Search Results (58)

Psychoactive substance use is a significant public health issue. Developing effective preventive strategies to reduce its incidence requires a deep understanding of the motivations and risks underlying its development and maintenance. This study examines the associations between substance use risks, self-esteem, and body image perceptions within a Spanish sample (n = 174). Data were collected using standardized instruments (ASSIST v3.1, RSES, BSQ-8D, BIS) and an ad hoc questionnaire regarding aesthetic-related beliefs. Findings revealed that while alcohol (90.2%), tobacco (47.1%), and cannabis (29.3%) were the most prevalent substances used in the last three months, associated health risks were predominantly low. Significant negative correlations were identified between self-esteem and the risk of alcohol (ρ = −0.155) and sedative use (ρ = −0.221), as well as cocaine prevalence (ρ = −0.155). Gender differences emerged, with males exhibiting higher risks for cannabis and stimulants, while females reported greater body image concern. Approximately 38.5% of the sample had used substances for aesthetic purposes, primarily dietary supplements among men. Beliefs regarding the impact of consumption on physical appearance were predominantly negative. These results suggest that high self-esteem and negative aesthetic perceptions of substances are consistent with a potential protective role. Effective prevention strategies should incorporate body image and self-esteem as pillars of psychological resistance. Full article

Intelligent transportation systems (ITSs) and traffic control promise substantial efficiency and safety improvements but frequently face public resistance and driver compliance issues. Many drivers perceive such control measures as unfair or unnecessary, despite measurable system-wide benefits. This study investigates how chronoception—the subjective perception of time—affects user acceptance of ITS control strategies and how signal design can be adapted to reduce perceived delays. We introduce a chronoceptive design framework that integrates insights from cognitive psychology into traffic-control design. Using ramp metering as a case study, we conduct virtual experience stated preference experiments with 101 participants, comparing standard and chronoceptive ramp metering designs featuring shorter signal cycles, three-phase lights, and countdown timers. The results show that chronoceptive signal designs significantly improve user acceptance (by up to 12%) and reduce perceived waiting times, despite identical or slightly longer objective travel times. These findings reveal a systematic bias between factual and perceived benefits and highlight the potential of chronoceptive design to enhance compliance and fairness perception. This study contributes a new human-centred design paradigm for traffic control that aligns objective performance with user perception and outlines how chronoception and perceived fairness can be operationalised in traffic control. The source code and survey data can be found open-source on GitHub. Full article

Early engagement with psychotherapy is a public mental health issue because potential patients’ first appraisals of psychological care may shape treatment expectations, willingness to continue, and openness to receiving effective support. In first-contact therapeutic encounters, people respond not only to the content of a therapist’s intervention but also to the interpersonal meaning conveyed by the therapist’s response style. Guided by a recognition–resistance framework and models of narcissistic self-regulation, we examined how therapist response style and trait narcissistic admiration and rivalry shape early appraisals of psychological care in a vignette-based psychotherapeutic encounter. In a between-subjects vignette experiment, Hebrew-speaking adults in Israel (N = 972) were randomly assigned to read a validation-based, recognition-supportive, autonomy-supportive therapist response or a more directive and challenging response to the same clinical scenario. Participants then reported perceived recognition, autonomy-related resistance, anticipated alliance, therapist credibility, expected benefit, and willingness to continue. The validation-based response elicited higher perceived recognition, lower autonomy-related resistance, and greater willingness to continue. Perceived recognition and autonomy-related resistance mediated the effects of response style on all therapy-related outcomes. Narcissistic admiration predicted more favorable appraisals, and narcissistic rivalry predicted lower recognition and greater resistance, but neither moderated style effects nor indirect pathways. Recognition and autonomy-related resistance emerged as proximal appraisal pathways linking therapist response style to anticipated engagement with psychological care in this analogue vignette context. However, the predicted moderation and moderated-mediation effects involving narcissistic admiration and rivalry were not supported. This pattern suggests that, in the present design, admiration and rivalry functioned more as general appraisal orientations than as differential-susceptibility moderators of therapist response style. The moderated-mediation component of the recognition–resistance framework should therefore be regarded as unsupported pending independent replication and more ecologically valid tests. These findings position first-contact therapist communication as a candidate modifiable feature of public mental health engagement, with implications for future research on treatment uptake, early retention, trust in services, and access to effective psychological care. Full article

