Search Results (2,483)

Background: Multiple sclerosis (MS) is a condition that requires long-term, multidisciplinary management. The growing digital transformation in healthcare has highlighted the central role of nurses in supporting key aspects such as patient self-management, continuity of (at home) care, and patient empowerment. However, evidence on nurse-led digital interventions in MS remains fragmented. Objective: To map the available literature on nurse-led digital interventions in MS, focusing on the role of nurses, clinical outcomes, and research gaps. Methods: The review was conducted using the methodological framework of the Joanna Briggs Institute (JBI) and the PRISMA-ScR checklist. A systematic search was performed in PubMed, Scopus, Web of Science, and CINAHL. Studies were included if they described digital or telehealth interventions led or coordinated by nurses in patients with MS. Results: A total of 12 studies published between 2015 and 2025 met the inclusion criteria. Four main thematic areas were identified: (1) telenursing and empowerment-based interventions; (2) mobile and web-based patient self-management programs; (3) digital systems for monitoring and integrated care pathways; and (4) digital interventions targeting symptom management and psychosocial outcomes. Across the studies, nurse-led digital interventions were associated with improvements in self-management, treatment adherence, self-efficacy, and health-promoting behaviors. Positive effects were also reported on clinical outcomes such as fatigue, sleep quality, and balance, as well as on psychosocial variables including quality of life, coping strategies, and emotional well-being. Furthermore, the identified systems, in general, contributed to enhanced continuity of care, patient engagement, and organizational efficiency. Conclusions: Nurse-led digital interventions represent a promising approach in the management of patients with multiple sclerosis, supporting both clinical and psychosocial outcomes while enhancing continuity of care. However, the current evidence base remains limited by small sample sizes, heterogeneity of interventions, and short follow-up periods. Future research should prioritize multicenter randomized studies with larger samples and long-term follow-up to strengthen the evidence. Additionally, the integration of digital interventions into routine clinical practice, along with targeted training for nurses, is essential to ensure sustainability, accessibility, and equitable implementation. Further studies should also explore cost-effectiveness and the impact on caregivers and long-term quality of life. Full article

Environmental degradation caused by unsustainable farming practices has depleted soil resources across sub-Saharan Africa. Conservation agriculture (CA) has been promoted to reverse this damage, yet outcomes remain variable, and the role of long-term training is underexplored. Using propensity score matching with 238 smallholder households across five communities in Ghana, we examine the impacts of long-term CA training. Specifically, we assess whether participation in a training program characterized by repeated engagement and follow-up workshops improves yields, farmer knowledge of soil health, and soil indicators (nitrogen and carbon). Farmers receiving long-term CA training did not exhibit significantly better soil chemical metrics. However, they demonstrated significantly more accurate knowledge of soil health (nitrogen, p < 0.001; carbon, p < 0.05), produced a 10.7% higher maize yield (kg/acre) (p < 0.001), and reported fewer soil problems, including fertilizer runoff, top-soil erosion, and waterlogging, compared to conventional farmers (all p < 0.05). We conclude that long-term CA training enhances farmer knowledge and maize yields, suggesting it is a critical intervention for improving productivity and farm management resilience, even where direct improvements in measured soil metrics are not immediately detectable. These findings highlight the need for training programs to emphasize the full suite of CA principles and for evaluation timeframes of 5–10 years to capture soil regeneration. Full article

This study aimed to analyze the observed variations in the research competencies of first-year nursing students following the implementation of a pedagogical problem-solving strategy based on Polya’s method and integrated with STEM technological resources. The study was conducted within the context of higher education, where strengthening research skills in the early stages of academic training continues to represent a formative challenge. A pre-experimental pretest–posttest design with a single group was employed, involving 69 students enrolled in an introductory research course. The intervention was implemented over 16 weeks and structured according to the four phases of Polya’s method—understanding the problem, planning, execution, and review—while also integrating the use of a STEM educational kit and visual programming tools. The results showed descriptive increases across all evaluated dimensions. The overall mean score increased between the pretest and posttest, revealing statistically significant differences in research competencies (p < 0.001) and a large effect size (r = 0.896). Likewise, significant differences were identified in the dimensions related to research background and objectives, development of research activities, and evaluation of results. In contrast, the dimension concerning problem identification and formulation did not show statistically significant differences, suggesting that this competency may require longer formative processes and greater academic support. Although the results suggest favorable associations between the implemented strategy and the observed variations in research competencies, these findings should be interpreted with caution due to the limitations inherent to the pre-experimental design employed. In this sense, the study provides preliminary evidence regarding the pedagogical potential of integrating problem-solving and STEM technological resources to promote the early development of research competencies in university students in the health sciences. Full article

