Search Results (2,688)

The aim of this review was to harmonize major consensus statements (European Working Group on Sarcopenia in Older People 2; Asian Working Group for Sarcopenia 2019; Foundation for the National Institutes of Health Sarcopenia Project operational criteria) into a stage- and setting-stratified algorithm. It maps diagnostic strata to dose-defined resistance and combined training, integrates multimodal and technology-enabled options (whole-body electrical muscle stimulation, whole-body vibration, virtual reality, AI-assisted telerehabilitation) with safety cues, and embeds nutrition (≥1.2 g/kg/day protein, vitamin D, key micronutrients) and education to sustain adherence. Sarcopenia is a consequential geriatric syndrome linked to falls, loss of independence, hospitalization, mortality, and psychosocial burden, yet translation to practice is hindered by heterogeneous definitions, diagnostics, and treatment guidance. Literature searches via PubMed/MEDLINE, EBSCO, SciELO, and Google Scholar (January 2000 to August 2025) yielded 354 records; after screening and deduplication, 132 peer-reviewed studies were included. We summarize tools for screening, strength, muscle mass, and function (e.g., Sarcopenia Five-Item Questionnaire, grip strength, dual-energy X-ray absorptiometry, gait speed) and identify resistance exercise as the cornerstone, with aerobic, balance, and flexibility training adding functional and metabolic benefits. Clinic-ready tables and figures operationalize a stepwise program across primary to severe sarcopenia and across acute or iatrogenic to community settings. Early screening plus structured, exercise-centered care, augmented by targeted nutrition and education, offers pragmatic, scalable benefits. Full article

Background: Low back pain (LBP) profoundly impacts daily life, requiring assessment tools that capture its complex effects on the body and mind. This study explores a measurement tool designed to assess LBP disability, testing whether Exploratory Structural Equation Modeling (ESEM) better reveals its multidimensional nature compared to Confirmatory Factor Analysis (CFA). Methods: We analyzed data from 266 LBP patients using CFA and ESEM. The tool, developed from the items from existing scales, included 99 questions on body functions, activities, and participation. Using Mplus 8 software, we compared model fit and item connections. Results: Two main factors; “Body Functions” and “Activity-Participation” identified by CFA were tested using ESEM. While ESEM had slightly better fit compared to CFA model, many items linked across both factors which shows how pain and emotions overlap with daily activities. These results align with the International Classification of Functioning, Disability and Health (ICF) and reflect LBP’s broad impact. Conclusions: ESEM offers a broader understanding of LBP’s multidimensional nature compared with CFA, guiding clinicians to create a holistic management approach that address physical and psychosocial challenges. This preliminary study supports the use of ESEM in disability research, demonstrating its usefulness in identifying the multifaceted nature of LBP, therefore providing a broader perspective for assessment and management. Full article

Introduction: In recent decades, the burden of mental disorders has become a major determinant of population health in the European Union, generating profound clinical, socioeconomic, and institutional consequences. Despite political recognition of this silent crisis, substantial methodological challenges persist in the transnational monitoring of mental health and in linking disease burden with the resources allocated to address it. The present analysis develops a multivariate taxonomy of EU Member States from a psychosocial perspective, using an integrative quantitative approach. Methods: This cross-sectional, comparative study follows international standards for transparent and reproducible quantitative reporting and is based on 18 harmonized clinical, epidemiological, and institutional indicators collected for 27 EU Member States over the period 2014–2023. The indicators used in this study were grouped according to their position along the care continuum. Hospital-based indicators refer to inpatient activity and institutional capacity, including total hospital discharges, psychiatric admissions (affective disorders, schizophrenia, dementia, alcohol- and drug-related disorders), and hospital bed availability. Outpatient and community-level indicators reflect the capacity of systems to provide non-hospital psychiatric care and consist primarily of psychiatrist density and total specialist medical workforce. Finally, subjective perception indicators capture population-level self-assessed health status, complementing clinical and institutional measures by integrating a psychosocial perspective. After harmonization and standardization, Principal Component Analysis (PCA) with Varimax rotation was applied to identify latent dimensions of mental health. Model adequacy was confirmed using the Kaiser–Meyer–Olkin coefficient (0.747) and Bartlett’s test of sphericity (p < 0.001). Results: Three latent dimensions explaining 77.7% of the total variance were identified: (1) institutionalized psychiatric burden, (2) functional capacity of the health care system, and (3) suicidal vulnerability associated with problematic substance use. Standardized factor scores allowed for the classification of Member States, revealing distinct patterns of psychosocial risk. For example, Germany and France display profiles marked by high levels of institutionalized psychiatric activity, while the Baltic and Southeast European countries exhibit elevated suicidal vulnerability in the context of limited medical resources. These results highlight the deep heterogeneity of psychiatric configurations in Europe and reveal persistent gaps between population needs and institutional response capacity. Conclusions: The analysis provides an empirical foundation for differentiated public policies aimed at prevention, early intervention, and stigma reduction. It also supports the case for institutionalizing a European mental health monitoring system based on harmonized indicators and common assessment standards. Overall, the findings clarify the underlying structure of mental health across the European Union and underscore the need for coherent, evidence-based strategies to reduce inequalities and strengthen system performance at the continental level. Full article