Background/Objectives: COVID-19 vaccine resistance was detrimental to herd immunity and worsened COVID-19 morbidity and mortality during outbreaks. Despite more evidence showing reactionary behavior among residents exposed to vaccine mandates, little research has been conducted on the effects of state proof-of-vaccine (POV) mandate bans in the United States (US). We sought to investigate the causal effects of POV mandate bans, overall and stratified by policy passage via executive order or state legislature, on first-dose COVID-19 vaccinations. Methods: In the contiguous US, 21 states enacted POV mandate bans from 8 February 2021–25 October 2021. Using a geographic regression discontinuity design, we selected treatment and control counties within 150 miles of the POV mandate ban state border. The resulting sample was 4612 county-observations and 2466 unique counties. We conducted two-way fixed-effects estimation to compare changes in weekly, first-dose COVID-19 vaccinations among individuals <65 years old before and after POV mandate ban enactment between treatment and control counties. Results: Among executive order POV mandate ban counties, we saw an additional increase in weekly, first-dose COVID-19 vaccinations following POV mandate ban enactment when compared to controls. There was an additional 38.2% increase in Weeks 1–2, 40.6% in Weeks 3–4, 41.3% in Weeks 5–6, and 43.9% in Weeks 7–8. Conclusions: While seemingly counterintuitive, these findings follow Psychological Reactance Theory. Once the perceived threat to freedom was removed, reactance to COVID-19 vaccinations declined and constituents received the COVID-19 vaccine of their own volition. Future public health efforts should consider potential reactance to mandatory policies and tailor efforts to community values. Full article

Background/Objectives: Adaptogens are plant-derived substances that enhance the body’s nonspecific resistance to physical, chemical, biological, and psychological stressors by normalizing physiological functions. This article discusses the molecular mechanisms of action of seven key plant adaptogens—Rhodiola rosea, Schisandra chinensis, Withania somnifera, Eleutherococcus senticosus, Panax ginseng, Ocimum tenuiflorum, and Bacopa monnieri—in the context of chronic stress and lifestyle-related diseases. Methods: A review of the scientific literature is performed, including preclinical in vitro and in vivo studies, randomized placebo-controlled clinical trials, and studies employing network pharmacology analyses, molecular docking, and genomic techniques such as gene expression profiling. The interactions of active constituents with signaling pathways, molecular targets, and synergistic mechanisms were analyzed based on publications from the years 2010–2025. Results: Adaptogens exhibit pleiotropic activity: they regulate the HPA axis (Hypothalamic–Pituitary–Adrenal axis); induce Hsp70/Hsp16 expression; modulate SAPK/JNK, FOXO, and NF-κB pathways; and demonstrate antioxidant and mitoprotective effects. Specific mechanisms include: salidroside from R. rosea activating PI3K/Akt; schizandrin B from S. chinensis stimulating Hsp70; withanolides from W. somnifera inhibiting PDE4D; ginsenosides from P. ginseng suppressing FKBP51; and bacosides from B. monnieri enhancing acetylcholine synthesis. Clinical studies confirm reductions in cortisol levels (14–30%), decreased fatigue, and improved cognitive function without adverse effects. Conclusions: Understanding the molecular mechanisms of adaptogens supports their application in integrative medicine for the treatment of stress-related disorders, depression, anxiety, and neurodegenerative diseases. Further clinical studies are needed to optimize dosages and standardize extracts. Full article

Background: The belief that “sugar feeds cancer” is widespread and has strongly influenced public perceptions, patient behavior, and dietary recommendations, despite uncertainty regarding its scientific validity. This belief largely stems from misinterpretation of the Warburg effect, which describes altered glucose metabolism in cancer cells rather than dietary sugar dependence. The objective of this review was to critically evaluate whether dietary sugar intake directly contributes to cancer development or progression by examining the totality of epidemiological, experimental, and mechanistic evidence. Methods: We conducted a narrative review of human epidemiological studies, experimental animal and cell-based models, and mechanistic investigations published between 1980 and July 2025. Evidence was synthesized across cancer types, sugar sources, and biological pathways, with careful consideration of study design, exposure relevance, and key confounders, including obesity, insulin resistance, and overall dietary patterns. Results: Across cancer types, epidemiological evidence showed predominantly null or inconsistent associations between sugar intake and cancer risk or outcomes, with positive findings largely confined to metabolically susceptible subgroups and often attenuated after adjustment for adiposity and energy intake. Experimental studies suggested potential tumor-promoting effects under non-physiological conditions, while mechanistic data indicated that sugar influences cancer risk indirectly through insulin signaling, inflammation, and metabolic dysfunction rather than direct tumor fueling. Conclusions: Current evidence does not support the hypothesis that dietary sugar directly “feeds” cancer in humans. Overemphasis on sugar avoidance risks nutritional and psychological harm, particularly among cancer patients. Evidence-based guidance should prioritize overall dietary quality, metabolic health, and patient well-being rather than isolated sugar restriction. Full article

