Search Results (544)

Nature-based health interventions (NBHIs) are increasingly used in the healthcare system to support people with anxiety, depression and/or stress, highlighting the need for systematic development and evaluation. This study aims to identify target group, professionals, mechanisms, and outcomes of NBHIs for people with mild to moderate anxiety, depression, and/or stress. A Delphi-based study was conducted to explore core components of NBHIs in healthcare settings. Thirteen vs. eleven researchers with expertise related to the target group responded in two rounds. Respondents rated statements on a 7-point Likert scale and prioritised core components regarding target group, professionals, mechanisms, and outcomes. A thematic analysis was applied to synthesise qualitative responses. Consensus was achieved on 12 of 21 items across the four domains. Highest agreement concerned core mechanisms (nature interaction, social community, and physical activity), outcome priorities (mental wellbeing and quality of life), and professional competencies. Greater variation was observed regarding group composition and team delivery. Analysis of qualitative expert responses highlighted four key themes: (1) Balancing Group Composition, (2) Adapting Competencies to Context, (3) Core Mechanisms for Change, and (4) Weighing Perspectives in Outcome Selection. By setting out guiding principles for a programme theory, the study lays the foundation for the design and implementation of context-adapted NBHIs. The study underscores the need to approach NBHIs as complex interventions, thus contributing to a paradigm shift towards a new era of a bio-psycho-social health perspective. Full article

Climate change and land-use intensification are speeding up the loss of ecosystem services that support human health, food security, and environmental stability. Vegetative interventions—such as urban forests in cities and cover crops in farming systems—are increasingly seen as nature-based solutions for climate adaptation. However, their benefits are often viewed separately. This review combines 20 years of research to explore how these strategies, together, improve provisioning, regulating, supporting, and cultural ecosystem services across various landscapes. Urban forests help reduce urban heat islands, improve air quality, manage stormwater, and offer cultural and health benefits. Cover crops increase soil fertility, regulate water, support nutrient cycling, and enhance crop yields, with potential for carbon sequestration and biofuel production. We identify opportunities and challenges, highlight barriers to adopting these strategies, and suggest integrated frameworks—including spatial decision-support tools, incentive programs, and education—to encourage broader use. By connecting urban and rural systems, this review underscores vegetation as a versatile tool for resilience, essential for reaching global sustainability goals. Full article

This follow-up study investigates the long-term environmental sustainability and remediation outcomes of the UPPER (‘Urban Productive Parks for Sustainable Urban Regeneration’-UIA04-252) project in Latina, Italy, focusing on Nature-Based Solutions (NbS) applied to urban green infrastructure. By integrating proximal and satellite-based remote sensing methodologies, the research evaluates persistent improvements in vegetation health, soil moisture dynamics, and overall environmental quality over multiple years. Building upon the initial monitoring framework, this case study incorporates updated data and refined techniques to quantify temporal changes and assess the ecological performance of NbS interventions. In more detail, ground-based data from meteo-climatic, air quality stations and remote satellite data from the Sentinel-2 mission are adopted. Ground-based measurements such as temperature, humidity, radiation, rainfall intensity, PM10 and PM2.5 are carried out to monitor the overall environmental quality. Updated satellite imagery from Sentinel-2 is analyzed using advanced band ratio indices, including the Normalized Difference Vegetation Index (NDVI), the Normalized Difference Water Index (NDWI) and the Normalized Difference Moisture Index (NDMI). Comparative temporal analysis revealed consistent enhancements in vegetation health, with NDVI values significantly exceeding baseline levels (NDVI 2022–2024: +0.096, p = 0.024), demonstrating successful vegetation establishment with larger gains in green areas (+27.0%) than parking retrofits (+11.4%, p = 0.041). However, concurrent NDWI decline (−0.066, p = 0.063) indicates increased vegetation water stress despite irrigation infrastructure. NDMI improvements (+0.098, p = 0.016) suggest physiological adaptation through stomatal regulation. Principal Component Analysis (PCA) of meteo-climatic variables reveals temperature as the dominant environmental driver (PC2 loadings > 0.8), with municipality-wide NDVI-temperature correlations of r = −0.87. These multi-scale findings validate sustained NbS effectiveness in enhancing vegetation density and ecosystem services, yet simultaneously expose critical water-limitation trade-offs in Mediterranean semi-arid contexts, necessitating adaptive irrigation management and continued monitoring for long-term urban climate resilience. The integrated monitoring approach underscores the critical role of continuous, multi-scale assessment in ensuring long-term success and adaptive management of NbS-based interventions. Full article

