Search Results (4,393)

Background/Objectives: Nicotine-free electronic cigarettes (NFECs) are becoming increasingly popular, especially among youth and non-smokers, yet their effects on the gastrointestinal tract (GIT) remain poorly understood. This systematic review synthesizes available in vitro, in vivo, and limited human evidence on NFEC-associated changes in gastrointestinal health and function. Methods: Literature searches were conducted in Medline, Web of Science, Cochrane, and Scopus in July 2025, following PRISMA guidelines. Eligible studies examined NFEC effects on any GIT segment, including the oral cavity, liver, intestines, and microbiome. Data on study design, exposure characteristics, and main outcomes were extracted and narratively synthesized. Results: Of 111 identified records, 94 full-text articles were retrieved, and 21 studies met the inclusion criteria. Most were preclinical, with only one human pilot study. Evidence from oral cell and microbial models suggests that NFEC aerosols can induce pro-inflammatory cytokine production, impair cell viability, and disrupt microbial metabolism through their base constituents (propylene glycol, vegetable glycerine, and flavourings). Animal studies indicate possible hepatic oxidative stress, altered lipid metabolism, and gut barrier dysfunction, with some data suggesting more pronounced steatosis in nicotine-free exposures compared to nicotine-containing counterparts. Microbiome studies report reduced tight junction expression and altered neutrophil function. Conclusions: Current evidence is limited and predominantly preclinical but indicates that NFEC exposure can affect multiple aspects of gastrointestinal health. Robust longitudinal and interventional human studies are urgently needed to determine the clinical relevance of these findings and to inform regulation and public health policy. Full article

Aflatoxins (AFs), harmful secondary metabolites produced by the genus Aspergillus, particularly Aspergillus flavus and Aspergillus parasiticus, are one of the best-known potent mycotoxins, posing a significant risk to public health. The primary type, especially aflatoxin B₁ (AFB₁), is a potent carcinogen associated with liver cancer, immunosuppression, and other health problems. Environmental factors such as high temperatures, humidity, and inadequate storage conditions promote the formation of aflatoxin in staple foods such as maize, peanuts, and rice. Immunocompromised individuals, including those with HIV/AIDS, hepatitis, cancer, or diabetes, are at increased risk due to their reduced detoxification capacity and weakened immune defenses. Chronic exposure to AF in these populations exacerbates liver damage, infection rates, and disease progression, particularly in developing countries and moderate-income populations where food safety regulations are inadequate and reliance on contaminated staple foods is widespread. Biomarkers such as aflatoxin-albumin complexes, urinary aflatoxin M₁, and aflatoxin (AF) DNA adducts provide valuable insights but remain underutilized in resource-limited settings. Despite the globally recognized health risk posed by AF, research focused on monitoring human exposure remains limited, particularly among immunocompromised individuals. This dynamic emphasizes the need for targeted studies and interventions to address the particular risks faced by immunocompromised individuals. This review provides an up-to-date overview of AF exposure in immunocompromised populations, including individuals with cancer, hepatitis, diabetes, malnutrition, pregnant women, and the elderly. It also highlights exposure pathways, biomarkers, and biomonitoring strategies, while emphasizing the need for targeted interventions, advanced diagnostics, and policy frameworks to mitigate health risks in these vulnerable groups. Addressing these gaps is crucial to reducing the health burden and developing public health strategies in high-risk regions. Full article

Background: Tuberculosis (TB) remains a major global health challenge, including in Thailand, where both asymptomatic and symptomatic cases sustain transmission. The disease burden increases treatment complexity and mortality, requiring integrated care and coordinated policies. Methods: We developed a deterministic compartmental model to examine the transmission dynamics of TB in Thailand, incorporating both latent and active stages of infection, as well as vaccination coverage. The model was calibrated using national TB incidence data, and sensitivity analysis revealed that the TB transmission rate was the most influential parameter affecting the basic reproduction number (R₀). We evaluated the impact of several intervention strategies, including increased treatment coverage for latent and active TB infections and improved vaccination rates. Results: Our analysis indicates that among the single interventions, scaling up effective treatment for latent TB infections produced the greatest reduction in asymptomatic and symptomatic cases, while enhanced treatment for active TB cases was second most effective for reducing both asymptomatic and symptomatic cases. Importantly, our results indicate that combining multiple interventions yields significantly greater reductions in overall TB incidence than any single approach alone. Our findings suggest that a modest investment in integrated TB control can substantially reduce TB transmission and disease burden in Thailand. However, complete eradication of TB would require a comprehensive and sustained investment to achieve near-universal coverage of both preventive and curative strategies. Conclusions: TB remains a significant public health threat in Thailand. Targeted interventions and integrated strategies are key to reducing disease burden and improving treatment outcomes. Full article

