Search Results (2,273)

Objectives: The present study aimed to examine the relationships between screen time (ST), sleep time (SLT), physical activity engagement (PA), Mediterranean diet (MD) adherence, body mass index (BMI), self-esteem (SE) and academic performance (AP) in high-socioeconomic-status (SES) school-aged youth in southern Spain. Methods: A descriptive, comparative, non-experimental and cross-sectional research study was conducted with a total sample of 217 Spanish students (13.88 ± 1.32). Structural equation modelling (SEM) was employed to analyse relationships between study variables as a function of sex. Results: SLT was positively associated with MD adherence and negatively related with BMI. Both PA and MD adherence were positively linked to SE, whilst MD adherence and SE were also positively related to AP. Regarding sex differences, ST was a stronger determinant among girls, showing negative associations with PA (β = −0.378; p < 0.001) and MD adherence (β = −0.315; p < 0.001), with this pattern not being observed in boys. PA was positively associated with SE in both sexes, but more strongly in boys (β = 0.332; p < 0.001) than in girls (β = 0.190; p = 0.034). In girls, both MD adherence (β = 0.295; p < 0.001) and SE (β = 0.224; p = 0.008) were positively associated with AP, with these associations not being found in boys. Conclusions: The findings underscore the complex interplay between lifestyle behaviours, psychosocial factors, and AP in school-aged youth. Regardless of SES, interventions should focus on reducing ST, promoting PA and MD adherence, and enhancing SE whilst considering sex-specific patterns. Full article

Sleep is a fundamental biological process in athletes, indispensable for tissue regeneration, exercise adaptation, and injury prevention. Disruptions in sleep architecture and duration have been consistently associated with diminished physical performance and adverse health outcomes, impairing muscular strength, power output, and endurance capacity, and concurrently compromising cognitive function. On a physiological level, insufficient sleep disrupts endocrine homeostasis, elevating cortisol levels and reducing anabolic hormones such as testosterone and growth hormone. At the molecular level, sleep loss promotes the upregulation of pro-apoptotic gene expression and exacerbates pro-inflammatory signalling pathways. Optimal sleep duration and quality represent a critical “regenerative window”, essential for enhancing athletic performance and safeguarding physiological resilience. Ensuring adequate sleep among athletes can be effectively achieved through educational, behavioural, and nutritional interventions outlined in this review. Full article

Background: Autism Spectrum Disorder (ASD) affects ~1 in 36 children and is increasingly studied as a candidate for non-invasive neuromodulation. Two of the most widely applied modalities are quantitative EEG (QEEG)-guided repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), both targeting the dorsolateral prefrontal cortex (DLPFC). While both have shown promise, questions remain regarding their relative clinical profiles and scalability. Objective: To conduct a within-cohort reanalysis of QEEG-guided rTMS outcomes in paediatric ASD and to contextualise these findings alongside published reports of home-supervised tDCS. Methods: Individual participant data (n = 56, ages 6–17) from a prospective rTMS cohort were reanalysed, focusing on the Social Responsiveness Scale (SRS-2), Autism Diagnostic Observation Schedule (ADOS-2), Aberrant Behavior Checklist (ABC), Repetitive Behavior Scale–Revised (RBS-R), and QEEG biomarkers. Findings were then situated within a narrative synthesis of published paediatric tDCS trials, which consistently report caregiver-supervised feasibility but did not provide raw, baseline-adjusted data suitable for reanalysis. Results: rTMS was associated with large within-cohort improvements (Hedges’ g ≈ 1.0–1.6), including an 11-point reduction in SRS-2 T-scores, a 12-point reduction in ABC totals, and robust QEEG normalisation (β/γ suppression, α enhancement). Published tDCS studies report moderate, clinically meaningful improvements in social communication, executive functioning, and regulation (Cohen’s d ≈ 0.4–0.6), with excellent adherence and no serious adverse events. Conclusions: rTMS produced robust behavioural and neurophysiological improvements within its cohort, while published tDCS trials demonstrate moderate, feasible benefits in home settings. Because of incomplete baseline data and protocol differences, no direct statistical comparison was possible. These findings suggest complementary roles: rTMS as a high-intensity clinic-based intervention, and tDCS as a scalable, family-centred option. A stepped-care framework that combines both modalities should be considered hypothesis-generating only and requires validation in harmonised, randomised controlled trials. Full article

