Search Results (9,580)

Objective: This study aims to evaluate the effectiveness of a combined rehabilitative program integrating Graded Motor Imagery (GMI) and Occupational Therapy in improving upper limb function and autonomy in individuals with acquired brain injuries (ABIs), including stroke and traumatic brain injury. Methods: Twelve patients (mean age of 56.4 years) underwent a six-week intervention combining GMI and Occupational Therapy. Outcome measures included the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH), Jebsen Taylor Hand Function Test (JTHFT), Canadian Occupational Performance Measure (COPM), 12-Item Short Form Health Survey (SF-12), Numeric Rating Scale for pain (NRS), and Montreal Cognitive Assessment (MoCA). Assessments were conducted at baseline, post-treatment, and at 3- and 6-month follow-ups. Data were analyzed using the Wilcoxon signed-rank test. Results: Statistically significant improvements (p < 0.05) were found in upper limb function (DASH), occupational performance and satisfaction (COPM), and physical health status (SF-12 physical component). Specific gains in hand function—particularly in writing and eating—were detected using the JTHFT. No significant changes were observed in pain perception or mental health outcomes. Conclusions: The integration of GMI with Occupational Therapy appears to be a promising and well-tolerated intervention for enhancing motor function and daily life participation in individuals with ABI. Although the small sample limits generalizability, these preliminary findings support further investigation through larger, controlled studies. Full article

Background/Objectives: Gestational weight gain (GWG) is a crucial factor influencing mother and fetal health, as high GWG is associated with adverse pregnancy outcomes and an increased long-term risk of obesity and metabolic issues in the children. In addition to controlling weight, maternal physical activity (PA) during pregnancy may influence fetal development through potential epigenetic mechanisms, including histone modifications, DNA methylation, and the production of non-coding RNA. Methods: This narrative review synthesizes evidence from randomized controlled trials (RCTs; n = 11, 3654 participants) investigating the impact of aerobic PA on GWG, while also highlighting emerging, primarily indirect findings on maternal–fetal epigenetic programming. Results: The majority of RCTs found that supervised PA interventions, especially when paired with nutritional counseling, decreased both the incidence of excessive GWG and total GWG. Enhancements in lipid metabolism, adipokine profiles, and maternal insulin sensitivity point to likely biochemical mechanisms that connect PA to epigenetic modification of fetal metabolic genes (e.g., IGF2, PGC-1α, LEP). Animal and observational studies suggest that maternal activity may influence offspring epigenetic pathways related to obesity and cardiometabolic conditions, although direct human evidence is limited. Conclusions: In addition to potentially changing gene–environment interactions throughout generations, prenatal PA is a low-cost, safe method of improving maternal and newborn health. Future RCTs ought to incorporate molecular endpoints to elucidate the epigenetic processes by which maternal exercise may provide long-term health benefits. Full article

Exercise plays a crucial role in promoting overall health by activating molecular pathways that contribute to the prevention and management of chronic diseases, slowing epigenetic aging, improving body composition, and reducing the risk of obesity. In skeletal muscle, these benefits are largely mediated by exercise-induced transcriptional and epigenetic responses. Recent advances in epigenetics have intensified interest in understanding how physical activity influences long-term health and body composition at the molecular level. Epigenetic modifications, which regulate gene expression without altering the DNA sequence, are key mechanisms in this process. Emerging research has provided deeper insights into the processes such as DNA methylation, histone modification, and non-coding RNAs, and their connection to exercise. While numerous studies have demonstrated the influence of exercise on the epigenome, fewer have directly examined how these molecular changes relate to alterations in fat mass, lean body mass, and other components of body composition. This comprehensive review synthesizes the current evidence on the interplay between exercise, epigenetic regulation, and body composition, with a focus on adolescents and adults. We highlight key genes involved in metabolism, fat storage, muscle development, and epigenetic aging, and explore how their regulation may contribute to individual variability in exercise response. Understanding these molecular pathways may provide valuable insights for optimizing exercise interventions aimed at improving health outcomes across the lifespan. Full article

