Search Results (3,411)

Background/Objectives: Lebanon is undergoing a rapid demographic transition, with older adults projected to exceed one-fifth of the population by 2050. Supporting healthy and independent aging requires a robust evidence base that extends beyond clinical care to encompass community, environmental, psychosocial, and policy dimensions of aging in place. This bibliometric review maps the landscape of gerontology and geriatrics research in Lebanon to identify research trends, gaps, and future priorities for advancing holistic approaches to aging. Methods: A bibliometric review was conducted of gerontology and geriatrics research published between 2015 and 2026. Publications were retrieved from the Scopus database and screened according to predefined eligibility criteria. Results: A total of 403 publications met the inclusion criteria. Research productivity increased steadily over the study period, reaching its highest level in 2025, although publications remained concentrated among a relatively small number of authors and institutions. The literature was predominantly oriented toward clinical, epidemiological, and public health aspects of aging, with comparatively limited attention to community-based aging, psychosocial well-being, age-friendly environments, policy, social participation, and other determinants that support older adults’ ability to age safely and independently within their communities. Research evaluating interventions outside tertiary healthcare settings was particularly scarce. Conclusions: This review provides the first bibliometric mapping of gerontology and geriatrics research in Lebanon and indicates that, despite substantial growth in scientific output, the identified literature is largely centered on diseases and institutional healthcare. Future research should adopt more holistic and multidisciplinary perspectives to promote psychosocial well-being and aging well in one’s community. These priorities may guide researchers, practitioners, and policymakers in developing strategies for aging well in Lebanon. Full article

Background/Objectives: Schools constitute the principal setting for the identification of children’s psychosocial risk and the delivery of preventive support, and school-health surveillance therefore depends on informant reports. Selection of the reporting informant is constrained by feasibility, cost, and questionnaire length, which frequently preclude multi-informant assessments, and the question of whether adult and child reports index a common property has predominantly been examined in single-country designs. The present study estimated the criterion-related validity of child, teacher, and principal reports of school safety across multiple education systems, against outcomes spanning children’s experience, institutional functioning, and externally assessed achievements; the estimand was thus informant-specific validity rather than cross-informant agreement. Methods: TIMSS 2023 Grade 4 data from 12,955 schools in 63 education systems (395,961 children, 27,100 teacher records) were analyzed, with child, teacher, and principal reports modeled as separate informants. Students were randomly split within schools so that no student contributed both a predictor and an outcome; the split was replicated 50 times and averaged. Convergence was evaluated with a multitrait–multi-informant model, with ceiling effects and differential unreliability specified as rival explanations; informant contributions were estimated by an exact relative-importance (LMG) variance decomposition, with response surface analysis reported as a secondary characterization of directional discrepancy. Results: Median school-level cross-informant correlations were below 0.10 and were not attributable to ceiling effects or to unreliability. With all three informants retained, the child report accounted for 95% (95% CI 92–97) of the informant-explained variance in school belonging and 75% (65–82) in peer victimization, but 44% (28–59) in mathematics, where the three contributions were approximately equal. These proportions were computed on a modest total: the three informant scores jointly explained between 1% and 13% of between-school variance. The pattern was robust to informant, item, covariate, and weighting specifications, and to correction for differential predictor unreliability. Conclusions: Criterion-related informant validity in school safety measurement was domain-specific. For outcomes describing children’s experience, adult reports contributed substantially lesser than child reports and cannot be regarded as interchangeable substitutes for children’s reports of experienced safety. Because school-health surveillance, risk identification, preventive targeting, and resource allocation depend on these inputs, valid monitoring requires student self-reports rather than adult proxy reports alone. Full article

