Search Results (3,997)

Background: Exposure-based cognitive behavioral therapy (Ex-CBT) is widely seen as the gold-standard treatment for anxiety and obsessive-compulsive disorder (OCD). Yet, minoritized youth are underrepresented in efficacy studies, raising questions about the applicability of Ex-CBT to minoritized youth. Effectiveness data suggest systematic adaptation of Ex-CBT to address youth culture and context is likely needed, and many clinicians make adaptations and augmentations in practice. However, research on the specific strategies clinicians use to address their youth clients’ culture and context within anxiety and OCD treatment is lacking. In the current study, we assess practice-based adaptations, augmentations, and process-based approaches utilized when delivering treatment to youth for OCD and anxiety in public mental health clinics. Methods: We conducted qualitative interviews with 16 clinicians from both specialty anxiety and general mental health clinics serving youth with anxiety or OCD in the public mental health system. Participating clinicians had a mean age of 32.19 (SD = 5.87) and 69% of therapists identified as female; 69% identified as White, 25% identified as Asian, and 6% as Black or African American. In qualitative interviews, clinicians shared how they addressed clients’ culture and context (e.g., social identities, stressors and strengths related to social identities and lived environment). Thematic analysis identified the strategies clinicians employed to address culture and context. Results: Clinicians reported incorporating culture and context through process-based approaches (e.g., building trust gradually, considering clients’ social identity stressors, engaging in self-awareness to facilitate cultural responsiveness) and through culturally adapting and augmenting treatment to promote person-centered care. Core strategies included proactive and ongoing assessment of clients’ cultural and contextual factors, adapting exposures and augmenting Ex-CBT with strategies such as case management and discussion of cultural context, and taking a systems-informed approach to care. Conclusions: Examining practice-based adaptations, augmentations, and process-based approaches to treatment for minoritized youth with OCD or anxiety can inform efforts to understand what comprises person-centered culturally responsive Ex-CBT. Empirical testing of identified strategies is a needed area of future research. Full article

The global Black Lives Matter movement and COVID-19 pandemic drew attention to the urgency of addressing entrenched structural dynamics such as racialization, gender, and colonization shaping health inequities for diverse racialized people. Canadian community-based research with racialized immigrant women recognized the need to enhance service provider capacity using a strengths-based activism approach to support client health and wellbeing. In this study, we aimed to understand the impacts of this mental health promotion practice on service providers and strategies to support them. Through purposeful convenience sampling, three focus groups were completed with 19 service providers working in settlement and mental health services in Toronto, Canada. Participants represented varied ethnicities and work experiences; most self-identified as female and racialized, with experiences living as immigrant women in Canada. Postcolonial feminist and critical mental health promotion analysis illuminated organizational and structural dynamics contributing to burnout and vicarious trauma that necessitate a focus on trauma- and violence-informed care. Transformative narratives reflected service provider resilience and activism, which aligned with and challenged mainstream biomedical approaches to mental health promotion. Implications include employing a postcolonial feminist lens to identify meaningful and comprehensive anti-oppression strategies that take colonialism, racialization, gender, and ableism and their intersections into account to decolonize nursing practices. Promoting health equity for diverse racialized women necessitates focused attention and multilevel anti-oppression strategies aligned with critical mental health promotion practices. Full article

Zoological environments aim to promote natural behaviours and optimal welfare conditions. Over the past decade, research on the use of artificial ultraviolet-B (UV-B) exposure has improved vitamin D₃ levels and reduced incidences of metabolic bone disease in diurnal primates; however, this has not been investigated in nocturnals. Aye-ayes (Daubentonia madagascariensis), nocturnal lemurs often housed indoors in zoos with little to no exposure to natural sunlight, have been reported to have low vitamin D₃ levels. This study aims to investigate the impacts of artificial UV-B as a supplemental healthcare strategy for aye-ayes, examining its influences on vitamin D₃ levels and positional sleeping behaviour. The 25-hydroxy-vitamin D₃ (25OHD₃) blood levels were tested before and after exposure to different levels of artificial UV-B and heat sources. Statistical analysis showed no correlation between UV-B and 25OHD₃ at group parameter levels. However, one individual showed a positive correlation. Sleeping position duration analysis showed a potential basking behaviour with the use of increased ear exposure and other thermoregulatory responses. Despite representing 8.06% of the European captive aye-aye population, these findings highlight the need for further research on vitamin D₃ parameters and responses to UV-B to optimise captive conditions and support the species’ long-term health. Full article