Background/Objectives: Adolescence is a crucial stage of development, in which life skills are essential for promoting psychological well-being. Social and Emotional Learning (SEL) interventions aim to develop social–emotional and relational skills that foster resilience and adaptation. Short-term effects may be nonlinear and influenced by gender differences, with possible fluctuations in self-assessments due to increased social–emotional awareness (response shift). Methods: This action research study involved 179 preteens (ages 11–17) from educational settings in Aosta Valley. The SEL program consisted of three experiential sessions on key life skills, led by psychologists and psychiatrists and including group activities and role-playing. Quality of life was assessed before and after the intervention using the Q-LES-Q, which measures satisfaction and well-being in the areas of social relationships, physical health, academic performance, leisure activities, and subjective feelings. Subscale scores were calculated as the mean of the corresponding items. Results: The results revealed nonlinear patterns: a decline in satisfaction with social relationships, which may reflect a response shift. Males reported higher initial levels and greater perceived positive effects, while females reported lower post-intervention scores, likely due to greater self-reflection and self-criticism. Conclusions: The data highlight the complexity of the short-term effects of SEL interventions and the importance of considering developmental trajectories and gender differences when evaluating their effectiveness. Full article

High-nickel NCA/Si–C 21700 cells exhibit strongly condition-dependent degradation, but the coupled influence of temperature and rate on electrochemical, thermal, and structural evolution remains insufficiently resolved. Here, Samsung INR21700-50E cells were aged under a 3 × 3 matrix of ambient temperatures (0, 23, and 40 °C) and C-rates (0.5C, 1C, and 2C). Periodic reference performance tests were used to track capacity, 10 s direct-current internal resistance, electrochemical impedance, pseudo-open-circuit voltage, differential voltage/incremental capacity behavior, heat generation, and post-mortem morphology. Guided by the hypothesis that temperature and rate history change not only the speed but also the dominant pathway of aging, the results show that both ambient temperature and the charge/discharge rate program govern the aging trajectory. Low-temperature cycling accelerates capacity loss and resistance growth through severe polarization and lithium plating, indicating dominant loss of lithium inventory. High-temperature operation promotes interfacial side reactions, impedance rise, and cathode structural degradation, leading to stronger loss of active material at later stages. An increasing C-rate amplifies these effects by raising overpotential and thermal load. Heat generation power increases markedly with aging and depends strongly on temperature–rate history. Scanning electron microscopy confirms cathode cracking, anode surface film thickening, and separator degradation under severe conditions. These experimental indicators are integrated into a mechanism-aware diagnostic framework that maps capacity retention, DCIR/EIS parameters, ICA/DVA indices, and heat generation metrics to dominant aging modes, supporting BMS state-of-health estimation, lifetime prediction, thermal management, and second-life screening of high-nickel NCA cells. The condition-averaged trajectories are further converted into a semi-empirical aging law that links capacity loss, resistance growth, and heat generation increase for BMS-oriented lifetime prediction. Full article

Introduction: Evidence supports using multicomponent lifestyle medicine programs to alleviate depression, yet few studies detail the program development process. This study aimed to systematically develop a complex lifestyle medicine program for depression based on Traditional Chinese Medicine theory. Methods: A stepwise, multi-method study was conducted. The preparation phase involved understanding the public health issue, identifying resources, and reviewing published evidence. Based on these results, a Delphi survey was performed, followed by an analysis of the context understanding as well as design and refinement of the program. Subsequently, the program was modeled, and a program theory was developed, incorporating explanations and assumptions in a relevant conceptual framework and logic model. Results: A complex lifestyle medicine program and program manual were established. The program involves three major themes, each with six 120 min weekly consecutive sessions: nourishing the heart (two sessions), nourishing according to the time (two sessions), and nourishing the Qi (two sessions). The program covered TCM theory and practice to promote healthy sleep, diet, stress management, and self-administered acupressure and TCM exercise. Teaching materials were created accordingly. Conclusions: This study reports the development of a complex multicomponent TCM lifestyle medicine program to relieve depression thoroughly and transparently, with a specific focus on the Hong Kong context and a particular focus on TCM theory. The developed program will be examined for feasibility, acceptability, and preliminary efficacy in alleviating depression in a mixed-methods clinical study. Full article

