach emerged as a critical strategy for SFTS prevention, complemented by proactive regulatory engagement to compress vaccine development timelines. This report summarizes these key insights from the workshop, delineating a strategic framework for delivering safe, effective, and accessible vaccines for SFTS and broader Disease X threats. Full article

Purpose: Anemia remains a major public health concern among vulnerable rural adolescent girls in many countries, including India. This study aimed to assess the prevalence of anemia, nutritional status, and anemia-related knowledge, attitudes, and practices (KAP) among school-going rural adolescent girls, along with predictors of KAP score, complemented by stakeholder perspectives. Methods: A mixed-methods cross-sectional study was conducted among 553 school-going adolescent girls aged 14–19, selected through a multi-stage stratified random sampling technique from three rural districts of Andhra Pradesh, India. Quantitative data were collected using a structured questionnaire assessing KAP, anthropometric measurements to collect Body Mass Index (BMI) and middle upper arm circumference (MUAC), dietary assessments using a dietary diversity score, and hemoglobin estimation using standardized procedures. Qualitative insights were obtained through focus group discussions (FGDs) with teachers, parents, frontline health workers, and community leaders and analyzed thematically. Logistic regression analysis was performed to identify predictors of KAP. Results: The prevalence of anemia among the participants was 55.3%, and 30.7% were underweight. Although over half of the girls demonstrated adequate knowledge of anemia, only 39.6% reported good anemia-preventive practices, indicating a significant gap between knowledge and practice. Dietary scores indicated micronutrient-deficient diet consumption by participants (36.2%), which might be contributing to anemia. Multivariable analysis revealed that maternal education, hemoglobin status, diet patterns, and type of school attended were significantly associated with KAP scores. Qualitative findings highlighted challenges related to health-seeking behavior, cultural misconceptions, gaps in awareness and implementation of existing adolescent health programs. Conclusions: Anemia remains highly prevalent among rural school-going adolescent girls in Andhra Pradesh, with suboptimal anemia-preventive practices despite moderate levels of knowledge. Strengthening school-based nutritional education, improving dietary diversity, and enhancing the reach and effectiveness of adolescent health programs through community engagement may help combat anemia. Full article

Scientific evidence shows that perception of adolescents’ psychological adjustment in residential care varies depending on the informant. This study examined discrepancies between adolescents’ self-reports and caregiver reports of psychological adjustment in 46 residential care institutions across Portugal. Data were collected from a sample of 511 adolescents (aged 12–24) and their institutional caregivers using the Strengths and Difficulties Questionnaire and the Socially Desirable Response Set-5. Descriptive statistics and paired-samples t-tests were conducted to compare mean scores between informants. Intraclass correlation coefficients and Cohen’s Kappa were calculated to assess agreement. Results revealed significant differences across all subscales and the total difficulties score, with adolescents consistently reporting more emotional, behavioral, and peer-related problems than caregivers, regardless of sex or age. Agreement ranged from poor to moderate, with the lowest concordance for internalizing symptoms. These discrepancies underscore the role of developmental factors in shaping self- and caregiver perceptions and highlight the importance of multi-informant, developmentally sensitive assessments in residential care. Practical implications include incorporating adolescents’ perspectives into evaluation and intervention, enhancing caregiver training to recognize internalizing issues, and implementing age- and gender-tailored mental health programs. Full article

Background: Recent data show that approximately 3.8% of the global population has a diagnosis of depression. Understanding psychological risk and protective factors is crucial for improving prevention strategies and mental health interventions. Among these, worry and emotional intelligence (EI) have emerged as relevant, yet they are rarely studied together. To date, no studies that analyzed the relationship between emotional intelligence, worry, and depression have been found. Therefore, this study aims to investigate the association among EI, worry, and depression. Methods: This study included 924 participants (N = 806 non-clinical and N = 118 subclinical sample with elevated depressive symptoms), with a mean age of M = 25.55 years (SD = 11.38). A total of 118 participants (12.8%) met the criteria for clinical depression based on the BDI-II cut-off. All participants completed the Penn State Worry Questionnaire, the Beck Depression Inventory-II, and the Emotional Intelligence Scale. To examine the relationships among all variables examined, zero-order correlation coefficients were calculated. To investigate the predictive power of EI and worry on depression, Bayesian linear regression was conducted. Results: The results showed significant and positive correlations between worry and depression in both samples. EI showed significant and negative correlations with both depression and worry in both the subclinical sample with elevated depressive symptoms and the non-clinical sample. Finally, worry emerged as the strongest contributor to the somatic dimension of depression in both groups. In the subclinical sample with elevated depressive symptoms, age and Evaluation and Expression of Emotion to Self, along with worry, were the best predictors of somatic symptoms. Conclusions: Our data suggest that higher worry levels are associated with higher levels of depressive symptoms, whereas higher EI was negatively associated with depressive symptoms and may play a potential buffering role. Training programs designed to enhance EI could help mitigate the impact of negative events, improve problem-solving skills, and enhance the expression of one’s own emotions. Full article