Heavy metals are widespread environmental contaminants from natural and anthropogenic sources, posing risks to human health and ecosystems. In urban areas, levels are elevated due to industrial activity, traffic emissions, and building materials. Camden, New Jersey, a city with a history of industry and illegal dumping, faces increased risk due to aging sewer and stormwater systems. These systems frequently flood neighborhoods and parks, heightening residents’ exposure to heavy metals. Despite this, few studies have examined metal distribution in Camden, particularly during storm events. This study analyzes stormwater metal concentrations across residential and commercial areas to assess contamination levels, potential sources, and land use associations. Stormwater samples were collected from 33 flooded street locations after four storm events in summer 2023, along with samples from a flooded residential basement during three storms. All were analyzed for total lead, cadmium, and arsenic using inductively coupled plasma–mass spectrometry (ICP-MS, (Department of Chemistry and Biochemistry, Rowan University, Glassboro, NJ, USA)). Concentration data were visualized using geographic information system (GIS)-based mapping in relation to land use, socioeconomic, and public health factors. In Camden’s stormwater, lead levels (1–1164 µg L⁻¹) were notably higher than those of cadmium (0.1–3.3 µg L⁻¹) and arsenic (0.2–8.6 µg L⁻¹), which were relatively low. Concentrations varied citywide, with localized hot spots shaped by environmental and socio-economic factors. Principal component analysis indicates lead and cadmium likely originate from shared sources, mainly industries and illegal dumping. Notably, indoor stormwater samples showed higher heavy metal concentrations than outdoor street samples, indicating greater exposure risks in flooded homes. These findings highlight the spatial variability and complex sources of heavy metal contamination in stormwater, underscoring the need for targeted interventions in vulnerable communities. Full article

Climate change and sea-level change (SLC) are intensifying flooding in U.S. coastal communities, with disproportionate impacts on Black and minority neighborhoods that face displacement, economic hardship, and heightened health risks. In Norfolk, Virginia, sea levels are projected to rise by at least 0.91 m (3 ft) by 2100, placing underserved neighborhoods such as Oakleaf Forest at particular risk. This study investigates the compounded impacts of flooding at both the building and urban scales, situating the work within the framework of the UN Sustainable Development Goals (UN SDGs). A mixed-method, community-based approach was employed, integrating literature review, field observations, and community engagement to identify flooding hotspots, document lived experiences, and determine preferences for adaptation strategies. Community participants contributed actively through mapping sessions and meetings, providing feedback on adaptation strategies to ensure that the process was collaborative, place-based, and context-specific. Preliminary findings highlight recurring flood-related vulnerabilities and the need for interventions that address both environmental and social dimensions of resilience. The study proposes multi-scale, nature-based solutions (NbS) to mitigate flooding, restore ecological functions, and enhance community capacity for adaptation. Ultimately, this work underscores the importance of coupling technical strategies with participatory processes to strengthen resilience and advance climate justice in vulnerable coastal neighborhoods. Full article

Dysphagia and dysarthria are common, co-occurring manifestations in neurodegenerative diseases, resulting from damage to distributed neural networks involving cortical, subcortical, cerebellar, and brainstem regions. These disorders profoundly affect patient health and quality of life through complex sensorimotor impairments. Objective: The aims was to provide a comprehensive, evidence-based review of the neuroanatomical substrates, pathophysiology, diagnostic approaches, and management strategies for dysphagia and dysarthria in neurodegenerative diseases with emphasis on their multisystem nature and integrated treatment approaches. Methods: A narrative literature review was conducted using PubMed, Scopus, and Web of Science databases (2000–2024), focusing on Parkinson’s disease (PD), amyotrophic lateral sclerosis (ALS), progressive supranuclear palsy (PSP), and multiple system atrophy (MSA). Search terms included “dysphagia”, “dysarthria”, “neurodegenerative diseases”, “neural networks”, “swallowing control” and “speech production.” Studies on neuroanatomy, pathophysiology, diagnostic tools, and therapeutic interventions were included. Results: Contemporary neuroscience demonstrates that swallowing and speech control involve extensive neural networks beyond the brainstem, including bilateral sensorimotor cortex, insula, cingulate gyrus, basal ganglia, and cerebellum. Disease-specific patterns reflect multisystem involvement: PD affects basal ganglia and multiple brainstem nuclei; ALS involves cortical and brainstem motor neurons; MSA causes widespread autonomic and motor degeneration; PSP produces tau-related damage across multiple brain regions. Diagnostic approaches combining fiberoptic endoscopic evaluation, videofluoroscopy, acoustic analysis, and neuroimaging enable precise characterization. Management requires multidisciplinary Integrated teams implementing coordinated speech-swallowing therapy, pharmacological interventions, and assistive technologies. Conclusions: Dysphagia and dysarthria in neurodegenerative diseases result from multifocal brain damage affecting distributed neural networks. Understanding this multisystem pathophysiology enables more effective integrated assessment and treatment approaches, enhancing patient outcomes and quality of life. Full article

