Search Results (2,250)

Despite a large number of African-born individuals residing in the United States, there is a significant disparity in how this community accesses and utilizes mental health treatment. Low screening rates for common mental health concerns is one crucial part of ongoing inequities in mental healthcare access. Willingness to engage in screening is negatively impacted by a lack of culturally responsive ways to make screening more acceptable and stigma with mental health. This study therefore aimed to examine the perceived acceptability and utility of community-developed patient vignettes created to increase willingness to be screened for common mental health concerns. Employing a qualitative approach, a community advisory board (CAB) (n = 5) was enlisted to co-develop vignettes outlining an African community member’s symptoms of anxiety and subsequent help-seeking behavior. Two focus groups of community members (n = 18) provided qualitative feedback on the vignettes and shared their general attitudes towards mental health and recommendations for mental health screening and treatment in the African community. Using a hybrid inductive and deductive qualitative descriptive approach and classifying responses based on the socioecological model, four major themes emerged from the data: (1) between support and strain: the role of family; (2) reducing stigma: community voices as education; (3) culture as a barrier and a bridge; and (4) the importance of stories that reflect lived experience. Overall, participants were receptive to the culturally-responsive mental health vignettes and provided fruitful suggestions for how these stories can be used to reduce stigma and increase willingness to seek screening and treatment in African-born residents of the United States. Full article

Background: The pivotal role of caregivers in HIV care for older people living with HIV (PLWH) stands in stark contrast to the scarcity of research on their experiences, particularly regarding affiliate stigma. Older PLWH face a unique intersection of HIV-related stigma and ageism, which may place their family caregivers at heightened risk of affiliate stigma. However, the manifestations, sources, and coping strategies related to this stigma remain poorly understood. Methods: The descriptive phenomenological study was conducted between May and June 2025 at an HIV care clinic of a tertiary hospital in Sichuan Province, China. Using purposive sampling, fifteen caregivers of elderly individuals living with HIV were recruited. Data were collected through face-to-face, semi-structured interviews. Results: Four overarching themes and eleven sub-themes were extracted: (1) sources of affiliate stigma—‘Inadequate knowledge of HIV transmission routes’, ‘Ageism’, and ‘Infidelity stigma’; (2) experiences of affiliate stigma—‘Stigma endorsement’, ‘Concealment of a family member’s HIV-positive status’ and ‘Psychological distress’; (3) consequences of affiliate stigma—‘Estrangement among family members’, ‘Substantial caregiver burden’ and ‘Social avoidance’; and (4) coping with affiliate stigma—‘Enhancing knowledge of HIV/AIDS’ and ‘Seeking social support’. Conclusion: This study investigates affiliate stigma among caregivers of older people with HIV. Healthcare providers should recognize this stigma and its negative effects. Effective interventions must be developed to alleviate this burden, thereby improving the welfare of both caregivers and patients. Full article

Background: Diabetes-related stigma is an underrecognized psychosocial factor that may contribute to emotional burden among individuals with diabetes. In Saudi Arabia, where the prevalence of diabetes is among the highest globally, limited evidence exists on how stigma across different social contexts influences interpersonal diabetes distress. We aimed to assess the association between diabetes-related stigma and interpersonal diabetes distress and to determine whether these associations differed across family, workplace, and healthcare stigma domains among adults with diabetes in Saudi Arabia. Methods: This cross-sectional study analyzed survey data collected from 438 patients with diabetes. Diabetes-related stigma was measured using an adapted 12-item diabetes stigma scale covering family, workplace, and healthcare domains, while interpersonal diabetes distress was assessed using the Interpersonal Distress subscale of the Diabetes Distress Scale (DDS). The relationships between stigma and distress were estimated using multiple linear regression analysis adjusted for age, gender, education level, years since diagnosis, and presence of complications. Results: Participants reported moderate levels of stigma (mean: 2.50, SD: 1.08) and interpersonal distress (mean: 2.31, SD: 1.23). Higher stigma scores were strongly associated with greater interpersonal distress (β = 0.57, 95% CI: 0.48 to 0.66). Domain-specific analysis showed that workplace (β = 0.26, 95% CI: 0.10 to 0.42) and healthcare stigma (β = 0.23, 95% CI: 0.07 to 0.38) were significantly associated with distress, while family stigma was not. Individuals with diabetes complications had higher distress (β = 0.49, 95% CI: 0.25 to 0.73). No evidence of effect modification by gender or education was observed. Spline models confirmed a positive and strengthening association at higher levels of stigma. Conclusions: Diabetes-related stigma is a strong and consistent factor associated with interpersonal diabetes distress in Saudi Arabia, with workplace and healthcare stigma demonstrating the strongest associations. These findings highlight the importance of addressing stigma within both social and healthcare environments and suggest that stigma reduction strategies may help alleviate the psychosocial burden associated with diabetes. Full article

