Search Results (9,497)

Background/Objectives: Cancer represents a significant health challenge, with high mortality and morbidity rates. Its diagnosis often triggers chronic stress, adversely affecting patient outcomes. Exercise has emerged as complementary therapy, enhancing treatment adherence and mitigating the side effects of chemotherapy. This study examines the effects of mild exercise during chemotherapy on patient anxiety. Methods: This prospective paired cohort study was conducted in the General Oncology Hospital of Kifisia “Agioi Anargyroi” in Athens, Greece. Adult cancer patients undergoing chemotherapy participated, excluding those with cognitive, hearing, or motor impairments, those who experienced side effects, or those who declined consent. Anxiety was measured before and after a 20-minute exercise routine performed during chemotherapy, using the Greek-translated State–Trait Anxiety Inventory (STAI). The exercise regimen included warm-up, full-body stretching, and cool-down exercises. Pre- and post-exercise scores were analyzed using the Wilcoxon signed-rank test. Results: Forty-five patients (20 women, 25 men; mean age 69.02 ± 10.62 years) with various cancer backgrounds participated. Pre-intervention anxiety levels were in the borderline “moderate” range, dropping post-exercise to the “low” range. Mean STAI scores decreased from 37.73 ± 13.33 to 32.00 ± 14.22 (p < 0.0001), with a medium-large effect size (Cohen’s d for paired samples = −0.646). No significant correlation was found between age and anxiety scores. Discussion: This study found a significant short-term reduction in anxiety, suggesting that incorporating mild exercise during chemotherapy may help in alleviating patient stress. The medium-to-large effect size supports the potential for meaningful short-term benefits. Conclusions: Incorporating mild exercise during chemotherapy may help reduce anxiety and psychological burden. These findings underscore the need for more comprehensive research in larger, more diverse populations to better understand the benefits of incorporating mild exercise during chemotherapy. Full article

Background: Midwifery’s Intangible Heritage was officially recognized by the United Nations Educational, Scientific and Cultural Organization on 6 December 2023, highlighting that elements of midwifery knowledge and practice, shaped over generations, constitute cultural heritage worth safeguarding. While previous studies have investigated midwives’ perceptions of professional identity, none have done so within the explicit framework of MIH. Objective: this study explored how midwives and student midwives in Cyprus perceive the intangible heritage of their profession and how it relates to their shared professional identity. Methods: A qualitative descriptive study was conducted between April and July 2023. Three focus groups were held, involving 22 participants: 15 registered midwives and 7 student midwives. A semi-structured interview guide consisting of 10 questions was used, developed by the lead author (M.P.) based on the literature and improvisation and finalized with the research team (E.H., S.V., N.M.) after expert input. Thematic analysis was performed inductively to identify recurrent themes. Results: Four major themes emerged: (1) key elements of Midwifery’s Intangible Heritage and their transmission across generations; (2) a sense of shared professional identity; (3) perceived threats to the midwifery profession; and (4) midwives’ expectations for the future of the profession. Conclusions: The findings reflect the historical background of midwifery in Cyprus and its contrast with contemporary practice, particularly within the context of the overmedicalization of birth and societal perceptions of midwifery in the socio-cultural setting. Safeguarding Midwifery’s Intangible Heritage requires both empowering women to seek midwifery-led care and enabling midwives to practice autonomously within their full professional scope. In addition, policymakers and educational bodies must support the preservation of midwives’ core skills through targeted educational curricula, structured mentorship, and continuous professional development. Full article

Objective: This study explored HIV testing prevalence and its associated factors among reproductive-aged women in Liberia. Study Design: A secondary and descriptive cross-sectional study was performed among Liberian women aged 15–49 years using the 2019 Liberia Demographic and Health Survey (LDHS) data set. Methods: Descriptive statistics were used to describe the characteristics of these women. Bivariate and multivariable logistic regression models were applied to determine factors associated with HIV testing. All analyses were adjusted for unequal probabilities of selection and non-response by use of survey weights. Results: Among the 8065 participants in this survey, 490 women had never had sex and were excluded, leading to the final sample size being 7575 women. The prevalence of HIV testing among Liberian women aged 15 to 49 years in 2020 was 57.17% (95% CI: 56.2 to 60.4). HIV testing among these women is associated with pregnancy history (aOR 6.40, 95% CI:4.99 to 8.22, p < 0.001), STI history (aOR 1.21, 95% CI:1.02 to 3.19, p < 0.001), knowledge of vertical transmission (aOR 1.65, 95% CI:1.23 to 2.21, p = 0.001), and highest educational level (primary (aOR 1.39, 95% CI:1.16 to 1.68, p < 0.001), secondary (aOR 2.10, 95% CI:1.73 to 2.53, p < 0.001), and higher education (aOR 6.80, 95% CI:3.75 to 12.32, p < 0.001)). Conclusions and Contribution: HIV testing prevalence of 57.17% demonstrates an unmet need for HIV testing among Liberian women aged 15 to 49 years and, thus, it is recommended that HIV testing and counseling services should mostly target these women in rural areas, with limited health services and less educated women. Full article