Dementia is a progressive condition that affects cognition, communication, mobility, and independence, posing growing challenges for individuals, caregivers, and healthcare systems. While traditional care models often focus on symptom management in later stages, emerging artificial intelligence (AI) technologies offer new opportunities for proactive and personalized support across the dementia trajectory. This concept paper presents the Assistive Intelligence framework, which aligns AI-powered interventions with each stage of dementia: preclinical, mild, moderate, and severe. These are mapped across four core domains: cognition, mental health, physical health and independence, and caregiver support. We illustrate how AI applications, including generative AI, natural language processing, and sensor-based monitoring, can enable early detection, cognitive stimulation, emotional support, safe daily functioning, and reduced caregiver burden. The paper also addresses critical implementation considerations such as interoperability, usability, and scalability, and examines ethical challenges related to privacy, fairness, and explainability. We propose a research and innovation roadmap to guide the responsible development, validation, and dissemination of AI technologies that are adaptive, inclusive, and centered on individual well-being. By advancing this framework, we aim to promote equitable and person-centered dementia care that evolves with individuals’ changing needs. Full article

Hypertension is a major global health challenge, with excessive dietary salt intake recognized as a key environmental factor contributing to its pathogenesis. However, safe and effective dietary interventions for salt-sensitive hypertension remain limited. Vine tea (Ampelopsis grossedentata), a traditional herbal tea widely consumed for centuries in southern China, has been reported to exhibit antioxidant, anti-inflammatory, and hepatoprotective activities, yet its antihypertensive efficacy and underlying mechanisms remain unclear. In this study, the chemical profile of vine tea aqueous extract (VTE) was characterized by UPLC–Q–TOF–MS, identifying dihydromyricetin, isoquercitrin, and myricetin as the predominant flavonoids. The protective effects of VTE were evaluated in C57BL/6J mice with high-salt-diet (HSD)-induced hypertension. VTE treatment significantly lowered systolic blood pressure and ameliorated cardiac and renal injury, accompanied by reduced inflammation, fibrosis, and cardiac stress-related gene expression. Gut microbiota analysis using 16S rRNA gene sequencing revealed that VTE restored microbial richness and diversity, enriching short-chain fatty acid-producing taxa while suppressing pathogenic Desulfovibrio and Ruminococcus torques. Untargeted plasma metabolomic profiling based on UPLC–Q–TOF–MS further showed that VTE normalized tryptophan, bile acid, and glycerophospholipid metabolism, decreasing the uremic toxin indoxyl sulfate while increasing tauroursodeoxycholic acid. Notably, these protective effects were abolished under antibiotic-induced microbiota depletion, confirming that VTE acts through a gut microbiota-dependent mechanism. Collectively, VTE mitigates salt-induced hypertension and cardiorenal injury by remodeling the gut microbiota–metabolite axis, supporting its potential as a natural dietary intervention for managing hypertension. Full article

Urban rivers are essential resources for human societies; however, their degradation poses serious public health, economic, and environmental risks. Conventional physical remediation methods can partially mitigate pollution by targeting specific contaminants, but they are often limited in scope, lack long-term sustainability, and fail to restore ecological functions. In contrast, biotechnological approaches integrated with ecological engineering offer sustainable and nature-based solutions for river depollution, conservation, and revitalization. Although these strategies are supported by a solid theoretical framework and successful applications in other aquatic systems, their large-scale implementation in urban rivers has only recently begun to gain momentum. This review critically examines strategies for the revitalization of polluted urban rivers, progressing from conventional remediation techniques to advanced biotechnological interventions. It highlights real-world applications, evaluates their advantages and limitations, and discusses policy frameworks and management strategies required to promote the broader adoption of biotechnological solutions for sustainable urban river restoration. The goal is to demonstrate the transformative potential of integrated biotechnological, eco-engineering, and data-driven approaches—particularly microbial, phytoplankton-based, and biofilm systems—to reduce energy demand and carbon emissions in urban river restoration while highlighting the need for scalable designs, adaptive management, and supportive regulatory frameworks to enable their large-scale implementation. Full article