Background: Lifestyle behaviors and psychosocial factors are key determinants of cardiometabolic health across the life course. Beyond traditional risk factors, emerging evidence suggests that chronic stress and burnout may influence metabolic risk through behavioral pathways such as physical inactivity and poor diet. However, their joint contribution to type 2 diabetes risk in working populations remains insufficiently understood. Objectives: Our objectives were to examine the joint contribution of lifestyle habits, sociodemographic factors, and burnout to type 2 diabetes risk, and to explore potential behavioral pathways linking psychosocial stress to metabolic risk in a large adult population. Methods: A cross-sectional study was conducted in 92,480 Spanish workers undergoing routine occupational health assessments between 2021 and 2023. Type 2 diabetes risk was assessed using validated tools (FINDRISC, QDScore, CANRISK). Lifestyle indicators included adherence to the Mediterranean diet and physical activity levels; burnout was assessed using the Burnout Assessment Tool (BAT). Multivariable logistic regression models were used to evaluate associations between determinants and diabetes risk. Mediation analyses were performed to assess the contribution of lifestyle behaviors to the association between burnout and diabetes risk, and predictive performance analyses evaluated the incremental value of burnout. Results: Burnout was independently associated with a higher probability of moderate-to-high diabetes risk across all screening tools. Exploratory cross-sectional mediation analyses indicated that lifestyle behaviors, particularly physical inactivity and low adherence to the Mediterranean diet, statistically accounted for approximately 45% of the observed association. Adding burnout to the models significantly improved discrimination and reclassification of moderate-to-high diabetes-risk classification. In addition, higher diabetes risk was consistently observed among individuals from lower socioeconomic groups and those with unhealthy lifestyle profiles. Conclusions: Lifestyle behaviors and psychosocial stress were associated with estimated diabetes risk across adulthood. Burnout was independently associated with a higher probability of moderate-to-high diabetes-risk classification, with exploratory analyses suggesting that lifestyle behaviors may statistically account for part of this association. These cross-sectional findings highlight the potential relevance of considering both behavioral and psychosocial factors when studying cardiometabolic risk in working populations, while prospective studies are needed to establish temporal and causal relationships. Full article

Pediatric chronic kidney disease (CKD) is traditionally viewed as a disorder of impaired renal function, yet its effects extend far beyond the kidneys. Growing evidence indicates that CKD may disrupt brain development through interconnected biological, vascular, inflammatory, and psychosocial mechanisms, with lasting consequences for cognition, mental health, and educational attainment. In this perspective, we propose the kidney-brain axis as a neuro-renal framework for understanding these neurological consequences of pediatric CKD. We discuss current evidence linking CKD with neurocognitive impairment, structural brain abnormalities, psychosocial burden, and adverse educational outcomes, while examining the biological mechanisms that may underlie these associations. We also consider the role of kidney transplantation, emphasizing that restoration of renal function does not necessarily restore normal neurodevelopmental trajectories. Finally, we outline the clinical implications of integrating routine neurodevelopmental assessment into pediatric nephrology care and highlight priorities for future research. Recognizing neurodevelopment as a core component of pediatric CKD may help redefine disease burden and support more comprehensive, lifelong care for affected children. Full article

Diabetes-related hypoglycemia contributes substantially to increased morbidity, mortality, health-care utilization, and reduced quality of life. Older adults with diabetes represent a heterogeneous group of patients who need individualized blood glucose targets to avoid hypoglycemia. Since the elderly present with varying degrees of functional and cognitive status and individualized health needs, their management varies among individuals. Complicating this, the hypoglycemia risk in older adults treated with insulin also varies due to aging, renal dysfunction, cognitive impairment, and other comorbidities. The challenge for healthcare providers is in considering all aspects of care in order to avoid hypoglycemia in elderly individuals. In this review, we introduce a Patient and Function Centric Approach to the assessment and management of hypoglycemia in older adults. This holistic framework extends beyond blood glucose values to systematically evaluate the other domains of patients’ health that influence hypoglycemia risk, including biochemical, medication, timing, autonomic, cognitive, mood, renal, pancreatic, hepatic, social, and physical function. The management of hypoglycemia in older adults should also include strategies to address both fear of hypoglycemia and hypoglycemia unawareness. In addition to physical limitations, the psychosocial barriers to self-care in older individuals with hypoglycemia are also of paramount importance. Using tools that measure diabetes burden, diabetes distress, and fear of hypoglycemia provides valuable insights into patient wellbeing. The use of newer anti-hyperglycemic medications, sensor-augmented insulin pump therapy, intranasal glucagon, and continuous glucose monitoring (CGM) has significantly contributed to reduced hypoglycemia incidence in individuals with diabetes. Overall, successful management requires a collaborative approach that empowers patients, respects their individual needs and preferences and helps them face the challenges associated with diabetes management with confidence rather than fear or anxiety. Adopting a patient- and function-centric approach to hypoglycemia management allows clinicians to move beyond a one-size-fits-all model and adopt individualized glycemic targets that improve overall diabetes control and mental well-being. Full article