The increase in the elderly population globally reflects a change in the population’s mindset regarding preventive health measures and necessitates a rethinking of healthcare strategies. The integration of machine learning (ML)-type algorithms in geriatrics represents a direction for optimizing prevention, diagnosis, prediction, monitoring, and treatment. This paper presents a systematic review of the scientific literature published between 1 January 2020 and 31 May 2025. The paper is based on the applicability of ML techniques in the field of geriatrics. The study is conducted using the Web of Science database for a detailed discussion. The most studied algorithms in research articles are Random Forest, Extreme Gradient Boosting, and support vector machines. They are preferred due to their performance in processing incomplete clinical data. The performance metrics reported in the analyzed papers include the accuracy, sensitivity, F1-score, and Area under the Receiver Operating Characteristic Curve. Nine search categories are investigated through four databases: WOS, PubMed, Scopus, and IEEE. A comparative analysis shows that the field of geriatrics, through an ML approach in the context of elderly nutrition, is insufficiently explored, as evidenced by the 61 articles analyzed from the four databases. The analysis highlights gaps regarding the explainability of the models used, the transparency of cross-sectional datasets, and the validity of the data in real clinical contexts. The paper highlights the potential of ML models in transforming geriatrics within the context of personalized predictive care and outlines a series of future research directions, recommending the development of standardized databases, the integration of algorithmic explanations, the promotion of interdisciplinary collaborations, and the implementation of ethical norms of artificial intelligence in geriatric medical practice. Full article

Avocado (Persea americana), originally from Mesoamerica, has emerged as a focus of intense scientific and industrial interest due to its unique combination of nutritional richness, bioactive potential, and technological versatility. Its pulp, widely consumed across the globe, is notably abundant in monounsaturated fatty acids, especially oleic acid, which can comprise over two-thirds of its lipid content. In addition, it provides significant levels of dietary fiber, fat-soluble vitamins such as A, D, E and K, carotenoids, tocopherols, and phytosterols like β-sitosterol. These constituents are consistently associated with antioxidant, anti-inflammatory, glycemic regulatory, and cardioprotective effects, supported by a growing body of experimental and clinical evidence. This review offers a comprehensive and critical synthesis of the chemical composition and functional properties of avocado, with particular emphasis on its lipid profile, phenolic compounds, and phytosterols. It also explores recent advances in environmentally sustainable extraction techniques, including ultrasound-assisted and microwave-assisted processes, as well as the application of natural deep eutectic solvents. These technologies have demonstrated improved efficiency in recovering bioactives while aligning with the principles of green chemistry. The use of avocado-derived ingredients in nanostructured delivery systems and their incorporation into functional foods, cosmetics, and health-promoting formulations is discussed in detail. Additionally, the potential of native cultivars and the application of precision nutrition strategies are identified as promising avenues for future innovation. Taken together, the findings underscore the avocado’s relevance as a high-value matrix for sustainable development. Future research should focus on optimizing extraction protocols, clarifying pharmacokinetic behavior, and ensuring long-term safety in diverse applications. Full article

