Search Results (497)

Obesity has emerged as one of the most complex and urgent public health challenges of the twenty-first century, driven by genetic, environmental, metabolic, and psychosocial determinants that collectively disturb energy homeostasis and systemic health. It is characterized by adipose tissue dysfunction, insulin resistance, chronic low-grade inflammation, and gut microbiota dysbiosis, all of which interact to perpetuate metabolic and cardiovascular diseases. Beyond the biological dimension, obesity profoundly affects mental health, being closely linked to depression, anxiety, body-image dissatisfaction, and stigma, which further reduce adherence to treatment. Current therapeutic strategies rely on a stepped-care approach, beginning with lifestyle interventions encompassing dietary modification, physical activity, and behavioral therapy. Pharmacologic treatments, particularly incretin-based agents such as semaglutide, liraglutide, and tirzepatide have transformed medical management through substantial and sustained weight loss, while bariatric surgery remains the most effective long-term option for severe obesity. Emerging approaches, including gene therapy, microbiome modulation, and nanomedicine, offer mechanistically targeted and potentially safer alternatives, though they remain largely experimental. Pharmacoeconomic analyses support the cost-effectiveness of combining behavioral, pharmacological, and surgical modalities, highlighting the economic advantage of integrated care models. Meanwhile, artificial intelligence and machine learning are redefining obesity research and management, enhancing cancer risk prediction, personalizing pharmacotherapy, optimizing resource allocation, and enabling precision medicine through multi-omics and imaging integration. Collectively, these insights support a shift toward a learning health-system paradigm that unites mechanistically anchored therapies with digital and AI-driven personalization to achieve sustainable weight reduction, reduce cardiometabolic and cancer burden, and improve global health outcomes. Full article

Background/Objectives: Cancer is the second leading cause of death in Puerto Rico, its impact worsened by an aging population. Many survivors experience long-term effects that reduce health-related quality of life (HRQoL). Chronic comorbidities are common in Puerto Rico, yet cancer survivors remain underrepresented in HRQoL research, raising concern about their impact on survivorship. This study examined whether comorbidity burden was associated with HRQoL and if patient navigation services or perceived social support moderated this association. Methods: This cross-sectional analysis included 643 cancer survivors from the START-PR study (November 2023–August 2025). HRQoL was measured using the Functional Assessment of Cancer Therapy—General (FACT-G) and dichotomized at the sample median (≤71 = poor; >71 = non-poor). Comorbidity burden was grouped as 0, 1, or ≥2 conditions. Patient navigation was assessed by self-reported service use in the past year. Perceived social support was measured using an adapted Multidimensional Scale of Perceived Social Support and dichotomized at the sample median (≤40 = low; >40 = high). Logistic regression estimated odds ratios (OR; 95% CI), adjusting for covariates. Interaction terms tested effect modification. Results: Participants with one (OR = 1.85; 95% CI: 1.15–2.97) or ≥2 comorbidities (OR = 2.95; 95% CI: 1.88–4.61) had significantly higher odds of poor HRQoL than those without comorbidities. Hypertension, depression, diabetes, arthritis, and asthma were more common among participants with poor HRQoL. Neither patient navigation nor perceived social support significantly moderated the comorbidity burden-HRQoL association. Conclusions: Greater comorbidity burden was associated with poor HRQoL. These findings underscore the need for survivorship care models that integrate chronic disease management, including mental health, to improve outcomes in underserved populations. Full article

Objective: The primary objective of this pilot randomized clinical trial was to determine the effect of adding a supervised resistance exercise programme to a home-based physical activity plan on health-related quality of life in patients with colorectal cancer undergoing active treatment. The secondary objectives were to evaluate its effects on anxiety, depression, sleep quality, and inflammatory parameters. Methods: This is a pilot randomized clinical trial with parallel groups. Patients with CRC were recruited through the Oncology Department at the Salamanca University Health Care Complex in Spain. They were randomly allocated to receive either a home-based physical activity plus a supervised resistance training programme, or the home-based physical activity plan only. The primary outcome was health-related quality of life measures and the secondary outcomes included anxiety, depression and sleep quality evaluations. The supervised training lasted 8 weeks for each patient. Results: A total of 40 patients were recruited, 20 for each group. Adding a supervised resistance exercise programme to the home-based activity plan improved symptoms related to quality of life, such as fatigue (p = 0.040) and constipation (p = 0.015). However, no significant effect was found with regard to other health-related quality of life, anxiety, depression or sleep variables. Conclusions: Fatigue and constipation in patients with CRC receiving chemo- and/or immunotherapy may benefit from the introduction of supervised resistance exercise training programmes. Full article