CR is a cornerstone of secondary prevention for cardiovascular disease, offering well-established benefits across mortality, hospital readmission, functional capacity, and quality of life. Despite Class I guideline endorsements and decades of supporting evidence, CR remains vastly underutilized, particularly among women, racial and ethnic minorities, older adults, and individuals in low-resource settings. This review synthesizes the current evidence base for CR, with emphasis on disease-specific benefits across different cardiovascular diseases, and highlights recent data on its role in expanding populations, including patients with HFpEF, older adults, patients with advanced heart failure, and those undergoing transcatheter interventions. We also examine persistent barriers to CR access and participation, including system-level and referral limitations, as well as patient-level disparities by age, sex, race and ethnicity, and socioeconomic status. Building on this, we explore innovative delivery models and recent policy initiatives such as hybrid programs and reimbursement reform, all designed to expand access, promote equity, and modernize CR delivery. The findings underscore the need for continued investment, advocacy, and innovation to ensure equitable access to CR and its life-saving benefits across the full cardiovascular care continuum. Full article

Background: Visual impairment (VI) continues to be a significant global public health concern, especially in underserved rural communities. Objectives: This study aims to assess the prevalence of VI and refractive errors, as well as to identify the causes and risk factors associated with VI in Duhknah, a rural area in Qassim Province, Saudi Arabia. Methods: This cross-sectional study, conducted in May 2024, included 929 participants aged 6–90 years from Duhknah, a rural area in Qassim Province, Saudi Arabia. Refractive errors (REs) were measured using a non-cycloplegic autorefractometer. Anterior and posterior eye examinations were performed using slit lamp biomicroscopy, direct ophthalmoscopy, and 90 D fundus biomicroscopy. VI was classified based on the International Classification of Diseases 11th revision (ICD-11), 2018. Results: The findings revealed that 671 (72.2%) participants had never undergone an eye examination. The overall prevalence of presenting VI was 370 (39.8%), comprising 21.6% with mild VI, 11.0% moderate, 4.1% severe, and 3.1% classified as blind. The prevalence of hyperopia, myopia, and astigmatism was 20.6%, 36.9%, and 13.2%, respectively. Uncorrected REs were the most common cause of VI (81.4%), followed by amblyopia (13.5%) and cataracts (3.2%). Regression analysis showed that women had 1.58 times higher odds of VI (p = 0.001). Participants with eye examinations for one year or more had 3.64 times higher odds (p < 0.001). Additionally, the risk of VI was significantly lower among older participants (ages 18–90) compared to younger ones (ages 6–17), (p < 0.001). Conclusions: This study found most participants had never had an eye exam, and VI was highly prevalent in the rural community. These findings underscore the need to strengthen primary eye care in rural Saudi Arabia. Regular vision screening, particularly for children, and better access to refractive services could significantly reduce VI and support the goals of Saudi Vision 2030. Full article

Background: Diabetes mellitus (DM) is a significant factor affecting prognosis and functional capacity in patients after cardiovascular events. This study aimed to assess the impact of coexisting diabetes on exercise tolerance and hemodynamic parameters in patients qualified for cardiac rehabilitation. Methods: A total of 452 patients (86 women, 366 men; mean age 63.21 ± 7.16 years) who had experienced cardiovascular incidents, including 226 individuals with coexisting DM (DM group) and 226 age- (±1 year) and sex-matched individuals without DM (non-DM group), were included in the analysis. All participants underwent an exercise test using a bicycle ergometer. Clinical data, comorbidities, medication use, left ventricular ejection fraction, and exercise test parameters were evaluated. Results: Patients with DM displayed a higher number of comorbidities (4.29 ± 1.26 vs. 3.19 ± 1.30; p < 0.001), greater medication use (8.71 ± 2.16 vs. 7.83 ± 2.05; p < 0.001), higher body mass (86.93 ± 13.35 kg vs. 80.92 ± 15.25 kg; p < 0.001), and a lower left ventricular ejection fraction (48.78 ± 8.99% vs. 50.01 ± 8.40%; p = 0.002) compared to those in the non-DM group. Diabetic patients also exhibited lower exercise capacity, expressed as peak power per kilogram of body mass (1.05 ± 0.27 W/kg vs. 1.16 ± 0.31 W/kg; p < 0.001). No significant differences were observed regarding absolute peak power or maximum heart rate. Conclusions: In patients after cardiovascular incidents, the presence of diabetes is associated with reduced relative exercise capacity and lower ejection fraction. Full article

