Search Results (124)

Background/Objectives: Healthcare workers have faced increasing emotional strain driven by organizational constraints, rising workload, and accumulated post-pandemic pressure. To support emotional well-being in primary care professionals, the Catalan Health Institute implemented a large-scale psychoeducational group program in its primary care centers. This study explored its feasibility, acceptability, and the factors shaping real-world implementation from the perspectives of participating professionals and community psychologists who taught it. Methods: A qualitative study was conducted involving five online focus groups held with community psychologists (two groups) and primary care professionals who participated in the program (three groups), selected through purposive sampling. Additional qualitative material was obtained from implementation-related field notes. Session transcripts were analyzed using inductive thematic analysis. The study is registered at ClinicalTrials.gov (NCT05720429). Results: Participants described a context of sustained emotional strain that increased motivation to engage with the program. The sessions were perceived as a valuable protected space for emotional expression, interpersonal connection, and learning self-care strategies. Community psychologists were regarded as key facilitators due to their embedded role and contextual knowledge. However, inconsistent managerial engagement, lack of protected time, competing workloads, and inadequate physical spaces were barriers to successful implementation. Participants proposed strengthening institutional support and offering follow-up sessions to consolidate benefits. Conclusions: The program was positively valued and was perceived to provide individual and team-level benefits. Its sustainability requires stronger organizational commitment and integration into routine practice. Findings underscore the need to complement individual-focused interventions with systemic actions addressing workload, staffing, and organizational culture. Full article

Background: Schizophrenia is strongly associated with severe oral health deterioration, driven by cognitive deficits, behavioral dysfunction, and medication-related biological changes. Objective: To examine how neurocognitive dysfunction in schizophrenia, particularly cognitive deficits, is associated with poorer oral hygiene control, motivation, and self-regulation, contributes to oral health decline by disrupting everyday oral hygiene behaviors and dental care engagement, and to discuss the implications of this framework for interdisciplinary prevention strategies. Methods: This manuscript follows a narrative review design aimed at conceptually integrating evidence on neurocognitive mechanisms underlying oral health decline in schizophrenia. To identify relevant literature, a targeted search of PubMed/MEDLINE, Scopus, and Web of Science was conducted, covering publications from 2000 to 2025. The search strategy was used to support thematic exploration and conceptual synthesis, rather than to perform a systematic study selection or quantitative evidence aggregation. This narrative review summarizes findings from 90 peer-reviewed studies selected from the available literature. Results: Executive dysfunction, attentional deficits, and low motivation impair routine oral hygiene and delay dental care-seeking. Antipsychotic-induced xerostomia, metabolic disturbances, oxidative stress, immune dysregulation, and oral microbiome dysbiosis accelerate periodontal breakdown and caries progression. These interacting processes generate a self-reinforcing cycle of inflammation, tissue destruction, and treatment avoidance. Epidemiological data show markedly elevated DMFT/DMFS indices and up to a three-fold higher risk of edentulism compared with the general population. Emerging evidence suggests that integrated psychiatric–dental care models may be associated with improvements in oral health and care engagement, although current findings are largely preliminary and based on small or heterogeneous study populations, including related neurocognitive disorders. Conclusions: Unlike existing epidemiological syntheses, this review highlights oral health deterioration in schizophrenia as a functionally mediated consequence of neurocognitive impairment, underscoring the need for preventive approaches aligned with patients’ cognitive and motivational capacities. Full article

Background/Objectives: Emerging evidence suggests that multiple micronutrient supplements (MMS) provide additional benefits for maternal and neonatal health compared with iron and folic acid (IFA) supplements. To achieve effective coverage, acceptability, and adherence—and to inform a nationwide rollout of MMS—it is essential to understand the context-specific factors that shape implementation. This study evaluated the pilot implementation of MMS in Rwanda to identify key enablers, areas for improvement, and challenges related to antenatal care (ANC) attendance and MMS use. Methods: Data were collected through a survey of 3257 women who attended ANC services, seven focus group discussions with 35 ANC attendees, and key informant interviews with 20 ANC nurses and 21 community health workers. Results: Pregnant women reported high ANC attendance (74%) and MMS consumption (79%), largely driven by strong motivation and awareness of MMS benefits. Strategies to remember daily intake and to manage side effects supported adherence, as did reminders, motivation, and information from family members and healthcare providers. Limited patient-centered counselling, financial constraints, barriers to accessing ANC services, and product stock-outs were key areas for strengthening service delivery in Rwanda. Conclusions: Sustaining high ANC attendance and MMS adherence as the program transitions from the pilot phase to national scale-up is essential. Improving counseling quality and strengthening supply chains may reinforce ANC services and support sustained MMS adherence, with benefits for maternal and child health. Full article