Background: AMR causes a large global health burden, with approximately 4.95 million deaths linked to bacterial AMR in 2019, 1.27 million due to AMR directly. Although Brazil mandated prescriptions for systemic antibiotics in 2010/2011, self-medication and access without prescriptions continue, with community pharmacists playing a vital part in antimicrobial stewardship (AMS). This study examined antibiotic misuse and AMR in Brazil through community pharmacists’ perspectives, emphasising their dual role as professional actors and frontline observers of public behaviour. Methods: We conducted 20 semi-structured interviews with community pharmacists and performed reflexive thematic analysis of their accounts, repeating five independent analytic cycles to confirm thematic robustness. Results: Six themes were consistently identified as recounted by pharmacists in their practice contexts: Access and Self-Medication; Relationships with Healthcare Professionals; Knowledge and Beliefs about Antibiotics; Use and Adherence; Healthcare System Barriers; and Regulation and Enforcement. Pharmacists mentioned regular requests for antibiotics without prescriptions, drug reuse, and significant impact from community, i.e., from relatives, and peers. The common misunderstanding was that antibiotics treat viral illnesses. Structural issues, for instance GP appointment costs and long waits, made patients seek help from pharmacies. Due to regulation being applied inconsistently, pharmacies struggled to refuse unsuitable requests. Conclusions: Framed through pharmacists’ dual vantage as professionals and frontline observers, the findings highlight intertwined factors underpinning inappropriate antibiotic use in Brazil and support a multi-pronged intervention spanning health system strengthening, professional education, economic considerations, and community engagement. Full article

This umbrella review examined the application of behaviour change techniques (BCTs) and their associations with physical activity (PA) outcomes in interventions targeting adults with chronic conditions. A comprehensive search of five databases was conducted up to 20 December 2024, identifying eighteen eligible systematic reviews (including nine meta-analyses), encompassing 468 primary studies and over 57,500 participants. BCTs were coded using the BCT Taxonomy v1, and review quality was assessed using AMSTAR 2. Across the included studies, eleven BCTs were most frequently employed, clustering into four core domains: self-regulation, instruction/information, social or contextual support, and modelling. Among these, four BCTs—goal setting (behaviour), social support (unspecified), instruction on how to perform the behaviour, and graded tasks—were consistently associated with significant increases in PA. Subgroup analysis revealed condition-specific patterns: graded tasks combined with social incentives were most effective for metabolic disorders, instructional techniques for cardiovascular disease, combined instruction and social support for musculoskeletal conditions, goal setting for mixed chronic conditions, and pairing action planning with graded tasks for cancer survivors. These findings advance both theoretical and practical understanding of components associated with successful PA interventions and provide a robust evidence base to inform future program design for chronic disease management. Full article

