Search Results (4,407)

As an essential component of the built environment, outdoor artificial lighting at night, has a profound impact on visitors’ experience quality. Research on the light environment extends beyond visual effects to encompass broader psychophysiological impacts, such as perception, emotion, and public health. Shooting tree lights (STLs) are a distinctive type of outdoor lighting, commonly installed in landscape environments. This study aims to investigate the effects of different colors (yellow, red, green, and blue) of STL on alertness at night. Sixty participants took part in an experimental design assessing the impact of four different colors on electroencephalogram (EEG) and self-reported alertness. Our results indicate that STL color is a significant factor influencing physiological alertness levels. Exposure to yellow light reduced beta power, diminished alertness, and enhanced relaxation and comfort compared to red, blue, and green light. The study also identified variations in alertness based on age and gender. With respect to age, younger individuals exhibited greater alertness, while women were more alert than men. This study suggests that yellow light is generally more favorable than other colors in enhancing subjective light comfort. These findings underscore the importance of prioritizing yellow-colored STLs in landscape planning and design to promote relaxation and comfort for nighttime visitors. Full article

Objective: To analyze the association between physical activity, health-related quality of life (HRQoL), and perceived barriers to physical activity with the risk of symptoms of depression, anxiety, and stress in Chilean adolescents. Method: A quantitative, cross-sectional, descriptive-correlational study was conducted with a sample of 351 secondary school students (mean age = 15.75 ± 1.47 years) from several educational institutions in the south-central region of Chile. Validated instruments were used to assess physical activity (PAQ-A), symptoms of mental health (DASS-21), HRQoL (Kidscreen-52), and the short scale of barriers to physical activity. For exploratory purposes, mental health outcomes were dichotomized based on standard cut-off scores, and binary logistic regression models were estimated to identify associated factors. Results: Based on the binary categorization, a substantial proportion of students exceeded the risk thresholds for depressive (54.4%), anxiety (63%), and stress symptoms (42.2%). Across models, lower physical activity levels, reduced autonomy and weaker relationships with parents, and barriers related to self-concept and motivation were consistently associated with higher mental health risk. Additionally, passive commuting and the perceived school environment emerged as specific predictors of stress and depression risk, respectively. Conclusions: These findings suggest that individual and contextual factors linked to lifestyle behaviors and perceived social support may play a critical role in adolescent mental health, and could represent key targets for school-based interventions. Full article

Certain environmental exposures are associated with COVID-19 incidence and mortality. To determine whether environmental context is associated with other COVID-19 experiences, we used data from the nationally representative Tufts Equity in Health, Wealth, and Civic Engagement Study data (n = 1785; three survey waves 2020–2022 for adults in the United States). Environmental context was assessed using self-reported climate stress and county-level air pollution, greenness, toxic release inventory site, and heatwave data. Self-reported COVID-19 experiences included willingness to vaccinate, health impacts, receiving assistance for COVID-19, and provisioning assistance for COVID-19. Self-reported climate stress in 2020 or 2021 was associated with increased COVID-19 vaccination willingness by 2022 (odds ratio [OR] = 2.35; 95% confidence interval [CI] = 1.47, 3.76), even after adjusting for political affiliation (OR = 1.79; 95% CI = 1.09, 2.93). Self-reported climate stress in 2020 was also associated with increased likelihood of receiving COVID-19 assistance by 2021 (OR = 1.89; 95% CI = 1.29, 2.78). County-level exposures (i.e., less greenness, more toxic release inventory sites, and more heatwaves) were associated with increased vaccination willingness. Air pollution exposure in 2020 was positively associated with the likelihood of provisioning COVID-19 assistance in 2020 (OR = 1.16 per µg/m³; 95% CI = 1.02, 1.32). Associations between certain environmental exposures and certain COVID-19 outcomes were stronger among those who identify as a race/ethnicity other than non-Hispanic White and among those who reported experiencing discrimination; however, these trends were not consistent. A latent variable representing a summary construct for environmental context was associated with COVID-19 vaccination willingness. Our results suggest that intersectional equity issues affecting the likelihood of exposure to adverse environmental conditions are also associated with health-related outcomes. Full article

