Search Results (35,584)

Background/Objectives: Cancer-related pain remains one of the most prevalent and distressing symptoms across the disease trajectory, significantly impairing function and quality of life. Although opioids are central to managing moderate to severe pain, their limitations, including adverse effects, dependence risk, and societal concerns, highlight the need for more individualized and comprehensive strategies. This review aims to synthesize current approaches to cancer pain management within a palliative care framework, emphasizing multimodal, mechanism-based, and patient-centered care. Methods: A narrative review was conducted using literature searches of PubMed, Scopus, and Google Scholar. Articles published between 2010 and 2026, with emphasis on recent literature (2020–2026), were included. Search terms included combinations of “cancer pain,” “palliative care,” “multimodal analgesia,” “opioids,” “adjuvant analgesics,” and “neuropathic pain.” Peer-reviewed studies, clinical guidelines, systematic reviews, and meta-analyses relevant to cancer pain mechanisms and management were considered. Results: Cancer pain is heterogeneous, arising from tumor progression and treatment-related injury, and includes neuropathic, visceral, and somatic components. Effective management requires mechanism-based assessment and multimodal strategies. Adjuvant analgesics, such as antidepressants, anticonvulsants, corticosteroids, and topical agents, enhance pain control and reduce opioid reliance. Non-pharmacological interventions and early integration of palliative care further improve symptom management and quality of life. Emerging therapies, including cannabinoid-based treatments and gene-targeted approaches, show promise but require further clinical validation. Conclusions: A multidisciplinary, patient-centered approach that integrates pharmacologic and non-pharmacologic strategies is essential for optimizing cancer pain management. Advancing toward personalized and multimodal care models may improve outcomes, reduce opioid-related risks, and enhance quality of life for patients with cancer. Full article

Background/Objectives: Uncorrected refractive errors (UREs) are a primary cause of preventable visual impairment in children globally, impacting education and quality of life. In Jakarta, prevalence has surged to 40% post-pandemic, categorizing it as a serious public health problem. This study aimed to develop and validate the CIPSEL questionnaire as a rapid, culturally adapted screening tool for identifying visual impairment consistent with possible UREs among Indonesian school-aged children. Methods: A cross-sectional study was conducted in South Jakarta with 131 students aged 8–12 years. The 10-item CIPSEL questionnaire, exploring visual behaviors and symptoms, was administered via face-to-face interviews. Visual acuity was assessed using a standard Snellen chart by medical personnel blinded to the questionnaire results. Diagnostic accuracy was assessed using receiver operating characteristic (ROC) curve analysis, with optimal thresholds determined via the Youden Index and the shortest distance to (0, 1). Results: Visual impairment was identified in 26 students (19.8%). Mean CIPSEL scores were significantly higher in students with visual impairment (4.73) compared to those with normal vision (1.95). ROC analysis showed considerable diagnostic accuracy with an AUC of 0.887 (95% CI: 0.829–0.946). A safety-first cutoff of 2.5 prioritized sensitivity (96.2%), while a balanced cutoff of 3.5 provided 80.8% sensitivity and 79.0% specificity. A tiered risk system (Low, Medium, and High) demonstrated a robust statistical association with actual clinical findings (Cramer’s V = 0.534, p < 0.001). Conclusions: CIPSEL is a reliable and scalable screening tool for the early detection of visual impairment in Indonesian children. Its tiered risk stratification framework facilitates nuanced clinical decision-making and efficient resource allocation in school-based settings. Its accessibility for non-medical personnel and potential for digital integration support national efforts toward universal eye health. Full article

Objective: This study aimed to assess quality of life (QoL) and its determinants among Saudi adults diagnosed with type 2 diabetes mellitus (T2DM). Methods: A cross-sectional study was conducted among 200 (45% male and 55% female) Saudi adults with T2DM aged 30–65 years. Data were collected using the Audit of Diabetes–Dependent Quality of Life (ADDQoL) and the Personal Diabetes Questionnaire (PDQ). Anthropometric and clinical measures included weight, height, body mass index (BMI), blood pressure, and glycated hemoglobin (HbA1c). Results: Most participants (73.5%) were ≤50 years of age, and the majority were obese (56.0%) or overweight (28.0%). Nearly half (54.5%) had HbA1c levels ≥ 8.0%, while (50.5%) were hypertensive. Overall, 96% of participants reported a poor to extremely poor QoL. Female sex (p = 0.003), higher BMI (p = 0.034), diet type (p = 0.039), and satisfaction with glucose control (p < 0.001) were significantly associated with the QoL. Conclusions: T2DM substantially impairs the QoL of affected Saudi adults. Psychosocial and lifestyle-related factors, particularly obesity, gender, dietary practices, and perceived glucose control, are more influential than traditional clinical markers. Culturally tailored interventions targeting these determinants may improve patient outcomes. Full article