Objectives: The aim of this study was to evaluate the prevalence of anxiety and depression symptoms and their predictors in 16–19-year-old adolescents with prelingual hearing loss (HL) who use spoken language. Methods: Self- and parent-reported symptoms were measured using RCADS-25 in 250 adolescents with HL (55.2% males; mean age = 17.1 years). A normal hearing (NH) peer group of 69 adolescents (56.5% males; mean age = 16.7 years) completed the self-reported RCADS-25. Key predictor variables included audiological factors, demographic factors, non-verbal IQ, language, communication, prosocial behaviour, and peer relations. Results: The proportion of adolescents with high self-reported anxiety was similar between HL and NH groups (~8%). Depression symptoms were more common in the HL group (11.2% self-reported, 15.8% parent-reported) than in the NH group (7.2%), but the difference was not statistically significant. Across informants, females had worse symptoms, but this association was no longer significant after accounting for communication difficulty. Among hearing aid users, higher prosocial behaviour was associated with fewer depression symptoms, while peer relations were a protective factor in cochlear implant users. Parent- and self-report congruence in symptom rating was modest (r = 0.56–0.68). Predictors of symptoms were consistent across informants, with parent happiness and socio-economic status additionally influencing parent-reported symptoms. Symptoms were unrelated to device type (hearing aid/cochlear implant), degree of hearing loss, or age at intervention. Adolescents with elevated symptoms also reported increased school absenteeism. Conclusions: Adolescents with HL reported anxiety at similar rates to NH peers but may have a higher prevalence of depression. Emotional well-being was influenced primarily by psychosocial and communication factors, not audiological characteristics. Full article

Objectives: This study investigates psychedelic drugs to treat substance use disorder (SUD). Researchers have recently begun conducting clinical trials of psychedelic treatment for SUD. The current meta-analysis investigates the extent of efficacy in alleviating SM behaviours (P) using psychedelic therapy (I), concurrent with determining which psychedelic enables the greatest effect (C) as a treatment tool for reducing SUD (O). Methods: The inclusion criteria in this study include evaluating the efficacy of LSD, psilocybin, ketamine, or ibogaine in human beings with an SUD. The exclusion criteria include studies on rodents, patients with schizophrenia, case studies, incomplete or ongoing trials, and studies with insufficient quantitative data. The search criteria obtained 1278 articles, acquired through PubMed and PsycINFO. After excluding literature, 30 papers were kept in the final meta-analysis. A random-effects model analysis was applied to investigate individual psychedelic interventions, with a corresponding combined psychedelic intervention analysis. Results: The results favoured psychedelics as an SM treatment, with ibogaine evidencing the most prominent. We also found a non-significant difference between the effectiveness of psychedelic treatment paired with psychotherapy and psychedelic treatment alone. This study aims to contribute knowledge to future clinical research on the psychedelic treatment of SUD. Full article

Endometrial cancer is one of the most common malignancies of the female reproductive system, with incidence rising globally due to population ageing and life-style-related risk factors. Calcium (Ca²⁺) is a ubiquitous second messenger regulating diverse physiological processes, and its dysregulation has been increasingly implicated in carcinogenesis, including endometrial. Altered expression and function of Ca²⁺ channels, pumps, exchangers, and binding proteins disrupt the finely tuned balance of Ca²⁺ influx, efflux, and intracellular storage, leading to aberrant signalling that promotes tumour proliferation, migration, survival, and metastasis. This review summarises current knowledge on the molecular “Ca²⁺ toolkit” in the human uterus, highlighting the role of voltage-gated calcium channels (VGCCs), transient receptor potential (TRP) channels, store-operated calcium entry (SOCE) components, Na⁺/Ca²⁺ exchangers, purinergic receptors, P-type ATPases (SERCA, SPCA, PMCA), ryanodine (RyR) and inositol 1,4,5-trisphosphate (IP₃R) receptors, and mitochondrial Ca²⁺ uniporter (MCU) complexes in endometrial cancer progression. Multiple Ca²⁺-handling proteins, including CACNA1D, CACNA2D1, TRPV4, TRPV1, TRPM4, MCU, and RyR1, exhibit cancer-associated overexpression or functional changes, correlating with poor prognosis and aggressive disease features. Emerging evidence supports the therapeutic potential of targeting Ca²⁺ homeostasis using small-molecule inhibitors, ion channel modulators or gene-silencing strategies. These interventions may restore Ca²⁺ balance, induce apoptosis or autophagy, and suppress metastatic behaviour. While no clinical trials have yet explicitly focused on Ca²⁺ modulation in endometrial cancer, the diversity of dysregulated Ca²⁺ pathways offers a rich landscape for novel therapeutic strategies. Targeting key components of the Ca²⁺ signalling network holds promise for improving outcomes in endometrial cancer. Full article