Background: T1D is generally associated with increased psychological burden, but evidence from Middle Eastern populations remains scarce. The present study assessed the gender differences in management, prevalence, and risk factors of perceived depression and anxiety among people with T1D in Saudi Arabia. Methods: A cross-sectional online survey was conducted among people withT1D across Saudi Arabia to collect demographic, clinical, and diabetes management data. Perceived depression and anxiety symptoms were assessed using a validated questionnaire. Multinomial logistic regression was used to identify risk factors of severe depression and anxiety. Results: Among 1073 PwT1D (303 males and 770 females), perceived depressive and anxiety symptoms were highly prevalent. Females had higher perceived anxiety compared with males (p = 0.003). Age- and BMI-adjusted regression analysis showed that, overall, higher income (p = 0.008), no neuropathy (p = 0.002), above-average benefit from the diabetes education clinic (p = 0.02), practicing carbohydrate counting (p = 0.002), and HbA1c < 7.0% (p = 0.01) were protective against perceived severe depression. Friends with T1D as the preferred education source (odds ratio [OR] = 2.8, p = 0.04) and a rejected request for continuous glucose monitoring (CGM) (OR = 1.88, p = 0.02) or insulin pump (OR = 2.8, p = 0.001) were significant risk factors. Perceived severe anxiety was associated with insulin pump rejection (OR = 2.4, p < 0.001) and self-reading as the preferred education source (OR = 2.0, p = 0.03). Being male (p = 0.02), no neuropathy (p = 0.01), practicing carbohydrate counting (p < 0.001), and HbA1c < 7.0% (p = 0.001) were protective. Conclusions: Symptoms of depression and anxiety are highly prevalent among people with T1D in Saudi Arabia, with females and socioeconomically disadvantaged individuals at greater risk. The findings highlight an urgent need for integrated mental health support within diabetes care and improved access to resources. Full article

Psychological distress remains a significant public health concern, particularly among youth. With the growing integration of mobile and wearable technologies into daily life, digital phenotyping has emerged as a promising approach for early self-detection and intervention in psychological distress. Objectives: The study aims to determine how behavioral and device-derived data can be used to identify early signs of emotional distress and to develop and evaluate a prototype system that enables users to self-detect these early warning signs, ultimately supporting early intervention and improved mental health outcomes. Method: To achieve this, this study involved a multi-phase, mixed-method approach, combining literature review, system design, and user evaluation. It started with a scoping review to guide system design, followed by the design and development of a prototype system (ESFY) and a mixed-method evaluation to assess its feasibility and utility in detecting early signs of psychological distress through digital phenotyping. Results: The results demonstrate the potential of digital phenotyping to support early self-detection for psychological distress while highlighting practical considerations for future deployment. Conclusions: The findings highlight the value of integrating active and passive data streams, prioritizing transparency and user empowerment, and designing adaptable systems that respond to the diverse needs and concerns of end users. The recommendations outlined in this study serve as a foundation for the continued development of scalable, trustworthy, and effective digital mental health solutions. Full article

Background/Objectives: Individuals with posttraumatic stress disorder (PTSD) tend to show patterns of elevated cardiovascular disease (CVD) risk earlier in life than the general population. The need for effective interventions for CVD risk-reduction in PTSD is increasingly evident. In this paper we present preliminary results from a longitudinal study of a health behavior intervention, as an adjunct to standard trauma therapy in PTSD. The health behavior intervention addresses CVD-related heath behaviors (physical activity, nutrition, sleep, and stress) in a 12-week program delivered individually in 90-min sessions. Behavior change recommendations included: increased aerobic activity; establishing a balanced diet, enhancing consumption of fruits and vegetables and reducing sugars and fat/saturated fat; incorporating strategies to enhance sleep and lower PTSD-related disruptions (e.g., nightmares); and relaxation and cognitive coping skills to reduce general stress. Methods: Participants were randomized to the health behavior intervention plus standard trauma therapy experimental condition or a standard trauma therapy control group. Outcomes were measured at baseline and after the 12-week intervention phase. Sleep efficiency was measured from actigraphy watches. Physical activity was assessed by self-report and blood pressure was measured using an automated device. The preliminary outcomes are for 29 participants to date who have pre-post data. Results: Sleep efficiency was improved in the intervention group compared to controls (p < 0.05). The intervention group also evidenced significant pre-post increases in moderate physical activity compared to the control group (p < 0.05). Changes in vigorous physical activity did not reach statistical significance in this preliminary sample but the pattern of results are similar to those for moderate activity. Trends toward significance were also observed for pre-post changes in systolic (p = 0.06) and diastolic blood pressure (p = 0.07), with small reductions for the intervention group and increases for the control group. Conclusions: These findings provide preliminary information about the effectiveness of the health behavior intervention on multiple parameters for adults with PTSD. The findings suggest that focusing on health behavior change in multidisciplinary treatments for PTSD may enhance outcomes such as sleep and physical activity and potentially result in greater quality of life. However, the small preliminary sample size reported here should be considered when interpreting the outcomes. Further research may also determine how improvements in health parameters impact other indices of long-term cardiovascular health. Full article