Dynamic network conditions in precision agriculture motivate a scalable, privacypreserving federated learning architecture that tightly integrates ground-based edge intelligence with a space-assisted hierarchical aggregation layer. In Phase 1, heterogeneous tractors act as intelligent farm nodes that train local models, form capability- and task-aware clusters, and employ Network Quality Index (NQI)-driven scheduling, similarity-based checkpointing, and compressed transmissions to cope with highly variable 3G/4G/5G connectivity. In Phase 2, cluster drivers synchronize with Low Earth Orbit (LEO) and Geostationary Earth Orbit (GEO) satellites that perform regional and global aggregation using staleness- and fairness-aware weighting, while end-to-end Salsa20 + MAC encryption preserves the confidentiality and integrity of all model updates. Across two representative tasks—nutrient prediction and crop health assessment—our full hierarchical system matches or exceeds centralized performance (e.g., AUC 0.92 vs. 0.91 for crop health) while reducing uplink traffic by ∼90% relative to vanilla FedAvg and cutting the communication energy proxy by more than 4×. The proposed fairness-aware GEO aggregation substantially narrows regional performance gaps (standard deviation of AUC across regions reduced from 0.058 to 0.017) and delivers the largest gains in low-connectivity areas (AUC 0.74 → 0.88). These results demonstrate that coupling on-farm intelligence with multi-orbit federated aggregation enables near-centralized model quality, strong privacy guarantees, and communication efficiency suitable for large-scale, connectivity-challenged agricultural deployments. Full article

Background: Tribulus terrestris (Tt) is a popular herbal supplement marketed to enhance fitness performance, despite inconclusive evidence regarding its efficacy and safety. This study aimed to investigate the prevalence of TT use, awareness, and motivations for its use among recreational athletes in Italy, helping to address the lack of empirical data describing who actually uses Tt, for what purposes, and with what behavioral risks. Methods: A cross-sectional anonymous survey was administered between May and October 2024 across Italian gyms and fitness clubs using Microsoft Forms. A total of 696 individuals initiated the questionnaire; after removal of duplicate, incomplete and ineligible entries, 510 responses were analyzed. Two indicators of Tt consumption were assessed: ever use and current use, with the latter designated as the primary outcome. A multivariable logistic regression evaluated predictors of current Tt use, entering sex, age category (18–24, 25–34, 35–44, ≥45 years), and motivation for supplement consumption. Results: Current Tt use was reported by 7.8% of respondents, while 10.5% declared ever using a Tt-containing product. Motivation was the only independent predictor of Tt consumption (p = 0.012). Individuals reporting performance enhancement as their primary motivation were markedly more likely to currently use Tt, compared with those using supplements for other purposes (adjusted OR ≈ 18.5; p = 0.008). Neither sex (p = 0.918) nor age category (p = 0.519) significantly predicted Tt use. Admission of anabolic steroid use was infrequent but was linked to online purchasing from potentially unregulated sources. Conclusions: Tt consumption in fitness settings is driven predominantly by performance-oriented expectations rather than demographic characteristics. The observed discrepancy between consumer beliefs and scientific evidence suggests a pressing need for educational interventions and regulatory vigilance in sports nutrition. Public health policies should focus on improving label literacy, strengthening consumer protection, and countering misinformation within supplement marketing environments. Full article

This study examines the motivations, socio-demographic profiles, and behavioural orientations of residents in Northern Italy toward mountain and forest visitation, with a focus on their propensity to engage in forest-based health and wellness activities. The analysis draws on a large stratified survey conducted between December 2023 and January 2024, involving 1218 respondents, of whom 976 reported regular forest visitations. Exploratory factor analysis identifies two main attitudinal dimensions: “Health and Wellness-Driven Forest Engagement”, centred on psychophysical restoration, and “Comfort-Oriented Forest Use”, related to accessibility and low physical effort. Regression models show that wellness-oriented engagement is strongly associated with psychological well-being, walking and hiking habits, and gender, while comfort-oriented use reflects seasonal patterns and preferences for easily accessible forests. A small subset of respondents reports discomfort in forest environments, forming a distinct attitudinal barrier. Overall, the results indicate substantial potential for forest-based wellness tourism to support healthier lifestyles and diversify mountain economies. Policy implications highlight the need for accessible infrastructures, targeted communication, and the integration of wellness-oriented services into regional development strategies. Full article

