Search Results (589)

Background: Fasting-based interventions are increasingly investigated as adjuncts to cancer treatment for the potential to reduce therapy-related toxicities, improve metabolic health, and enhance quality of life. However, clinical evidence regarding their efficacy, tolerability, and acceptability remains limited and fragmented. This scoping review aimed to systematically map the current evidence on fasting-based interventions in cancer patients and survivors. Methods: A literature search was conducted in PubMed, Scopus, Web of Science, and CINAHL up to 10 June 2025. Eligible interventional studies included cancer patients or survivors and evaluated fasting-based interventions, such as time-restricted eating, intermittent fasting, short-term fasting, or fasting-mimicking diets. Studies were categorized by fasting types and outcomes like fatigue, treatment toxicity, metabolic and hematologic parameters, weight, quality of life, adherence, acceptability, illness perception, and adverse events were assessed. Result: Twenty interventional studies of FMD, TRE, STF, IF, or fasting combined with altered dietary approaches conducted across 10 countries were included, comprising a total of 871 participants. Participant ages ranged from 28 to 75 years. Overall, 9 of 20 studies exclusively enrolled breast cancer patients or survivors, and chemotherapy was the most common treatment context in 11 studies. Five of six studies reported reductions in fatigue. Among the five studies assessing quality of life, one demonstrated improvement, three reported no change, and one yielded mixed results. Six of eight studies reported reductions in chemotherapy-related toxicity, and weight loss was observed in 10 of 12 studies. Reductions in IGF-1 and insulin levels were reported in six of seven and four of five studies, respectively. Hematologic changes were noted in six studies, and only one study assessed illness perceptions, reporting positive findings. Fasting-related adverse events, reported in nine studies, were generally mild and transient. High adherence and acceptability were observed across studies; however, findings were heterogeneous across intervention types and were largely derived from small or moderate-strength studies. A descriptive quality metric assessment indicated that most studies were of moderate methodological strength. More intensive fasting protocols, such as FMD and STF, appeared to demonstrate more consistent metabolic effects, whereas TRE showed higher adherence but more variable clinical outcomes. Conclusions: Fasting-based interventions have the potential to be feasible and well tolerated among cancer patients and survivors, with early evidence suggesting benefits in reducing fatigue, minimizing treatment-related toxicities, and favorable metabolic effects. Large, well-designed trials including diverse cancer populations are needed to confirm long-term outcomes and guide clinical integration. Full article

Foodborne illness remains a persistent public health issue, yet domestic food safety practices are shaped by individual knowledge, social expectations, and gendered norms. This study examines how gender norms and expectations shape Australian consumers’ safe food-handling knowledge, perceptions, and practices. Guided by a social constructionist epistemology and feminist framework, semi-structured interviews were conducted with 28 participants aged 18–24 years recruited from a university research participation pool. Data were analysed using reflexive thematic analysis. Three themes were identified: “I know what I am doing”, optimism bias and false confidence, “Men’s casualness versus women’s strictness”, gendered safe food handling practices and expectations, and “Careful about others, relaxed for myself”, food safety as a social performance. Participants often expressed false confidence in their practices, reflecting optimism bias and reduced perceived susceptibility to foodborne illness. Women tended to portray vigilance and responsibility, while men described more relaxed approaches, reflecting gendered socialisation. Food safety also emerged as performative, with heightened care displayed when cooking for others. These findings highlight that domestic food safety is socially embedded and both reflects and reproduces gender norms. Addressing these dynamics through socially informed, context-sensitive interventions may improve public health outcomes. Full article

Background/Objectives: The incidence of cardiac arrest among critically ill patients has been increasing, with many patients experiencing clinical exacerbation prior to the event. Early detection and rapid treatment are essential to reduce the risks associated with cardiac arrest; however, difficulties such as limited ICU resources and inadequate monitoring of vital signs reduce the effectiveness of treatment. Various cardiac arrest prediction systems have been developed to overcome these issues. This study performed a summative evaluation of a Central Monitoring System with AI-based Cardiac Arrest Prediction. Methods: A summative usability evaluation was conducted in a simulated ICU environment with 22 ICU nurses experienced in using patient monitoring devices. Participants completed tasks based on the device workflow and then filled out the System Usability Scale (SUS) and satisfaction surveys, with task performance and survey responses analyzed to assess usability. Results: The usability test achieved a task success rate of 90%, with critical tasks achieving success rates ranging from 73% to 100%. The SUS score was 67.3 (“OK”), and the satisfaction survey showed an average score of 4.5, indicating generally positive user perception. Conclusions: Participants generally rated the system as acceptable, although some tasks showed lower success rates due to design issues such as poor button visibility. Further studies in clinical settings are needed to evaluate the system’s effectiveness, user experience, and contribution to the timely detection of cardiac arrest. Full article