Background/Objectives: The search for biomarkers of cognition has garnered significant interest over the past decade, owing to their objective nature, in contrast to the currently available cognition screening tools, which are based on subjective measures. Retina imaging is used in this field because its tissue is considered as an extension of the brain’s vascular and neural structures, reflecting overall brain health. In cognitive disorders, early detection and intervention are essential for achieving the best possible outcomes. To evaluate the physiological correlates of cognitive function in healthy young adults by assessing retinal structures as a non-invasive biomarker of cognitive health. Methods: Eighty healthy young adults participated in this study. Optical Coherence Tomography (OCT) was used to measure retinal morphology, including macular thickness, volume, and retinal nerve fiber layer thickness; then, OCT results were correlated with cognitive assessments using the Montreal Cognitive Assessment (MoCA). Results: Participants with mild cognitive impairment exhibited thinner macular thickness and lower macular volume (p < 0.05, p < 0.001) than participants with normal cognitive function. We also found that macular thickness is positively associated with cognitive function in healthy adults (p < 0.001). The RNFL was found to be normal in all groups, despite changes in macular thickness, indicating that cognitive function in normal individuals depends on macular changes rather than the optic nerve. Conclusions: Macular OCT, which is a cost-effective and widely available tool, can be used to screen for mild cognitive impairment. A clinical trial is recommended to validate these findings and to generate guidelines for assessing cognitive physiology through the retina. Full article

Background: Psychological services within hospitals are essential to delivering integrated, patient-centred care, yet in many health systems they remain fragmented, variably organised, or confined to specific medical specialties. The Clinical Psychology Unit of the Fondazione Policlinico Universitario Agostino Gemelli, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), represents one of the few examples of a hospital-wide psychological governance model in Italy, but its organisational structure and longitudinal activity have not previously been systematically described. Objective: This study (I) describes the organisational design and operational components of the Gemelli Unit; (II) compares it with international organisational models using a typological framework; and (III) examines its resilience and adaptive capacity during the coronavirus disease 2019 (COVID-19) pandemic. Methods: A descriptive–narrative approach was adopted, integrating institutional documentation, routinely collected service data (2019–2024), anonymised case vignettes, and a structured comparison with national and international psychological care structures. The analysis was informed by theoretical models of integrated health-care delivery and by Donabedian’s structure–process–outcome framework. Results: Between 2019 and 2024, psychological interventions increased from 28,878 to 47,076 (+63%), with a post-pandemic average of 41,868 annual interventions. In 2024, the Unit supported 2150 patients and 340 healthcare professionals, with psycho-oncology accounting for approximately one-third of all activities. The model integrates clinical activity, staff support, conflict management, research, and training under a centralised governance structure, ensuring hospital-wide coverage and coordinated referral pathways. The comparative analysis identified four international organisational types—department-based, liaison/specialty-based, structured health-system, and academic–clinical hybrid—highlighting the hybrid and transversal nature of the Gemelli Unit and its capacity to maintain and adapt services during the COVID-19 emergency. Conclusions: The Gemelli Unit represents a distinctive hospital-wide organisational model that combines centralised governance, transversal deployment, personalised care, and structured support for healthcare professionals. These characteristics position it as a potentially transferable benchmark for health systems seeking to integrate psychological care into core organisational and clinical processes. Future work should prioritise the development of standardised outcome indicators and national frameworks to support the evaluation and harmonisation of hospital-based psychological services. Full article

Background/Objectives: Suicide is the second leading cause of death among adolescents and young adults. Those suffering from psychiatric illnesses are at particular risk. Our study, conducted at an outpatient mental health facility in Northern Italy, aimed at delineating demographic and psychopathological features of youths aged 16–29 who attempted suicide and were referred to our community-based outpatient service. Methods: We identified 63 subjects, most of whom suffered from personality disorders, mood disorders, and schizophrenia spectrum disorders. Analysis of variance and post hoc pairwise comparisons were performed. Results: Inferential analysis yielded significant results in terms of age at index suicide attempt across diagnostic groups. Patients with personality disorders attempted suicide at a younger age (M = 18.70) compared to those with schizophrenia spectrum disorders (M = 23.64; η² = 0.32). Conclusions: Our findings highlighted the period of transition from adolescence to adulthood as a stress on the need of preventive approaches towards suicidality in young people in both clinical and non-clinical settings. Moreover, the difference of age at index suicide attempt across different diagnostic groups stresses the need for tailored clinical interventions based on the specific psychopathological trajectories and natural histories of the diseases. Full article