Introduction: As global cancer incidence and survival rates continue to rise, understanding the experiences and needs of individuals in the survivorship phase is critical to inform policies that promote equitable care and adequate support for cancer survivors. Objective: The objective of this study was to examine the lived social and workplace experiences of cancer survivors in Newfoundland and Labrador (Canada) using a qualitative research design. Methods: The study was open to cancer survivors of majority age who resided in Newfoundland and Labrador after their diagnosis. Between June 2023 and August 2024, twenty-five individuals participated in the study. Data were collected virtually through focus groups, individual interviews, or written responses. Demographic and socioeconomic characteristics of participants were collected via a survey. Thematic analysis was performed on all qualitative data. Two patient partner investigators informed the research throughout the entire project. Results: Data were rich and diverse, revealing a range of positive and negative experiences in social and workplace settings. Major themes included stigma in social and workplace environments, financial toxicity, workplace accommodations, social support and information needs. Young participants had unique challenges. Participants offered recommendations aimed at enhancing available supports and improving the quality of life of cancer survivors. Overall, findings highlight shared experiences across different regions and cultures while also painting the local context. Discussion: The results of this study reveal diverse experiences among cancer survivors within social and workplace settings. The findings and resulting recommendations can inform meaningful improvement to policies and programs, thus promoting equity and enhancing the lived experiences of cancer survivors. Full article

Cinematic representations of mental health operate at the intersection of science, culture and visual meaning, while medical academic discourse plays an important role in shaping how such representations are conceptualized. This study examines how the PubMed-indexed literature (2010–2025) engages with mental health in relation to narrative film and related screen media, combining bibliometric mapping with interpretive analysis. Through a structured PubMed query and VOSviewer co-occurrence analysis, this study identifies 5292 unique terms, of which 530 meet the minimum frequency threshold. Comparison between low- and high-frequency maps reveals a shift from lexical diversity to a consolidated biomedical core centered on classification, diagnosis and measurable affect. Six clusters are identified (neuro-affective, educational stigma, media–behavioral, neuropharmacological–technological, perceptual–emotional and pandemic-related), which together structure the field’s dominant semantic orientations. The findings indicate three main patterns: the predominance of standardized biomedical language, the limited visibility of intersectional categories (e.g., gender, race, identity) at the level of indexed metadata, and a gap between visual processes and narrative meaning. While individual studies often engage with cinematic complexity, this dimension is only partially reflected in the dominant lexical structure. Building on these results, a cluster-informed conceptual framework for film-based medical education is proposed, in which narrative film can support complementary forms of clinical, social and interpretive learning. This study contributes to the field of Medical Humanities by demonstrating that medical discourse not only reflects but also structures the visibility of mental health in relation to screen media, while highlighting the need for more integrated approaches that connect biomedical knowledge with narrative and cultural understanding. Full article

