Search Results (815)

Ageism refers to prejudice on the basis of a person’s age, often directed toward older adults. Arab culture represents a pertinent case, as this culture is historically known for its appreciation of older people, but recent studies have indicated high levels of ageism. This systematic integrative review aims to synthesize the attitudes toward older adults in Arab culture and their determining factors. Research was screened using the PRISMA guidelines, and 23 articles were included for synthesis. Thematic and content analyses were performed, from which five themes emerged: “demographic factors”, “psychological factors”, “knowledge of ageing”, “sociocultural factors and aspects” and “self-ageism and ageing experiences”. Knowledge of aging and close interpersonal relationships with older adults were associated with lower levels of ageism and more positive attitudes. Sociocultural aspects, including the low socioeconomic status in most Arab countries, seem to be associated with ageism. Moreover, individual factors like low self-esteem, low empathy, and high death anxiety were related to negative attitudes toward older adults. The review also underlines the experiences and self-ageism among older people. The article provides insights into ageism directed towards older adults in Arab culture and ties knowledge with practice by highlighting the social and policy implications of the findings. Full article

The study of human skeletal remains from historic contexts is uniquely positioned to explore inequality over time by linking the underlying sociocultural factors that enforce marginalization with lived experiences and health outcomes. We analyzed mortality rates among historic individuals of low socioeconomic status from a documented human skeletal collection, to examine how culture and identity become biologically embodied. Because pre-existing health conditions affect mortality risk, we examined whether individuals with short stature experienced earlier mortality. Kaplan–Meier analyses and log rank tests indicated significant differences in survivorship over time and among social race groups, indicating that African American individuals showed significantly higher mortality, but no sex differences were observed within population groups. Logistic regressions tested for the effects of age-at-death, combined sex and population group, and birthdate on the outcome of bone length. Age and birthdate were not significant, suggesting no relationship between short stature and age-at-death, which also did not change over time. However, odds ratios indicated fewer African Americans were surviving up to adulthood. While many individuals in the collection likely suffered some poverty and marginalization, survivorship was significantly worse for African Americans. The likely effects of systematic racism resulting in further socioeconomic marginalization significantly affected the health of the African American community. Full article

Background: Globally, an estimated 1.4 billion people had hypertension in 2014, yet only just over 20% had controlled blood pressure, and about 580 million remained undiagnosed. Evidence indicates that salt substitutes facilitate meaningful blood-pressure reductions, yet their implementation remains restricted by social and healthcare constraints. The comparative effectiveness of alternative sodium-reduction interventions for elevated blood pressure remains unclear, limiting their introduction across diverse clinical and public health contexts. This study is registered with PROSPERO (CRD420251130153). Methods: We systematically searched PubMed, MEDLINE, and supplementary sources for randomised controlled trials (RCTs) published between 2000 and 2025. All behavioural sodium-reduction interventions among populations with elevated blood pressure, including hypertension, were included. The mean difference in systolic blood pressure (SBP) was the primary outcome, as evidence indicates that intensive control of SBP to levels below 120–130 mmHg is significantly associated with a reduced risk of major cardiovascular disease (CVD) and all-cause mortality. Network and subgroup pairwise meta-analyses were performed, with sensitivity analyses conducted to assess robustness of the findings and subgroup analyses used to explore clinical and public health factors influencing intervention effectiveness (clinical factors: blood pressure stage, trial duration, and medication status; public health factors: setting, implementation period, and country income level). Results: Of 10,404 records identified, 42 studies (46 trials, n = 46,771) were included. While the use of salt substitutes was ranked the most effective intervention in the network meta-analysis, with reductions of −6.78 mmHg (95% CI, −8.42, −5.14) compared to no intervention and −5.35 mmHg (95% CI, −7.89, −2.81) compared to conventional health education, self-monitoring devices and low-sodium diets, when combined with health education, demonstrated similar magnitudes of SBP reductions. Digital health education showed a larger point estimate for SBP reduction by −3.59 mmHg (95% CI −7.40 to 0.22) than conventional education (−1.43 mmHg; 95% CI −3.49 to 0.63), but both confidence intervals crossed zero, indicating no statistically significant difference. Subgroup analyses indicated that, except for trial duration, intervention setting, and country income level in specific intervention comparisons, clinical and public health factors did not generally account for differences in SBP reduction. No evidence of publication bias was observed, except between salt substitutes and no intervention and low-sodium diets and no intervention. Conclusions: Network meta-analysis ranked the use of salt substitutes as the most effective intervention, yet self-regulated interventions, such as low-sodium diets and self-monitoring devices, when combined with education-based sodium-reduction approaches, showed comparable point estimates for SBP reductions. Digital health education showed promise as a supportive adjunct to self-regulated interventions, although its effects were variable and require further quantification. These findings underscore the need for alternative sodium-reduction interventions supported by digital or conventional health education to improve blood pressure control. Health education on sodium reduction, including clinical counselling, should be viewed primarily as a complementary component that enhances other interventions. Full article