Rapid weight loss (RWL) is a common strategy among combat sports athletes aiming for a competitive advantage. However, it imposes significant immunological stress that compromises both innate and adaptive immune defenses. This systematic review synthesizes current experimental and mechanistic evidence on the effects of RWL in combat sports, focusing on cellular immunity, neuroendocrine regulation, and inflammatory pathways. Acute RWL activates the hypothalamic–pituitary–adrenal axis, elevating plasma cortisol and suppressing lymphocyte proliferation, T-cell function, and natural killer cell cytotoxicity. Although neutrophil counts increase, their phagocytic and oxidative burst capacities decline, reflecting impaired host defense. Monocyte and macrophage systems shift toward proinflammatory phenotypes, while mucosal immunity is weakened by reductions in secretory immunoglobulin A, leading to increased upper respiratory tract infection risk. The magnitude and speed of weight loss are critical determinants of immune dysfunction, with reductions exceeding 5% of body mass producing particularly severe consequences. Evidence-based intervention strategies—including gradual weight management, nutritional optimization, and biomarker monitoring—are essential to mitigate immunosuppression and safeguard athlete health. This review highlights key gaps in combat sports-specific protocols and proposes integrated approaches to preserve immune competence and optimize performance. Full article

Urban health, well-being, and equity—core objectives of Sustainable Development Goals (SDGs 3, 10, and 11)—have become key themes in contemporary urban planning research and landscape research. While existing studies focus predominantly on quantitative assessment, environmental exposure, and human mobility, the historical origins of health-oriented urban green space planning remain insufficiently explored. Focusing on Lingnan area as a representative case, this research investigates the emergence of public green space in late Qing cities and its early contributions to urban health and spatial governance. Through a systematic examination of American and British Gardens at the Thirteen Factories in Guangzhou, the planned public green space system of the Shameen concession, and the municipal greening practices of neighboring Hong Kong and Macao, the study further analyzes Zhang Zhidong’s tree-lined boulevard project along Changdi avenue as a key instance of localized institutional adaptation. Drawing on late-Qing and Republican newspapers, nineteenth-century Western travelogs and reports, historical and contemporary studies and photo albums, the study finds the following: (1) the American and British Gardens marked the earliest emergence of health-oriented urban green space in Lingnan area; (2) the systematically planned green space network of the Shameen concession constituted a prototypical form of health-oriented urban green space planning; (3) the botanical gardens, street-tree systems, public parks, and institutionalized management practices in Hong Kong and Macao exerted a strong regional demonstrative influence on Guangzhou; (4) the street-tree planting along Changdi Avenue represented a localized absorption of foreign planning paradigms and marked the institutionalization of municipal greening in Guangzhou. Although these early practices did not yet form a modern healthy city planning framework at that time, they played a crucial role in improving urban sanitation, enhancing public space quality, and shaping urban order. By tracing the historical trajectory from transnational demonstration to local adaptation and institutional consolihdation, this study provides new insights into the historical foundations of health-oriented urban planning in China and contributes a long-term perspective to contemporary debates on healthy cities and nature-based urban interventions. Full article

Background: Balneotherapy (BT) has been proposed as a supportive intervention for post-COVID-19 musculoskeletal (MSK) and fatigue-related symptoms; however, comparative evidence across different BT delivery modes remains limited. This study aimed to evaluate the long-term effects of a BT-based treatment program on MSK health and related functional outcomes in individuals with a history of COVID-19. Methods: This secondary analysis was derived from a multicenter, randomized, controlled, single-blinded trial conducted from January to September 2023 across six Lithuanian medical spa centers. Participants with a self-reported history of COVID-19 and persistent multisystem symptoms were assigned to one of three BT modalities or a control group. Primary outcomes included MSK pain, muscle tension and spasm, handgrip strength, and trunk flexibility. Secondary outcomes included fatigue, sleep, quality of life, and analgesic use. Assessments were performed at baseline, post-treatment, and at three- and six-month follow-ups. The 2-week BT program consisted of daily sessions of light pool exercise, mineral baths, sapropel body wraps, and halotherapy. Data were analyzed using repeated-measures GLM in IBM SPSS Statistics (version 28.0). Results: Significant time effects were observed for MSK pain, muscle tension, spasms, fatigue, sleep disturbance, flexibility, and quality of life (all p < 0.05). Improvements occurred primarily within groups and were most pronounced immediately post-treatment, with partial maintenance at 3–6 months. Between-group differences were modest; however, ambulatory BT, inpatient BT, and BT combined with nature therapy demonstrated greater long-term improvements in several outcomes. Conclusions: BT was associated with beneficial changes across MSK and psychosocial domains in individuals recovering from COVID-19, although differences between BT modalities were limited. These findings support BT as a complementary component within multimodal post-COVID rehabilitation frameworks and highlight the need for further research on long-term maintenance and individualized treatment strategies. Full article