Land defense is crucial in the face of the current ecological crisis. From a qualitative perspective, this work describes and analyzes the relations between place attachment disruption, emotions, and psychological distress among a group of Mexican land defenders in El Salto and Juanacatlán, Jalisco. Following an ethnographical methodology, the data was collected through seven individual narrative interviews, two discussion groups, and participant observation during four years of fieldwork. The resulting qualitative data was transcribed, coded, categorized, and analyzed using qualitative software and narrative analysis perspective. Results: Place attachment disruption is associated with unpleasant emotions, leading to psychological distress. Through organized actions and emotional management strategies, land defenders produce emotions of resistance that help reconstruct place attachment and overcome psychological distress. Repeated disruptions and changes to place increase psychological distress; in response, restorative actions of place attachment strengthen emotions such as love, pride, and joy. These findings highlight that observing the simultaneity of place attachment disruption and reconstruction processes is central to understanding the emotional impact of prolonged territorial damage and the double role of psychological distress: increasing vulnerability while also contributing to positive action. These findings have theoretical and practical implications for mental health, ecology, and public policy, and highlight the need for interdisciplinary approaches in designing effective, community-based and collaborative strategies to sustain land defense and ecological activism. Full article

Recurrent urinary tract infections (rUTIs) are a prevalent public health problem in women, with significant clinical, psychological, and economic consequences. Standard antibiotic prophylaxis, while effective, is limited in the medium term due to the risk of bacterial resistance and potential side effects. This narrative review summarizes the current evidence on the efficacy, safety, and economic impact of Uromune^®—a sublingual bacterial vaccine—as a preventive strategy for rUTIs. A literature search was conducted, focusing on systematic reviews and meta-analyses that evaluated Uromune^® in women and in other specific at-risk populations. Available data show that Uromune^® reduces the frequency of UTI episodes, prolongs recurrence-free intervals, and decreases overall antibiotic use. The vaccine has a favorable safety profile, with predominantly mild adverse effects and a low discontinuation rate. Furthermore, its use has been associated with improved quality of life and a marked reduction in direct and indirect healthcare costs. These findings support Uromune^® as an effective, safe, and potentially cost-effective alternative to conventional antibiotic prophylaxis in the current context of increasing antimicrobial resistance. Full article

Criminal laws and their deserts-based punishments, particularly in Anglo-American systems, remain grounded in folk psychology assumptions about free will, willpower, and agency. Yet advances in neuropsychiatry, neuromicrobiology, behavioral genetics, multi-omics, and exposome sciences, are revealing how here-and-now decisions are profoundly shaped by antecedent factors. This transdisciplinary evidence increasingly undermines the folk psychology model: some argue it leaves “not a single crack of daylight to shoehorn in free will”, while others suggest the evidence at least reveals far greater constraints on agency than currently acknowledged. Historically, courts and corrections have marginalized brain and behavior sciences, often invoking prescientific notions of monsters and wickedness to explain harmful behavior—encouraging anti-science sentiment and protecting normative assumptions. Earlier disciplinary silos, such as isolated neuroscience or single-gene claims, did little to challenge the system. But today’s integrated sciences—from microbiology and toxicology to nutrition and traumatology, powered by omics and machine learning—pose a threat to the folk psychology fulcrum. Resistance to change is well known in criminal justice, but the accelerating pace of biopsychosocial science makes it unlikely that traditional assumptions will endure. In response to modern science, emergent concepts of reform have been presented. Here, we review the public health quarantine model, an emergent concept that aligns criminal justice with public health principles. The model recognizes human behavior as emergent from complex biological, social, and environmental determinants. It turns away from retribution, while seeking accountability in a way that supports healing and prevention. Full article