Student well-being, encompassing mental, social, cognitive, and behavioral domains, is increasingly compromised by academic stress, social isolation, and sedentary lifestyles. Horticulture-based interventions (HBIs), involving plant-based activities, have shown potential in promoting holistic health across populations. Nevertheless, no systematic review has synthesized global evidence for its effects on students. This systematic review aimed to evaluate HBI’s impact on students’ well-being, synthesizing global evidence to inform educational and therapeutic practices. This systematic review was registered in PROSPERO (CRD420251250712). Following PRISMA guidelines, we searched PubMed, Web of Science, MEDLINE, EMBASE, and APA PsycInfo from inception to 30 June 2025. Keywords were used to search for related articles. Fifteen studies (n > 2000 students, aged 5–18 years) from South Korea (n = 8), Taiwan (n = 3), Chinese Mainland (n = 1), Hong Kong, China (n = 1), Italy (n = 1), and the United States (n = 1) were included for analysis. Results showed that HBI has the potential to enhance emotional/psychological well-being (e.g., stress reduction, mood improvement), social well-being (e.g., peer relations, social skills), cognitive and education benefits (e.g., attention, academic attitudes), and physical and overall health benefits (e.g., physical activity, quality of life). HBI may contribute to multifaceted student well-being, particularly emotional and social domains. This systematic review provides a reference for educators to integrate horticultural programs into the curriculum. Government and school policies may consider funding school gardens. Future randomized controlled trials with diverse populations are needed to address limitations like small samples and geographic bias. Full article

Migraine severely impacts the quality of life of young adults. During the past few years, many studies have been done regarding the pathophysiology of this condition. There has been intense debate regarding CGRP, but research is still underway about the glymphatic system and PACAP. This review provides an overview of the current literature in this area of migraine pathophysiology. The inflammatory mediators and neuropeptides that activate trigeminovascular pathways can be accumulated during migraine attacks as a result of a failure of glymphatic clearance. Neuroinflammation, CGRP, CSD, and sleep have all been linked to the glymphatic system and migraine. In this article, we also discuss the latest hypotheses regarding the PACAP pathway in the neurophysiology of migraine. Additionally, recent research suggests that glymphatic dysfunction could enhance PACAP-mediated signaling. This article will explore possible correlations between these mechanisms and migraine pathophysiology. Full article

Background: Erectile dysfunction (ED) is a common complication of type 2 diabetes and obesity and significantly affects patients’ quality of life. Nursing care for patients with metabolic multimorbidity requires a holistic, structured approach. The International Classification for Nursing Practice (ICNP^®) enables standardized formulation of nursing diagnoses, interventions, and outcomes and supports structured and individualized ICNP^®-based care planning. Aim: This study aimed to develop and present an ICNP^®-based nursing care plan for a patient with erectile dysfunction associated with type 2 diabetes and obesity and to demonstrate the applicability of ICNP^® in holistic nursing management of chronic disease. Methods: A descriptive single-case study was conducted in 2025 in a cardiology ward in Poland. Data were collected using a nursing interview, observation, medical documentation analysis, and standardized tools (IIEF-5, SF-36v2). Based on a comprehensive assessment of physical, psychological, and social status, nursing diagnoses, interventions, and expected outcomes were formulated according to ICNP^® terminology. Results: The patient presented with poorly controlled diabetes, class I obesity, moderate erectile dysfunction, reduced testosterone levels, and decreased quality of life, particularly in psychosocial domains. Key ICNP^® nursing diagnoses included erectile dysfunction, deficient knowledge, obesity, disturbed psychological status, impaired endocrine function, impaired cardiovascular function, and impaired adaptation. Individualized ICNP^®-based interventions focused on metabolic control, lifestyle modification, sexual health support, education, and psychosocial support. Implementation of the care plan was associated with improvements in health behaviors, disease knowledge, and psychological well-being. Conclusions: ICNP^® provides a useful framework for structured and comprehensive nursing care in patients with diabetes-related erectile dysfunction and multimorbidity. Case-based ICNP^® care planning supports holistic management, interdisciplinary collaboration, and quality improvement in chronic disease nursing. Full article