Use of anticholinergic and sedative medications is potentially inappropriate in older adults due to associated adverse effects, including impaired cognitive and physical function. This study evaluated anticholinergic and sedative burden in Croatian community-dwelling older adults using the Drug Burden Index (DBI) and examined its association with self-reported health and healthcare utilization over 12 months. This observational, cross-sectional study, part of the EuroAgeism H2020 ESR 7 project, included conveniently sampled adults ≥ 65 years from community pharmacies in three Croatian regions. Data were collected using a standardized research questionnaire. DBI was used to quantify exposure to anticholinergic and sedative medications. Multivariate regression analyses examined associations between DBI and health outcomes, using logistic regression for binary outcomes and linear regression for self-reported health. Among 388 participants (63.7% female, median age 73), most had multimorbidity (median five diagnoses) and polypharmacy (63.9%), while 57% used at least one DBI medication—most commonly diazepam (15.5%) and tramadol (14.7%). High DBI (≥1) independently predicted more emergency department (ED) visits (OR = 2.45) and worse self-rated health (B = −0.26), but not hospitalization. High DBI in older adults was associated with more ED visits and poorer self-rated health, highlighting the need for targeted interventions to reduce anticholinergic and sedative use in this vulnerable population. Full article

(1) Background: The global increase in life expectancy has generated growing interest in strategies that support functional independence and quality of life among older adults. Functional fitness—including strength, mobility, flexibility, and aerobic endurance—is essential for preserving autonomy during aging. In this context, physical exercise, particularly High-Intensity Interval Training (HIIT), has gained attention for its time efficiency and physiological benefits. This randomized controlled trial aimed to evaluate the effects of a group-based HIIT program on functional fitness in older adults; (2) Methods: Functional outcomes were assessed before, during, and after a 65-week intervention using standardized field tests, including measures of upper and lower body strength, flexibility, aerobic endurance, and agility. This study was prospectively registered at ClinicalTrials.gov (NCT07170579); (3) Results: Significant improvements were observed in the HIIT group across multiple domains of functional fitness compared to the control group, notably in upper body strength, lower limb flexibility, cardiorespiratory endurance, and mobility; (4) Conclusions: These results suggest that HIIT is an effective and adaptable strategy for improving functional fitness in older adults, with the potential to enhance performance in daily activities and support healthy aging in community settings. Full article

Over the past decades, women’s participation in horticulture has become increasingly apparent across Africa. Women perform physically demanding agricultural work on family farms, as hired laborers, or as paid workers on other farms. To increase yield and protect crops, pesticides are used, yet the health risks faced by these women remain under-researched. This qualitative exploratory case study conducted in 2023, in four villages in northern Tanzania, explored pesticide exposure risks, gender roles, and awareness among women working on horticultural farms. Data were collected through four focus group discussions with 46 women (mean age, 39 years; mean work experience, 10 years). Data was transcribed and thematically analyzed. Six themes emerged: gender division of labor, limited training and awareness, adverse health effects, unsafe storage and disposal practices, inadequate protective measures, and resilience. Although pesticide spraying was typically performed by men, poor or unmarried women also undertook this task. Women had limited access to training on safe pesticide handling, and protective gear was rarely used. Despite awareness of potential health risks, economic necessity and prevailing gender norms compelled continued exposure. Gender-sensitive interventions including targeted occupational health education and promotion of safer agricultural practices are urgently needed to reduce pesticide-related health effects among women. Full article

Background/objectives: Alcohol use during pregnancy can result in adverse outcomes for the offspring, including Fetal Alcohol Spectrum Disorders (FASD). Psychosocial and contextual factors may influence gestational alcohol intake and women’s risk perception. This systematic review aimed to assess pregnant women’s and women of childbearing age’s perceived risk of alcohol use during pregnancy and to evaluate their knowledge of its potential effects on children. Methods: Following the PRISMA guidelines, a systematic search was conducted in Web of Science, PubMed and PsycArticles databases for studies published up to May 2025. Eligible studies examined gestational alcohol use, risk perception, or knowledge of fetal consequences among pregnant women or women of reproductive age. Methodological quality was assessed with the Critical Appraisal of Qualitative Studies tool from the Centre for Evidence-Based Medicine (CEBM). Results: Twenty-nine studies were included. Reported prevalence of alcohol consumption during pregnancy varied considerably across settings. A substantial proportion of women perceived alcohol use during pregnancy as acceptable, often depending on quantity, frequency, type of beverage, or stage of gestation. Knowledge of FASDs was generally limited and frequently restricted to physical malformations. Misconceptions were more common among women with prior alcohol use. The findings highlight persistent gaps in risk perception and knowledge about FASDs. Conclusions: Prevention strategies should not be limited to pregnant women but should also target women of childbearing age, especially those with active drinking patterns, as well as their immediate sociocultural environment. Strengthening professional training, community-based interventions, and consistent public health messaging are essential to reduce gestational alcohol exposure. Full article