Flowering plants have evolved a wide range of strategies to avoid self-fertilization. Although allogamy is common among members of the genus Vanilla, V. lindmaniana is widely known for its ability to self-fertilize, resulting in fruit-set rates of 83–100% following self-pollination. During studies of Vanilla species in the Brazilian Cerrado, populations of V. lindmaniana exhibiting low fruit set under natural conditions were identified. Here, the factors associated with low fruit set in these Cerrado populations were investigated through analyses of floral traits, field observations of pollinators, and experimental treatments designed to assess the breeding system. The flowers of V. lindmaniana are adapted for bird pollination. Although the species commonly produces fruits through facultative autogamy, flowers from the Cerrado populations exhibited a stigma that was separated from the anther by a large rostellum, preventing self-pollination. While autogamy is common in V. lindmaniana, completely allogamous populations may also occur. Such a mixed breeding system may provide advantages over reproductive systems based exclusively on autogamy. Furthermore, it may promote reproductive assurance in the event of pollinator decline or in environments where biotic pollination is irregular or absent. Full article

The study examines discrepancies between personally reported and declared use of generative artificial intelligence (GenAI) among university students from a public university located in the Peruvian Andes, operationalized as the AI Use Gap, an exploratory discrepancy indicator based on two self-reported measures. Drawing on a sequential explanatory mixed-methods design, the study combines survey data (N = 150), experimental vignette evaluations, and qualitative follow-up interviews to explore how students manage the visibility and disclosure of AI use in academic contexts. Findings indicate relatively high levels of AI use alongside a consistent discrepancy between personally reported and declared use, suggesting patterns of differential reporting across contexts. Quantitative analyses did not show clearly differentiated exploratory relational patterns between the AI Use Gap and the psychosocial/contextual indicators examined, including perceived stigma, concealment, normative ambiguity, and peer pressure. Given the exploratory nature and limited internal consistency of the contextual indicators, these findings were interpreted cautiously as provisional exploratory patterns rather than as evidence of stable psychosocial relationships. Qualitative findings suggest that AI disclosure practices are shaped by socially evaluative and context-dependent processes, including fear of judgment, uncertainty regarding acceptable AI use, and selective disclosure strategies. Participants frequently described AI use as widespread but not consistently disclosed across academic settings. Overall, the findings suggest that discrepancies between AI use and disclosure may be better understood as forms of visibility management shaped by institutional ambiguity and social expectations rather than by stable individual-level characteristics alone. Rather than validating stable psychosocial mechanisms, the study explores an emerging and context-sensitive phenomenon using provisional contextual indicators intended to capture heterogeneous patterns of perception and disclosure. The study contributes to ongoing discussions regarding transparency, academic integrity, and the social regulation of AI use in higher education, particularly in under-researched Global South contexts. Full article

Tobacco is a plant with a wet stigma, which produces reactive oxygen species (ROS) and abscisic acid (ABA) which is important for in vivo pollen germination. Furthermore, ROS can be linked to growth processes, stimulating or inhibiting them. However, to what extent do differences in the redox environment and ABA level on the stigma and in pistil tissues correlate with flower growth, pollination success and resulting fruit parameters? We investigated redox homeostasis and ABA concentrations in stigma exudates of two tobacco lines (“Samsun” and “Fortune”) with different floral organ size and seed production. Fortune has longer flowers, larger fruits, and more seeds than Samsun. We report here that Samsun has a higher total oxidative capacity in stigma exudate, and possibly also higher NO level, than Fortune, as estimated by electron paramagnetic resonance spectroscopy. Fortune has a higher ascorbate peroxidase (APX) content in stigma tissues, as determined by Western blot analysis, and a higher ABA concentration in stigma exudate. Analyzing ROS levels and enzyme activity during the elongation stage in buds, we found that shorter Samsun styles had higher ROS levels, but they also had higher superoxide dismutase (SOD) and APX activity. The results of this study may help in developing approaches to a targeted increase in flower size and seed productivity. Full article