Objectives: This study aimed to investigate the effects of physical activity and mental health on chewing difficulty in South Korean adults using data from the seventh Korea National Health and Nutrition Examination Survey (KNHANES VII, 2016–2018). Methods: A total of 8212 participants aged ≥20 years who completed surveys on their physical activity, mental health, and chewing status were included. Chewing difficulty was assessed via a five-point Likert scale based on self-reported discomfort when chewing due to oral problems, and dichotomized for analysis. The participants were divided into two groups: those aged <40 and those aged ≥40 years. Complex sample analyses, including cross-tabulations and logistic regression, were used to examine the associations. Results: Among men aged <40, high perceived stress was associated with 1.71 times higher odds of experiencing chewing difficulty (p < 0.05). For men aged ≥40, high perceived stress (OR of 1.45) and a sleep duration of <7 h (OR of 1.32) were significant risk factors (p < 0.05). In women aged ≥40 years, high Patient Health Questionnaire 9 (PHQ-9) scores (≥10; OR of 2.35) and high perceived stress (OR of 1.64) were significantly associated with chewing difficulty (p < 0.001). Conclusions: Perceived stress, insufficient sleep, and depression are significant mental health factors associated with chewing difficulty in adults. These findings emphasize the necessity of a multifaceted approach, including psychosocial mental health issues, to effectively manage chewing difficulty in this population. Full article

Background: Functional disability is a growing concern in aging populations with chronic health conditions, yet few studies have compared disability profiles across diagnostic categories using standardized tools. Objectives: This study aimed to characterize the functional profiles of adults with neurological, musculoskeletal, and chronic pain conditions using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) and to examine differences by age and sex. Methods: A total of 419 participants (median age = 73 years; 73% female) completed the 36-item WHODAS 2.0. Diagnoses were classified into three groups: neurological (n = 134), musculoskeletal (n = 230), and pain-related (n = 55). Domain-level scores were analyzed using non-parametric tests and Spearman correlations. Results: revealed that neurological conditions were associated with the highest disability levels, particularly in cognition, interpersonal relations, and participation. Musculoskeletal conditions showed greater impairments in mobility and self-care, while pain-related conditions demonstrated variable disability, especially in participation. Women reported higher disability scores in the neurologic group, with significant differences observed in the cognition domain among neurological cases (p = 0.048). Age was positively correlated with disability in self-care and mobility, especially in musculoskeletal conditions. Conclusions: These findings highlight the utility of WHODAS 2.0 in identifying domain-specific limitations across clinical populations. They support the need for individualized, diagnosis- and gender-sensitive rehabilitation strategies, and suggest that WHODAS 2.0 can inform targeted care planning and resource allocation in rehabilitation settings. Future research should incorporate longitudinal designs and explore contextual factors influencing functional outcomes. Full article