Lime-based repair mortars, plasters, and renders are widely utilized in the conservation of traditional buildings. Historically, considerable emphasis has been placed on ensuring that new repair mortars are aesthetically compatible with existing historic materials. However, comparatively less focus has been placed on ensuring hygric compatibility, which is critical to maintaining the moisture equilibrium of traditional masonry walls and preventing moisture accumulation caused by repair interventions. The FabTrads project examined the hygrothermal properties of newly fabricated quicklime mortars, prepared with binder-to-aggregate ratios of 1:2 and 1:4, alongside a range of historic lime-based mortars, plasters, and renders, sourced from buildings across Ireland. This paper presents a comparative analysis of their hygric behaviour. Experimental results indicate that the capillary absorption of the fabricated mortars correlates well with their historic counterparts. Both fabricated mortars exhibited vapour diffusion resistance factors within the range of the historic samples, albeit towards the higher end. Hygrothermal simulations of vapour and liquid water transport revealed that the moisture behaviour of the fabricated mortars is largely within the range of performance of their historic counterparts. Relative humidity was slightly elevated for the fabricated mortars in the models concerning vapour transfer. Notwithstanding this, the findings provide a reassuring indication that the hygric performance of fabricated quicklime mortars is comparable with that of traditional lime-based materials, supporting their appropriate use in conservation practices without adversely affecting the moisture dynamics of the building fabric. Full article

The first 1000 days (F1D), from conception to a child’s second birthday, constitute a critical window for shaping long-term health, development, and wellbeing. While conventional approaches often rely on external interventions to support young families, the Positive Deviance (PD) framework offers a compelling alternative: identifying and amplifying successful behaviours already present within communities facing similar constraints. This paper explores how PD can be harnessed to foster sustainable, community-led change during the F1D. By uncovering local success stories, promoting participatory engagement, and strengthening caregiver self-efficacy, PD enables communities to co-create solutions that are culturally relevant and contextually grounded. However, effective application of PD requires careful attention to structural inequities, ethical storytelling, and rigorous methodological standards to avoid inadvertently shifting responsibility onto individuals. When implemented thoughtfully, PD reveals “what works” in resource-limited settings, empowering communities to build child-inclusive environments rooted in local expertise and resilient practices. Full article

Background: Unhealthy diets are major contributors to obesity and chronic diseases. In 2023, 50.7% of Chinese adults were overweight or obese, underscoring the need to strengthen healthy-eating intentions. Methods: We analysed a cross-sectional online survey of 1145 adults (18–64 years) from Henan and Shandong. Moderation was tested using multiple linear regression with mean-centred interaction terms between each Theory of Planned Behaviour (TPB) construct (attitude, subjective norms, and perceived behavioural control [PBC]) and each food-literacy component (production, choices, preparation and cooking, intake, disposal). Models were adjusted for age, occupation, marital status, alcohol use, physician-diagnosed chronic disease, and living with family. To address multicollinearity, we performed a ridge-regression robustness check (L2-regularised linear model; λ = 0.02 selected by 10-fold cross-validation; CV-RMSE = 0.483; CV-R² = 0.631). We report B, SE, β, p-values, and R²/adjusted R². Results: The overall food-literacy score did not significantly moderate the associations between attitude, subjective norms, or PBC and healthy-eating intention (p = 0.328, 0.671, 0.985). In component-wise analyses, only intake (intake) significantly moderated the PBC–intention association (B = 0.002, SE = 0.001, t = 2.497, p = 0.013); in the ridge model, the effect remained positive (β = 0.182; λ = 0.02). PBC (β = 0.459) and subjective norms (β = 0.169) were the strongest main-effect predictors. The best-fitting model explained R² = 0.663 of the variance in intention (adjusted R² = 0.663). Conclusions: Among adults in Henan and Shandong, the intake component of food literacy strengthened the association between PBC and healthy-eating intention, whereas overall food literacy showed no general moderating effect. Interventions should prioritise intake-related skills (e.g., portion planning, lower-sodium choices and nutrition label use) to enhance perceived behavioural control and, in turn, intention. Given the cross-sectional design, causal inference is limited; longitudinal, capability-building evaluations are warranted. Full article