Background: Regular physical activity benefits people of all ages by enhancing both mental and physical health, whereas inactivity raises the risk of noncommunicable diseases (NCDs) like cardiovascular diseases, cancer, and diabetes, which can result in premature death. The objective of this cross-sectional study was to determine the prevalence and associated factors of physical inactivity among adults in Malaysia. Methods: Data on physical inactivity were extracted from the 2023 National Health and Morbidity Survey (NHMS), conducted from July to September 2023 among adults aged 18 and above across all states of Malaysia. Physical activity was assessed using the Global Physical Activity Questionnaire, with individuals classified as inactive if they did not achieve at least 600 metabolic equivalents of task (MET) minutes per week. Logistic regression was used to identify factors associated with physical inactivity. Results: A total of 10,858 out of 13,616 respondents participated in the study, resulting in a response rate of 79.7%. The overall rate of physical inactivity was 29.9%. The multivariable logistic regression analysis showed that physical inactivity was significantly higher among urban residents (aOR 1.42; 95% CI: 1.16, 1.75), individuals who were single/divorced/widowed (aOR 1.16; 95% CI: 1.01, 1.33), those not working (aOR 1.61; 95% CI: 1.24, 2.09), and those with sedentary time exceeding four hours per day (aOR 1.46; 95% CI: 1.20, 1.76). Inactivity was also more likely among individuals with diabetes (aOR 1.17; 95% CI: 1.00, 1.37) or disabilities (aOR 1.67; 95% CI: 1.39, 2.02). Conclusions: About one-third of Malaysian adults are physically inactive, with higher rates among urban residents, single/divorced/widowed, those not working, those with extended sedentary time, diabetes, or disabilities. Targeted interventions are needed to encourage behaviour change, foster active urban design, and strengthen policies that support active lifestyles. Full article

Background/Objectives: Patients with multimorbidity frequently rely on emergency services when continuity of care is weak. Strengthening communication between emergency and primary care can prevent unnecessary hospitalizations, yet this relationship remains underexplored. The aim of this study was to analyze the relationship between primary health care utilization in patients with multimorbidity and their demand for prehospital emergency services. Methods: An observational, longitudinal, analytical, and retrospective study was conducted in Málaga (Spain) between 2013 and 2017. Adults (>18 years) with multimorbidity who requested prehospital emergency care services at home were included; those with cancer, rare diseases, severe mental disorders, or incomplete electronic records were excluded. Variables encompassed sociodemographic, clinical, and behavioral characteristics, comorbidities, functional status, polypharmacy, resource type, and outcomes (on-site resolution or hospital referral). Primary health care visits before and after prehospital emergency use were extracted from electronic records. Descriptive, bivariate, and multivariate analyses were performed. Results: Among 532 patients, prior primary health care attendance predicted subsequent utilization (β = 0.57; p < 0.001), along with caregiver availability (β = 0.12; p = 0.001) and prehospital emergency services hyper-demand (β = 0.08; p = 0.022). Super-utilizers were younger, had ≥4 comorbidities, polypharmacy, prior family medicine visits, home oxygen therapy, and lower substance or alcohol use. Conclusions: In multimorbid adults, prehospital emergencies demand is influenced by factors beyond severity, including comorbidities, polypharmacy, the use of home medical devices, caregiver availability, and primary health care utilization patterns. Strengthening coordination between prehospital emergencies and primary health care, promoting patient–caregiver education, and implementing early notification pathways may improve care continuity and reduce avoidable emergencies. Full article

Background: Recent advances in childhood cancer treatment and increased survival rates have led to a growing number of adolescents and young adults (AYAs) who are survivors of childhood cancer (CCSs). This study aimed to examine health status, health-related quality of life (HRQoL), and social outcomes in AYA CCSs. Methods: Sixty-two AYAs who were CCSs (treated within the same tertiary Pediatric Hematology–Oncology Department in Crete, Greece) were enrolled in the study. Self-reported HRQoL was assessed using the Short-Form Health Survey (SF-36). Sixty-five never-ill peers constituted the control group. Results: CCSs reach adolescence and young adulthood without significant deviations in HRQoL from their healthy peers. The presence and severity of late effects were significantly correlated with lower scores in physical health. The cancer type seems to play a pivotal role: Langerhans cell histiocytosis survivors displayed significantly lower scores in mental health, and brain tumor survivors scored substantially lower scores in physical functioning. Acute lymphoblastic leukemia survivors reported the highest scores in mental health. Age at diagnosis of neoplasia was negatively correlated with physical functioning. No significant sex differences were identified. Adherence to multiple healthy lifestyle behaviors (regular exercise, abstaining from alcohol consumption and smoking, and using sun protection) and active employment were correlated with significantly higher scores in mental health. Conclusions: Appropriate therapy and regular follow-up after treatment have led to improved clinical and social outcomes, as assessed by CCSs. More efforts are needed to increase awareness of avoiding harmful behaviors that raise the risk of late effects in this specific group. Full article