Currently, mental health diagnoses are associated with a negative connotation in society, leading to discriminatory and rejecting behaviours towards individuals with mental health conditions and their families. This hinders access to specialised resources, education and employment. This stigma is based on erroneous knowledge and discriminatory attitudes and behaviours within the population, which are closely linked to the concepts of stereotype, prejudice, and discrimination. These factors create situations that affect the quality of life and recovery processes of individuals with diagnoses. A quantitative, cross-sectional, analytical–descriptive study was conducted to identify knowledge, attitudes and behaviours relating to individuals with mental health diagnoses in a large community-based sample of the Spanish population. The S3 scale was used to identify the necessary factors associated with lower levels of stigma from a structural perspective. The sample consisted of 563 participants, with an average age of 35.81 years, predominantly women (n = 381, 65.2%). Notably, 87.0% (n = 490) of the sample had contact with at least one person diagnosed with a mental health condition during their lifetime. The most significant findings revealed that individuals without training and those with central or conservative ideologies exhibited significantly higher levels of stereotypes, stigmatising attitudes, and discriminatory behaviours than their counterparts. Based on these results obtained, it is recommended that existing personal and economic resources be expanded and focused to provide specific mental health training to the Spanish population, as well as to promoting the creation of spaces for contact and inclusive participation with individuals diagnosed with mental health conditions. Full article

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder. Early and accurate diagnosis is critical to delaying disease progression, alleviating clinical symptoms, and improving the long-term quality of life for the affected patients. The deep integration of artificial intelligence (AI) and medical imaging enables efficient early AD screening, overcoming traditional limitations. This study presents a systematic review of AI-driven applications in the early diagnosis of AD with a dual focus on single-modal and multimodal analytical frameworks, comprehensively analyzing core technical components across existing research including data preprocessing pipelines, mainstream deep learning and machine learning diagnostic models, standard performance evaluation metrics, and widely adopted public research datasets, while further qualitatively comparing the diagnostic efficacy and applicability of diverse methodologies across distinct imaging and non-imaging modalities. In addition, this review systematically delineates and compares the application merits, technical bottlenecks, and clinical suitability of AI-enabled diagnostic methods across diverse modalities, providing robust methodological guidance and clear directional references for future research on the early diagnosis of AD and facilitating the advancement of the field toward higher diagnostic precision, broader population applicability, and tighter integration with real-world clinical practice. Full article

Background/Objectives: Sickle cell disease (SCD) is the most prevalent inherited pediatric hematologic disease. Pain is the most common complaint and primary reason for emergency care. Effective coping is critical to improved quality of life for individuals with SCD and other chronic illnesses. Hope, engendered by provision of comprehensive care, may explain the positive impact of effective coping and improved health outcomes. The relevance of effective coping skills and hope’s impact on repeated hospitalizations and/or length of hospitalization stay (LOS) among adolescents with SCD is considered. A regional, comprehensive pediatric sickle cell center (RCPSCC) provided the services. Methods: Patients with SCD, ages 13 through 21 years seen in a university RCPSCC (URCPCC-SCD), completed surveys: a general scale providing a broad range of positive and maladaptive coping-related issues, and KIDCOPE, a standardized scale measuring pediatric coping strategies. Medical records were reviewed for frequency of hospitalization and length of stay (LOS) for the eight months before study entry. Results: Thirty-four URCPCC-SCD outpatients, mean/median age of 16 years, entered the study, and data were analyzed for 33. All reported some sense of future hopefulness, and almost half reported feeling “tense or wound up” most of the time. Use of avoidant or negative coping strategies in response to daily stress correlated positively with increased LOS. Conclusions: Youths with SCD require effective coping strategies to improve self-efficacy and related hope for brighter futures. Individualized, comprehensive treatment and support to families and individuals at risk for sickle cell crisis are uniquely offered in a URCPCC-SCD. Their contributions to service delivery and clinical outcome are expected to enhance hope, mitigate prolonged hospitalizations, and improve adherence to treatment (N = 268). Full article