Background: Fathers may experience psychological difficulties during the transition to parenthood, and depressive symptoms during the antenatal period may be associated with fathers’ well-being and adjustment to the paternal role. Marital satisfaction and paternal attachment may be important psychosocial factors associated with fathers’ mental health during this period. This study aimed to examine the relationships among marital satisfaction, paternal attachment, and depressive symptoms among expectant fathers. Methods: A descriptive cross-sectional study design was employed. The study was approved by the Van Yüzüncü Yıl University Non-Interventional Clinical Research Ethics Committee (20 December 2024; Approval No. 2024/13-07). Institutional permission was obtained from the hospital where the study was conducted. Written and verbal informed consent was obtained from all participants, and the study was conducted in accordance with the principles of the Declaration of Helsinki. Data were collected between January 2025 and September 2025 at a hospital located in the Eastern Anatolia Region of Türkiye. The study was completed with 336 fathers. Data collection instruments included the Personal Information Form, Marital Life Scale (MLS), Paternal–Antenatal Attachment Questionnaire (PAAQ), and Edinburgh Postpartum Depression Scale (EPDS). Multiple regression analysis and forest plot analysis were performed. Results: A statistically significant difference was observed between EPDS scores and MLS, PAAQ, educational status, spouse’s educational status, place of residence, family type, income status, spousal attendance at antenatal visits, and history of depression (p < 0.05). The regression model was statistically significant (F(9326) = 14.4, p < 0.001) and explained 26.4% of the variance in EPDS scores (R² = 0.284). In the adjusted regression model, MLS, educational level, PAAQ, and family type were significantly negatively associated with EPDS scores, whereas a history of depression was significantly positively associated with EPDS scores (p < 0.05). Conclusions: Higher marital satisfaction and paternal attachment were associated with lower depressive symptoms among expectant fathers, whereas a history of depression was associated with higher depressive symptoms. These findings highlight the importance of considering marital and attachment-related factors when assessing fathers’ psychological well-being during the antenatal period. Full article

Background/Objectives: Private security work combines prolonged standing, extended schedules and shift demands, yet evidence on multisite musculoskeletal pain, burnout and sleep in this group is limited. In this exploratory cross-sectional study, we examined the 12-month prevalence and anatomical distribution of musculoskeletal pain and its associations with burnout, sleep and occupational characteristics. Methods: A total of 110 male private security officers in Ümraniye, Istanbul, Türkiye (110/127 approached; participation 86.6%), completed the Nordic Musculoskeletal Questionnaire, Pittsburgh Sleep Quality Index (PSQI) and Maslach Burnout Inventory. Officers reporting pain in ≤2 versus ≥3 regions (multisite pain) were compared, and correlates of multisite pain were examined with binary logistic regression; robustness was assessed with Firth-penalized, count-based, ordinal and re-specified working-hour models. Results: Ninety-one participants (82.7%) reported pain in at least one region and 52 (47.3%) in ≥3 regions. Low back pain was most prevalent (54.5%; 95% CI 45.2–63.5), followed by neck and ankle/foot pain (41.8% each). The multisite-pain group had higher emotional exhaustion (14.13 ± 6.26 vs. 10.81 ± 6.77; p = 0.009; d = 0.51) and daytime-dysfunction scores (p = 0.013), and lower body mass index (p = 0.012) and shorter tenure (p = 0.026); weekly working hours did not differ significantly in the primary non-parametric comparison. Emotional exhaustion was the only independent correlate in the primary logistic model (OR 1.12, 95% CI 1.02–1.23; p = 0.019) and remained associated in Firth-penalized (p = 0.029) and covariate-adjusted (p = 0.025) analyses, although the association attenuated to borderline significance in count-based, ordinal and categorized working-hour specifications. Conclusions: Musculoskeletal symptoms were common and frequently multisite. Emotional exhaustion showed the most consistent—though modest and specification-dependent—association with multisite pain. These exploratory cross-sectional findings should not be interpreted causally. Full article