Evidence on the interplay between perceived stress, dietary behaviour, and weight-related psychosocial burden in Romanian young adults remains scarce. This cross-sectional study assessed associations between BMI, perceived stress, multi-system somatic symptom severity, and psychosocial burden in 117 participants aged 16 to 20 years (89.7% female; mean age 19.23 ± 0.74 years; mean BMI 22.66 ± 3.85 kg/m²), recruited by convenience sampling in Târgu Mureș, Romania, during June 2025. Non-parametric methods were used throughout. Female participants scored significantly higher than males across digestive (p < 0.001), neurological (p = 0.001), cutaneous (p = 0.014), and total symptom domains (p < 0.001), with a median total symptom score of 21.0 versus 3.0 in males. Perceived stress correlated positively with neurological (rS = 0.445), cardiovascular (rS = 0.350), digestive (rS = 0.316), and total symptom scores (rS = 0.401; all p < 0.001). BMI was not associated with somatic symptoms but correlated with weight-related stigma (rS = 0.391, p < 0.001). Emotional distress was prevalent regardless of weight status: 60.7% reported food-related guilt and 59.8% reduced self-confidence, yet only 6.0% had consulted a mental health professional. Stress management, nutritional counselling, and body image support should target young adults across all BMI categories. Full article

Background: Black Sub-Saharan African immigrants are among the fastest-growing immigrant populations in the United States, and their mental health needs, particularly with respect to depression, remain understudied. Cultural beliefs, linguistic frameworks, and coping practices in this population often diverge from Western psychiatric models, suggesting that conventional approaches may fail to capture how distress is experienced and expressed. Objective: This scoping review mapped literature on how Black Sub-Saharan African immigrant adults in the United States perceive, report, and respond to depression. Methods: Following PRISMA-ScR guidelines, six electronic databases were systematically searched for empirical studies published between 2000 and 2026. Two reviewers independently screened and extracted data using a standardized form. Data were analyzed using a narrative synthesis approach combining deductive thematic categorization across three predefined review domains with inductive identification of subthemes through iterative team discussion and consensus, with sociocultural, religious, linguistic, and structural factors examined as cross-cutting themes. Findings were synthesized narratively across three domains: perceptions of depression, reporting and communication, and responses to depression. Results: A total of 19 studies met the inclusion criteria (7 quantitative, 10 qualitative, 2 mixed methods; total N ≈ 1900), generating 24 themes. Perception themes highlighted cultural non-recognition of depression (12 of 19 studies), absence of equivalent terms in African languages (7 studies), spiritual explanatory models, and profound stigma. Reporting patterns showed predominant somatic symptom expression and very low disclosure to providers (2.6–4.2%), with depression prevalence ranging from 8.1% to 100% and no validated screening instrument identified for this population. Response themes emphasized religion and social support as primary coping strategies, with formal mental health utilization virtually absent due to structural, cultural, and intersectional barriers. Conclusions: Depression among Black Sub-Saharan African immigrants is widely experienced yet rendered invisible through interlocking cultural, linguistic, somatic, and institutional mechanisms, which this review terms an architecture of invisibility, leaving it largely unaddressed by formal mental health systems. The identification of only one intervention study underscores a substantial gap between documenting the burden of depression and advancing evidence-informed solutions. Culturally validated measures, faith-based intervention models, longitudinal designs, and attention to structural determinants are urgently needed. Full article