Background: The Carnivore Diet (CD) is an almost exclusively animal-based dietary pattern that has gained increasing popularity on social media. Despite numerous health-related claims, a standardized definition is lacking, and scientific evidence regarding the long-term effects of this diet remains unclear. Methods: The literature search for this scoping review was conducted in accordance with PRISMA guidelines (PRISMA-ScR) using the databases PubMed, LIVIVO, Web of Science, and the Cochrane Library. Results: Nine human studies were included. Individual publications reported positive effects of the CD, such as weight reduction, increased satiety, and potential improvements in inflammatory or metabolic markers. At the same time, potential risks of nutrient deficiencies, particularly in vitamins C and D, calcium, magnesium, iodine, and dietary fiber, as well as elevated low-density-lipoprotein (LDL-) and total cholesterol (TC) levels, were identified, along with one case describing a deterioration in health status. Overall, the quality of evidence is very limited due to small sample sizes, short study durations, and the absence of control groups. Conclusions: The CD may offer short-term health benefits but carries substantial risks of nutrient deficiencies, reduced intake of health-promoting phytochemicals, and the development of cardiovascular disease. At this time, long-term adherence to a CD cannot be recommended. Full article

Background: Discogenic low back pain (LBP) is a significant therapeutic and social problem. Discopathy is associated with neurological symptoms that severely disrupt the patient’s functional status. Regardless of the choice of neurosurgical procedure for discopathy, its effectiveness highly varies. Aims: This study aimed to assess the effectiveness of neurosurgical treatment and neurorehabilitation procedures based on a comprehensive analysis of a number of neurological symptoms and the functional status of patients with chronic discogenic LBP. Material and Methods: This study involved 110 patients (56 women and 54 men) who underwent first-ever lumbar spine surgery. Before the surgery and 3 months after the hospital discharge, all patients were subjected to neurological examination and comprehensive assessment of neurological symptoms. Results: After the procedure, improvement was shown in sensory disturbance (p < 0.0001), pain (p < 0.0001), and sexual dysfunction (p < 0.0001). The results of lower limb paresis, monoplegia, and sphincter complications remained non-significant. A reduction in scoliosis (p = 0.0040) and lumbar pain (p < 0.0001) was observed. There was a reduction in pain in the lower leg (p = 0.0136) and foot (p = 0.0122) during movements. Improvement in passive and active mobility as well as pain reduction in the lumbar spine area were demonstrated (p < 0.0001). There was significant improvement in the knee and ankle reflexes (p < 0.0001). There were no significant changes in the superficial sensation. In the functional assessment, an improvement in the toe-to-floor test of 13.3 cm was confirmed (p < 0.0001), while there was no difference in the Lasègue’s test. Conclusions: The general and neurological condition of patients with LBP significantly improved after the spine surgery. The improvement included mainly a reduction in pain and sensory disturbances, return of deep reflexes, and increased mobility of the lower limbs and spine. Full article