Background and Objectives: Sarcopenic obesity, or the coexistence of sarcopenia and obesity, carries an additional load of health risks, including functional decline and metabolic disorders. Despite its increasing importance, data on Korean adults’ prevalence and risk factors are poor. The objective of this study was to estimate the prevalence of sarcopenic obesity, sarcopenia, and obesity to identify factors associated with each condition using the most recent nationally representative data. Materials and Methods: This study analyzed data from 4332 adults aged ≥ 40 years who participated in the 2022–2023 Korea National Health and Nutrition Examination Survey (KNHANES). Sarcopenia was defined using the appendicular skeletal muscle index (SMI) via bioelectrical impedance analysis (BIA), and obesity by waist circumference per Korean criteria. Participants were categorized into four body composition groups. Complex sample logistic regression was used to identify factors independently associated with each condition. Results: The prevalence rates of sarcopenic obesity, sarcopenia-only, and obesity-only were 1.9%, 14.4%, and 35.5%, respectively. Sarcopenic obesity was significantly more common among older women with low education level, poor subjective health, diabetes, and low HDL-C. They were associated with older age, lower physical activity, lower education level, past smoking, and poor health condition. Obesity was associated with male sex, diabetes, hypertension, dyslipidemia, and moderate-to-poor perceived health. Conclusions: Sarcopenic obesity, while less prevalent, is relatively uncommon and represents a high-risk phenotype associated with metabolic and functional deficits. These results highlight the importance of identifying vulnerable subgroups and implementing targeted strategies that address both muscle loss and adiposity in aging Korean adults. Full article

In 1913, the Fabergé workshops in St Petersburg produced the most expensive of their famed Imperial egg commissions, the so-called “Winter Egg,” designed by Alma Pihl. Fashioned from translucent rock crystal and decked in a glittering array of gemstones, the egg followed several other designs on winter themes by the highly respected jeweller. In this article, Fabergé’s winter-themed creations are the starting point for an exploration of how ice, frost, and snow were portrayed by Russian artists of the late imperial period. Such works both reflected and realised many of the shifts in the art world from the mid-nineteenth century onwards, for example, the renewed focus on making art “national,” the rise of artistic opportunities for women, the erasure of boundaries between fine and applied art, the influx of such European movements as Impressionism and Symbolism, and the development of modernist approaches to content and style. The principal focus is on works by artists associated with the Abramtsevo artistic circle (Abramtsevskii khudozhestvennyi kruzhok). How did representations of ice, snow, and frost participate in the emerging dynamic between the national idea and the decorative, which in turn fed into the move towards abstraction? Why did these subjects appear frequently in art by women? Why was winter often presented through the lens of the imagined and the ludic? These works evidence a new subjectivity that arose from Abramtsevo artists’ greater freedom to render lived experience. The paths open to them when working outside the Academic system, permitted creativity to range freely in the forging of a national modern style. Full article

The global Black Lives Matter movement and COVID-19 pandemic drew attention to the urgency of addressing entrenched structural dynamics such as racialization, gender, and colonization shaping health inequities for diverse racialized people. Canadian community-based research with racialized immigrant women recognized the need to enhance service provider capacity using a strengths-based activism approach to support client health and wellbeing. In this study, we aimed to understand the impacts of this mental health promotion practice on service providers and strategies to support them. Through purposeful convenience sampling, three focus groups were completed with 19 service providers working in settlement and mental health services in Toronto, Canada. Participants represented varied ethnicities and work experiences; most self-identified as female and racialized, with experiences living as immigrant women in Canada. Postcolonial feminist and critical mental health promotion analysis illuminated organizational and structural dynamics contributing to burnout and vicarious trauma that necessitate a focus on trauma- and violence-informed care. Transformative narratives reflected service provider resilience and activism, which aligned with and challenged mainstream biomedical approaches to mental health promotion. Implications include employing a postcolonial feminist lens to identify meaningful and comprehensive anti-oppression strategies that take colonialism, racialization, gender, and ableism and their intersections into account to decolonize nursing practices. Promoting health equity for diverse racialized women necessitates focused attention and multilevel anti-oppression strategies aligned with critical mental health promotion practices. Full article