Background: Frailty is highly prevalent among older adults with cardiovascular disease (CVD) and strongly predicts disability and mortality after cardiac events. Although cardiac rehabilitation (CR) improves prognosis, frail older patients often face barriers to participating in in-person programs. eHealth-based, home-delivered CR programs incorporating tele-rehabilitation and remote monitoring may improve accessibility, yet evidence regarding their effectiveness on frailty status remains limited. Methods: We designed a multicenter, randomized, parallel-group trial enrolling people ≥65 years recently hospitalized for acute heart failure (AHF) and/or acute coronary syndrome (ACS). Participants were randomized 1:1 to an eHealth home-based tele-rehabilitation program or the usual care. The primary endpoint is frailty prevalence at follow-up, defined by an Essential Frailty Toolset (EFT) score ≥3, with co-primary outcomes being between-group differences in the mean levels of EFT and Short Physical Performance Battery (SPPB) scores after 3–6 months. Secondary endpoints include mortality and hospitalization, among others. Results: The full protocol and study procedures are reported. Between May 2024 and December 2025, 589 patients were screened at the two Italian centers involved; 442 met eligibility criteria and 209 were enrolled and randomized. Baseline characteristics were largely comparable between groups. The mean age was 77 ± 9 years, 70% were male, and 55% had ACS. Lower-than-expected enrollment was mainly attributable to refusal related to difficulties in using digital devices. Conclusions: This randomized trial will evaluate whether a multidomain, eHealth-based CR intervention can reduce the prevalence or degree of frailty in older people after AHF or ACS. We report the study protocol and baseline characteristics of the enrolled cohort, highlighting the challenge of digital illiteracy in contemporary older populations. Full article

Background/Objectives: Breastfeeding represents a critical developmental window during which maternal biology, environmental exposures, and nutrition converge to influence infant gastrointestinal health and long-term developmental trajectories. From a One Health perspective, breastfeeding can be conceptualized not as a static nutritional act, but as a dynamic and modifiable biological system in which maternal factors shape early-life microbiota assembly and immune programming. This narrative review explores how microbiota-oriented strategies during breastfeeding may foster a favorable trajectory of infant health, potentially extending to transgenerational outcomes. Methods: This narrative review is structured around a ten-point decalogue addressing interconnected domains relevant to the maternal–milk–infant microbiota axis, including maternal diet, microbial diversity, environmental exposures, psychological stress and probiotic use. Current mechanistic and clinical evidence was examined to evaluate how these domains may modulate microbiota composition and function during breastfeeding. Attention was given to probiotic supplementation, including strain specificity, timing of administration, and clinical context, as well as to the broader implications of a One Health framework. Results: Available evidence suggests that maternal nutritional patterns, environmental and psychosocial exposures, and targeted microbiota-modulation strategies may influence the composition and functional properties of human milk and the developing infant microbiota. Probiotic use during breastfeeding appears to have strain-specific and context-dependent effects, with potential benefits in selected clinical scenarios. However, findings remain heterogeneous, and uncertainties persist regarding optimal strains, timing, and long-term outcomes. Conclusions: Breastfeeding can be understood as a dynamic biological interface shaped by maternal and environmental factors. Integrating microbiota-oriented strategies within a One Health framework may support infant gastrointestinal health and possibly contribute to longer-term developmental trajectories. Nevertheless, careful interpretation of the current evidence is warranted to avoid reductionist, supplement-centered approaches and to prevent maternal overmedicalization or blame. Full article