Soft spread cheese is highly perishable, and conventional packaging offers limited protection against surface spoilage. Here, we present a sustainable, multifunctional solution: edible films made from whey protein concentrate (WPC), a valuable by-product of the cheese industry, incorporated with the probiotic Lactobacillus acidophilus LA5 (LA5). The objective of this study was to evaluate these films as active coatings for soft cheese, specifically assessing their physicochemical properties, probiotic viability during storage and simulated gastric transit, and their impact on cheese microbial stability and sensory quality over 60 days. Applied as active coatings on soft cheese stored at 4 °C for 60 days, these films were evaluated for their physicochemical properties, probiotic viability, microbial stability, and sensory acceptance. The incorporation of LA5 did not significantly alter film thickness (control: 0.20 ± 0.03 mm; test: 0.18 ± 0.02 mm), moisture content (control: 33.42 ± 0.54%; test: 32.34 ± 1.28%), or water solubility (control: 21.44 ± 1.14%; test: 22.89 ± 0.75%) (p > 0.05). However, mechanical properties were markedly modified: tensile strength decreased from 35.42 ± 5.38 MPa (control) to 6.04 ± 0.55 MPa (test), while elongation at break increased from 4.87 ± 0.93% to 68.23 ± 3.46% (p < 0.05), indicating a transition from rigidity to flexibility upon probiotic incorporation. The probiotic strain exhibited exceptional resilience, retaining 100% viability during simulated gastric exposure at both day 0 and day 30 of storage. During cheese storage, LA5 counts in test film-coated samples remained above the recommended therapeutic threshold (10⁶ cfu/g), starting at 7.44 ± 0.15 log(cfu/g) on day 0 and maintaining 6.56 ± 0.20 log(cfu/g) after 60 days. Critically, yeast and mold spoilage were delayed in probiotic-coated cheese, with detectable growth appearing only at day 60 (1.64 ± 1.34 log(cfu/g)), whereas uncoated cheese showed spoilage as early as day 28 (1.33 ± 1.62 log(cfu/g)). Sensory evaluation revealed no significant differences (p > 0.05) between the coated and uncoated samples for color, appearance, texture, flavor, or overall acceptability. By valorizing a dairy by-product into an active, probiotic-loaded edible film, this approach offers a sustainable, waste-reducing strategy that enhances cheese preservation while delivering added functional value—bridging the gap between food packaging and nutrition. Sensory evaluation (n = 8, preliminary) indicated no significant differences between coated and uncoated samples, but these results require confirmation with a larger, validated panel. Full article

Objective: This study examines whether access to basic services is associated with health-related social participation among people with disabilities, with a particular focus on participation in cultural and sports activities. Methods: Using data from the 2022 census of people with disabilities in X Province, China, we estimated Probit models to assess the association between access to three types of basic services—rehabilitation, social welfare, and social assistance—and participation in cultural and sports activities. Results: Greater access to basic services was associated with a significantly higher likelihood of participation in cultural and sports activities. Among the three service categories, rehabilitation services showed the strongest positive association. The positive association was stronger among individuals with lower disability severity. Conclusions: Access to disability-related basic services, especially rehabilitation services, may promote health-related social participation and social integration among people with disabilities. These findings highlight the importance of service access and rehabilitation support for disability healthcare, community inclusion, and quality of life. Full article

The use of non-biodegradable plastic food packaging materials has become a major environmental concern. These plastics release chemicals and microplastics during degradation, harming wildlife and entering the food chain, posing risks to both environmental and human health. This study aimed to evaluate electrospun poly(vinylpyrrolidone) (PVP) mats incorporating natural antibacterial Thymus vulgaris L. extract (TE) and natural crosslinker citric acid (CA) as alternative food packaging materials. Packaging mats with TE and/or CA combinations in PVP were evaluated for their structural, chemical, optical, and shelf-life-enhancing effects on blueberries. The results show that dissolving PVP in TE extract and adding CA in PVP ethanol-water or TE-based solutions significantly affected the viscosity and conductivity of the electrospinning solutions, thereby influencing the morphology of electrospun mats. FTIR analysis confirmed the incorporation of TE into the polymer and indicated CA induced hydrogen bonding, interactions that may reduce the polymer chain mobility and increase the brittleness of the electrospun mat. In tests with blueberries, it was estimated that the commonly used traditional food film minimized blueberry weight loss, whereas the porous electrospun PVP and PVP/TE mats allowed greater moisture release and preserved better visual quality by reducing wrinkling and dehydration. Overall, electrospun PVP-based mats functionalized with TE show promise as sustainable food packaging materials that balance moisture management with product appearance. Full article