Graduate Medical Education trainees’ wellness has become an important topic in academic medicine. The Accreditation Council for Graduate Medical Education (ACGME) requires oversight, education, and resources, understanding that medical training happens within a complex environment. Patients, personal and psychosocial issues, overlays, administrative demands, and intense oversight at various levels add additional elements of complexity and stress. The demographics of medicine are changing, with a greater proportion of women, minorities, and international medical graduates entering training with different needs and greater expectations. GME trainees constitute a population with unique needs that demand an adaptable and broad approach toward wellbeing and training success. The University of Texas Health San Antonio (UTHSA) created the Wellness Home, a comprehensive and adaptable model inspired by those used in primary care, where support is offered to trainees and training programs. It addresses issues beyond mental health management by including interventions such as coaching, access to medical services, or financial literacy. We present here a detailed description of the program and a rationale for developing this holistic approach in other institutions. Case studies are used to illustrate the complex needs of trainees and the innovative approaches used in their support. Usage data is presented as additional evidence that this model is increasingly and successfully being used. Full article

Neuromuscular diseases (NMDs) include a heterogeneous group of progressive chronic conditions that frequently lead to substantial physical disability and loss of autonomy. Although motor and functional impairments of NMDs are well documented, the psychological burden remains underexplored. This narrative review synthesizes current literature regarding four psychological domains in individuals with NMDs: (i) anxiety, (ii) depression, (iii) coping strategies, and (iv) quality of life. Evidence indicates that anxiety and depressive symptoms are highly prevalent in the spectrum of NMDs, influenced by factors such as disease severity, onset age, and perceived social support. Maladaptive coping strategies, including avoidance and denial, are associated with poorer mental health outcomes and reduced involvement in rehabilitation. In contrast, adaptive strategies, such as acceptance and problem-focused coping, may help buffer psychological distress. Quality of life is consistently reported to be lower in people with NMDs compared to the general population, with psychosocial factors such as social support playing a role. Despite these findings, psychological care remains inconsistently integrated in NMD management. Full article

Background/Objectives: Relapsing-remitting multiple sclerosis (RRMS) is a chronic neurological disease that significantly impacts health-related quality of life (HRQoL). This study aimed to analyze the evolution of HRQoL in individuals with RRMS, identify associated factors, and determine predictive variables. Methods: A prospective observational study was conducted with 35 participants diagnosed with RRMS at the Lucus Augusti University Hospital between January 2023 and March 2025. HRQoL was assessed using the MSQOL-54 questionnaire at baseline, 3 months, and 6 months. Data were analyzed using non-parametric tests to account for the small sample size and non-normal distribution of the variables. Results: Results showed overall stability in HRQoL (mean score: 62.4 ± 14.1 at baseline, 62.8 ± 12.7 at 3 months, and 62.4 ± 11.8 at 6 months), although significant declines were observed in emotional limitations (64.4 ± 23.0 at baseline to 58.9 ± 20.5 at 6 months) and social functioning (70.5 ± 16.7 at baseline to 65.5 ± 12.8 at 6 months). Improvements were noted in pain perception (78.9 ± 23.6 at baseline to 81.8 ± 20.5 at 6 months) and stress (44.3 ± 22.5 at baseline to 48.9 ± 17.8 at 6 months). Factors such as family history (associated with mental health at diagnosis, p = 0.028), autoimmune diseases (associated with physical function at diagnosis, p = 0.035), and lifestyle habits (e.g., tobacco use associated with physical limitations at 3 months, p = 0.045) were significantly associated with HRQoL. Baseline HRQoL emerged as a strong predictor of future scores (Spearman’s correlations, p < 0.01), indicating that early assessments may guide interventions. Conclusions: Although overall HRQoL remains stable in RRMS, specific domains such as emotional and social functioning exhibit progressive decline, highlighting the need for tailored interventions. The findings underscore the importance of integrating early psychosocial support and lifestyle interventions into routine care to mitigate vulnerabilities in emotional and social domains of HRQoL. Full article