This narrative review examines how immersive virtual and mixed-reality (VR/MR) technologies, combined with AI-driven virtual agents, can support the prevention and long-term management of chronic illness. Chronic diseases represent a significant global health burden, and conventional care models often struggle to sustain patient engagement, motivation, and adherence over time. To address this gap, we conducted a narrative review of reviews and meta-analyses. We selected empirical studies published between 2020 and 2025, identified through searches in PubMed, Web of Science, and Google Scholar. The aim was to capture the state of the art in the integrated use of VR/MR and AI in chronic illness care, and to identify key opportunities, challenges, and considerations relevant to clinical practice. The reviewed evidence indicates that VR/MR interventions consistently enhance engagement, motivation, symptom coping, and emotional well-being, particularly in rehabilitation, pain management, and psychoeducation. At the same time, AI-driven conversational agents and virtual therapists add adaptive feedback, personalization, real-time monitoring, and continuity of care between clinical visits. However, persistent challenges are also reported, including technical limitations such as latency and system dependence, ethical concerns related to data privacy and algorithmic bias, as well as psychosocial risks such as emotional overattachment or discomfort arising from avatar design. Overall, the findings suggest that the most significant clinical value emerges when VR/MR and AI are deployed together rather than in isolation. When implemented with patient-centered design, clinician oversight, and transparent governance, these technologies can meaningfully support more engaging, personalized, and sustainable chronic illness management. Full article

Consumer demand for organic products has grown substantially in Southern Europe, driven by health, environmental, and ethical concerns. Understanding cross-country differences in attribute preferences and sociodemographic influences is critical to inform marketing strategies and policy interventions targeting organic food consumption. To perform a comparative study across Portugal, Spain, and Greece, regular organic consumers were surveyed (250 per country) using a culturally adapted Best–Worst Scaling questionnaire. Socio-demographic variables and ten organic food attributes were analysed using MANOVA, Kruskal–Wallis tests, PCA, and cluster analysis. Spanish and Portuguese consumers prioritised health, environmental impact, absence of GMOs, and certification, while Greeks emphasised price, appearance, taste expectation, and nutrition. Age, gender, and education influenced attribute importance differently across countries, revealing distinct national consumption patterns and preferences. Findings highlight substantial heterogeneity: health and environmental attributes dominate in Portugal and Spain, reflecting strong certification and sustainability awareness, whereas Greek consumers focus on value, sensory qualities, and nutrition, indicating lower organic uptake and stronger price sensitivity. Older and more educated consumers valued certification and provenance, women emphasised health and environmental benefits, and men responded more to convenience and status cues. These patterns suggest that marketing and policy strategies should combine universal motivators with tailored approaches addressing national, demographic, and cultural differences to enhance organic consumption. Cross-country differences reveal the need for context-specific interventions promoting organic food while leveraging common health and sustainability drivers. Full article

Background/Objectives: University students are particularly vulnerable to unhealthy eating patterns and body image dissatisfaction. The association between lifestyle factors and eating disorders (EDs) can be ambiguous as healthier lifestyle choices may paradoxically be related to ED risk. In this study, we aimed to analyze physical activity (PA) and dietary patterns—specifically food type and diet quality—as lifestyle indicators in university students with and without ED risk. Motivations for engaging in PA and the association between PA levels and diet quality were also examined. Methods: A descriptive cross-sectional study was conducted on a convenience sample of 1982 undergraduate students aged 18–30 years from the University of the Balearic Islands. Dietary intake, diet quality, PA levels, and motivations were self-reported using a questionnaire. Results: Students at risk of EDs reported higher diet quality, including greater adherence to the Mediterranean diet (p < 0.001) and more adequate consumption of fruits (p < 0.001), vegetables (p < 0.001), and red and processed meat (p < 0.001). Regarding PA, participants with ED risk engaged in more weekly PA sessions (p < 0.001) and accumulated a longer total weekly duration (p = 0.019), with physical appearance being the main motivation. In participants without ED risk, PA levels were positively associated with adherence to the Mediterranean diet (p < 0.001); however, no such association was observed in participants with ED risk (p = 0.538). Conclusions: Students at risk for EDs exhibited comparatively healthier diet and PA patterns, seemingly driven by concerns related to body image and an aversion to energy-dense foods. Therefore, apparent health behaviors should not be used to rule out ED risk. Full article