This study investigates the impact of the COVID-19 pandemic on clinically diagnosed depression in South Korea, focusing on gender disparities and structural risk factors such as job loss and childcare burden. Although mental health inequalities have received growing attention during the pandemic, most existing research relies on self-reported survey data with inherent limitations. To address this gap, we utilized administrative health data from a 2% stratified random sample of the total population (N = 297,368) in the National Health Insurance Database, focusing on employed individuals without a prior history of depression. Multivariable Cox proportional hazard regression revealed that women had significantly higher risks of depression than men, particularly among those in their 20s to 40s, those who experienced job loss, those who had children aged 7–9, and those who belonged to high-income groups. These findings suggest that the intersection of employment instability and caregiving responsibilities disproportionately affected women’s mental health during the pandemic. The results underscore the urgent need for gender-sensitive public health policies that expand childcare support, institutionalize flexible work arrangements such as telecommuting, and enhance access to targeted mental health services to reduce pandemic-induced gender disparities in mental health. Full article

In response to contemporary challenges such as the COVID-19 pandemic, climate change, armed conflicts, and economic instability, healthcare systems worldwide are increasingly confronted with multifaceted and overlapping crises—collectively referred to as polycrisis. These interconnected threats amplify one another, placing unprecedented strain on healthcare infrastructure, governance, and equity. The COVID-19 pandemic alone led to an estimated 16.3 million missed hospitalizations in 2020 and 14.7 million in 2021, revealing systemic vulnerabilities and deepening social inequalities. Armed conflicts, such as in Syria and Gaza, have devastated healthcare access. In Gaza, by mid-2024, 85% of the population had been forcibly displaced, with only 17 of 36 hospitals partially functioning and over 885 healthcare workers killed. Climate change further exacerbates health burdens, with over 86% of urban residents globally exposed to harmful air pollution, contributing to 1.8 million deaths annually. This study introduces a novel perspective by applying social epidemiology to the analysis of polycrisis. While the existing literature often emphasizes political or economic dimensions, our approach highlights how overlapping crises affect population health, social vulnerability, and systemic resilience. By integrating sociodemographic and environmental data, social epidemiology supports crisis-resilient care models, targeted interventions, and equitable health policies. We argue for a stronger mandate to invest in data infrastructure, enhance surveillance, and embed social determinants into health system responses. Full article

Sexual dysfunction affects an estimated 50–70% of cancer survivors but remains underrecognized and undertreated, impacting quality of life and emotional well-being. This narrative review involves a comprehensive search of PubMed/MEDLINE, CINAHL, Scopus, Web of Science, and ScienceDirect for English-language publications (January 2010–May 2025), using combined MeSH and free-text terms for ‘sexual health’, ‘cancer’, ‘nursing’, ‘roles of nurses’, ‘immunotherapy’, ‘targeted therapy’, ‘sexual health’, ‘sexual dysfunction’, ‘vaginal dryness’, ‘genitourinary syndrome of menopause’, ‘sexual desire’, ‘body image’, ‘erectile dysfunction’, ‘climacturia’, ‘ejaculatory disorders’, ‘dyspareunia’, and ‘oncology’. We used the IMRAD (Introduction, Methods, Results, and Discussion) approach to identify 1245 records and screen titles and abstracts. Fifty studies ultimately met the inclusion criteria (original research, reviews, and clinical guidelines on oncology nursing and sexual health). Results: All the treatments contributed to reduced libido, erectile dysfunction, dyspareunia, and body image concerns, with a prevalence of 57.5% across genders. Oncology nurses can provide sex education and counseling. Barriers (limited training, cultural stigma, and the absence of protocols) hinder effective intervention. Addressing these issues through sexual health curricula, formal referral systems, and policy reforms can enhance nursing care. Future research should assess the impact of targeted nurse education and the institutional integration of sexual health into cancer care. Full article

The health technology assessment (HTA) is a multidisciplinary process utilized to determine the clinical, economic, social, and ethical value of new health technologies before they are incorporated into healthcare systems. In the case of rare diseases, such as Cystic Fibrosis (CF), challenges arise due to limited evidence and high treatment costs. Indeed, although CF transmembrane conductance regulator (CFTR) modulators are breakthrough therapies for CF, their incorporation into public health systems has been complex with considerable challenges, especially in low- and middle-income countries. This article presents a descriptive and exploratory case study of the regulatory and policy journey for CFTR modulators to be approved in Brazil. Based on a narrative review and document analysis, we highlight the importance of building lay society knowledge to shape policy decisions and promote equitable access to innovative therapies. In parallel, we critically reflect on the HTA process and highlight efforts in the training, education, and coordination required to enable meaningful public engagement and landmark achievements. Full article