Mental health disorders among adolescents have risen significantly in recent years, particularly following the COVID-19 pandemic, highlighting the need for effective preventive and supportive interventions. Nurses play a key role in the promotion, early detection, and management of mental health issues in adolescents, both in school and community settings. This study aimed to synthesize quantitative and qualitative evidence on the role, effectiveness, and implementation of nursing interventions for adolescent mental health. A systematic mixed-methods review was conducted in accordance with the PRISMA 2020 guidelines. It was registered in PROSPERO (CRD42024502076). Databases including PubMed, Scopus, SciELO, Dialnet, BVS, and Cuiden were searched for studies published between 2014 and 2024. Twelve studies met the inclusion criteria, comprising randomized and non-randomized quantitative studies, qualitative studies, and previous reviews. The interventions identified included cognitive-behavioral therapy programs, resilience and life skills training, physical activity initiatives, digital interventions, and mental health literacy strategies. Overall, the findings suggest improvements in symptoms of anxiety and depression, coping skills, resilience, and knowledge about mental health, particularly in structured school-based programs. Qualitative evidence highlighted the importance of accessibility, multidisciplinary collaboration, cultural sensitivity, and sustained commitment for successful implementation. However, considerable heterogeneity was observed in study designs, interventions, and outcome measures. In conclusion, nursing interventions can make a positive contribution to adolescents’ mental health, particularly in school and community settings. However, further rigorous, long-term studies are needed to strengthen the evidence base. Full article

Background: Armed conflict and geopolitical instability increasingly affect mental health beyond directly exposed populations through continuous media exposure and digital information dissemination. Nursing students may be particularly vulnerable because of high academic demands, emotional sensitivity to human suffering, and intensive engagement with social media and online news platforms. This study examined the association between conflict related news exposure and depression, anxiety, and stress among nursing students in Saudi Arabia during the February 2026 regional military escalation involving Iran, and explored the role of perceived safety concern and the potential indirect associations involving sleep difficulty and study disruption. Methods: A multi-center cross sectional study was conducted among nursing students from different public universities across five regions of Saudi Arabia. Psychological distress was assessed using the Depression Anxiety Stress Scale. A composite conflict exposure index was developed from conflict news following frequency and exposure intensity measures. We used Gamma generalized linear models, interaction analyses, and structural equation modeling to evaluate associations, moderation by information source, and mediation pathways. Results were reported as arithmetic mean ratios (AMRs) with 95% confidence intervals, representing the relative change in mean psychological distress scores associated with each predictor. Models were adjusted for sociodemographic, academic, and living-related factors. Results: A total of 247 nursing students were included. Moderate to severe depression, anxiety, and stress were reported by 50.2%, 59.9%, and 32.4% of participants, respectively. Our findings showed that higher conflict exposure was associated with increased stress levels (AMR = 1.17, 95% CI: 1.02–1.34), while associations with depression (AMR = 1.14, 95% CI: 0.99–1.30) and anxiety (AMR = 1.13, 95% CI: 0.99–1.28) were weaker. Associations between conflict-related exposure and depression, anxiety, and stress were substantially attenuated after accounting for perceived safety concern, which remained strongly associated with all psychological distress outcomes (AMR = 1.32, 95% CI: 1.19–1.47), anxiety (AMR = 1.31, 95% CI: 1.18–1.44), and stress (AMR = 1.36, 95% CI: 1.24–1.51). Compared with television news users, students relying on online news demonstrated substantially higher depression (AMR = 1.92, 95% CI: 1.32–2.78), anxiety (AMR = 1.84, 95% CI: 1.29–2.64), and stress scores (AMR = 1.88, 95% CI: 1.29–2.74). Structural equation modeling identified significant indirect associations involving sleep difficulty and study disruption, whereas direct associations between exposure and psychological distress were comparatively weak. Conclusions: Conflict-related media exposure was associated with poorer mental health among nursing students, with perceived insecurity, sleep difficulties, and study disruption showing strong associations with psychological distress and patterns consistent with indirect relationships. Universities and nursing education programs should consider implementing mental health support, media literacy interventions, sleep health promotion, and psychosocial support strategies during periods of regional geopolitical instability. Full article