The integration of artificial intelligence (AI) tools, such as the chat generative pre-trained transformer (ChatGPT), into health professions education is rapidly accelerating, creating new opportunities for personalized learning and clinical preparation. These tools have demonstrated the potential to enhance learning efficiency and critical thinking. However, concerns regarding reliability, academic integrity, and potential overreliance highlight the need to better understand how healthcare students adopt and perceive these technologies in order to guide their effective and responsible integration into educational frameworks. This nationwide, cross-sectional, survey-based study was conducted between February and April 2024 among undergraduate students enrolled in medical, pharmacy, nursing, dental, and allied health programs in Saudi Arabia. An online questionnaire collected data on ChatGPT usage patterns, satisfaction, perceived benefits and risks, and attitudes toward integrating them into the curricula. Among 1044 participants, the prevalence of ChatGPT use was 69.25% (n = 723). Students primarily utilized the tool for content summarization, assignment preparation, and exam-related study. Key motivators included time efficiency and convenience, with improved learning efficiency and reduced study stress identified as major benefits. Conversely, major challenges included subscription costs and difficulties in formulating effective prompts. Furthermore, concerns regarding overreliance and academic misconduct were frequently reported. In conclusion, the adoption of generative AI tools such as ChatGPT among healthcare students in Saudi Arabia was high, driven by its perceived ability to enhance learning efficiency and personalization. To maximize its benefits and minimize risks, institutions should establish clear policies, provide faculty oversight, and integrate AI literacy into the education of health professionals. Full article

In recent years, China has made strong national commitments to waste reduction and circular economy, including the implementation of mandatory municipal solid waste separation policies and the rollout of zero-waste city initiatives. These efforts represent a strategic shift toward systemic environmental governance. However, the outbreak of the COVID-19 pandemic in early 2020—and the subsequent implementation of the country’s stringent zero-COVID policy—led to an abrupt disruption of these programs. Under this policy, strict lockdowns, quarantine of both confirmed and suspected cases, and city-wide containment became top priorities, sidelining environmental initiatives such as waste separation and sustainable waste infrastructure development. This study investigates how Chinese residents’ motivations for waste separation evolved across three key phases: pre-pandemic, during the zero-COVID enforcement period, and post-pandemic recovery. Grounded in the Theory of Planned Behavior and pro-environmental behavior theory, we developed an extended model incorporating pandemic-related social, psychological, and policy variables. Based on 526 valid questionnaire responses collected in late 2023 in Shanghai, we conducted structural equation modeling and repeated-measures analysis. Findings reveal a significant shift from externally driven compliance—reliant on governmental enforcement and service provision—to internally motivated behavior based on environmental values and personal efficacy. This transition was most evident after the pandemic, suggesting the potential for sustained pro-environmental habits despite weakened policy enforcement. Our findings underscore the importance of strengthening internal drivers in environmental governance, especially under conditions where policy continuity is vulnerable to systemic shocks such as public health emergencies. Full article

Understanding how emotions and psychological states influence both individual and collective actions is critical for expressing the real complexity of biosocial and ecological systems. Recent breakthroughs in mathematical modeling have created new opportunities for systematically integrating these emotion-specific elements into dynamic frameworks ranging from human health to animal ecology and socio-technical systems. This review builds on mathematical modeling approaches by bringing together insights from neuroscience, psychology, epidemiology, ecology, and artificial intelligence to investigate how psychological effects such as fear, stress, and perception, as well as memory, motivation, and adaptation, can be integrated into modeling efforts. This article begins by examining the influence of psychological factors on brain networks, mental illness, and chronic physical diseases (CPDs), followed by a comparative discussion of model structures in human and animal psychology. It then turns to ecological systems, focusing on predator–prey interactions, and investigates how behavioral responses such as prey refuge, inducible defense, cooperative hunting, group behavior, etc., modulate population dynamics. Further sections investigate psychological impacts in epidemiological models, in which risk perception and fear-driven behavior greatly affect disease spread. This review article also covers newly developing uses in artificial intelligence, economics, and decision-making, where psychological realism improves model accuracy. Through combining these several strands, this paper argues for a more subtle, emotionally conscious way to replicate intricate adaptive systems. In fact, this study emphasizes the need to include emotion and cognition in quantitative models to improve their descriptive and predictive ability in many biosocial and environmental contexts. Full article