Background: Concerns over women’s mental health have intensified globally, especially among mothers managing dual careers and family responsibilities. Positive Psychology Interventions (PPIs), such as gratitude journaling and well-being workshops, have demonstrated promise in enhancing mental health; however, their applicability in Arab contexts remains underexplored. This study aims to investigate the effectiveness of PPIs on mothers’ well-being, gratitude, depression, anxiety, and stress in Saudi Arabia. Methods: This quasi-experimental, one-group pretest–posttest study assessed the effects of a four-week PPI on 37 Saudi working mothers (aged 21–50 years) employed at a private school in Riyadh. The intervention included guided gratitude journaling thrice weekly and two workshops on positive psychology and gratitude. Pre- and post-intervention assessments used validated Arabic versions of the Depression Anxiety Stress Scale (DASS-21), WHO-5 Well-being Index, and Gratitude Questionnaire (GQ-6). Results: Significant improvements were found post-intervention: depression, anxiety, and stress scores decreased (p < 0.001), while well-being and gratitude increased (p = 0.001). However, participants with lower household income (<50,000 SAR) showed less improvement, indicating a potential moderating effect of socioeconomic status. Conclusions: The intervention demonstrated promising short-term improvements in mental health and well-being among Saudi mothers. The findings underscore the importance of culturally appropriate PPIs and highlight the need for further research using controlled, long-term designs. Limitations include the small, non-random sample, absence of a control group, and restriction to a single geographic region. Full article

Background: The relationship between sports participation and food preferences in adults, as well as the influence of gender, is still unclear. Objective: The objective of this study was to investigate the association between sports participation and individual food preferences and to explore potential gender differences among sports participants in a large group of Italian adults. Methods: This cross-sectional study involved 2665 adults (aged ≥ 18 years) who lead normal lives and underwent a routine lifestyle and dietary assessment at a clinical centre specialising in nutrition, metabolic health, and lifestyle counselling in Rome. Participants completed an online questionnaire on food preferences (19 foods) and sports practice. Multivariate logistic regression models, adjusted for age, sex, and smoking, were used to assess associations. Results: Sports participation was defined as engaging in structured physical activity at least once per week and was reported by 53.5% of subjects (men: 60.1%; women: 49.0%; p < 0.0001). After adjustment, active individuals were significantly more likely to prefer plant-based drinks, low-fat yoghurt, fish, cooked and raw vegetables, fruit, whole grains, tofu, and dark chocolate (all p < 0.05) and less likely to prefer cow’s milk (p = 0.018). Among sport participants, males were more likely to prefer meat (general, white, red, processed) and eggs, while females preferred plant-based drinks. No significant gender differences were observed for dairy products, legumes, or fish. Differences in food preferences were also observed according to the type of sport, with bodybuilders showing higher preference for tofu and dark chocolate. The strongest associations were found in the 25–44 age group. Conclusions: Sports participation is independently associated with specific food preferences, characterised by greater preference for plant-based and fibre-rich foods, and gender differences in food choices persist even among active adults. These findings highlight the need to consider both sports participation and gender when designing nutritional interventions. Full article

Objectives: Paratubal cysts (PTCs) are embryological remnants and are potentially hormonally responsive. Since hyperandrogenism (HA) is representative of polycystic ovary syndrome (PCOS), we examined whether biochemical hyperandrogenism is associated with PTCs in women with PCOS and if body mass index (BMI) and insulin resistance (IR) mediate this association. Methods: This retrospective study included 577 women diagnosed with PCOS at a tertiary academic center from 2010 to 2018. Clinical data included age at diagnosis, BMI, and diagnoses of hypertension, non-alcoholic fatty liver disease, and metabolic syndrome. Laboratory measures included total testosterone, sex hormone-binding globulin, anti-Müllerian hormone, luteinizing hormone, fasting glucose, insulin, and triglycerides (TG). Derived indices included a free androgen index (FAI), homeostasis model assessment of insulin resistance (HOMA-IR), and fasting glucose-to-insulin ratio. PTCs were identified through imaging or surgical findings. Structural equation modeling (SEM) assessed direct and indirect relationships between FAI, BMI, HOMA-IR, and PTCs, while adjusting for diagnostic age. Results: PTCs were identified in 2.77% of participants. BMI, FAI, TG, and IR indices were significantly higher for women with PTCs than those without PTCs. SEM revealed significant indirect effects of FAI on PTCs via BMI and HOMA-IR. The direct effect was negative, resulting in a non-significant total effect. A sensitivity model using HOMA-IR as the predictor showed a significant direct effect on PTCs without mediation via FAI. Conclusions: Biochemical HA may influence PTC development in PCOS through metabolic pathways, establishing the need to consider metabolic context when evaluating adnexal cysts in hyperandrogenic women. Full article