Background/Objectives: Early detection of undiagnosed prediabetes (PD) and type 2 diabetes (T2D) could prevent or delay the onset of diabetes and its complications. The dental setting has been suggested as a location for expanding diabetes screening in primary care. This study aimed to investigate behavioural factors that influence an oral healthcare professional’s (OHP) participation in diabetes screening and their decision to refer individuals at a high risk of diabetes for medical follow-up and confirmatory diagnosis. These factors provide targets for future interventions to encourage screening implementation and increase referral guideline compliance. Methods: This qualitative study utilised OHPs who had participated in a diabetes screening trial in Victoria, Australia. Qualitative, semi-structured interviews were conducted by telephone or videoconferencing and transcribed and analysed thematically. The themes identified were deductively mapped onto the Capability, Opportunity, Motivation, and Behaviour (COM-B) model and the Theoretical Domains Framework (TDF). Results: In total, eight interviews were conducted (seven dentists and one oral health therapist). Five COM-B domains were identified: reflective motivation, automatic motivation, social opportunity, physical opportunity, and psychological capability. Nine TDF domains were associated with issues related to knowledge, the environmental context and resources, memory, attention and decision processes, skills, social influences, beliefs about consequences, emotion, beliefs about capability, and social influence. Conclusions: This is the first study to investigate the factors influencing an OHP’s participation and decision making in diabetes screening and referral processes in the dental setting. The results demonstrate that OHPs need more education and training to screen for diabetes in dental clinics. This study represents the first step in developing interventions to target these factors and improve the effectiveness of diabetes screening in the dental setting. Full article

Different sports require elevated visual-spatial and related cognitive abilities, which are increasingly recognized as crucial not only for athletic performance but also for broader public health implications. Sex-related differences in these abilities have often been explained through both biological and sociocultural factors, with males traditionally described as having superior visual-spatial skills. However, fewer studies have investigated how targeted physical training can enhance these abilities in women. This study aimed to analyze the influence of two different cycling interval training exercises on visual-spatial ability in women. Seventy-two healthy, active, and young women engaged in (1) a High-Intensity Interval Training (HIIT) session followed by a cognitive training (CT); or (2) a Low-Volume Interval Training (LVIT) session followed by a CT; or (3) a cognitive (COG) session, consisting of listening to music followed by a CT; or (4) a control (CTRL) session, consisting of solely listening to music. Cognitive performance was assessed at baseline and after the training sessions using the Metzler and Shepard Test (MS), the Paper Folding and Cutting Test (PFC), and the Mental Rotation Test (MRT). No significant between-group differences were observed. However, in all groups the time to complete the PFC and MRT tests was significantly lower and the number of errors was significantly smaller for the PFC test in the post-test compared with the pre-test. These findings expand the current literature by demonstrating that interval training, whether high intensity or low volume, when combined with cognitive training, may improve certain aspects of visual-spatial cognitive performance in healthy, active, young women. These findings highlight the potential of combining structured exercise with cognitive challenges. Such interventions may promote cognitive health in women and contribute to long-term public health outcomes. Full article

Background/Objectives: Subjective well-being (SWB) in pre-adolescents declines with age due to rising school-related stress and boredom. Outdoor physical activity (PA) may mitigate these effects, yet age-specific associations remain understudied. This study investigated age differences in relationships between outdoor PA and school emotional well-being (stress and arguments) using multinational data. Methods: Cross-sectional secondary analysis of the International Survey of Children’s Well-Being (ISCWeB) third wave (2017–2019) involved 128,184 pre-adolescents (mean age 10.24 years, SD 1.70; 49.56% boys) from 35 countries, stratified by age (8, 10, 12 years). Outdoor PA was assessed on a 0–6 frequency scale; stress and arguments on 0–10 scales, with 8-year-olds’ responses harmonized from 5-point emoticons. Descriptive statistics and stratified Spearman correlations were calculated (p < 0.05). Results: Outdoor PA peaked at age 10 (mean 3.17, SD 1.62), while stress varied with age (mean 3.99, SD 0.50 at 8 years; 4.20, SD 2.50 at 12 years). Very small associations emerged: Weak negative stress correlations (r = −0.02 to −0.07, p ≤ 0.045; r² < 0.005) across ages, alongside positive argument associations (r = 0.03–0.08, p < 0.001). Conclusions: Outdoor PA modestly associates with lower stress in older pre-adolescents but may be associated with elevated peer conflicts. This dual effect adds nuance to interventions, highlighting supervision needs. Age-tailored, supervised school interventions could optimize emotional benefits during late pre-adolescence. Full article