Background: Dementia and Type 2 diabetes (T2D) represent two of the most pressing global public health challenges of our time, both exacerbated by physical inactivity. These conditions disproportionately affect Global Majority populations, who experience earlier onset, higher prevalence, and poorer access to culturally appropriate preventive care. However, conventional research and interventions often overlook the sociocultural and structural factors that underpin this disparity. This study synthesises current evidence to understand how these three conditions intersect and to identify equitable pathways for prevention and support. Methods: A meta-narrative review approach was employed to integrate evidence from diverse biomedical, public health, sociocultural and intervention science traditions. Searches were undertaken across MEDLINE/PubMed-adapted searches, CINAHL, PsycINFO, Web of Science Core Collection, AMED and ASSIA, supplemented by grey literature searching and citation chasing. Five meta-narratives were identified: biomedical and epidemiological, public health, health disparities, sociocultural and behavioural, and intervention science. Cross-narrative synthesis produced a conceptual framework linking upstream determinants, lifestyle factors, and disease outcomes. Results: The review revealed that structural inequities such as deprivation, environmental barriers and sociocultural factors including stigma, gendered norms, limited access to culturally appropriate facilities that restrict physical activity (PA) opportunities within Global Majority communities. These constraints elevate T2D and dementia risk through biological pathways involving insulin resistance, vascular injury, and neuroinflammation. Community-based participatory research (CBPR) interventions particularly those delivered in trusted cultural or faith settings emerged as effective strategies to improve PA, glycaemic control, and cognitive well-being. Conclusions: This synthesis reframes dementia and diabetes as interlinked within a wider syndemic driven by structural and sociocultural inequities. The proposed framework underscores the importance of culturally grounded, community-led approaches to promote brain health, reduce risk, and achieve equitable healthy ageing among Global Majority populations. Full article

Burnout among intensive care unit (ICU) nurses is an escalating occupational health concern due to the high psychological and physical demands of critical care, with implications for staff well-being, patient safety, and healthcare quality. Despite its importance, limited evidence exists on burnout among ICU nurses in Saudi Arabian tertiary hospitals. This study investigated the prevalence of burnout, associated factors, and potential interventions to reduce stigma and support mental health among ICU nurses at a tertiary healthcare setting, Saudi Arabia. A quantitative cross-sectional design was employed using the Maslach Burnout Inventory–Human Services Survey (MBI-HSS). Simple random sampling selected 250 registered ICU nurses with at least six months of experience. Data was analysed using SPSS v30 with descriptive statistics, and chi-square tests at a significance level of p < 0.05. Findings indicated a high prevalence of burnout, with 52% of nurses reporting elevated emotional exhaustion. Burnout was significantly associated with overtime hours (χ² = 29.155, df = 12, p = 0.015), nurse-to-patient ratios (χ² = 36.170, df = 20, p = 0.015), shift patterns (day: χ² = 4.931, df = 8, p = 0.765; night: χ² = 263 4.226, df = 8, p = 0.836; rotating: χ² = 3.739, df = 4, p = 0.442), living arrangements ((χ² = 13.153, df = 16, p = 0.662), and perceived impact on patient outcomes. Participants identified mental health education, anonymous support programmes, psychological check-ins, and leadership encouragement as helpful coping strategies. The study concludes that burnout among ICU nurses is influenced by workload, work schedules, and organisational support, underscoring the need for systemic interventions to enhance nurse well-being and sustain healthcare quality. Full article

Psoriasis is a chronic immune-mediated inflammatory skin disease often associated with systemic inflammation and multiple comorbidities, resulting in a substantial negative impact on patients’ quality of life and mental health. In addition to cutaneous and joint involvement, patients frequently experience psychological distress, social stigma, and symptoms of anxiety and depression, which may be comparable in clinical relevance to the physical manifestations of the disease. In recent years, biologic therapies have become increasingly established in the treatment of psoriasis due to their targeted action on key inflammatory pathways involved in disease pathogenesis and their high clinical efficacy. Beyond improving disease severity, biologic agents have also been associated with meaningful improvements in health-related quality of life and mental health outcomes. Importantly, currently available evidence suggests that psychological and quality-of-life outcomes in psoriasis are influenced by multiple interacting clinical and psychosocial factors. This narrative review summarizes recent scientific evidence on the relationship between psoriasis, quality of life, and mental health, with particular emphasis on the impact of biologic therapy on these outcomes. The available data suggest that treatment response reflects a multidimensional process, in which clinical improvement, psychological status, and broader psychosocial factors interact to influence patient-reported outcomes. Overall, the reviewed studies indicate that biologic therapies not only reduce disease severity but are also associated with meaningful improvements in health-related quality of life and psychological well-being in patients with psoriasis. Full article