Childhood, adolescent, and young adult cancer (CAYAC) survivors often face challenges entering the workforce due to long-term physical, cognitive, and psychological late effects, defined as chronic health conditions resulting from cancer and its treatments. This study evaluated a vocational integration programme that addresses these barriers and promotes psychosocial well-being. The multidisciplinary intervention combined career guidance, soft-skills training, and a paid internship. Using a mixed-method design with questionnaires and semi-structured interviews, we assessed feasibility, satisfaction, and psychosocial outcomes. Thirteen participants (mean-age-at-diagnosis: 12.9 years, SD 5.2; mean-age-at-interview: 27.2 years, SD 5.3) reported over 40 late effects, mostly of moderate severity. Health-Related Quality of Life (HRQoL), measured by the SF-12, showed a Physical Component Score mean of 45.2 (SD 9.1) and a Mental Component Score mean of 43.5 (SD 11.2), indicating greater psychological impact. The programme received high satisfaction ratings (mean 8.3/10) and was described as motivating and valuable, enhancing self-confidence and career prospects. Social support emerged as a key facilitator, while participants noted the need for flexibility and individualised pacing. Despite a limited sample size and potential recruitment bias, this study provides preliminary insights into the feasibility and perceived value of tailored vocational programmes, emphasising the importance of adaptable, socially supportive interventions for CAYAC survivors. Full article

Background/Objectives: Lay Community Health Workers (CHWs) play a critical role in reducing mental health disparities, particularly among underserved and vulnerable populations, by bridging gaps in care and promoting mental well-being. This narrative review aimed to identify and characterize training programs designed for CHWs, with a focus on those targeting cancer patients and individuals with chronic conditions. Methods: A comprehensive literature search was conducted across databases including PubMed, EBSCOhost, Scielo, Redalyc, and Google Scholar. From an initial pool of 10,372 references, 27 relevant articles were selected, encompassing research articles, training materials, curricula, and other resources. Results: The identified training methods included role-playing, instructional videos, and manuals designed to equip CHWs with skills in mental health intervention, prevention, management, education, and stigma reduction. Training programs also incorporated evidence-based interventions and psychological skill training. This review highlights a notable gap in research on CHW-led interventions in cancer palliative care and mental health. Conclusions: The findings support the development of a specialized mental health training program tailored for CHWs working with cancer survivors, to enhance their capacity to address mental health challenges, reduce stigma, and promote psychological well-being. Future efforts involve developing a training intervention for CHWs to support the needs of cancer survivors. Full article

Background: Depression affects around 280 million people globally and is one of the main causes of disability. Among people with cancer, depression and anxiety affect 20–25%, significantly reducing quality of life, adherence to treatments, and survival. Despite the availability of pharmacological and psychological treatments, their application can be limited by side effects, accessibility, and costs—especially in low- and middle-income countries. Physical exercise is emerging as a valuable complementary strategy, improving both physical and mental well-being. Nevertheless, structured exercise programs are still rarely implemented in oncology. This review aims to provide evidence-based recommendations for integrating physical activity into mental health support for people with cancer. Methods: This review includes six randomized controlled trials (RCTs) evaluating physical exercise interventions for depression and anxiety in people with cancer aged over 18 years. Included studies compared exercise interventions to control or standard care and reported outcomes related to psychological well-being and adverse effects. Exclusion criteria included non-original studies, non-English articles, and works not focused on exercise. The search was conducted in PubMed, Scopus, Google Scholar, and the Cochrane Library using MeSH terms and Boolean operators. The review protocol was registered in PROSPERO (CRD42025637522). Results: Exercise interventions—such as aerobic, resistance, and mind–body practices—proved effective and feasible across cancer types. Benefits were seen in both psychological and physical outcomes. However, variations in protocols and outcome measures, as well as a lack of long-term data, limit generalizability. Conclusions: Personalized exercise programs can significantly reduce depression and anxiety in people with cancer. Standardized core methods, long-term research, and systemic support are needed to integrate exercise into routine oncology care. Full article