Introduction: Acquired brain injury (ABI) produces significant cognitive, motor, and psychosocial impairments that affect people’s daily functioning. Rehabilitation programs increasingly combine physical activity with neuropsychological strategies for greater effectiveness. Purpose: The aim of this study was to analyze the effects of neurophysiotherapy based on physical activity and neuropsychological rehabilitation on cognitive and psychosocial functioning in individuals with an acquired brain injury (ABI). Method: A total of 19 individuals between the ages of 24 and 89 years (M ± SD: age = 59.26 ± 19.01) belonging to the Acquired Brain Injury Association of Málaga (ADACEMA) participated in this study. A quasi-experimental design with pre- and post-test measures and multiple experimental groups was used. The instruments used were the digit subtest of the Barcelona Test, the Five Digit Test (FDT), the Tower of Hanoi, the modified six-element subtest of the Behavioural Assessment of the Dysexecutive Syndrome, the Trail Making Test (TMT), the WHOQOL-BREF, and the Profile of Mood States (POMS) questionnaire. The Kruskal–Wallis H, Mann–Whitney U, and Wilcoxon tests were used to analyze the data. Results: The results obtained showed a positive effect of physical activity (PA) combined with neuropsychological rehabilitation on working memory, planning, emotional well-being, personal relationships, depressive symptoms, and overall quality of life. Conclusions: The findings suggest that combining neurophysiotherapeutic physical-activity-based rehabilitation with other neuropsychological interventions may be a promising approach to improving executive functioning, emotional well-being, and quality of life in people with an ABI. These preliminary results highlight the potential value of multidisciplinary programs in post-injury recovery, although further studies with larger and more homogeneous samples are needed to confirm these effects. Full article

Background: Stunting, a form of chronic malnutrition, is a global health concern, especially in South Asia. Stunting remains a significant public health issue in Pakistan, particularly in remote regions like Gilgit-Baltistan and Chitral, where geographic isolation and socioeconomic challenges exacerbate malnutrition. The Aga Khan Development Network is leading the implementation of a program, Central Asia Stunting Initiative (CASI), with an aim to reduce stunting through community-driven maternal and child health interventions in the targeted areas of Gilgit Baltistan and Chitral. This study aimed to evaluate the effectiveness of CASI in improving child nutritional outcomes in Gilgit-Baltistan and Chitral. Methods: In this study, a single-group pre–post evaluation design was employed using baseline and midline cross-sectional surveys among households with children aged 0–59 months in Gilgit-Baltistan and Chitral. Data on child anthropometry, household food security, maternal education, and child feeding practices were collected from over 500 households using stratified sampling. Results: Results showed improvement in child health indicators between baseline and midline. Between baseline and midline, stunting declined from 40.9% to 35.4% in GBC (p = 0.02), with severe stunting dropping significantly (17.8% to 10.9%, p < 0.001). Wasting and underweight rates also showed marked reductions. Improvements in breastfeeding rates (71.3% to 88.3%) and dietary diversity (4.0% to 26.8%) were observed. However, food security declined sharply from 95.2% to 11.9%, underscoring persistent economic stress. Conclusions: CASI interventions yielded substantial improvements in child nutrition and maternal behaviours. However, sustained progress requires integrated strategies addressing food insecurity, economic empowerment, and long-term resilience. Future programs should adopt a multi-sectoral approach to tackle chronic malnutrition comprehensively. Despite this, results indicated an overall improvement due to CASI interventions, signifying the importance of integrated, community-based approaches in addressing stunting. Full article