Background: Ultra-Processed Foods (UPFs) make up a growing share of older adults’ diets and may contribute to frailty through pro-inflammatory pathways. The objective of this study was to examine the association of UPF intake with frailty development and with annual changes in select frailty components. Methods: This prospective cohort study used data from 2547 participants in the Framingham Offspring Cohort. UPF intake was assessed using a food frequency questionnaire and classified according to the NOVA framework, and frailty was defined by the Fried frailty phenotype. We used cumulative and mixed logistic regression models to examine the association between daily servings of UPF and odds of developing frailty, adjusting for baseline age, education, energy intake, multivitamin use, smoking, self-rated health, history of diabetes, cancer, cardiovascular disease, and diet quality. For the frailty component analysis, we used cumulative linear regression models to assess the association between UPF intake and annual changes in grip strength, gait speed, and weight, further adjusting for BMI and physical activity. We also evaluated potential effect modification by sex and baseline age (<60 vs. ≥60 years). Results: The study population was 55.1% female, with a mean age of 60.3 ± 8.9 years. Over an average follow-up of 10.8 years, 233 participants (9.2%) developed frailty. UPF intake was not associated with frailty development in either the cumulative or mixed regression models. UPF intake was not associated with annual weight change but was inversely associated with annual change in gait speed and with annual change in grip strength in men only. Conclusions: Our findings contribute preliminary evidence that, in middle-aged and older adults, increased UPF intake is not associated with frailty but may be related to worsening muscle strength and function. Further research with a more granular approach to UPF classification is required to translate these findings to practical recommendations and to clarify their clinical significance. Full article

Objective: To evaluate the short-term clinical impact of daily use of calibrated interdental brushes (IDBs) on gingival bleeding among dental and dental hygiene students within academic curricula. Methods: A prospective cohort of 117 students from three Italian universities was followed over three months. All participants received personalized training and calibrated interdental brushes matched to their interdental spaces. The primary outcome was the percentage of interdental sites exhibiting bleeding on interdental brushing (BOIB), assessed at baseline (T0), one month (T1), and three months (T2). Adherence was self-reported. Statistical analyses included Wilcoxon tests, multivariate regression, and adjusted ANCOVA models. Results: Median bleeding scores decreased from 50.0% [IQR: 26.9–69.2] at baseline to 15.4% [IQR: 3.8–30.8] at one month and further to 11.5% [IQR: 0.0–26.9] at three months (p < 0.001). Regular interdental brush users showed a 15 to 16 percentage point greater reduction in bleeding compared to occasional users (p < 0.001). Dental hygiene students had significantly lower baseline bleeding scores than dental students, but both groups experienced comparable benefits from the intervention. Adjusted analyses confirmed a sustained beneficial effect of regular interdental brushing. Initial weak and transient correlations between behavioral factors and bleeding likely reflect multifactorial influences and variable adherence. Conclusions: Daily use of calibrated interdental brushes produces a rapid, significant, and sustained reduction in gingival bleeding among dental students. Systematic integration of this protocol within dental education programs is feasible and effective, promoting early adoption and maintenance of essential preventive oral health behaviors. Full article

With the widespread implementation of bridge structural health monitoring (SHM) systems, monitored bridge networks have gradually formed. Understanding vehicle loads and considering spatio-temporal correlations within bridge networks is critical for structural condition assessment and maintenance decision making. This study aims to predict traffic flows by investigating traffic flow correlations within a bridge network using multi-bridge data, thereby supporting bridge network-level SHM. A transformer-based traffic flow prediction model considering spatio-temporal correlations of bridge networks (ST-TransNet) is proposed. It integrates external factors (processed via fully connected networks) and multi-period traffic flows of input bridges (captured by self-attention encoders) to generate traffic flow predictions through a self-attention decoder. Validated using weigh-in-motion data from an 8-bridge network, the proposed ST-TransNet reduces prediction root mean square error (RMSE) to 12.76 vehicles/10 min, outperforming a series of baselines—SVR, CNN, BiLSTM, CNN&BiLSTM, ST-ResNet, transformer, and STGCN—with significant relative reductions of 40.5%, 36.9%, 36.6%, 37.3%, 35.6%, 31.1%, and 22.8%, respectively. Ablation studies confirm the contribution of each component of the external factors and multi-period traffic flows, particularly the recent traffic flow data. The proposed ST-TransNet effectively captures underlying the spatio-temporal correlations of traffic flow within bridge networks, offering valuable insights for enhancing bridge assessment and maintenance. Full article