Low social status leads to chronic social stress that predicts risk for physical and mental illness, especially when it starts early in life. To examine the longitudinal effects of low social status on the immune system, this study assessed the effects of low social status on developmental secretory patterns of pro- and anti-inflammatory markers under baseline conditions, as well as in response to an immune challenge (lipopolysaccharide (LPS)-induced activation of pro- and anti-inflammatory cytokines) in a translational rhesus monkey model of lifelong social subordination stress. Baseline blood samples were collected in 27 socially housed female rhesus monkeys (13 dominants, DOM, and 14 subordinates, SUB) during infancy (6 months), the juvenile pre-pubertal period (16 months), and adulthood (9–10 years) to examine the longitudinal effects of social status on inflammatory markers in unstimulated versus LPS-stimulated conditions mimicking exposure to bacterial infection. Basal levels of the stress hormone cortisol in blood were measured to examine associations between inflammation and activity of the hypothalamic–pituitary–adrenal (HPA) axis throughout the life span. Basal peripheral levels of inflammatory markers (e.g., IL-6) increased across development in both SUB and DOM animals with no significant differences. Basal cortisol levels were significantly higher in infancy as compared to adulthood, but no significant effects of social rank were detected. However, in adulthood, SUB animals showed a cytokine-specific immune response to ex vivo LPS stimulation with significantly higher secretions of IL-1β, IL-2, and IL-10 compared to DOM animals, whereas IL-8 response to LPS was lower in SUB animals than in DOMs. This cytokine-specific response to an immune challenge that mimics bacterial infection could reflect dysregulated immune cells that may have short-term adaptation, but at the cost of longer-term risks for low-grade chronic inflammation and accelerated immune aging for socially subordinate female macaques. Full article

Introduction: The COVID-19 pandemic had significant effects on mental health and lifestyle behaviours, especially among university students who experienced academic disruptions, social isolation, and fewer social interactions. Alcohol consumption has long been part of student culture. Still, the influence of post-pandemic academic reintegration on drinking patterns and psychological distress remains relatively unexplored, particularly in countries like Portugal, where student traditions heavily shape consumption habits. This study aimed to describe the prevalence of alcohol consumption, depression, anxiety, and stress in a sample of Portuguese university students during the post-pandemic academic period, and to explore associations with sociodemographic variables. Methods: A cross-sectional study was conducted in November 2021 with 90 students from a private higher education institution in northern Portugal. Data were collected via an online questionnaire including sociodemographic information, the Alcohol Use Disorders Identification Test (AUDIT), and the Depression, Anxiety and Stress Scale (DASS-21). Result: The majority of the participants were not at risk of alcohol addiction (95.3%). In total, 15.1% of students reported anxiety symptoms ranging from severe to extremely severe. A binomial logistic regression was performed to ascertain the effects of being away from home and psychological distress (DASS-42 score), on the likelihood that participants were at risk of alcohol addiction (Level 3 and 4 in the AUDIT scale). The logistic regression model was statistically significant, χ²(2) = 9.20, p = 0.010. Living away from home was associated with a substantially lower likelihood of high-risk status (B = −2.79, p = 0.034), corresponding to an odds ratio of 0.06, indicating a strong protective effect. DASS-42 total score was positively associated with high-risk status (B = 0.04, p = 0.039), such that higher psychological distress increased the odds of being classified as high risk. Conclusions: The findings reveal a low prevalence of alcohol risk but heightened symptoms of anxiety, depression, and stress. Psychological distress notably increases the likelihood of hazardous alcohol use, emphasising the importance of targeted mental health and alcohol-use interventions among university students. Full article

The successful attainment of the Sustainable Development Goals (SDGs) necessitates robust monitoring frameworks capable of tracking progress toward tangible outcomes while capturing dynamic sustainability trajectories. However, existing SDG evaluation methods suffer from three critical limitations: (1) misalignment between global targets and national priorities, which undermines contextual relevance; (2) fragmented assessments that neglect holistic integration of social, economic, and ecological dimensions, thereby obscuring systemic interdependencies; and (3) insufficient longitudinal analysis, which restricts insights into temporal patterns of sustainable development and hinders adaptive policymaking. To address these gaps, we employed China’s 31 provinces as a case study and constructed an SDG indicator framework comprising 178 metrics—harmonizing global SDG benchmarks with China’s national development priorities. Using official statistics and open-source data spanning 2006–2021, we evaluate longitudinal SDG scores for all 17 goals (SDGs 1–17). Additionally, we developed a composite SDG index that considers the coupling coordination degree of the social–economic–ecological system and evaluated the index value under different economic region settings. Finally, we developed a two-threshold model to analyze the dynamic evolution of SDG conditions, incorporating temporal sustainability (long-term development resilience) and action urgency (short-term policy intervention needs) as dual evaluation dimensions. This model was applied to conduct a longitudinal analysis (2006–2021) across all 31 Chinese provinces, enabling a granular assessment of regional SDG trajectories while capturing both systemic trends and acute challenges over time. The results indicate that China’s social SDG performance improved substantially over the 2006–2021 period, achieving a cumulative increase of 126.53%, whereas progress in ecological SDGs was comparatively modest, with a cumulative growth of only 23.93%. Over the same period, the average composite SDG score across China’s 31 provinces increased markedly from 0.502 to 0.714, reflecting a strengthened systemic alignment between regional development trajectories and national sustainability objectives. Further analysis shows that all provinces attained a status of “temporal sustainability with low action urgency” throughout the study period, highlighting China’s overall progress in sustainable development. Nevertheless, pronounced regional disparities persist: eastern provinces developed earlier and have consistently maintained leading positions; central and northeastern regions exhibit broadly comparable development levels; and western regions, despite severe early-stage lagging, have demonstrated accelerated growth in later years. Our study holds substantial significance by integrating multi-dimensional indicators—spanning ecological, economic, and social dimensions—to deliver a holistic, longitudinal perspective on sustainable development. Full article