(1) Background: Genomic medicine—i.e., the use of laboratory-based biomarkers that measure the expression, function and regulation of genes and gene products to aid healthcare decision making is a rapidly emerging technology. Readiness to consider and adopt new testing programs effectively and avoid critical challenges requires health systems to harbor a number of key conditions that address infrastructural, as well operational and other needs. This assessment re-examines Canada’s state of readiness since a previously published 2023 assessment. (2) Methods: A mixed-methods approach of a review of the literature and key informant interviews with a purposive sample of experts was used. Health system readiness was assessed using a previously published set of conditions. (3) Results: This updated analysis of Canada’s state of readiness for genetic and genomic testing reveals Canada is only partially ready for a future of genomic medicine, although some progress has been made since 2023. The most established conditions were the use of appropriate service models and the integration of innovation and healthcare delivery functions. They suggest that Canada’s major healthcare regions are moving closer to a state of readiness for the consideration and adoption of new testing required for genomic medicine, although using different approaches and at different rates. These findings should be seen as generalizable to other regions internationally—health systems need to have functions that promote responsiveness and resilience, i.e., are able to recognize valuable innovation and quickly shift priorities and create conditions necessary to enable it. Full article

Falls among older adults are a major public health concern. Older adults living in low-income housing (LIH) are at higher risk of falls due to disadvantages linked to social determinants of health, yet remain underrepresented in research. This study aimed to assess the feasibility of a program addressing fear of falling and its consequences on activity levels among older adults living in LIH in Côte-des-Neiges (Montreal, QC, Canada). A mixed-methods pilot feasibility study was conducted using Bowen et al.’s framework, drawing on data collected through questionnaires, observation grids, attendance records, and semi-structured interviews. The program consisted of six 90 min sessions designed to enhance participants’ confidence in preventing falls while promoting engagement in activities. Fourteen older adults (mean age = 75.5 years) were recruited. Outcome data on fall-related psychological factors, activity engagement, and knowledge about falls were collected before and after the program. Moreover, older participants’ perceived benefits were assessed following program completion. Post-program interviews with older adults, facilitators, and a community field worker were conducted to further explore program feasibility, including its acceptability, implementation, and integration. The program showed strong acceptability and a high attendance rate (95%). Although no statistically significant pre-post changes were observed in the outcome variables, older participants reported several benefits at post-test, including improved knowledge about fall prevention (100%) and greater confidence in their ability to avoid falls (85%). These findings support the feasibility of implementing this culturally adapted fall prevention program in similar LIH settings and provide valuable insights for its refinement and future research. Further investigation is warranted to examine the program’s feasibility across other LIH settings and linguistic groups, as well as to assess its effectiveness. Full article

Chronic kidney disease (CKD) affects millions globally and represents a major health burden. This narrative review adopts a life-course perspective to synthesize current evidence on CKD as a consequence of adverse early-life exposures that disrupt nephrogenesis, leading to kidney programming and reduced nephron endowment. The objective of this review is to integrate emerging mechanistic and translational evidence linking developmental programming, gut microbiota, and redox biology within a unified gut–redox axis framework, and to identify potential targets for early-life prevention of CKD. Central to this process is the gut–redox axis, a bidirectional network linking gut microbiota with host redox homeostasis. A balanced axis preserves epithelial integrity, metabolic stability, and immune regulation, whereas dysbiosis and oxidative stress form a self-perpetuating cycle that promotes CKD and related comorbidities. Maternal oxidative stress and impaired microbial transmission exacerbate early-life dysbiosis, persistent epigenetic alterations, and nephron deficits. In adulthood, protein-bound uremic toxins amplify oxidative injury and inflammation, further perturbing microbial composition. Experimental and clinical studies show that early-life interventions—including probiotics, prebiotics, postbiotics, antioxidants, and toxin-lowering strategies—can restore gut–redox balance and improve renal outcomes. These insights highlight opportunities for precision prevention and mechanism-based therapies targeting CKD across the life course. Full article

Placenta-derived extracellular vesicles (EVs), particularly exosomes, serve as key mediators that influence metabolic programming in offspring under adverse early nutritional conditions, such as maternal obesity or gestational diabetes. They respond to maternal nutritional disturbances—such as obesity or gestational diabetes—by altering the composition of the miRNAs and proteins they carry. Evidence from in vivo and in vitro studies suggests that these modified EVs influence offspring metabolic programming through multiple putative pathways: regulating fetal pancreatic β-cell development and function, modulating lipogenesis via PPARγ signaling, affecting placental angiogenesis, and promoting inflammation and epigenetic alterations. By transmitting maternal environmental signals to the fetus, placental EVs are hypothesized to contribute to long-term metabolic phenotypes and disease susceptibility. This review critically examines the current evidence positioning placental EVs as key messengers in maternal–fetal communication, evaluates the strength of evidence supporting their role in shaping offspring metabolic health, identifies major knowledge gaps (e.g., limited direct evidence in human offspring, lack of standardized isolation methods), and suggests their potential as early intervention biomarkers or therapeutic targets for preventing metabolic disorders in offspring. We also highlight the need for prospective cohort studies and mechanistic validation in appropriate animal models to establish causality. Full article