This study aims to understand the meaning nursing professionals attribute to their lived experiences of providing humanized care within a public hospital setting. Grounded in Jean Watson’s theory of human caring, the research adopts a qualitative, descriptive phenomenological design to capture the perceptions and emotions of nurses regarding humanized care. Data were collected through semi-structured interviews with nine experienced nurses, selected through purposive sampling. The interviews, conducted virtually between July and December 2024, were analyzed using Colaizzi’s method and supported by Atlas.ti software. Four main thematic categories emerged: institutional health policies, professional image and identity, strengths and challenges in care, and essential competencies for humanized care. The findings highlight the critical role of empathy, cultural sensitivity, ethical commitment, and emotional presence in delivering compassionate care. Participants emphasized that, beyond clinical procedures, humanized care requires relational and contextual sensitivity, often hindered by institutional limitations and excessive administrative burdens. The study concludes that nursing professionals are key agents in promoting ethical, empathetic, and culturally respectful practices that humanize health services. These insights offer valuable contributions for designing policies and training strategies aimed at strengthening humanized care as a cornerstone of quality healthcare systems. Full article

Aging is a complex physiological process that profoundly affects the functionality of the musculoskeletal system, contributing to an increase in the incidence of diseases such as osteoporosis, osteoarthritis, and sarcopenia. Cellular senescence plays a crucial role in these degenerative processes, promoting chronic inflammation and tissue dysfunction through the senescence-associated secretory phenotype (SASP). Recently, senotherapeutics have shown promising results in improving musculoskeletal health. Natural compounds such as resveratrol, rapamycin, quercetin, curcumin, vitamin E, genistein, fisetin, and epicatechin act on key signaling pathways, offering protective effects against musculoskeletal decline. On the other hand, molecules such as dasatinib, navitoclax, UBX0101, panobinostat, and metformin have been shown to be effective in eliminating or modulating senescent cells. However, understanding the mechanisms of action, long-term safety, and bioavailability remain areas for further investigation. In this context, physical exercise emerges as an effective non-pharmacological countermeasure, capable of directly modulating cellular senescence and promoting tissue regeneration, representing an integrated strategy to combat age-related diseases. Therefore, we have provided an overview of the main anti-aging compounds and examined the potential of physical exercise as a strategy in the management of age-related musculoskeletal disorders. Further studies should focus on identifying synergistic combinations of pharmacological and non-pharmacological interventions to optimize the effectiveness of anti-aging strategies and promoting healthier musculoskeletal aging. Full article

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline, memory loss, and neuronal dysfunction. It is driven by the accumulation of amyloid-beta (Aβ) plaques, Tau protein hyperphosphorylation, oxidative stress, and neuroinflammation. Resveratrol (RSV) is a natural polyphenolic compound found in grapes, berries, and red wine that has garnered attention for its potential neuroprotective properties in combating AD. The neuroprotective effects of RSV are mediated through the activation of sirtuins (SIRT1), inhibition of Aβ aggregation, modulation of Tau protein phosphorylation, and the attenuation of oxidative stress and inflammatory responses. RSV also enhances mitochondrial function and promotes autophagy, which are important processes for maintaining neuronal health. Preclinical studies have demonstrated its efficacy in reducing Aβ burden, improving cognitive performance, and mitigating synaptic damage; however, challenges such as poor bioavailability, rapid metabolism, and limited blood–brain barrier penetration restrict its clinical applicability. Recent technological advances and selected modifications are being explored to overcome these limitations and enhance its therapeutic efficacy. This review summarizes the multifaceted neuroprotective mechanisms of RSV, the synergistic potential of natural compounds in enhancing neuroprotection, and the advancements in formulation strategies aimed at mitigating AD pathology. Leveraging the therapeutic potential of natural compounds represents a compelling paradigm shift for AD management, paving the way for future clinical applications. Full article