Introduction: Religious practices can shape lifestyles, influence health choices, and help individuals cope with illness and suffering. Understanding which aspects of religiosity support health-promoting attitudes is particularly important. This study explores how belonging to a religious community affects health and well-being among religious sisters. Materials and Methods: An anonymous survey was conducted among 463 women from international, apostolic Catholic congregations in Poland and 33 other countries. The questionnaire included questions on lifestyle, physical health (including diet, physical activity, sleep, chronic conditions, and medication use), and perceptions of how community life influences health and encourages health-conscious behaviors. Results: Overall, 57% of participants reported following a healthy lifestyle, most commonly sisters aged 65 and older (73%). Non-Polish sisters and those living outside Poland were more likely to report healthy habits. Among sisters who saw their community as beneficial for health, 69% led a healthy lifestyle. Retreats, a sense of belonging, communal prayers, and vacations were consistently rated as having the most positive impact on well-being, particularly among older sisters and missionaries. Conclusions: Life in a religious community appears to support health both directly, through structured daily routines and shared responsibilities, and indirectly, by providing social support and fostering a sense of purpose. Spiritual practices, rest, and close interpersonal relationships emerge as the most influential factors for well-being, while formal obligations such as wearing religious attire or attending formation meetings were rated as less impactful. These findings highlight the important role of communal life in promoting both physical and spiritual health among religious sisters. Full article

Background: Return to work (RTW) after acute coronary syndrome (ACS) or acute heart failure (HF) is a pivotal outcome reflecting functional recovery and quality of life (QoL). While survival after cardiac events has improved through reperfusion and guideline-directed pharmacotherapy, sustainable RTW depends on an integrated set of clinical, psychological, social, and occupational determinants. Objective: This study aimed to synthesize and expand the evidence on predictors of RTW, delineate practical workload-matching rules using METs and CPET, and position multidisciplinary cardiac rehabilitation (CR) as the bridge from clinical recovery to durable vocational reintegration. Key findings: Beyond left ventricular ejection fraction (LVEF), depression, anxiety, illness perceptions, and RTW self-efficacy are robust predictors of vocational outcomes. CPET-guided exercise prescriptions and MET-based job matching ensure adequate metabolic reserve; sustained task demand should remain at ≤35–40% of maximal capacity, with peak capacity ≥2× average job demand. CR (Class IA in the 2023 ESC ACS Guidelines) improves exercise tolerance, medication adherence, psychosocial well-being, and deployment of vocational support, including stepwise reintegration plans and ergonomic adaptations. Telerehabilitation extends monitoring and counseling into the workplace and maintains adherence after RTW. Conclusions: Comprehensive CR that integrates exercise training, psychosocial counseling, lifestyle modification, and vocational interventions offers the most effective pathway to stable RTW, improved QoL, and reduced socio-economic burden. Early identification of vulnerable subgroups and personalized, digitally supported follow-up are essential for long-term job retention. Full article

Background: Adequate nutritional knowledge among intensive care nurses is essential for early identification of nutritional risk and prevention of complications in critically ill patients. The questionnaire “Nurses’ perceptions of responsibility, knowledge and documentation focusing on enteral nutrition and nursing practice regarding enteral feeding in the intensive care unit”, developed by Persenius et al., is used internationally, yet no culturally adapted Spanish version has been available. Objectives: This study aimed to translate and culturally adapt Persenius et al.’s questionnaire and evaluate its content for use among Spanish-speaking intensive care unit (ICU) nurses. Materials and methods: A multistep process was conducted, including forward–backward translation, expert review by an expert panel of ICU nurses (N = 26) with at least 2 years of critical care experience, and content validity analysis. Experts rated item relevance and comprehensibility. Item Content Validity Index (I-CVI), Scale CVI, and Aiken’s V were calculated using predefined thresholds. Linguistic clarity/comprehensibility was assessed on a 5-point Likert scale (1–5). To assess the questionnaire’s reliability, Cronbach’s alpha was also analysed in a pilot study (N = 99). Results: The Spanish version retained all 47 original items after minor linguistic adjustments. All items met the minimum content validity threshold; most showed I-CVI values > 0.78 and acceptable Aiken’s V coefficients. The mean comprehensibility score for all items exceeded 4.0, indicating high clarity. No item required significant semantic modification after expert review. Cronbach’s alpha coefficient of 0.85 reflected its reliability. Conclusions: The Spanish version of Persenius et al.’s questionnaire demonstrated adequate content and linguistic validity and internal consistency in a pilot sample of ICU nurses. Full article