Indigenous women experience a disproportionate burden of adverse perinatal health outcomes, yet the extent and nature of health promotion interventions addressing modifiable behavioural and social determinants remain poorly synthesised. This scoping review mapped smoking, nutrition, alcohol, physical exercise, and social and emotional wellbeing (SNAPS(o))-related perinatal health promotion programs delivered through Australian Aboriginal Community Controlled Health Organisations (ACCHOs), supplemented by relevant peer-reviewed evidence identified across Australia, Aotearoa New Zealand, Canada, and the United States. A two-phase design looked at peer-reviewed literature from January 2010 to January 2025 across PubMed, CINAHL, and the Cochrane Library, followed by a structured review of Aboriginal Community Controlled Health Organisation (ACCHO) websites in Australia (n = 145). Data were extracted on program characteristics, SNAPS(o) components, implementation models, and evaluation outcomes. Findings were synthesised using content analysis. Thirty-four programs were identified in total, most delivered through ACCHOs (n = 26) and predominantly implemented in Australia (n = 29). Smoking was the most frequently addressed component (n = 18, 55%), while nutrition and social and emotional wellbeing were each included in 27% of programs (n = 9), physical exercise in 18% (n = 6), and alcohol in 15% (n = 5). Grey-literature programs more commonly reflected multi-component, holistic models compared with peer-reviewed studies and formal evaluations. Only 10 programs had identifiable formal evaluation evidence, including published or publicly reported evaluations, almost all of which were identified through academic sources. Evaluations focused primarily on tobacco-related behavioural outcomes, with limited reporting of sustained maternal or infant health endpoints. The perinatal SNAPS(o) intervention landscape for Indigenous women is characterised by strong community-controlled delivery but limited published evaluation, particularly of integrated models implemented within ACCHOs. The concentration of evidence on smoking cessation highlights a need to expand evaluation across broader domains of maternal wellbeing. Strengthening Indigenous-led evaluation frameworks and outcome measures that reflect holistic models of care is essential to advancing equitable and culturally grounded perinatal health systems. Full article

Preventing sexual risk behaviors among early adolescents is essential, as it may delay premature sexual initiation and reduce the incidence of sexually transmitted infections. This quasi-experimental study aimed to evaluate the effectiveness of a sexual health literacy promotion program in enhancing preventive sexual risk behaviors among lower secondary school students. The sample consisted of 114 eighth-grade students selected through multistage sampling and assigned to either an intervention group or a control group, with 57 participants in each group. The intervention group received the sexual health literacy promotion program (CoMMIT program), based on the health literacy framework and comprising five structured learning activities. The control group received the standard curriculum. Data were collected using demographic, sexual health literacy, and sexual risk behavior prevention questionnaires. Measurements were conducted at pre-intervention, post-intervention, and one-month follow-up. Data were analyzed using two-way mixed-design repeated measures ANOVA and independent t-tests. The intervention group demonstrated significantly higher mean scores for sexual health literacy and preventive sexual risk behaviors at post-intervention and one-month follow-up compared with baseline and the control group (p < 0.001). Large effect sizes were observed for sexual health literacy (η² = 0.932) and sexual risk behaviors prevention (η² = 0.791). The CoMMIT program effectively improved sexual health literacy and preventive sexual risk behaviors among lower secondary school students and is recommended for implementation in secondary schools to promote adolescent sexual health. Full article

This study assessed physical activity (PA) levels and energy expenditure among students across various medical disciplines at Wroclaw Medical University. Data were collected in late 2024 using the International Physical Activity Questionnaire (IPAQ) long-form. Statistical analysis, including Mann–Whitney U and Kruskal–Wallis tests were used to reveal significant differences based on gender, age, and field of study. While female students generally achieved higher metabolic equivalent (MET) MET-min/week values at home and in transport, male students demonstrated significantly higher scores in total physical activity, total vigorous physical activity, and vigorous activity in free time. Gender based analysis did not reveal any statistically significant differences. Significant variations across study programs were observed only in occupational PA, same as in age-related analysis. The findings highlight sedentary risks within specific student subgroups, which may contribute to professional burnout and diminished effectiveness as future health promoters. Consequently, the study suggests that medical institutions should incorporate lifestyle medicine and health promotion strategies into their curricula to foster the long-term well-being of future healthcare professionals. Full article