The COVID-19 pandemic precipitated unprecedented social isolation measures, profoundly disrupting daily life, educational routines, and mental health worldwide. University students, already susceptible to psychological distress, encountered intensified challenges under remote learning and prolonged confinement. This longitudinal study examined fluctuations in anxiety and mood among 102 Brazilian university students during the pandemic, distinguishing between those solely engaged in academic pursuits and those simultaneously balancing work and study. Data collected via the Brunel Mood Scale and State-Trait Anxiety Inventory in April and July 2021 revealed that students exclusively focused on studies exhibited significant increases in depressive symptoms, anger, confusion, and anxiety, alongside diminished vigor. Conversely, participants who combined work and study reported reduced tension, fatigue, confusion, and overall mood disturbance, coupled with heightened vigor across the same period. Notably, women demonstrated greater vulnerability to anxiety and mood fluctuations, with socioeconomic disparities particularly pronounced among females managing dual roles, who reported lower family income. These findings suggest that occupational engagement may serve as a protective factor against psychological distress during crises, underscoring the urgent need for tailored mental health interventions and institutional support to mitigate the enduring impacts of pandemic-related adversities on the student population. Full article

Sleep is a vital physiological process for recovery and health. In people with knee osteoarthritis (OA), disrupted sleep is common and linked to worse clinical outcomes. Commercial sleep trackers provide an accessible option to monitor sleep in this population, but their accuracy for detecting sleep, wake, and sleep stages remains uncertain. This study compared nighttime sleep data from polysomnography (PSG) and Fitbit Sense in individuals with knee OA and insomnia. Data were collected from 53 participants (60.4% women, mean age 51 ± 8.2 years) over 62 nights using simultaneous PSG and Fitbit recording. Fitbit Sense showed high accuracy (85.76%) and sensitivity (95.95%) for detecting sleep but lower specificity (50.96%), indicating difficulty separating quiet wakefulness from sleep. Agreement with PSG was higher on nights with longer total sleep time, higher sleep efficiency, shorter sleep onset, and fewer awakenings, suggesting better performance when sleep is less fragmented. The device showed limited precision in classifying sleep stages, often misclassifying deep and REM sleep as light sleep. Despite these issues, Fitbit Sense may serve as a useful complementary tool for monitoring sleep duration, timing, and regularity in this population. However, sleep stage and fragmentation data should be interpreted cautiously in both clinical and research settings. Full article

Most academic papers on Jordanian colloquial Arabic allophonic consonant variants have primarily examined their influence on the social status of speakers and their role in shaping linguistic prestige. However, there is a significant lack of research exploring the potential for manipulation and establishment of power through the deliberate use of consonantal variants by Jordanian speakers in Arabic. Using a variety of allophonic consonantal variants, this study investigates how speakers of Jordanian colloquial Arabic attempt to construct their discourse of power. The targeted phonemes in the current study were /q/, /θ/, /ð/, and /k/. Focus groups were used to gather data, which were then examined within the framework of Fairclough’s technologized discourse and thematic approaches. Twenty persons, 10 women and 10 men, ranging in age from 18 to 45 years, comprised each of the two groups. The duration of each focus group session was 50 min. Analysis of the data indicates that the presence of [q], [θ], [ð], and [k] allophones in Standard Arabic is restricted to particular social circumstances, such as official and scientific environments. This usage is a common trait among those who have received formal education and privileged social standing. The findings also reveal that participants strategically utilize the allophonic variants [g], [ʔ], [k], [t̪], [d̪], and [tʃ] to exert influence over interlocutors by demonstrating authority related to social identity, gender, and emotional state. This study intends to advance discussions on allophonic consonant variants in Jordanian colloquial Arabic by providing insights into their manipulative functions. Full article