Background: Undernutrition among infants and young children in South Asia remains a major public health concern, contributing to high rates of morbidity and mortality. While quantitative systematic reviews have identified various risk factors for undernutrition, no review has focused on qualitative studies. This study aims to review published literature on family member and healthcare provider perceptions about influences on undernutrition among infants and young children in South Asia. Methods: We searched for qualitative research articles published from 2000 to 2026 in the PubMed, Scopus and CINAHL databases, and used the Critical Appraisal Skills Program (CASP) tool to assess the quality of selected articles. Selected articles were analyzed thematically. The PROSPERO registration number is CRD42022385382. Results: After screening 201 research articles, 19 articles were selected for inclusion in this review. Perceived influences of undernutrition among children were categorized into individual, socio-cultural, economic, environmental and system factors. Interconnected influences included maternal illness, single motherhood, mothers’ knowledge and awareness, convenience of providing low-quality ready-made and junk food, spiritual beliefs and superstition, violence against women, financial constraints in a context of rising food prices and seasonal impacts on food production, and physical accessibility of healthcare services. Conclusions: This review emphasizes the complex interplay of influences on undernutrition among young children in South Asia. Potential interventions must be culturally tailored and gender-sensitive, with key strategies including nutrition education, community-based support, maternal health improvements, and policies addressing food insecurity and healthcare accessibility. Full article

Background/Objectives: Although illness perception has been examined in oncology populations, there is a lack of empirical studies focusing specifically on post-treatment thoracic cancer patients and on the mechanisms through which illness perception relates to fear of cancer recurrence and generalized anxiety. In particular, prior research has rarely tested meaning-making and changes in beliefs and goals as mediating factors. This study aimed to examine the mediating roles of meaning-making and changes in beliefs and goals within a serial multiple mediation model between illness perception, fear of recurrence, and generalized anxiety. Method: A cross-sectional study was conducted with 284 thoracic cancer patients (149 men and 135 women) who had completed treatment. Participants completed validated self-report measures assessing illness perception, meaning-making, changes in beliefs and goals, fear of cancer recurrence, and generalized anxiety. Hierarchical regression analyses and serial multiple-mediation models based on path analysis were employed to examine direct and indirect associations among variables. Results: Negative illness perception was positively associated with fear of recurrence and generalized anxiety, while positive illness perception predicted lower levels of both outcomes. Path analyses revealed that meaning-making and changes in beliefs and goals jointly mediated the relationships between illness perceptions and psychological distress. Specifically, adaptive meaning-making and belief–goal restructuring were associated with lower fear of recurrence and generalized anxiety, whereas maladaptive forms were associated with higher levels of both outcomes. Conclusions: Findings indicate that both negative and positive illness perceptions influence post-treatment emotional adjustment in thoracic cancer patients through mediation effects. Based on the meaning-making model, interventions targeting maladaptive illness perceptions, promoting meaning-making, and supporting adaptive changes in personal beliefs and goals may reduce fear of recurrence and anxiety. These results support the incorporation of meaning-centered strategies into psychosocial oncology care, emphasizing cognitive–motivational cognitive-motivational factors as critical targets for improving emotional well-being in cancer survivorship. Full article

Background: Healthcare workers are at the forefront of the global battle against COVID-19. Their vaccination perspectives, particularly in regions like Sierra Leone that have faced health crises such as the Ebola outbreak, are essential for shaping public health strategies in low-income countries that routinely face infectious disease outbreaks. Objective: This research sought to understand the perceptions and experiences of Sierra Leone’s healthcare workers concerning COVID-19 vaccination and booster doses, set against the backdrop of global health resource disparities and regional vaccine distribution challenges. Methods: Utilizing a mixed-methods approach, the study analyzed data from an online survey, which saw 1001 complete responses from 2060 participants across six Ebola-impacted districts (October–November 2022), and in-depth interviews with 24 health workers from three of these districts (February–July 2022). Results: Approximately 80% of respondents reported having received a COVID-19 vaccine, predominantly Sinopharm and AstraZeneca, yet only 34% of vaccinated participants had received a booster dose. In multivariable analyses, personally knowing someone who experienced serious COVID-19 illness or death was associated with higher odds of both initial vaccination and booster uptake (p < 0.05). By contrast, prior Ebola-related experiences were not consistently associated with vaccination outcomes. Qualitative findings contextualized these patterns, highlighting the roles of professional exposure, limited booster-related information, and inequities in vaccine availability and distribution. Conclusion: These findings indicate that vaccination strategies must move beyond initial rollout to address barriers to sustained engagement, particularly for booster uptake among healthcare workers. They also emphasize the need for equitable vaccine access and transparent, locally tailored communication to mitigate structural and informational constraints in low-income settings. Full article