Introduction: Major depressive disorder (MDD) is a mental disorder with a high prevalence rate and a high recurrence rate. Therefore, identifying and intervening in the core symptoms of MDD patients is of great significance. Anhedonia is manifested as an individual losing interest in activities or experiencing a significant decrease in the sense of pleasure, which is one of the two core symptoms of MDD. Episodic Future Thinking (EFT) training refers to the process of stimulating individuals’ hope for positive future scenarios and encouraging them to take purposeful actions, which may have an effect in alleviating anhedonia. However, the perception of anhedonia of MDD patients among Chinese healthcare professionals is still unclear, and there has been no exploration of the views of healthcare professionals regarding the implementation of EFT training for MDD patients led by psychiatric nurses in a clinical setting. Aim: This study aimed to understand the attention paid by Chinese healthcare professionals to the symptom of anhedonia in patients with MDD, as well as their previous coping strategies. This study further explored the views of healthcare professionals regarding the implementation of EFT training for MDD patients led by psychiatric nurses with a psychological therapist certificate in China, as well as suggestions for future implementation. Methods: This qualitative descriptive study adopted a phenomenological approach. Using purposive sampling, 15 healthcare professionals (psychiatrists, psychiatric nurses and psychological counselors) were recruited from the psychiatry department of a public tertiary hospital in Wuhan, Hubei Province, China. Using the NVivo 12 Plus software, the semi-structured interviews and analyses were conducted by applying Colaizzi’s seven-step phenomenological method. Rigor was ensured through checks of credibility, dependability, and confirmability during data collection and analysis. Results: A thematic analysis revealed that, while psychia-trists and psychological counselors viewed anhedonia as a significant treatment target, nurses were more focused on immediate patient safety concerns. Participants recognized the potential of EFT training to alleviate anhedonia but identified several implementation challenges, including patient resistance, cognitive limitations, and the need for tailored interventions. Conclusions: The research results indicated that psychiatric nurses had relatively poor ability to identify anhedonia. Therefore, it is necessary to enhance the awareness of psychiatric nurses regarding the clinical significance of anhedonia, and incorporate knowledge related to anhedonia into routine nursing training. It is suggested that communication and collaboration among psychiatrists, psychiatric nurses and psychological counselors should be strengthened, and an assessment and feedback process for the lack of anhedonia in patients with MDD should be established, so as to assist these patients in achieving faster psychological recovery. Given the sufficient staffing conditions in the field of psychiatry nursing in China, the design concept and curriculum of EFT training for psychiatry nurses with a psychological therapist certificate should be promoted. Encourage psychiatry nurses with a psychological therapist certificate to conduct offline and online group EFT training intervention forms for MDD patients in the hospital wards during their hospitalization periods, as well as after discharge at home. Full article

(1) This systematic review evaluates the role of structured exercise within the Enhanced Recovery After Surgery (ERAS) protocol, a multidisciplinary approach designed to reduce surgical stress and enhance recovery. Prehabilitation, primarily through controlled physical activity, is a fundamental component of ERAS, preparing patients, both physically and mentally, for major surgery. (2) A systematic search following PRISMA guidelines was conducted using PubMed, ScienceDirect, Cochrane Library, Web of Science and Wiley databases to identify relevant studies published up to January 2025. Inclusion criteria encompassed randomized controlled trials, cohort studies, and meta-analyses reporting postoperative complications, length of hospital stay (LOS), and overall recovery. (3) A total of 64 studies met the inclusion criteria. The findings consistently demonstrate that structured exercise interventions—such as aerobic activities, resistance training, and flexibility routines—were associated with postoperative complications, shorten hospital stays, and enhance functional recovery. These interventions improve cardiorespiratory fitness, muscle strength, and psychological well-being. (4) Despite potential limitations in the systematic search, as heterogeneity of protocols, publication bias, language restrictions, the evidence supports the integration of structured exercise as a cornerstone of ERAS prehabilitation. Future research should focus on standardizing exercise protocols and exploring personalized strategies to optimize surgical outcomes across diverse patient populations. Full article