Background/Objectives: Respiratory syncytial virus (RSV) causes a significant hospitalization burden in infants. The objective of this study was to evaluate the cost-effectiveness of introducing clesrovimab, a recently approved long-acting monoclonal antibody, in all US infants born during or entering their first RSV season. Methods: A decision analytical model simulated the clinical and economic impact of clesrovimab in a yearly birth cohort, compared with three alternative interventions: nirsevimab, palivizumab, and the RSVpreF maternal vaccine. Model inputs were obtained from the published literature. Efficacy estimates for clesrovimab were derived from post hoc analyses of randomized control trial data, which were conducted to align endpoints from different studies (nirsevimab and RSVpreF). Medically attended lower respiratory infection (MALRI), quality-adjusted life years (QALYs, 3% discounting), and costs (in 2024 USD) were evaluated from a societal perspective. Both deterministic and probabilistic sensitivity analyses were performed. Results: Clesrovimab resulted in fewer (38,252) RSV-related MALRI outcomes and was cost-saving compared to nirsevimab, with significant reductions in total costs (USD 98 million saved). When compared with palivizumab, clesrovimab and nirsevimab were estimated to cost USD 38,655 and USD 79,912 per QALY, respectively. Results were sensitive to changes in intervention costs, efficacy, and QALY loss due to RSV infection. Conclusions: Clesrovimab may significantly reduce the burden of RSV among US infants in their first RSV season and may save costs compared to nirsevimab. Full article

Background: Ischemic stroke remains a major cause of disability and reduced quality of life (QoL). This study aimed to identify factors associated with QoL after ischemic stroke, with particular emphasis on independence, illness acceptance, social support, comorbidity status, and the timeliness of diagnosis and treatment. Methods: This single-center cross-sectional study included 100 consecutively recruited patients after ischemic stroke hospitalized in the Department of Neurology with the Stroke Unit at the S. Żeromski Specialist Hospital in Krakow. Data were collected using an author-designed questionnaire and standardized instruments: the World Health Organization Quality of Life-BREF (WHOQOL-BREF), the Multidimensional Scale of Perceived Social Support (MSPSS), the Lawton Instrumental Activities of Daily Living Scale (IADL), and the Acceptance of Illness Scale (AIS). Statistical analysis included Spearman’s rank correlation coefficient and the Mann–Whitney U, Friedman, and Kolmogorov–Smirnov tests. Results: Significant positive correlations were found between all WHOQOL-BREF domains and IADL, AIS, and MSPSS scores. The strongest correlations were observed between IADL and the physical and psychological QoL domains. A strong positive correlation was also found between IADL and AIS (rho = 0.88; p < 0.001). Better QoL and greater independence were observed in patients with fewer comorbidities. Patients who received timely diagnosis and treatment achieved better outcomes in terms of QoL, IADL, and AIS. Perceived social support was comparable across MSPSS subscales (p = 0.56) but positively correlated with all QoL domains (rho = 0.55–0.64; p < 0.001). Conclusions: Better QoL after ischemic stroke was associated with greater independence, higher illness acceptance, stronger perceived social support, and timely diagnosis and treatment, suggesting that post-stroke QoL is related to both functional and psychosocial factors. Full article

Background: The recombinant zoster vaccine (RZV) has been shown to reduce the risk of dementia and delay cognitive decline. However, economic evaluations in populations with mild cognitive impairment (MCI), particularly those incorporating cognitive outcomes, remain unavailable. This study evaluated the cost-effectiveness of RZV vaccination at age 50 among Chinese adults with MCI. Methods: A decision tree–Markov model was developed from a societal perspective to assess the lifetime cost-effectiveness of RZV (Shingrix, GSK) in a cohort of 1 million immunocompetent Chinese adults with MCI receiving vaccination at the age of 50. The primary outcome was the incremental cost-effectiveness ratio (ICER), while secondary outcomes included cases averted and the number needed to vaccinate (NNV) to prevent one case of herpes zoster (HZ), postherpetic neuralgia (PHN), and dementia. A willingness-to-pay (WTP) threshold equivalent to the 2024 Chinese gross domestic product (GDP) per capita (13,121 USD) was applied. Sensitivity analyses were conducted to test the robustness of the results. Results: Over a lifetime horizon, RZV vaccination was estimated to avert 54.64% of HZ cases, 97.58% of PHN cases, and 12.28% of dementia cases compared with no vaccination, resulting in an additional 2.23 million quality-adjusted life years (QALYs) gained. The ICER was 4216.99 USD/QALY, remaining well below the WTP threshold. The corresponding NNVs were 6.25 for HZ, 24.03 for PHN, and 280.82 for dementia progression. Conclusions: RZV vaccination is cost-effective for Chinese adults aged 50 years with MCI, providing substantial health gains through reductions in both HZ burden and dementia progression. Full article