Background/Objectives: Scabies is a contagious dermatological infestation that can cause not only physical symptoms but also considerable psychosocial burden. This study aimed to investigate the relationships between fear of scabies, internalized stigma, and dermatology-related quality of life in patients with scabies. Methods: This cross-sectional study included 131 patients diagnosed with scabies in a dermatology outpatient clinic. Data were collected using a structured questionnaire including sociodemographic and clinical characteristics, the Fear of Scabies Scale (FSS), the Internalized Stigma Scale (ISS), and the Dermatology Life Quality Index (DLQI). Correlation and regression analyses were conducted to examine the associations between fear of scabies, internalized stigma, and quality of life. Results: The mean DLQI score was 15.82 ± 5.69, indicating a considerable impairment in dermatology-related quality of life. Fear of scabies showed a weak but significant positive correlation with DLQI scores (r = 0.326, p < 0.001), whereas internalized stigma demonstrated a stronger correlation (r = 0.484, p < 0.001). Among the stigma subdimensions, social withdrawal showed the strongest association with impaired quality of life (r = 0.622, p < 0.001). Regression analyses revealed that internalized stigma explained 23% of the variance in DLQI scores (R² = 0.234), while fear of scabies explained 10% (R² = 0.106). In addition, longer symptom duration (β = 0.708, p < 0.001), nocturnal pruritus (β = 0.408, p = 0.009), and visible skin lesions (β = 0.263, p = 0.002) were associated with higher levels of fear of scabies. Conclusions: Internalized stigma and disease-related fear were associated with reduced quality of life, with stigma-related mechanisms appearing to play a particularly prominent role. These findings suggest that addressing stigma and providing psychosocial support may be important components of comprehensive scabies management. Full article

Background: Hepatitis B virus (HBV) infection poses a persistent global public health challenge, with substantial associated morbidity, mortality, and healthcare utilization. Although Saudi Arabia has maintained a national HBV vaccination program for decades, population-level data on hepatitis B infection knowledge, attitudes, and practices (KAP) remain scarce and regionally limited. This study aimed to comprehensively assess KAP toward hepatitis B infection prevention among the general adult population across all regions of Saudi Arabia and to identify independent sociodemographic predictors of each domain to inform targeted healthcare interventions. Methods: This nationwide cross-sectional study used a convenience sampling approach and a validated, self-administered questionnaire disseminated via online social media platforms across all regions of Saudi Arabia between August 2024 and February 2025. KAP was assessed using an instrument adapted from Haq et al. (Cronbach’s α = 0.70). Good knowledge was defined as a score ≥11/20 (≥55%), positive attitude as ≥5/7 (≥71.4%), and good practice as ≥6/8 (≥75%). Multivariable linear regression was used to identify independent predictors, adjusting for sociodemographic covariates. Results: A total of 1278 participants were included (mean age 30.3 ± 12.4 years; 60.9% female). Overall, 54.2% demonstrated good knowledge, 68.5% demonstrated positive attitudes, and only 16.2% exhibited good preventive practices. Screening (14.6%) and vaccination uptake (26.5%) were markedly low. Educational program participation was the strongest modifiable predictor across all three domains: knowledge (β = +1.89, 95% CI: 1.20–2.58, p < 0.001), attitude (β = +0.47, 95% CI: 0.25–0.69, p < 0.001), and practice (β = +1.43, 95% CI: 1.09–1.77, p < 0.001). Healthcare sector employment was independently associated with higher KAP scores across all domains. Income demonstrated a positive dose–response relationship with knowledge and practice outcomes. Polygyny was associated with lower scores across all three domains. Conclusions: Despite moderate knowledge and generally favorable attitudes, preventive practices remain critically deficient, revealing a persistent knowledge–practice gap. Integrated, behavior-oriented interventions targeting modifiable determinants, particularly health education, income disparities, and stigma, are urgently needed to support progress toward national and global HBV elimination targets. Full article