Background/Objectives: Military Service Members (SMs) require optimal nutrition to support health, readiness, and job performance. However, they often fall short of meeting nutrition guidelines. This study aimed to determine the impact and feasibility of implementing the U.S. Marine Corps (USMC) “Fueled to Fight^®” (F2F) nutrition program in non-appropriated fund (NAF) food venues. Objectives included evaluating changes in Military Nutrition Environment Assessment Tool (mNEAT) scores, feasibility of implementing and maintaining F2F strategies, and influence on customer purchasing patterns. Methods: Researchers conducted a pre-post interventional study from January to December 2024 at three NAF food venues across two USMC bases. F2F strategies, including identifying items using a stoplight color coding system (Green = healthy, Yellow = less healthy, Red = least healthy), menu revisions, food placement, promotion, and marketing, were implemented. Data included mNEAT assessments, sales reports, and stakeholder focus groups. Generalized Estimating Equations models were used to analyze sales data. Results: mNEAT scores increased across all venues post-intervention. Availability and sales of Green items increased, while sales of Red items decreased in some venues. Profit increased at all three food venues. Focus groups revealed feasibility and provided insights for future interventions. Conclusions: F2F interventions in NAF food venues are feasible and can positively impact the food environment and customer purchasing patterns without negatively affecting profit. This study highlights the importance of integrating nutrition programs into all military food venues, not just government-funded dining facilities, to support the nutritional fitness and readiness of SMs. Full article

With the global aging population on the rise, identifying environmental factors that modulate immunosenescence is critical for health interventions. While urban green spaces are known to confer health benefits, the long-term effects of forest exposure on immunosenescence remain unclear. This study investigated the differential impacts of urban forest versus urban environments on immunosenescence using a D-galactose-induced murine model. Mice were assigned to urban or forest environments for 8 weeks, with serum cytokines (IL-2, IL-6, TNF-α, IFN-γ), T-cell subsets, and organ indices analyzed. Forest environments exhibited significantly higher humidity and negative air ion concentrations alongside lower noise levels compared to urban settings. Aged forest-exposed mice showed attenuated immunosenescence markers, including significantly lower IL-6 levels (p < 0.01) and improved thymic indices, suggesting urban forest environments may mitigate immune decline. These findings highlight the potential of urban forests in promoting healthy aging, advocating for their integration into urban planning. Further human studies are warranted to translate these findings into public health strategies. Full article

Background/Objectives: The social importance of health literacy (HL) is widely understood, and its measurement is the subject of various studies. Due to the recent pandemic, several instruments for measuring HL about COVID-19 have been proposed in different countries, including the HLS-COVID-Q22 questionnaire. The diversity of cultures and languages necessitates the cross-cultural adaptation of this instrument. Thus, the present study translates, adapts, and validates the psychometric properties of the HLS-COVID-Q22 questionnaire to provide its cross-cultural adaptation from English to Spanish (Peru). Methods: As part of ensuring that the final questionnaire accommodates the cultural nuances and idiosyncrasies of the target language, the following activities were carried out: (a) a survey of 40 respondents; and (b) a focus group with 10 participants, followed by expert approval. In addition, the validity and reliability of the health instrument have been ascertained through a further pilot test administered to 490 people in the city of Tacna in southern Peru. Results: The resulting questionnaire helps measure HL in Peru, aiding better-informed decision-making for individual health choices. Conclusions: The presence of such a tool is advantageous in case of similar global health emergencies, when the questionnaire can be made readily available to support a promotion of strategies towards better self-care. Moreover, it encourages other Latin American stakeholders to adjust the instrument to their own cultural, language, and socio-economic contexts, thus invigorating the regional and global expansion of the HL study network. Full article

Background: With China’s rapidly aging population, frailty has become a growing concern among older adults. Physical activity (PA) is known to mitigate frailty-related decline, yet few studies have examined these associations longitudinally. Methods: Using five waves (2011–2020) of CHARLS data, we analyzed Chinese adults aged 60+ to assess the association between frailty—measured by a frailty index (FI)—and PA across various types (light, moderate, vigorous, total, and leisure). A generalized linear mixed-effects model was used, adjusting for demographic, socioeconomic, and health-related factors. Results: All PA types were significantly associated with lower odds of concurrent frailty, including light (OR = 0.37), moderate (OR = 0.37), vigorous (OR = 0.40), total (OR = 0.23), and leisure PA (OR = 0.56). Lagged PA also predicted reduced frailty risk over time, except for light PA. Conclusion: Regular PA is linked to a lower risk of frailty among older Chinese adults. These findings underscore the importance of sustained PA as a strategy to promote healthy aging and inform public health interventions for this population. Full article