Background: In many inpatient settings, physician coverage is organized around single-attending responsibility, which can create challenges in supervision and workload distribution, particularly in procedurally intensive environments. To address these issues, our department introduced a junior–senior inpatient team model in which multiple physicians jointly share responsibility for hospitalized patients. This study examined physicians’ perceptions of how this restructuring influenced clinical workflow, supervision, and workload. Methods: We performed a mixed-methods cross-sectional survey two months after implementation. Twenty-two physicians (13 junior, 9 senior) completed five-point Likert-scale items and open-ended questions. Responses were analyzed using non-parametric group comparisons. Qualitative comments were examined thematically to identify recurring perspectives on supervision and workload. Results: Junior physicians reported more favorable perceptions across several domains. Significant differences between junior and senior physicians were observed for reassurance during off-site duties (p = 0.013) and perceived reduction in burden when managing critically ill patients (p = 0.002). Qualitative findings indicated that junior physicians experienced greater shared responsibility and easier access to consultation, whereas senior physicians described increased supervisory demands, responsibility extending beyond subspecialty areas, and heavier weekend or holiday duties. Both groups emphasized the importance of flexible patient redistribution during staffing variability. Conclusions: The junior–senior inpatient team model was associated with improved perceived accessibility of supervision and collective support for junior physicians while increasing supervisory demands on senior staff. These findings suggest the potential importance of workload-sensitive implementation strategies and explicit role definition when introducing physician team–based coverage in high-acuity inpatient settings. Full article

Semantic point cloud maps play a pivotal role in smart agriculture. They provide not only core three-dimensional data for orchard management but also empower robots with environmental perception, enabling safer and more efficient navigation and planning. However, traditional point cloud maps primarily model surrounding obstacles from a geometric perspective, failing to capture distinctions and characteristics between individual obstacles. In contrast, semantic maps encompass semantic information and even topological relationships among objects in the environment. Furthermore, existing semantic map construction methods are predominantly vision-based, making them ill-suited to handle rapid lighting changes in agricultural settings that can cause positioning failures. Therefore, this paper proposes a positioning and semantic map reconstruction method tailored for orchards. It integrates visual, LiDAR, and inertial sensors to obtain high-precision pose and point cloud maps. By combining open-vocabulary detection and semantic segmentation models, it projects two-dimensional detected semantic information onto the three-dimensional point cloud, ultimately generating a point cloud map enriched with semantic information. The resulting 2D occupancy grid map is utilized for robotic motion planning. Experimental results demonstrate that on a custom dataset, the proposed method achieves 74.33% mIoU for semantic segmentation accuracy, 12.4% relative error for fruit recall rate, and 0.038803 m mean translation error for localization. The deployed semantic segmentation network Fast-SAM achieves a processing speed of 13.36 ms per frame. These results demonstrate that the proposed method combines high accuracy with real-time performance in semantic map reconstruction. This exploratory work provides theoretical and technical references for future research on more precise localization and more complete semantic mapping, offering broad application prospects and providing key technological support for intelligent agriculture. Full article

Background: Adults on maintenance hemodialysis experience multiple physical and psychological symptoms that can affect confidence in self-management and perception of care received from healthcare providers. Understanding the interplay between symptom burden, self-management self-efficacy, and perceptions about care received is essential to inform patient-centered nephrology nursing. Aim: This cross-sectional study aimed to describe dialysis symptom burden, self-efficacy to manage chronic disease, and satisfaction with nursing care, and to examine associations among these variables in adults undergoing maintenance hemodialysis in Oman. Methods: A cross-sectional study using consecutive sampling was conducted among 232 adults on maintenance hemodialysis at two dialysis units in Muscat, Oman. Data were collected using the Dialysis Symptom Index, the nursing care satisfaction questionnaire, and the self-efficacy scale. Descriptive, correlation, and multivariable linear regression analysis were used to summarize the findings. Results: The mean age was 55.9 years and the most common comorbidities were diabetes (58.2%) and hypertension (74.1%). Symptom burden was substantial, with over half reporting muscle soreness, anxiety, sleep disturbance, dry mouth, pruritus, appetite loss, and dyspnea, although severity was generally mild–moderate (1.1–1.6/4). Satisfaction with nursing care was high (90.2%), while self-efficacy was moderate (mean 30.52/44). Patient satisfaction correlated positively with self-efficacy (r = 0.25, p < 0.001), but not with symptom burden (r = 0.08, p = 0.24); Self-efficacy showed a small positive correlation with dialysis symptom burden (r = 0.14, p = 0.03), suggesting that patients who were more aware of and reported more symptoms also perceived themselves as more actively engaged in managing their illness. In multivariable analysis, higher satisfaction and more favorable laboratory indicators independently predicted higher self-efficacy. Conclusions: Adults on hemodialysis reported high satisfaction with nursing care but continued to experience multiple physical and psychological symptoms and had only moderate self-efficacy to manage their condition. There is a need to integrate structured symptom assessment and targeted, nurse-led self-management support intervention into routine dialysis care to reduce symptom burden and enhance patients’ confidence in managing their illness. Full article