Refugee children and adolescents face significant psychological and social challenges, especially in camps or during post-resettlement. We conducted a meta-synthesis of 24 qualitative studies including 870 participants aged 3–19 to explore how they perceive trauma, considering gender, age, and unaccompanied status. Thematic analysis identified five core themes: (1) mental health perceptions, showing reluctance to disclose distress due to stigma and cultural norms; (2) stigma regarding refugee status, reflecting societal prejudice and barriers to integration; (3) desire to belong, including social withdrawal, family cohesion, and religious coping; (4) gender-specific needs, with girls facing early marriage, safety threats, and psychosocial vulnerability; and (5) discrimination from host communities, including verbal, physical, and institutional exclusion. Participants reported pervasive emotional distress, identity conflicts, somatic symptoms, and disrupted social relationships. The findings highlight the complex, multi-layered impact of forced displacement. Thematic analysis proved effective for capturing lived experiences, coping strategies, and contextual influences. These results underscore the urgent need for culturally sensitive, trauma-informed interventions addressing mental health, social support, and protective factors to promote the well-being and integration of refugee minors. The scarcity of research in high-risk camp and detention settings underscores the importance of qualitative inquiry to inform culturally grounded, multi-level psychosocial support. Full article

Background/Objectives: This systematic review summarizes the evidence regarding potential mechanisms underlying the relationship between spiritual practices and cognitive health in adults. The review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Methods: An extensive search of six electronic databases (i.e., PubMed, PsycINFO, Embase, Sociological Abstracts, ATLA, CINAHL) was conducted using keywords related to spiritual practices, religious activities, and cognitive health from 1 January 2000 to December 2025. The quality of the included studies was assessed using the Mixed Methods Appraisal tool aligned with the study design. Results: A total of 34 studies were selected for final inclusion in this review, and a narrative synthesis is provided. The studies were conducted throughout the world, with most studies conducted in North America and Asia. Short- and medium-term effects of spiritual practices on cognitive health were identified across heterogeneous practices ranging from meditation, tai chi and yoga to general spiritual and religious activities. Across the strongest evidence, 73% of the randomized control trials examined reported better cognitive health among the more spiritually active; neurobiological factors of decreased inflammation and improved immune response helped to explain these effects. A total of 5 studies examined mediators, while 29 studies contained only secondary outcomes for determining potential mechanisms. Informed by findings across psychosocial, behavioral, and neurobiological pathways, a conceptual model was created and needs testing. Conclusions: Possible mechanisms for spiritual effects on cognition may be through mental health and neurobiological factors, although more rigorous and long-term studies are needed. Full article