Background: Atherogenic dyslipidemia is defined by the coexistence of high triglyceride concentrations, low levels of high-density lipoprotein cholesterol (HDL-C), and an excess of small, dense particles of low-density lipoprotein cholesterol (LDL-C). This lipid profile is strongly associated with an increased burden of cardiovascular disease and represents a leading cause of global morbidity and mortality. To better capture this risk, composite lipid ratios—including total cholesterol to HDL-C (TC/HDL-C), LDL-C to HDL-C (LDL-C/HDL-C), triglycerides to HDL-C (TG/HDL-C), and the atherogenic dyslipidemia index (AD)—have emerged as robust markers of cardiometabolic health, frequently demonstrating superior predictive capacity compared with isolated lipid measures. Despite extensive evidence linking these ratios to cardiovascular disease, few large-scale studies have examined their association with sociodemographic characteristics, lifestyle behaviors, and social isolation in working populations. Methods: We conducted a cross-sectional analysis of a large occupational cohort of Spanish workers evaluated between January 2021 and December 2024. Anthropometric, biochemical, and sociodemographic data were collected through standardized clinical protocols. Indices of atherogenic risk—namely the ratios TC/HDL-C, LDL-C/HDL-C, TG/HDL-C, and the atherogenic dyslipidemia index (AD)—were derived from fasting lipid measurements. The assessment of lifestyle factors included tobacco use, physical activity evaluated through the International Physical Activity Questionnaire (IPAQ), adherence to the Mediterranean dietary pattern using the MEDAS questionnaire, and perceived social isolation measured by the Lubben Social Network Scale. Socioeconomic classification was established following the criteria proposed by the Spanish Society of Epidemiology. Logistic regression models were fitted to identify factors independently associated with moderate-to-high risk for each lipid indicator, adjusting for potential confounders. Results: A total of 117,298 workers (71,384 men and 45,914 women) were included. Men showed significantly higher odds of elevated TG/HDL-C (OR 4.22, 95% CI 3.70–4.75) and AD (OR 2.95, 95% CI 2.70–3.21) compared with women, whereas LDL-C/HDL-C ratios were lower (OR 0.86, 95% CI 0.83–0.89). Advancing age was positively associated with all lipid ratios, with the highest risk observed in participants aged 60–69 years. Lower social class, smoking, physical inactivity, poor adherence to the Mediterranean diet, and low social isolation scores were consistently linked to higher atherogenic risk. Physical inactivity showed the strongest associations across all indicators, with ORs ranging from 3.54 for TC/HDL-C to 7.12 for AD. Conclusions: Atherogenic dyslipidemia and elevated lipid ratios are strongly associated with male sex, older age, lower socioeconomic status, unhealthy lifestyle behaviors, and reduced social integration among Spanish workers. These findings highlight the importance of workplace-based cardiovascular risk screening and targeted prevention strategies, particularly in high-risk subgroups. Interventions to promote physical activity, healthy dietary patterns, and social connectedness may contribute to lowering atherogenic risk in occupational settings. Full article

Background/Objectives: Agility and reaction speed are critical components of sports performance and are influenced by both physical conditioning and psychological state. Interventions such as SmartACT, which integrate mindfulness, acceptance, and commitment, guided imagery and hypnosis techniques are still underexplored in high-performance sport, despite their potential to affect both psychological and motor dimensions. Methods: This 7-week controlled trial investigated the effectiveness of SmartACT in reducing psychological and somatic symptoms and enhancing motor performance in adolescent athletes. A total of 193 athletes aged 15–18 years were assigned to three groups: SmartACT (n = 69), MAC (Mindfulness–Acceptance–Commitment, the standardized Gardner & Moore protocol; n = 65), and a control group (n = 59). Agility was measured using the T-Drill Agility Test with Microgate electronic timing, and reaction speed was assessed using BlazePod devices. Psychological and somatic symptoms were evaluated using the Depression, Anxiety, and Stress Scale (DASS-21) and the Ghent Multidimensional Somatic Complaints Scale (GMSCS). Results: The SmartACT group showed significantly improved agility (MD = −1.07 s, p < 0.001, d = 2.50, 95% CI [1.79, 3.35]), faster reaction times (MD = −643.75 ms, p < 0.001, d = 0.85, 95% CI [0.35, 1.41]), and a higher number of BlazePod touches (MD = +2.53, p < 0.001, d = 1.43, 95% CI [0.87, 2.07]). Psychological symptoms (DASS-21) and somatic complaints (GMSCS) decreased significantly more than in the MAC and control groups. Conclusions: SmartACT appears to be an effective hybrid psychological intervention to simultaneously improve physical performance and reduce psychological and psychosomatic distress in adolescent athletes. Full article