With the arrival of an aging society and the continuous extension of the human lifespan, the quality of life has not improved in a corresponding manner. People’s demand for happiness and health is increasing. As a result, a model emerged that integrates tourism and medical services, which is health tourism. This growing demand has prompted many service providers to see it as a business opportunity and enter the market. Tourism can help travelers release work stress and restore physical and mental balance; meanwhile, health check-ups and disease treatment can help them regain health. Consumers have long favored health and medical tourism because it helps relieve stress and promotes overall well-being. As people age, some consumers experience a gradual decline in physical functions, making it difficult for them to participate in regular travel services provided by traditional travel agencies. Therefore, this study aims to explore the service needs of health and medical tourism customers (tourists/patients) and the interrelationships among these service needs, so that health and medical tourism service providers can develop more customized and diversified services. This study identifies four key drivers of medical tourism services: medical services, medical facilities, tour planning, and hospitality facilities. This study uses the APA (attention and performance analysis) method to assess each dimension and criterion and utilizes the DEMATEL method with the NRM (network relationship map) to identify network relationships. By combining APA and NRM techniques, this study develops the APA-NRM technique to evaluate adoption strategies and identify suitable paths for health tourism services, providing tailored development strategies and recommendations for service providers to enhance the service experience. Full article

Today, ‘social sustainability’ is a key feature of many organisations’ environmental, social, and governance strategies, as well as underpinning sustainable development goals. The term refers to the implementation of targets such as reduced societal inequalities, the promotion of social well-being, and the practice of positive community relations. Building a meaningful, accountable, and quantifiable evidence-base from which to translate these high-level concepts into tangible and achievable goals is, however, challenging. The complexities of measuring social capital—often described as a building block of social sustainability—have been documented. The challenge lies in measuring the person, group, or collective in interaction with the context under investigation, whether that be a climate goal, an institution, or a national policy. Social identity theory is a social psychological approach that articulates the processes through which an individual internalises the values, norms, and behaviours of their contexts. Levels of social identification—a concept capturing the state of internalisation—have been shown to be predictive of outcomes as diverse as communication and cognition, trust and citizenship, leadership and compliance, and health and well-being. Applying this perspective to the articulation and measurement of social sustainability provides an opportunity to build an empirical approach with which to reliably translate this high-level concept into achievable outcomes. Full article

Background: The Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) was a 3-year, multicenter, randomized controlled trial to test the effects of the MIND diet on cognitive decline in 604 individuals at risk for Alzheimer’s dementia. Here, we describe the genotyping, imputation, and quality control (QC) procedures for the genetic data of trial participants. Methods: DNA was extracted from either whole blood or serum, and genotyping was performed using the Infinium Global Diversity Array. Established sample and SNP QC procedures were applied to the genotyping data, followed by imputation using the 1000 Genomes Phase 3 v5 reference panel. Results: Significant study-site, specimen type, and batch effects were observed. A total of 494 individuals of inferred European ancestry and 58 individuals of inferred African ancestry were included in the final imputed dataset. Evaluation of the imputed APOE genotype against gold-standard sequencing data showed high concordance (98.2%). We replicated several known genetic associations identified from previous genome-wide association studies, including SNPs previously linked to adiponectin (rs16861209, p = 1.5 × 10⁻⁵), alpha-linolenic acid (rs174547, p = 1.3 × 10⁻⁷), and alpha-tocopherol (rs964184, p = 0.003). Conclusions: This dataset represents the first genetic resource derived from a dietary intervention trial focused on cognitive outcomes. It enables investigation of genetic contributions to variability in cognitive response to the MIND diet and supports integrative analyses with other omics data types to elucidate the biological mechanisms underlying cognitive decline. These efforts may ultimately inform precision nutrition strategies to promote cognitive health. Full article