Under rapid urbanization and ecological transformation, balancing authenticity preservation with adaptive reuse presents a major challenge for industrial heritage landscapes. This study investigates the Dagushan Iron Mine in Anshan, China’s first large-scale open-pit iron mine and once the deepest in Asia, which is currently undergoing ecological backfilling that threatens its core landscape morphology and spatial integrity. Using a mixed-method approach combining archival research, spatial documentation, qualitative interviews, and expert evaluation through the Analytic Hierarchy Process (AHP), we construct a cross-validated evidence chain to examine how evidence-based industrial landscape heritage values can inform low-intervention digital narrative strategies for off-site learning. This study contributes theoretically by reframing authenticity and integrity under ecological transition as the traceability and interpretability of landscape evidence, rather than material survival alone. Evaluation involving key stakeholders reveals a value hierarchy in which historical value ranks highest, followed by social and cultural values, while scientific–technological and ecological–environmental values occupy the mid-tier. Guided by these weights, we develop a four-layer value-to-narrative translation framework and an animation design pathway that supports curriculum-aligned learning for off-site students. This study establishes an operational link between evidence chain construction, value weighting, and digital storytelling translation, offering a transferable workflow for industrial heritage landscapes undergoing ecological restoration, including sites with World Heritage potential or status. Full article

Background: Amyotrophic lateral sclerosis (ALS) progressively impairs motor function, compromising speech and limiting communication. Augmentative and alternative communication (AAC) is essential to maintain autonomy, social participation, and quality of life for people with ALS (PALS). This review maps technological developments in AAC, from low-tech tools to advanced brain–computer interface (BCI) systems. Methods: We conducted a scoping review following the PRISMA extension for scoping reviews. PubMed, Web of Science, SciELO, MEDLINE, and CINAHL were screened for studies published up to 31 August 2025. Peer-reviewed RCT, cohort, cross-sectional, and conference papers were included. Single-case studies of invasive BCI technology for ALS were also considered. Methodological quality was evaluated using JBI Critical Appraisal Tools. Results: Thirty-seven studies met inclusion criteria. High-tech AAC—particularly eye-tracking systems and non-invasive BCIs—were most frequently studied. Eye tracking showed high usability but was limited by fatigue, calibration demands, and ocular impairments. EMG- and EOG-based systems demonstrated promising accuracy and resilience to environmental factors, though evidence remains limited. Invasive BCIs showed the highest performance in late-stage ALS and locked-in syndrome, but with small samples and uncertain long-term feasibility. No studies focused exclusively on low-tech AAC interventions. Conclusions: AAC technologies, especially BCIs, EMG and eye-tracking systems, show promise in supporting autonomy in PALS. Implementation gaps persist, including limited attention to caregiver burden, healthcare provider training, and the real-world use of low-tech and hybrid AAC. Further research is needed to ensure that communication solutions are timely, accessible, and effective, and that they are tailored to functional status, daily needs, social participation, and interaction with the environment. Full article