Background/Objective: Sleep is a vital determinant of human health, where both its quantity and quality directly impact physical and mental well-being. Thermoregulation plays a pivotal role in sleep quality, as the body’s ability to regulate temperature varies across different sleep stages. This study examines the effects of a novel real-time temperature adjustment (RTA) mattress, which dynamically modulates temperature to align with sleep stage transitions, compared to constant temperature control (CTC). Through polysomnographic (PSG) assessments, this study evaluates how adaptive thermal regulation influences sleep architecture, aiming to identify its potential for optimizing restorative sleep. Methods: A prospective longitudinal cohort study involving 25 participants (13 males and 12 females; mean age: 39.7 years) evaluated sleep quality across three conditions: natural sleep (Control), CTC (33 °C constant mattress temperature), and RTA (temperature dynamically adjusted: 30 °C during REM sleep; 33 °C during non-REM sleep). Each participant completed three polysomnography (PSG) sessions. Sleep metrics, including total sleep time (TST), sleep efficiency, wake after sleep onset (WASO), and sleep stage percentages, were assessed. Repeated-measures ANOVA and post hoc analyses were performed. Results: RTA significantly improved sleep quality metrics compared to Control and CTC. TST increased from 356.2 min (Control) to 383.2 min (RTA, p = 0.030), with sleep efficiency rising from 82.8% to 87.3% (p = 0.030). WASO decreased from 58.2 min (Control) and 64.6 min (CTC) to 49.0 min (RTA, p = 0.067). REM latency was notably reduced under RTA (110.4 min) compared to Control (141.8 min, p = 0.002). The REM sleep percentage increased under RTA (20.8%, p = 0.006), with significant subgroup-specific enhancements in males (p = 0.010). Females showed significant increases in deep sleep percentage under RTA (12.3%, p = 0.011). Conclusions: Adaptive thermal regulation enhances sleep quality by aligning mattress temperature with physiological needs during different sleep stages. These findings highlight the potential of RTA as a non-invasive intervention to optimize restorative sleep and promote overall well-being. Further research could explore long-term health benefits and broader applications. Full article

Background/Objectives: Systemic lupus erythematosus (SLE) is associated with impaired functional capacity, persistent fatigue, and poor health-related quality of life despite advances in pharmacological therapy. Exercise training has been proposed as a non-pharmacological intervention, but its efficacy and safety remain incompletely defined. This systematic review aimed to evaluate the effects of exercise training on functional aerobic capacity and quality of life in adults with SLE. Methods: A comprehensive search of PubMed, EMBASE, Cochrane Library, and PEDro was conducted to identify randomized controlled trials published up to October 2022, in accordance with the PRISMA guidelines. Results: Twelve randomized controlled trials involving 619 participants were included. Exercise interventions were heterogeneous and comprised aerobics, resistance, combined programs, vibration training, home-based protocols, and counseling strategies, with durations ranging from 6 weeks to 12 months. Supervised aerobic and combined interventions consistently improved functional aerobic capacity, while quality of life benefits were reported across several domains, particularly physical health, vitality, and fatigue. Additional positive effects were observed on fatigue, depression, pain, sleep, insulin sensitivity, and self-care ability, without evidence of increased disease activity. Conclusions: Structured exercise is safe and can meaningfully enhance functional capacity and quality of life in patients with SLE, supporting its incorporation into multidisciplinary clinical management. Full article

Background: Bone health in youth is influenced by both modifiable factors, such as nutrition and physical activity, and non-modifiable factors, such as biological maturation and heredity. Understanding how these elements interact to predict body composition may enhance the effectiveness of early interventions. Importantly, the integration of both supervised and unsupervised machine learning models enables a data-driven exploration of complex relationships, allowing for accurate prediction and subgroup discovery. Methods: This cross-sectional study examined 94 male athletes during the developmental period. Anthropometric, performance, and nutritional data were collected, and bone parameters were assessed using dual-energy X-ray absorptiometry (DXA). Three supervised machine learning models (Random Forest, Gradient Boosting, and Support Vector Regression) were trained to predict Total Body-Less Head (TBLH) values. Nested cross-validation assessed model performance. Unsupervised clustering (K-Means) was also applied to identify dietary intake profiles (calcium, protein, vitamin D). SHAP analysis was used for model interpretability. Results: The Random Forest model yielded the best predictive performance (R² = 0.71, RMSE = 0.057). Weight, height, and handgrip strength were the most influential predictors. Clustering analysis revealed two distinct nutritional profiles; however, t-tests showed no significant differences in TBLH or regional BMD between the clusters. Conclusions: Machine learning, both supervised for accurate prediction and unsupervised for nutritional subgroup discovery, provides a robust, interpretable framework for assessing adolescent bone health. While dietary intake clusters did not align with significant differences in bone parameters, this finding underscores the multifactorial nature of skeletal development and highlights areas for further exploration. Full article