Background/Objectives: Nursing research on children with disabilities spans diverse disability groups, care settings, and areas of practice; however, its development and structure have not been comprehensively examined. This study aimed to examine publication trends, major research themes, temporal development, and collaboration patterns. Methods: The Web of Science Core Collection was searched on 29 June 2026 without publication-year restrictions. English-language articles and reviews indexed in Science Citation Index Expanded (SCI-EXPANDED) and Social Sciences Citation Index (SSCI) were included, yielding 1915 publications from 1977 to 2026. VOSviewer and Biblioshiny were used to analyze publication trends, keyword co-occurrence, thematic structure and evolution, trend topics, and country and institutional collaboration. Results: Research output increased substantially, particularly during the last decade. Across the study period, the United States had the highest publication output and co-authorship connectivity, followed by England, Canada, and Australia. Nursing, children, autism spectrum disorder, intellectual disability, and cerebral palsy were among the largest nodes in the keyword network. The thematic map positioned the autism–pediatrics–developmental disability cluster slightly within the motor themes quadrant, while the disability–children with disabilities–qualitative research, adolescents–communication–transition, and children–nursing–intellectual disability clusters were positioned among the basic themes. Thematic evolution showed both continuity and diversification, with autism, nursing, children, and intellectual disability represented across multiple periods, while quality of life, education, and mental health were represented in the most recent period. Trend topic analysis further showed that well-being, implementation, pediatric nursing, anxiety, and mental health were among the topics with more recent median publication years. Conclusions: Nursing research on children with disabilities has expanded and diversified, with recurring disability-specific topics alongside more recent topics related to psychosocial issues, pediatric nursing, and implementation. Future research could build on the thematic patterns identified in this study through systematic reviews and primary nursing research, while bibliometric studies incorporating additional databases could provide a more comprehensive view of the field. Full article

The development of depression frequently impacts epileptic patients due to unmanaged central nervous system changes. This may severely reduce their quality of life. These mental conditions can lead to the administration of illicit drugs for self-medication. However, these substances may increase seizure frequency. The combination of this condition may both interacting brain disorders deeply aggravate each other, requiring simultaneous, comprehensive treatment. The aim will be to systematically evaluate the role of phytomedicine in managing comorbid depression and recreational substance use in people with epilepsy. The methods followed the PRISMA guidelines. This systematic review protocol outlines an evaluation of phytomedicine’s role in managing comorbid depression and recreational substance use in epilepsy patients. Data were searched using nine online databases for 2000–2026 primary studies, extracted data, assessed risk of bias, and performed a narrative or meta-analysis synthesis. It is well documented that depression and recreational substance use frequently coexist, with severity influenced by youth, homelessness, unemployment, childhood trauma, and prolonged substance dependence. Several evidence globally consistently demonstrates strong associations between depressive symptoms and heroin, cocaine, benzodiazepine, and alcohol use. The statistical analyses obtained indicate that substance use and depression reinforce each other, highlighting the need for integrated mental health, addiction, and psychosocial interventions to improve clinical outcomes. This highlighted a complex interaction among depression, epilepsy, and substance use. It emphasised an integrated management approach while cautiously evaluating phytomedicine’s efficacy, safety, and drug interactions. Therefore, the use of phytomedicine may complement integrated epilepsy care by addressing depression and substance use, although robust clinical evidence remains essential for validation. Full article

Technostress has emerged as a central psychosocial risk in digital environments, yet existing bibliometric research provides only partial accounts of its development. This study offers an updated mapping of the global intellectual structure of technostress based on 1135 articles indexed in the Web of Science Core Collection as of October 2025. Using Price’s, Lotka’s, Bradford’s, and Zipf’s Laws, alongside co-authorship and keyword co-occurrence analyses, the study examines patterns of scientific growth, author productivity, and conceptual concentration. Results reveal exponential growth, highly unequal authorship distribution, and strong terminological concentration. Four stable thematic clusters were identified: foundational theory, workplace technostress, psychological consequences, and excessive technology use. Emerging topics, including artificial intelligence, digital stress, and information overload, indicate a shift toward broader socio-technical interpretations. Keyword networks further reveal a consistent relationship between technological overload, technostress, impaired performance, and reduced well-being. Despite its growing maturity, the field remains conceptually fragmented and lacks an integrative framework encompassing cognitive, behavioral, organizational, and AI-mediated dimensions. These findings highlight the need for interdisciplinary collaboration and interventions that address both individual capacities and contextual conditions to advance digital well-being and foster socially sustainable and resilient digital environments. Full article