Background/Objectives: Healthy ageing, focused on maintaining daily autonomy and cognitive function despite chronic comorbidities, poses a challenge for public health systems, especially for those aged ≥80, given the expected increase in this population. Promoting a healthy lifestyle in this group is essential to achieving this goal, with primary care services playing a key role in this effort. Therefore, our objective was to profile the participants based on these characteristics. Methods: The study included 222 non-institutionalized, dementia-free individuals (mean age 84.58 ± 3.72 years, 56.3% women) recruited from a primary healthcare service. Data were collected from medical records and interviews, including the cognitive Pfeiffer test, the functional Barthel index (BI), and ad hoc questionnaires (for lifestyle variables). Latent profiling analysis (LPA) was used to classify the participants. Results: The participants reported social support (97.7%), low-risk alcohol consumption (94.6%), adherence to the Mediterranean diet (85.1%), physical activity (74.8%), and never smoking (72.5%). Hypertension (86.5%), cataracts (74.3%), and osteoarticular diseases (68.5%) were the most frequent chronic conditions. Women showed a significantly different distribution of certain variables and a higher number of comorbidities (6.34 ± 2.38) than men (5.58 ± 2.44) (p = 0.019). After LPA, we found that 38.29% of individuals met characteristics compatible with healthy ageing, predominantly male (60%); the association of a high probability of cognitive impairment with a high degree (severe or total), exhibited by the profiles likely >85% women (18.5% of individuals); physical activity, smoking, osteoporosis, anxiety, COPD, chronic kidney disease (CKD), and creatinine blood levels exhibited statistical differences between profiles; and the probability of dependence severity was associated with an increase in age, although cognitive status conservation was associated being male. Conclusions: The studied +80 group seems to follow a healthy lifestyle, as self-reported. Women fare worse than men in resilient ageing. While common factors related to dysfunctionality did not differentiate between profiles, CKD, an increasingly common age-related condition, did. Full article

Background: Identifying factors associated with cognitive impairment among older adults is critical. This study investigates both concurrent and longitudinal associations between sleep quality, sleep duration, and cognitive performance among older adults in China, with particular emphasis on the moderating role of fruit and/or vegetable intake (FVI), a factor rarely examined in previous research. Methods: We pooled five waves of a specially designed nationwide sample of adults aged 65 years or older (N = 64,690; mean age: 86.3 years; men: 43.5%) in 2005, 2008, 2011, 2014, and 2018 in China. Cognitive impairment was assessed by the Mini-Mental State Examination. Among the sample, 10.7% were cognitively impaired. FVI was dichotomized into frequent (almost daily) versus infrequent (other low frequencies). Sleep hours were grouped into short (≤6 h), normal (7–9 h), and long (≥10 h) durations. Both concurrent and cross-lagged analyses were performed after adjusting for a wide set of covariates (demographics, socioeconomic status, family/social connections, health practices, disability, self-rated health, and chronic conditions). Analyses were further stratified by gender, age group, and urban–rural residence. Results: When all covariates were present (the full model), good sleep quality was associated with 22% lower odds of the prevalence of cognitive impairment, whereas the long sleep duration was associated with 24% higher odds as compared with the normal sleep duration. Although the short sleep duration was not associated with the prevalence of cognitive impairment in the full model, it was associated with 8% higher odds of cognitive impairment when health condition was not controlled for. Interaction analyses revealed that frequent FVI buffered the adverse cognitive effects of poor sleep quality and both short and long sleep durations. Subgroup analyses further show similar patterns across subpopulations, with more pronounced protective associations in older women and the oldest-old. Conclusions: Good sleep quality, normal sleep durations, and frequent FVI jointly contribute to better cognitive functioning at older ages. While the observed relationships are largely concurrent rather than causal, promoting both healthy sleep and dietary habits may be important for cognitive health among older adults. Full article

Background: An increasing number of university students report feeling lonely, a negative experience arising from a mismatch between perceived and actual social relationships. Loneliness has been linked to poorer mental health. However, the relationship between qualitative (sources of loneliness) and quantitative (high or low) differences in loneliness and mental health is under researched. The aims of this research were to (a) identify profiles of loneliness among university students across three indicators of loneliness, namely, social, family, and romantic indicators, using latent profile analysis (LPA); (b) examine the differences among identified profiles based on dimensions of mental health indicators (depression, anxiety, and stress), social support, and life satisfaction; and (c) assess profile membership based on demographic variables (gender, social isolation, relationship status, and education characteristics) and the Big Five personality traits (extraversion, agreeableness, openness, conscientiousness, and neuroticism). Method: A cross-sectional survey was conducted on 912 university students from five cities in Uttar Pradesh, India. Participants completed questionnaires covering demographic details and validated measures assessing loneliness, depression, stress, anxiety, social support, life satisfaction, and the Big Five personality traits. Data were analyzed using the latent profile module in Jamovi and fit indices, namely, BIC, AIC, and BLRT, and entropy was used to select the best profile. Results: The latent profile analysis identified four profiles for university student loneliness, including Social and emotional lonely (31.4%), Moderate romantic lonely (23.8%), Moderate social lonely (8.2%), and Severe romantic lonely (36.6%). Moreover, the Social and emotional lonely profile scored the highest on depression, anxiety, and stress. The Moderate romantic lonely profile scored the highest on life satisfaction and social support. Being in a relationship decreased the likelihood of being categorized as Severe romantic lonely. In terms of personality, neuroticism was the strongest predictor of profile membership. This study is a step towards identifying at-risk lonely individuals with varying sources of loneliness. Identifying different profiles of lonely individuals will have direct implications for designing interventions that cater to a particular group rather than a one-size-fits-all approach. Full article