5-Aminolevulinic acid (5-ALA) is used clinically for photodynamic therapy and fluorescence-guided diagnosis and surgery due to its selective accumulation in malignant cells, where it is converted into photoactive protoporphyrin IX (PpIX) via the heme biosynthesis pathway. The resulting buildup allows for selective visualization or destruction of the tissue under specific light exposure, particularly in pre-malignant and malignant skin lesions, brain tumors, and bladder cancer. More recently, 5-ALA and 5-ALA-induced PpIX have attracted interest for emerging diagnostic and therapeutic approaches. For instance, PpIX is being investigated as a potential marker for liquid biopsy. PpIX-mediated photodynamic therapy also shows promise for targeting specific cancer cell populations, including dormant cancer cells and cancer stem cells. In addition, the benefits of 5-ALA in neurological and mental health are under investigation, as disruptions in heme biosynthesis are increasingly linked to neurodegenerative diseases, chronic fatigue, and mood and sleep disorders. This review highlights these expanding research directions, discusses current challenges, and explores potential opportunities for 5-ALA-based applications. Full article

Lung cancer screening (LCS) with low-dose computed tomography is an effective strategy for early detection and improved survival. Despite its clinical benefits, public engagement with LCS topic remains unclear, particularly in the digital health communities. This study examines the thematic landscape of lung cancer-related discussions on Reddit. Using Python’s Reddit API Wrapper, we collected 109,868 posts from six lung cancer-related subreddits between January 2019 and December 2024. After preprocessing, 105,118 unique posts were analyzed using Latent Dirichlet Allocation topic modeling to identify emergent themes. Topics were qualitatively reviewed and categorized into four high-level themes: treatment, mental health, smoking, and LCS. Mental health (71.82%) and treatment (16.84%) dominated the discourse, followed by smoking (8.30%), while LCS remained underrepresented (3.04%). Despite an increase in overall engagement from 2022 onward, LCS-related posts remained sparse, with no sustained upward trend. Reddit users frequently discuss treatment and mental health concerns related to lung cancer but rarely engage with LCS as a topic, revealing a critical gap in public awareness. These findings highlight the need for targeted public health strategies to promote LCS awareness on social media platforms, leveraging the platforms’ growing role in health communication. Full article

Green tea, long consumed across Southeast Asia, is highly esteemed for its medicinal properties and is often favored over conventional treatments in Eastern cultures. Its health benefits are largely attributed to its minimal processing, which preserves pharmacologically active compounds, particularly catechins, a key class of polyphenols, with epigallocatechin-gallate (EGCG) being the most abundant and bioactive. These compounds exhibit antioxidant, anti-cancer, antimicrobial, and antiangiogenic properties. Beyond systemic health, EGCG has diverse applications in dermatology, including the treatment of viral warts, psoriasis, lichen sclerosus, acne, vaginal dryness, alopecia, and UV-induced skin damage. Emerging research also highlights its promise in aesthetic medicine for mitigating skin oxidative stress, improving skin brightness and neutralizing free radicals, responsible for wrinkles, hyperpigmentation, and loss of elasticity. The aim of this review is to examine the most recent literature on the wide-ranging clinical applications of Epigallocatechin-gallate (EGCG) and to assess its potential use as a daily foundational supplement to enhance both physical and mental well-being, focusing on the dermatological benefits. Full article