Background: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease that causes severe motor, respiratory and communication impairment and imposes a high psychosocial burden on patients and families. Recent evidence shows that integrated neuropalliative care—early collaboration between neurology and palliative services with community support—improves quality of life and reduces avoidable hospitalisations. Yet there are few descriptions of how such integration is operationalised. Objective: This study examines a Community-Integrated Neuropalliative Pathway (CINP) implemented in the province of Modena (Emilia-Romagna, Italy), analysing how neurology, palliative care and emergency services collaborate to provide continuous, person-centred care for people with ALS. Methods: A single, holistic case study was conducted following Yin’s analytical approach. Data sources included ten semi-structured interviews with neurologists, palliative physicians, nurses, home-care professionals and emergency clinicians; ethnographic observations in the ALS outpatient clinic; relevant organisational documents (the regional Clinical Pathway on ALS); and aggregated quantitative data from the palliative care registry (January 2023–December 2024). Thematic analysis with investigator triangulation was used to explore care integration, advance care planning and emergency coordination. Quantitative data were summarised descriptively. Results: Three interrelated themes were identified: (1) Progressive and flexible integration between neurology and palliative care. Neurologists remained longitudinal reference points while palliative teams were activated in response to evolving needs and became more relevant with the progression of the disease. Regular multidisciplinary meetings and shared discharge planning facilitated coordination. (2) The shared culture of advance care planning. Professionals framed advance care planning (ACP) as a relational, iterative process anchored in therapeutic relationships. Shared care plans, once completed, triggered an electronic Emergency Warning (“warning 118”) procedure that notified the emergency service of patient preferences. (3) The integration of palliative and emergency services. The warning system enabled emergency clinicians to respect care plans and avoid aggressive interventions during crises. Quantitative data on 47 ALS patients followed by territorial palliative services showed that 16 had an active Emergency Warning flag; among these, most died at home or in a hospice rather than in hospital. Conclusions: The Modena CINP exemplifies how a public health system can operationalise early neuropalliative integration and connect hospital, community and emergency services. The qualitative findings illustrate the cultural and organisational shifts required for continuous care, while the quantitative data show that the system is correctly used and that patients with the Emergency Warning activation died mostly at home or in a hospice. Lessons from this analytical case study can inform the development of similar pathways in other regions, although further research is needed to assess outcomes in larger populations and such models need to be adapted to local contexts. Full article

Purpose: Remote work continues to transform both organizational structures and individual work experiences, introducing new dynamics that can simultaneously enhance or undermine employees’ mental health and overall well-being. These evolving conditions influence levels of stress, resilience and burnout within increasingly digital and flexible work environments. The present study aimed to provide a comprehensive understanding of how remote work affects occupational stress, mental health, burnout and employee well-being through a bibliometric analysis of Scopus-indexed literature complemented by a narrative synthesis of emerging research themes. Methods: A total of 185 peer-reviewed documents were retrieved from the Scopus database and analyzed using the VOSviewer software, version 1.6.20 (0) (Leiden University, Leiden, The Netherlands). The study employed performance analysis techniques to assess annual publication trends, identify the most influential authors and sources and evaluate citation impact. Furthermore, science mapping methods, including co-authorship, bibliographic coupling, co-citation, and co-occurrence analyses, were used to visualize the intellectual structure and thematic evolution of the field. Results: The co-occurrence analysis identified three major thematic clusters. We first explored how the abrupt shift to teleworking redefined employee well-being, the second examined the psychological consequences of evolving work environments on mental health and occupational stress and the third investigated the prevalence, determinants and contextual factors of occupational burnout across professional domains. Conclusions: The findings demonstrated complex interrelations among remote work, occupational stress, mental health, and burnout, highlighting that the accelerated adoption of remote work—especially during and after the COVID-19 pandemic—has substantially reshaped employees’ psychological health and work experiences. Thus, remote work emerges as a double-edged phenomenon that can either foster resilience and well-being or heighten stress and burnout, depending on the availability of supportive organizational structures, psychosocial resources, and adaptive coping mechanisms. Full article

Engagement in physical activity (PA) has been considered to be influenced by multiple psychosocial factors (such as mental health, motivation and social support). However, current interventions often neglect these complex interactions. The Social Ecological Model (SEM) highlights the need for context-specific strategies addressing individual, social, environmental, and public engagement domains to enhance student PA. Therefore, this study aimed to develop strategies and recommendations to enhance the PA levels of undergraduate university students by using a SEM Approach. A co-creative consensus workshop, held between July and August 2024, was employed. The stakeholder group (n = 25) comprised undergraduate university students, professors and academic doctors specialising in PA and health-related disciplines. Data generated from the workshop were uploaded into Atlas Ti. V8 and thematically analysed. The co-created strategies underscore the importance of a multi-level approach to enhancing PA participation among undergraduate students. A total of 32 strategies were developed, reflecting the interconnected influence of psychosocial factors across the levels of the SEM. These include strategies related to PA (9), mental health (7), motivation (9), and social support (7). By developing context-specific strategies and recommendations that address individual, social, physical, and public engagement levels, the research offers practical, student-centred solutions to enhance PA participation. The co-created strategies hold the potential to foster long-term behavioural change and promote active, healthier lifestyles within the South African university context. Full article