The concept of neuroception of psychological safety, rooted in Polyvagal Theory, offers a framework for understanding how individuals perceive safety at a physiological and psychological level. Illness may disrupt this perception and affect bodily regulation, emotional resilience, social connection, and self-compassion. This study aims to explore how experiences of being unwell, across both acute and chronic contexts, affect individuals’ neuroception of psychological safety. Semi-structured interviews were conducted with eleven adult participants aged 20–79, including individuals with both acute and chronic illness experiences. Interview questions were informed by the Neuroception of Psychological Safety and Polyvagal Theory. Data were analysed using reflexive thematic analysis, following Braun and Clarke’s six-step process. Four key themes were identified: dysregulation and the narrowing window of tolerance (reduced emotional resilience and heightened bodily sensitivity); distrust and disappointment (a rupture in bodily and self-trust); responsibility and internalised guilt (moral and emotional burdens around illness and recovery); and illness demands attention and disrupts social connection (withdrawal, emotional depletion, and compromised compassion). Across these themes, participants described a diminished sense of psychological safety when unwell, shaped by both internal physiological changes and altered social dynamics. Illness can profoundly undermine psychological safety by disrupting neurobiological regulation, altering relational engagement, and eroding trust in one’s body and self. These findings highlight the importance of integrating psychological safety principles into models of care, particularly in how individuals experience and recover from illness. Full article

Depression is a mental illness with hidden characteristics that affects human physical and mental health. In severe cases, it may lead to suicidal behavior (for example, among college students and social groups). Therefore, it has attracted widespread attention. Scholars have developed numerous models and methods for depression detection. However, most of these methods focus on a single modality and do not consider the influence of gender on depression, while the existing models have limitations such as complex structures. To solve this problem, we propose a symmetric-structured, multi-modal, multi-layer cooperative perception model for depression detection that dynamically focuses on critical features. First, the double-branch symmetric structure of the proposed model is designed to account for gender-based variations in emotional factors. Second, we introduce a stacked multi-head attention (MHA) module and an interactive cross-attention module to comprehensively extract key features while suppressing irrelevant information. A bidirectional long short-term memory network (BiLSTM) module enhances depression detection accuracy. To verify the effectiveness and feasibility of the model, we conducted a series of experiments using the proposed method on the AVEC 2014 dataset. Compared with the most advanced HMTL-IMHAFF model, our model improves the accuracy by 0.0308. The results indicate that the proposed framework demonstrates superior performance. Full article

Alopecia Areata (AA) is a chronic disorder with significant psychological impact due to its unpredictability. While emotional distress (ED) is well-recognized in AA, the interplay between illness perception (IP) and obsessive–compulsive (OCD) symptomatology remains underexplored. This -sectional, observational study aimed to investigate the prevalence of OCD symptoms and ED in AA outpatients, analyzed the relationship between IP and OCD symptomatology. One-hundred-thirty-five AA outpatients, from a specialized Hospital in Rome, Italy, were recruited. Participants completed the DASS-21 for ED, the Brief IPQ for IP, and the OCI-R for OCD symptomatology. AA severity was assessed using standardized scores. Statistical analyses included correlations and a simple mediation model. OCD symptomatology was found in 18.5% of the sample, and clinical-level ED in 20.7%. Strong associations were found between OCI-R and DASS-21 (r = 0.56, p < 0.001), and DASS-21 and Brief IPQ (r = 0.56, p < 0.001). The mediation analysis indicated that ED fully mediated the relationship between IP and OCD symptomatology (indirect effect: b = 0.20, 95% CI [0.10, 0.30]), suggesting IP’s impact on OCD symptoms primarily occurs via ED. Negative IP exacerbate ED, which, in turn, drives OCD behaviors. Psychological assessment and targeted interventions in individuals with AA are needed. Full article