Adolescence is a critical developmental stage at which body image and lifestyle behaviours intersect. Research shows that having a positive body image during this period is linked to better mental health and certain aspects of a healthy lifestyle. However, more empirical evidence is needed, especially concerning boys. This cross-sectional study explored the association between body appreciation (BA) and lifestyle factors in a large sample of Lithuanian adolescents. These associations were examined while controlling for body mass index (BMI), and the role of sex in these relationships was evaluated. A cross-sectional study involved 1412 adolescents (59.6% girls) aged 16–17 years (mean age of 16.97 ± 0.46 years). Participants completed questionnaires assessing BA, self-esteem, life satisfaction and lifestyle factors such as physical activity and perceived fitness, sleep duration, screen time and disordered eating (DE) attitudes and behaviours. Data were analysed using descriptive statistics, analysis of covariance (ANCOVA), and binary logistic regression analysis. Higher BA was associated with greater life satisfaction, self-esteem, perceived physical fitness and healthier eating behaviours independent of BMI in boys and girls. Adolescents with high BA had significantly higher odds of participating in sports, having a healthy BMI, accurate body weight estimation, good self-rated health and non-smoking behaviours compared to those with low BA. BA was also associated with healthier sleeping hours, lower screen time and lower unhealthy and DE behaviour in girls. Boys with high BA were more likely to abstain from alcohol. Interaction effects indicated that the effect of BA on self-esteem, BMI and DE behaviours was stronger in girls than in boys. BA is strongly linked to positive lifestyle outcomes and self-esteem in adolescents, particularly in girls. The findings of this study indicate that initiatives designed to promote healthy lifestyles among adolescent boys and girls may be enhanced by the incorporation of education on positive body image. Interventions should be tailored to gender-specific needs, emphasizing prevention of dysfunctional eating for girls, and reducing substance use for boys. Incorporating body-positive education into schools and health programs can help create supportive environments that enhance both psychological well-being and physical health. Full article

Background/Objectives: Gestalt therapy traditionally opposes categorical diagnostic labelling due to its fundamental inconsistency with phenomenological and process-oriented ontology. However, this epistemological rigour can limit integration with structured evidence-based interventions for complex personality organizations such as Borderline Personality Disorder (BPD). Despite the evidence base for DBT and Schema Therapy in treating BPD, these approaches may inadvertently minimize the lived phenomenological experience and organismic wisdom central to recovery. Meanwhile, Gestalt therapy’s anti-diagnostic stance limits its integration with structured evidence-based protocols. This paper proposes a hybrid theoretical model that addresses this gap by integrating the clinical epistemology of Gestalt therapy with Linehan’s biosocial theory of Dialectical Behaviour Therapy (DBT) and schema-focused interventions, while preserving the core principles of Gestalt. Methods: we present a model of theoretical integration that draws on Gestalt contact theory, the four modules of DBT (mindfulness, distress tolerance, emotional regulation, interpersonal effectiveness) and the experiential techniques of Schema Therapy. The integration focuses on the dialectic of acceptance and change, which mirrors Gestalt’s paradoxical theory of change. The proposed framework preserves the non-protocol dimension of Gestalt therapy while incorporating the pragmatic utility of DBT and Schema Therapy. Results: key conceptual contributions we propose include: (1) theorizing the “Draft Self” as the object and subject of therapeutic work, (2) integrating mindfulness and grounding as embodied processes within live Gestalt experiments, (3) activation techniques to explore the identity fragmentation endemic to BPD. Conclusions:his integration offers a coherent, embodied, and process-oriented framework for understanding and treating BPD that validates patients’ lived experience, mobilizes evidence-based interventions, and opens up meaningful intertheoretical dialogue. Full article