Background/Objectives: Population aging in Europe presents significant healthcare, economic, and social challenges, particularly in the care of individuals with chronic diseases and frailty. Advance Care Planning (ACP) fosters patient autonomy and aligns end-of-life care with individual preferences. This study aimed to evaluate the acceptability and feasibility of an ACP model in nursing homes. Secondary objectives included exploring clinical characteristics of participants and assessing how frailty is associated with residents’ care goals and preferences. Methods: A prospective observational study was conducted among long-term residents of a Spanish nursing home in 2023. ACP was offered to all new permanent residents, with outcomes assessed through quarterly follow-ups. Acceptance rates, care preferences, and resident satisfaction were primary measures. Clinical data, frailty, functional status, cognitive assessments, and nutritional status were analyzed. The model of ACP is structured into three progressive levels: (1) identification of patients’ values, preferences, and global goals of care; (2) decision-making regarding specific clinical interventions in acute situations; and (3) end-of-life care preferences, including preferred place of death, desired companionship, and comfort-focused measures. Results: From 79 new residents admitted, 93.7% accepted ACP. The process required an average of 139 min to complete, distributed over 3–4 sessions. The main documented preferences included do-not-resuscitate orders (CPR) (79%), hospital transfer decisions (50%), and other individualized care choices. When stratified by frailty level, which was categorized as low, moderate, or high—we observed a clear gradient in care preferences. CPR preference increased from 59.3% (Low) to 87.5% (Moderate) and 95.2% (High). Preference to avoid hospital transfer rose from 22.2% to 50.0% and 85.7%, respectively. Avoidance of instrumentalization increased from 56.2% to 85.0% and 95.0%. Conclusions: ACP in nursing homes is highly acceptable and feasible, with benefits in aligning care with patient preferences and enhancing satisfaction. Full article

Background/Objectives: Loneliness is a significant public health issue among older adults, especially in rural and socioeconomically vulnerable groups. Telephone-based interventions have become a scalable, cost-effective way to reduce social isolation, although evidence of their long-term effects on various health outcomes remains limited. This study aimed to assess how effective HELPeN, a structured telephone program delivered by trained nursing students, is in decreasing loneliness and enhancing psychosocial and cognitive health in community-living older adults. Methods: A randomized controlled trial was conducted with 119 older adults (≥65 years) residing in the community. Participants were allocated to either an intervention group (n = 65), which received weekly structured telephone calls over 9 months, or a control group (n = 54), which received standard care. Outcomes were evaluated at baseline (M0), mid-intervention (M1–M3), and 3 months after the intervention (M4). The primary outcomes measured included loneliness and perceived social support. Secondary outcomes comprised functional status, comorbidities, depressive symptoms, quality of life, sleep quality, and cognitive function. The data were analyzed using repeated-measures ANOVA with Greenhouse–Geisser correction. Results: Significant group interactions over time were identified for loneliness (F = 5.92, p = 0.001, η² = 0.067), social support (F = 3.39, p = 0.023, η² = 0.043), depressive symptoms (F = 3.87, p = 0.019, η² = 0.046), and cognitive status (F = 5.35, p = 0.002, η² = 0.063). No significant differences were found for functional status, comorbidity, sleep quality, or quality of life. Conclusions: The HELPeN program demonstrated significant effectiveness in reducing loneliness and social isolation, and in improving emotional, cognitive, and sleep-related outcomes in older adults. As a low-cost and scalable model, this intervention strengthens the role of nursing students in addressing social determinants of health and may be integrated into community and public health strategies targeting vulnerable aging populations. Full article