Benzodiazepine misuse is most prevalent among young adults aged 18–25 and has been linked to recreational use, self-medication, and psychosocial stressors. Childhood emotional neglect is associated with adverse mental health outcomes and increased vulnerability to substance misuse; however, its relationship with benzodiazepine misuse among young adults remains understudied. This study examined the association between childhood emotional neglect and lifetime benzodiazepine misuse among young adults in Rhode Island. Data were drawn from 1008 participants aged 18–25 who completed the 2024 Rhode Island Young Adult Survey, a cross-sectional web-based survey of behavioral health. Lifetime benzodiazepine misuse was defined as self-reported use of non-prescribed benzodiazepines. Multivariable logistic regression models examined the association between childhood emotional neglect and lifetime benzodiazepine misuse while adjusting for age, race/ethnicity, sexual and gender identity, and subjective social status. Overall, 5.6% of participants reported lifetime benzodiazepine misuse and 33.4% reported childhood emotional neglect. More than half (55.4%) of participants who reported benzodiazepine misuse also reported a history of emotional neglect (p < 0.001). After adjustment for covariates, childhood emotional neglect was associated with nearly threefold greater odds of lifetime benzodiazepine misuse (aOR = 2.80, 95% CI: 1.57–5.00). Findings identify childhood emotional neglect as a significant correlate of benzodiazepine misuse among young adults and underscore the importance of trauma-informed prevention, screening, and early intervention efforts. Full article

In semi-arid Ghana, girls bear primary responsibility for household water collection in communities without on-premises access, a burden intensified by climate change associated with rising temperatures and frequent droughts. Yet little is known about how this responsibility shapes their embodied health and well-being. Guided by a political ecology of health framework, this qualitative study examined how water insecurity shapes girls’ physical, psychosocial, and neurological health in two communities, Wechiau and Kandue, in Ghana’s Upper West Region. We conducted in-depth interviews with nineteen purposively selected girls aged 10 to 19 and analyzed the transcripts thematically. Four interconnected themes emerged: structural and political determinants of water access, environmental and ecological conditions, gendered social relations, and embodied health consequences. Financial barriers, governance failures, and infrastructure deficits force girls into long queues and repeated trips, a burden that falls disproportionately on girls under cultural norms exempting boys from water duties. This gendered allocation of labour produces gendered health harm, whereby girls sustain musculoskeletal pain and injury carrying heavy loads over hazardous terrain, while chronic time loss disrupts sleep, schooling, and psychological well-being. Girls with pre-existing conditions such as epilepsy face the most acute risk, as water fetching directly exacerbates their vulnerability to seizures. These findings show that addressing this crisis requires more than infrastructure investment. Coordinated public–private investment in water access must be paired with social protection for vulnerable households, gender-responsive water policy, and rainwater-harvesting strategies that confront the structural and gendered inequities placing this burden on girls. Full article

Background/Objectives: School closures and social restrictions during the COVID-19 pandemic substantially disrupted adolescents’ everyday lives. However, much of the existing evidence relies on standardized measures or retrospective accounts, providing less insight into how adolescents themselves described the psychosocial meaning of this disruption while it was still unfolding. This study aimed to explore Hungarian secondary school students’ real-time written reflections on their experiences during COVID-19-related school closures, online education, and social restrictions, with a focus on adolescent mental health, peer connectedness, school belonging, and developmental disruption. Methods: A retrospective qualitative study was conducted using 111 anonymized open-ended student reflections written in 2021 during the active period of online education and social restrictions. The texts were originally produced in a pedagogical-reflective context, not as research interviews or questionnaire responses. The material was analysed using structured qualitative content analysis. Two researchers independently coded the texts; disagreements were resolved through discussion, and a third researcher was involved when consensus was required. Descriptive frequency summaries were used to contextualize the qualitative findings. Results: In the descriptive frequency summaries, negative appraisals were most common in relation to the general pandemic situation, online schooling, and peer relationships. Thematic analysis identified recurring patterns of confinement, loss of normality, reduced peer contact, weakened school routines, academic overload, uncertainty about graduation and the future, and the loss of age-specific adolescent experiences and transition rituals. Family appeared as both a stabilizing resource and, in some cases, a source of conflict or additional burden. A central interpretive theme was that adolescents experienced the pandemic not merely as educational disruption but as an interruption of adolescence itself. Conclusions: The findings highlight that adolescent mental health support during large-scale crises should extend beyond maintaining educational continuity. Early prevention and intervention strategies should preserve peer connectedness, school belonging, daily structure, emotional validation, and developmentally sensitive support during future pandemics or comparable periods of prolonged social restriction. Full article