Objective: To investigate public attitudes in New Zealand towards the euthanasia of dogs and cats and to explore the factors that influence these views. Materials and Methods: Data were collected through a nationwide online survey conducted in 2019 as part of the Furry Whānau Wellbeing research project. The survey included questions about pet euthanasia, and respondents were asked to indicate their level of agreement with various statements. Results: Of 2293 respondents to the 2019 New Zealand Pet Survey, the majority (n = 1756) opposed euthanasia for stray, unwanted, or financially burdensome pets (76.7%; 90.2% and 66.3% of these disagreed or strongly disagreed, respectively). In contrast, a slim majority (n = 1162) supported it for sick animals. Females were less likely to agree with euthanasia in most scenarios compared to males. Māori and New Zealand European respondents (n = 1790) showed higher levels of neutrality than other ethnicities regarding stray animals and lower levels of disagreement regarding financially constrained situations. Older respondents (65+) were more likely to support euthanasia for sick animals, while younger respondents (18–24) were less inclined. Higher education levels are correlated with increased neutrality towards euthanising stray animals and increased support for euthanising feral animals. Respondents with children were more likely to be neutral or to disagree with euthanasia in most scenarios. Those with rural upbringings were more accepting of euthanasia for stray and feral animals. A thematic analysis of 653 respondent comments revealed key themes: euthanasia was seen as complex and context-dependent, a humane last resort for suffering animals, but not for convenience. Respondents emphasised responsible pet ownership and a right to life, even for feral animals, advocating for alternatives such as trap–neuter–release. Conclusion: New Zealanders largely view euthanasia as an ethically acceptable option for terminally ill or suffering animals but reject it when driven by convenience or financial hardship. Attitudes vary across demographic groups, highlighting the need for culturally sensitive education and policy. The findings align with Sustainable Development Goal 3 (Good Health and Well-being) and support broader discussions on responsible pet ownership, ethical decision making, and animal welfare legislation. Full article

Background/Objectives: This study explores the subjective perceptions of stakeholders in South Korea’s nature-based healing industry and employs Q methodology to classify their viewpoints. As the healing industry continues to evolve across sectors such as forest therapy, marine healing, and healing agriculture, understanding diverse stakeholder perspectives is essential for informing coherent and inclusive policy development. Methods: A total of 25 participants—including policymakers, practitioners, and service users—sorted 39 statements derived from academic and media sources. This study analysed the data using Ken-Q software, applying principal component analysis with Varimax rotation. Results: The results revealed four distinct perception types: (1) a comprehensive and service-oriented type emphasising universal access and public benefit, (2) a professionalism-oriented type advocating for systematic administration and regional development, (3) a differentiation-oriented type concerned with conceptual clarity and distinctiveness, and (4) a sustainability-oriented type emphasising long-term impacts and collaborative structures. Conclusions: These findings highlight the multi-dimensional nature of stakeholder perceptions and suggest the need for differentiated governance strategies. By incorporating public choice theory and complementary insights from health economics, this study provides an empirical foundation for understanding stakeholder-driven policy considerations in developing nature-based healing services. Full article

Monk fruit extract (Siraitia grosvenorii, MFE) is a natural, non-caloric sweetener known for its intense sweetness, antioxidant properties, and potential metabolic health benefits. While certain aqueous monk fruit decoctions are recognised as non-novel foods in the UK and Ireland due to significant pre-1997 consumption, the European Union (EU) has adopted a more cautious approach under the Novel Food Regulation (EU) 2015/2283. As of October 2024, only one specific aqueous extract of monk fruit has been authorised in the EU under Regulation (EU) 2024/2345, permitting its use in several food categories. However, highly purified mogrosides and non-aqueous extracts remain unapproved due to gaps in toxicological data and the absence of industry-led applications. This review systematically analyses the EU’s regulatory barriers, comparing MFE’s legal status with other approved non-caloric sweeteners such as steviol glycosides and erythritol, and examining regulatory frameworks in the EU, United States, United Kingdom, and China. Findings indicate that although 18 non-caloric sweeteners are currently authorised in the EU, regulatory constraints continue to hinder the broader approval of MFE, limiting innovation and the availability of natural sweeteners for consumers. Harmonising regulations, leveraging international safety assessments, and promoting industry engagement are recommended to advance MFE’s authorisation and support sustainable food innovation in the EU. Addressing these challenges is crucial to ensure that European consumers and industry can benefit from safe, innovative, and health-promoting alternatives to sugar, aligning food policy with broader public health goals and sustainability commitments. Full article