Alcohol-associated liver disease (ALD) is a leading cause of liver-related morbidity, mortality, and premature death worldwide. Its pathogenesis is complex and incompletely understood, with disrupted methionine metabolism as a key contributor. This pathway converts methionine into S-adenosylmethionine (SAM or SAMe), the principal methyl donor, a precursor of glutathione (GSH), and a critical regulator of hepatocellular function. Alterations in methionine metabolism are primarily driven by downregulation of methionine adenosyltransferase 1A (MAT1A), the liver-specific gene encoding the MATα1 subunit responsible for SAMe biosynthesis. Reduced MAT1A expression and activity lead to hepatic SAMe and GSH deficiency, resulting in global hypomethylation, mitochondrial dysfunction, impaired lipid metabolism, and progressive liver injury, hallmarks of ALD. Recent studies show that MATα1 also localizes to hepatocyte mitochondria, where its selective depletion contributes to mitochondrial dysfunction in ALD. Experimental models demonstrate that SAMe supplementation restores methylation capacity, replenishes GSH, reduces oxidative stress, and improves mitochondrial function and liver histology. Preservation of mitochondrial MATα1 also protects against ALD, underscoring its importance in hepatocellular health. Clinical exploration of SAMe in early-stage ALD suggests potential benefit and motivates continued investigation into treatment strategies that build on and extend beyond supplementation. This review summarizes current knowledge on the role of the MAT1A/SAMe axis in ALD pathophysiology, emphasizing molecular functions and critically evaluating preclinical and clinical evidence for potential therapy. Full article

Instant noodles have become a staple convenience food worldwide, with rising consumption particularly among younger, busier populations. This study investigates consumer perceptions, health concerns, consumption habits, and purchasing behaviors related to pre-packaged noodles in Kosovo. A structured questionnaire was administered to 400 participants, exploring attitudes toward health impacts, ingredient awareness, product preferences, and purchasing motivations. Findings revealed mixed perceptions of noodle healthiness, with older and more educated individuals significantly more likely to view them as unhealthy (p < 0.001). Although most respondents expressed concern about ingredients such as fat, calories, and salt, awareness of additives like monosodium glutamate (MSG) remained low (p < 0.001), indicating a gap in consumer knowledge. Consumption patterns varied notably by age, gender, income, and health status. Younger and lower-income groups consumed noodles more frequently (p < 0.001), often driven by time constraints rather than taste or nutritional value. One-third of participants reported a sense of addiction, strongly linked to both frequency and portion size. When purchasing, consumers prioritized label clarity, origin, and natural ingredients over sensory appeal, and advertising exerted only a moderate influence on choices. These results suggest that while practical needs drive consumption, health concerns and demographic factors strongly shape perceptions and behavior. Efforts to reduce unhealthy consumption should focus on clearer labeling, accessible nutrition education, and promoting healthier, convenient alternatives. Full article

Background/Objectives: Excess alcohol consumption remains a major challenge for public health in the UK. This study aimed to define and characterise clusters of increasing- and high-risk drinkers, based on drinking motives and occasions and contextualised by demographics and psychosocial factors, to inform tailored harm-reduction strategies. Methods: Secondary analysis of the nationally representative Drinkaware Monitor 2023 survey (n = 10,473) identified six clusters of increasing- and high-risk drinkers (n = 2486 weighted). Segmentation was based on drinking occasions and drinking motives using the Drinking Motives Questionnaire for Adults (DMQ-A). Clusters were then characterised using demographic factors, drinking patterns, and psychosocial indicators (dependency symptoms, loneliness, and risk perception), with weighted two-proportion z-tests and false discovery rate correction applied. Results: Six distinct subgroups emerged. Cluster 1 consisted of older drinkers (55+) motivated by product and taste, with fewer dependency symptoms and lower loneliness. Cluster 2 showed lower social motives but greater likelihood of drinking alone at home and with meals. Cluster 3, younger and more diverse, displayed very high social and identity motives (e.g., drinking to feel confident), alongside elevated loneliness and dependency indicators. Cluster 4 also presented strong social motives but had fewer product and taste motives and more adverse outcomes. Cluster 5, typically older and C2DE, reported higher coping motives (e.g., drinking to unwind) and more solitary drinking. Cluster 6 had consistently lower motives, a narrower range of drinking occasions, and a mixed dependency profile. Conclusions: Increasing- and high-risk drinkers are heterogeneous, shaped by different motives and contexts. Tailoring interventions to subgroup profiles, such as socially motivated younger adults and older adults whose drinking is driven by coping motives, may strengthen alcohol harm-reduction strategies. Full article