This study examines differences in perceived parental emotional availability, emotion regulation (ER), and health-related quality of life (HRQoL) among adolescents, considering gender, age, and family structure. It also assesses contextual differences in ER (at home vs. at school) and investigates the mediating role of ER in the relationship between perceived parental emotional availability and HRQoL. The sample consisted of 202 Portuguese adolescents (M age = 13.44 years, SD = 1.01; 52.5% girls) who participated in this cross-sectional study. Self-report scales were used to assess perceived emotional availability, ER, and HRQoL, with data collected during classes using a paper-and-pencil procedure. The results showed that girls’ perceptions of mother and father emotional availability were smaller than perceptions reported by boys; girls reported lower HRQoL. Also, adolescents from divorced/separated families reported higher levels of expressive suppression at home and lower HRQoL. Both maternal and paternal perceived emotional availability were positively associated with better HRQoL in adolescents. Furthermore, expressive suppression (within the home context) and cognitive reappraisal (within the school context) partially explained these associations. These findings have important implications for both practice and research, highlighting the significance of perceived parental emotional availability and the role of ER in enhancing adolescents’ HRQoL. Full article

Aim: The purpose of this study was to explore the broad experience of continuous glucose monitoring from the perspective of patients diagnosed with type 1 diabetes mellitus, including not only their emotions and feelings but also the lifestyle changes, perceptions, and social aspects associated with its use. Design: This is a phenomenological qualitative study. Patient or Public Contribution: The sample consisted of 10 adult patients diagnosed with type 1 diabetes who had been using the continuous glucose monitoring system for at least 6 months and were patients of the Endocrinology and Nutrition Service of the University Hospital Complex of Ourense. Methods: The recorded interviews were conducted in November 2024. The conversations were audio-recorded with the participants’ consent, and then transcribed for thematic analysis. Results: Three main categories were identified: “experience prior to continuous glucose monitoring” (accessibility, prior knowledge, and expectations), “experience with the use of continuous glucose monitoring” (perception of healthcare support, concerns, strengths, and alarm management), and “experience regarding the disease” (self-management of the disease and safety). Despite the fact that diabetes mellitus is a complex chronic disease, all participants provided a positive assessment of their progress and improved control through continuous glucose monitoring. Conclusions: All participants felt more secure and protected with continuous glucose monitoring, improving their quality of life. The main concern among the subjects was the possibility of the sensor failing. They positively valued the alarm system in case of hypoglycemia. The CGM is a highly effective tool for the management and self-control of diabetes and promotes the relationship between patients and professional health. Impact: The findings of this study have important implications for clinical care, highlighting the need for more training and more health education at the first level of health care, such as health centers. 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

Background/Objectives: Few studies have examined the relationship between hearing aid use and physical activity levels, yielding inconsistent results. The aim of this study was to determine the possible association between hearing aid use and physical activity levels in a representative sample of older adults with hearing loss and a clinical indication for hearing aid use in Chile. Methods: We conducted a cross-sectional analysis of data from a nationally representative health survey employing geographically stratified, multistage probability sampling. Participants were aged ≥60, had medical indication for hearing aid use, demonstrated normal cognitive function, and reported no motor disability. Physical activity was assessed using the Global Physical Activity Questionnaire (GPAQ). We also collected data on self-perceived hearing status, specialist recommendations for hearing aid use, and adherence among device owners. Multivariate ordinal regression models evaluated the association between hearing aid use and physical activity, accounting for the survey’s complex sampling design. Results: The sample comprised 356 individuals, representing 599,912 older adults after applying survey weights. Overall, 50.5% reported owning a hearing aid; of these, 46.8% always used their device, and 19.1% never used it. Compared with consistent users, participants who used their hearing aid “sometimes” or “rarely” had significantly lower odds of higher physical activity levels (OR = 0.13; 95% CI: 0.02–0.85; p = 0.03 and OR = 0.13; 95% CI: 0.02–0.96; p = 0.04, respectively). Those who never used their hearing aid had 86% lower odds of higher physical activity (OR = 0.16; 95% CI: 0.03–0.94; p = 0.04). Conclusions: Consistent hearing aid use was associated with higher physical activity levels in older adults with hearing loss. These findings support the integration of hearing rehabilitation into broader strategies for promoting healthy aging. Full article