Background: Pancreatic cancer (PC) remains one of the deadliest malignancies, with long-term survival often reliant on early detection through surgery and chemotherapy. Unfortunately, the late-stage presentation of the disease contributes to its poor prognosis, leading to an increased focus on surveillance for high-risk individuals (HRIs) to facilitate earlier diagnosis. Despite the growing implementation of such programmes globally, there is a lack of longitudinal studies examining the benefits of PC surveillance, particularly regarding the well-being of participants. The study aimed to evaluate the distress experienced by HRIs 3-years after engaging in PC screening at Verona Pancreas Institute and to describe which participant characteristics contributed to the increase in stress. Methods: This is a longitudinal follow-up (FU) of a previously published cohort. HRIs with heredo-familial predisposition undergoing PC surveillance with MRCP and a clinical visit were re-evaluated from 2019 to 2023 in the same psychological assessment using Perceived Stress Scale (PSS), General Self-Efficacy Scale (GSES), Coping Orientation to Problems Experienced (COPE) and The Scale of Perceived Social Support (MSPSS) 3 years after the baseline assessment. The FU assessments were conducted by a clinical psychologist via telephone after the radiological and clinical evaluations were made. Results: Of the 54 HRIs initially evaluated, ten did not respond to phone contacts. The remaining 44 HRIs, of whom 29 (65.9%) were female, with a mean age of 56.1 years (SD = 10.2), agreed to participate in a FU psychological assessment. After 3 years, the participant exhibited an increase in stress levels (PSS—T0 mean 14.8; T1 mean 16.9), a decrease in problem-solving abilities (GSES—from 32.02 to 28.09, p < 0.01), a deterioration in adaptive capacity to the situation (COPE total score from 64.0 to 61.39, p = 0.05), and a reduction in perceived social support (MSPSS—T0: 4.59; T1: 4.27, p = 0.02). A significant decrease was also observed in the use of denial (from 2.84 to 2.32; p = 0.02). Based on the psychological characteristics of the 44 HRIs, stratified according to PSS reassessed at FU, 3 distinct clusters were identified: (a) Normal Stress (32% of the sample): HRIs with a PSS score < 14; (b) Stable Clinical Stress (46% of the sample): HRIs with PSS at FU > 14 and PSS at baseline > 14; (c) New Clinical Stress (22% of the sample): HRIs with PSS at FU > 14 and PSS at baseline < 14. After 3 years of surveillance for PC, 67% of the total study sample (Stable Clinical Stress group and New Clinical Stress group) exhibited high perceived stress. Over the course of the 3 years, 7 HRIs (15.9%) lost a family member due to PC. Conclusions: The data suggest the need to include psychological care pathways within the surveillance programmes. These insights can enhance existing literature and aid in creating comprehensive surveillance programmes for PC, addressing all care aspects, including mental health. Full article

Background: Exploring the connection between climate change awareness and overall well-being is crucial, particularly in how it impacts both the environment and mental health. The mental health consequences of climate change and its awareness have not been thoroughly examined, especially in the U.S. In this study, the relationship between awareness of climate change and depression or anxiety among U.S. adults was explored. Similarly, the role of climate change awareness has not been explored in relation to mental health concerns. Methods: Based on the HINTS-6 dataset, a nationally representative, cross-sectional survey conducted by the National Cancer Institute, a variety of statistical methods, including logistic regression models, to examine these relationships were used. This study had a sample size of 6154 participants. A statistically significant level of <0.05 was used. Result: The findings showed that individuals who are aware of climate change have a higher adjusted odds ratio of 1.392 (1.160–1.671) for experiencing depression or anxiety compared to those who are unaware. Additionally, non-heterosexual individuals displayed a significantly higher adjusted odds ratio of 2.691 (CI: 2.125–3.407) for depression or anxiety, underscoring the strong connection between mental health and climate change awareness. Conclusion: This study highlights a notable link between heightened awareness of climate change with depression and anxiety among the U.S. population. Full article

Healthy nutrition is of great importance to maintain the physical and mental health of individuals. In recent years, products such as snack bars have become widely used to encourage healthy eating habits. This study compared the environmental footprints of four snack bar prototypes that adhere to the Mediterranean diet (MD) through a life cycle assessment (LCA). LCA is used to calculate an environmental footprint, encompassing six impact categories: Global Warming Potential (GWP), Abiotic Depletion (AD), Human Toxicity (Cancer (HTC) and Non-Cancer Effects (HTNC)), land use (LU), and water use (WU). The total impacts were as follows (prototypes 1–4, respectively): GWP 0.221/0.224/0.234/0.194 kg CO₂-eq; AD 2.35/2.87/2.63/2.01 MJ; HTC 9.13 × 10⁻¹⁰/7.69 × 10⁻¹⁰/9.82 × 10⁻¹⁰/9.88 × 10⁻¹⁰ CTUh; HTNC 1.03 × 10⁻⁸/1.51 × 10⁻⁹/4.16 × 10⁻⁹/3.03 × 10⁻⁹ CTUh; LU 14.8/21.6/21.8/10.8; WU 0.132/0.287/0.198/0.068 m³. Prototype 4, which yielded the lowest value across four indicators (GWP, AD, LU, and WU), is the most environmentally favorable. A range of 89–91% of the GWP originates from raw material production, while the share attributed to transportation is 3–4%. Nuts and dried fruit contents are decisive for WU and LU. The findings suggest that environmental impacts are highly sensitive to ingredient composition and agricultural inputs, and that selecting raw materials and optimizing the supply chain is critical for mitigation. Full article