Background/objectives: This study aimed to identify and categorise the educational, training, and support needs of informal caregivers of stroke survivors in order to inform the development of an Immersive Virtual Reality (IVR) intervention within the European caregIVR project (Project No. 101129454; EU4Health Programme). Methods: A qualitative descriptive study was conducted using three focus groups involving informal caregivers, healthcare professionals and other stakeholders, and academics and healthcare students in Portugal (n = 33). Discussions explored everyday caregiving challenges, priority educational needs, and expectations regarding digital support tools. Data were analysed using qualitative content analysis with an inductive–deductive coding strategy supported by NVivo software (version 14). Results: Participants identified the transition from hospital to home as the most critical stage of the caregiving journey, characterised by poor continuity of care and insufficient preparation before hospital discharge. Major challenges included limited stroke-related health literacy, difficulties adapting the home environment, and substantial emotional, financial, and social burdens that frequently resulted in social isolation and caregiver burnout. Participants regarded IVR as a promising educational strategy for delivering practical, repetitive, and low-risk skills training. Conclusions: The findings suggest that caregiver empowerment should be promoted through progressive, person-centred, and non-judgemental educational programmes tailored to caregivers’ evolving needs. Caregivers should be supported by multidisciplinary teams capable of addressing the clinical, practical, and psychosocial complexity of post-stroke home care. Rather than replacing professional support, IVR should be considered a complementary educational tool with the potential to improve caregivers’ preparedness, confidence, and safety in the home-care setting. Full article

Background/Objectives: Musculoskeletal disorders (MSDs) represent a significant occupational health concern among medical laboratory workers (MLWs) worldwide. However, in cross-sectional epidemiological assessments, these are more accurately characterized as self-reported musculoskeletal symptoms (MSSs). Despite growing awareness of physical ergonomic risk factors, the multifactorial etiology of these symptoms, such as psychosocial factors, remains incompletely understood in research laboratory settings. Consequently, this study aimed to determine the prevalence of MSSs among MLWs in a Malaysian research institute, assess physical ergonomic risk in their daily tasks, and evaluate the empirical association between MSSs and psychosocial work engagement. Methods: A cross-sectional study was conducted among MLWs at a Malaysian medical research institute. The 12-month prevalence of self-reported MSSs was assessed using the Nordic Musculoskeletal Questionnaire. Physical ergonomic risk was evaluated utilizing the Rapid Entire Body Assessment (REBA). Psychosocial work engagement was measured using the 17-item Utrecht Work Engagement Scale. Results: A total of 115 MLWs participated, with 73 (63.5%) reporting MSSs. The neck had the highest complaints (n = 43, 37.4%), followed by the lower back (n = 35, 30.4%) and shoulders (n = 33, 28.7%). Multivariable modified Poisson Generalized Estimating Equations revealed that physical ergonomic risk (REBA) was significantly associated with symptoms in the shoulder, upper back, and lower back. Female sex was independently correlated with the overall prevalence of MSSs (aPR = 1.39; 95% CI = 1.14–1.68), with marked associations observed for the neck and knees. Psychosocially, high “absorption” in work was significantly associated with upper back symptom prevalence (aPR = 1.57; 95% CI = 1.15–2.14). Conclusions: Ergonomic strain demonstrates a strong association with axial and shoulder symptoms among MLWs, while demographic characteristics and cumulative tenure correlate with specific extremity symptoms. Paradoxically, high psychological absorption emerges as a distinct correlate of upper back symptoms, likely due to prolonged postural neglect during deep concentration. Occupational health programs may benefit from combining targeted ergonomic accommodations with strategies designed to mitigate the potential physical vulnerabilities of highly absorbed personnel. Full article