The outbreak of the COVID-19 pandemic and the control measures implemented by governments have caused serious harm to the physical and mental health of many, including professionals working in the construction industry. As one of the largest industries globally, it is important to examine the psychosocial hazards that occurred during the pandemic and their impacts on the mental health outcomes of construction professionals, especially those working for construction enterprises, as their work tends to be site-based and has been influenced more seriously during the pandemic. This research used a questionnaire to gather data from 531 professionals working in China’s construction industry. Descriptive analysis, Spearman’s correlation analysis, and partial least-squares structural equation modeling (PLS-SEM) were employed to analyze the data. The findings indicate that work–family-related factors were critical psychosocial hazards. Their prevalence rates of depression, anxiety, and stress symptoms are 32.96%, 32.58%, and 16.95%, respectively. Personal factors are the strongest predictors of poor mental health outcomes, especially anxiety, while work–family-related factors are influential on the development of depression symptoms. The findings are unique, as they reveal critical psychosocial hazards that affect the mental health of construction professionals during the pandemic. They provide important theoretical references for governments or construction enterprises to develop disaster management plans in cases of similar public health emergencies in the future. Full article

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: Excess alcohol consumption remains a major challenge for public health in the UK. This study aimed to define and characterise clusters of increasing- and high-risk drinkers, based on drinking motives and occasions and contextualised by demographics and psychosocial factors, to inform tailored harm-reduction strategies. Methods: Secondary analysis of the nationally representative Drinkaware Monitor 2023 survey (n = 10,473) identified six clusters of increasing- and high-risk drinkers (n = 2486 weighted). Segmentation was based on drinking occasions and drinking motives using the Drinking Motives Questionnaire for Adults (DMQ-A). Clusters were then characterised using demographic factors, drinking patterns, and psychosocial indicators (dependency symptoms, loneliness, and risk perception), with weighted two-proportion z-tests and false discovery rate correction applied. Results: Six distinct subgroups emerged. Cluster 1 consisted of older drinkers (55+) motivated by product and taste, with fewer dependency symptoms and lower loneliness. Cluster 2 showed lower social motives but greater likelihood of drinking alone at home and with meals. Cluster 3, younger and more diverse, displayed very high social and identity motives (e.g., drinking to feel confident), alongside elevated loneliness and dependency indicators. Cluster 4 also presented strong social motives but had fewer product and taste motives and more adverse outcomes. Cluster 5, typically older and C2DE, reported higher coping motives (e.g., drinking to unwind) and more solitary drinking. Cluster 6 had consistently lower motives, a narrower range of drinking occasions, and a mixed dependency profile. Conclusions: Increasing- and high-risk drinkers are heterogeneous, shaped by different motives and contexts. Tailoring interventions to subgroup profiles, such as socially motivated younger adults and older adults whose drinking is driven by coping motives, may strengthen alcohol harm-reduction strategies. Full article

Background/Objectives: This longitudinal study investigated psychosocial predictors of COVID-19 vaccine intentions before vaccine availability (July 2020) and vaccine uptake or ongoing intent after widespread vaccine rollout (April 2021) using constructs from the Health Belief Model (HBM) and a measure of trust in government. Methods: A U.S. adult sample (N = 142) completed surveys at two time points: prior to and following the release of COVID-19 vaccines. Key predictors included demographics, trust in government, and HBM constructs. Hierarchical logistic regression was used to predict vaccine intent and uptake at both time points. Results: At Time 1, intent to vaccinate was significantly predicted by higher perceived susceptibility (p = 0.038), greater perceived benefits (p < 0.001), and lower perceived barriers (p = 0.002). Trust in government was not a significant predictor. At Time 2, vaccine uptake/ongoing intent was significantly predicted by higher trust in government (p = 0.047), greater perceived benefits (p < 0.001), and lower perceived barriers (p = 0.002). Perceived susceptibility was no longer a significant predictor. Between time points, trust in government and self-efficacy increased, while perceived severity and barriers decreased. Conclusions: Perceived benefits and barriers were robust predictors of vaccine behavior across both time points. Trust in government became a stronger predictor once vaccines were available, underscoring the importance of building and maintaining public trust throughout a health crisis. Messaging should emphasize vaccine benefits, proactively address barriers, and adapt over time as public perceptions shift. These findings inform strategies for enhancing vaccine confidence and readiness in future pandemics. Full article