Climate change is the biggest global health threat of the 21st century. However, this challenge presents an opportunity to do things differently. This paper sets out how, using a design-led and collaborative approach, one can re-imagine the delivery of healthcare itself in a way that will deliver environmental sustainability. The paper presents a series of eight projects at the intersections of design, health and wellbeing, and complex net zero challenges, with an emphasis on inclusive, equitable, and sustainable design-led interventions. This encompasses diverse interventions across and beyond conventional design boundaries such as architecture, product design, and textile design providing insights that demonstrate the impact of design thinking, making, and acting on real-world net zero issues. Addressing such a broad and complex topic requires engagement across a wide range of stakeholders. The work undertaken has been conducted as part of a UK Government-funded Green Transition Ecosystem (GTE) Hub that has allowed multiple academic disciplines, research organisations, regional and local industry, and other public sector stakeholders, to connect with policy makers. Across seven themes, the paper describes how Design HOPES (Healthy Organisations in a Place-based Ecosystem, Scotland), as a design-led GTE Hub, brings in multiple and marginalised perspectives and how its design-led projects as one part of a wider movement for transformational change can re-use, nurture and develop these interventions sustainably. The overarching ambition being, through our collaborative design-led thinking, making, and acting, to build a more equitable and sustainable health and social care system across Scotland. Full article

The global expansion of shale oil and gas extraction has generated widespread attention for its environmental, economic, and political implications. However, its social consequences remain less systematically assessed. This review synthesizes interdisciplinary research on how shale energy development affects communities, particularly in rural and resource-dependent regions. While extraction activities may generate economic opportunities and strengthen national energy security, they are also associated with population influx, pressure on infrastructure, housing shortages, public health risks, and increased political polarization. These impacts can alter social relationships, institutional trust, and access to essential services. By organizing and analyzing key themes in the social science literature, this review offers a structured overview of how shale energy development shapes local experiences and social systems. The goal of the present paper is to support researchers, policymakers, and community stakeholders in understanding the civic, communal, and public dimensions of energy transitions and in developing more equitable and sustainable policy responses. Full article

Objective measurement of community participation is essential for evaluating functional recovery and intervention outcomes in clinical populations, yet current methods rely heavily on subjective self-report measures. This study developed and validated a classification model to distinguish between home- and community-based activities using stepping and lying data from activPAL devices. Twenty-four healthy participants wore activPAL 4+ monitors continuously while completing activity diaries over 7 days. A grid search optimisation approach tested threshold combinations for two stepping parameters: straight-line stepping time (SLS) and continuous stepping duration (CSD). The optimal model achieved 93.7% accuracy across 24-h periods using an SLS threshold of 26 s. The model demonstrated high precision with a median difference of just 7 min between the predicted and reported community participation time. Individual variation in model performance highlights the need for validation in diverse clinical cohorts. This represents a methodological advance in objective physical behaviour monitoring, enabling accurate classification of home and community activity from posture data. By identifying not just how much people move but where they move, the model supports more meaningful assessment of functional mobility and community participation. This can enhance clinical decision making, rehabilitation planning, and intervention evaluation. With potential for adoption in clinical pathways and public health policy, this approach addresses a key gap in measuring real-world recovery and independence. Full article

Scientific misinformation refers to false, misleading, or inaccurate information that contradicts, ignores, or misrepresents established scientific evidence or consensus. It can stem from accidental misunderstanding or ignorance of facts, as well as from their deliberate distortion (generally referred to as “disinformation”). Unlike rigorous scientific evidence, misinformation typically lacks a credible evidential basis and does not rely on the scientific method. Often spread through mass media, social networking platforms, or informal communication, scientific misinformation can undermine public trust in science, influence health and policy decisions, and contribute to confusion or harmful behaviours at both personal and societal levels. Full article

Strengthening the education of health professionals is imperative to effectively address contemporary public health challenges. Preceptorship, by integrating teaching and care within service settings, stands out as a relevant strategy for developing clinical, ethical, and relational competencies. This study aimed to construct a theoretical model based on the meanings attributed by nurse preceptors to preceptorship in pediatric nursing within the context of hospital-based training at a referral institute specializing in rare and complex diseases in Rio de Janeiro, Brazil. The study used Grounded Theory and Symbolic Interactionism as its methodological and theoretical frameworks, respectively, and involved interviews with 14 preceptors. The resulting model characterizes preceptorship as an interactive process materialized in pedagogical practices that integrate technical skill, empathy, responsibility, and creativity into the daily routine of care. The findings offer valuable insights for strengthening professional training programs in health and contribute to public policies that recognize preceptorship as a component of interprofessional education and of workforce development, with a focus on humanization, safety, and contextualized care. Full article