Multiple Chemical Sensitivity (MCS) is characterized by recurring symptoms in response to low-level chemical exposures that are typically well-tolerated by the general population. Despite the debilitating health impact of MCS, public indifference and prevailing skepticism often result in stigma, misinformation, and systemic barriers that obstruct individuals’ access to essential environments. This qualitative study examined the lived experiences of individuals with MCS, focusing on how their condition is misunderstood and the factors that contribute to misconceptions about MCS. Seven focus group transcripts were analysed using thematic analysis in NVivo. Participants (aged 50–60) were drawn from various regions in Canada. One main category emerged from the analysis, centred on misconceptions influenced by policy and community factors. This category was divided into four themes, each with subcategories: (1) Psychological misattribution of MCS, (2) Healthcare and Institutional Gaps, (3) Policy Barriers, Compliance, and Resistance, and (4) Commercial Influences and Misleading Practises. These themes suggest a need for improvements in policies and transparency related to chemicals used in household and personal-care products, institutional compliance with fragrance-free guidelines, and increased awareness of MCS to reduce stigma and misconceptions. Addressing these issues can lead to adequate accommodations and support systems, which significantly improve quality of life. Full article

Youth-onset type 2 diabetes (T2D) is a growing public health challenge. This narrative review aims to provide a comprehensive overview of epidemiology, pathophysiology, diagnosis, complications, and therapeutic strategies in children and adolescents with T2D, highlighting the most recent evidence and the distinctive features that differentiate youth-onset from adult-onset disease. Over recent decades, its incidence has increased worldwide, closely linked to rising rates of childhood obesity, sedentary behavior, and socioeconomic disparities. The disease typically emerges around puberty, a period marked by physiological insulin resistance, and is influenced by a complex interplay of genetic, environmental, and developmental factors. Diagnosis can be delayed or missed due to overlapping features with type 1 diabetes and limitations in current screening tools. The clinical course is often aggressive, with early onset of microvascular and macrovascular complications. Management is particularly challenging due to the limited number of pharmacologic agents approved for pediatric use and the psychological and behavioral complexities of adolescence. While metformin remains the first-line treatment, newer therapies such as GLP-1 receptor agonists and SGLT2 inhibitors show promise in improving metabolic outcomes. In conclusion, early diagnosis, multidisciplinary management, and equitable access to effective therapies are essential to improve long-term outcomes in this vulnerable population. Full article

Gestational diabetes mellitus (GDM) is a frequently encountered medical complication during pregnancy that is increasing at a rapid pace globally, posing significant public health concerns. Similarly, there is a rising trend in the number of women who have utilized assisted reproductive technology (ART). Numerous studies have been carried out to investigate the relationship between GDM and ART. This comprehensive systematic review seeks to identify potential biomarkers for the early diagnosis of GDM in pregnancies conceived through ART. We conducted a PubMed search covering the past five years to identify studies that explore biomarkers associated with the development of GDM in pregnancies conceived through ART. The outcome measures included human chorionic gonadotropin (HCG), the body mass index (BMI), the Follicle Stimulating Hormone to Luteinizing Hormone (FSH/LH) ratio, increased hemoglobin A1c levels, fasting insulin concentrations, homeostatic model assessment of insulin resistance (HOMA-IR), triglyceride levels, total cholesterol levels, low-density lipoprotein cholesterol concentrations, low-density lipoprotein/high-density lipoprotein (LDL/HDL), total cholesterol to high-density lipoprotein (TC/HDL), the estradiol/follicle ratio, soluble fms-like tyrosine kinase-1 (sFlt-1), Placental Growth Factor (PLGF), endometrial thickness, and psychological stress. Seventeen studies were included. The identification and development of serum or ultrasound biomarkers for the early detection of GDM in pregnancies conceived through ART pose considerable challenges. These challenges arise from the multifactorial nature of GDM, the methodological variations in ART, and the limited availability of relevant studies. The most promising biomarker identified was the estradiol/follicle ratio. Women with a higher estradiol/follicle ratio exhibited significantly lower rates of GDM. There is a pressing necessity for biomarkers to enable the early detection of GDM in pregnancies conceived through ART. E2 levels, β-hCG, and the E2/F ratio, along with the TC/HDL and LDL/HDL ratios, show potential as reliable biomarkers for identifying GDM. Full article

Background: Faced with the profound impact of major infectious diseases on public life and economic development, humans have long sought to understand disease transmission and intervention strategies. To better explore the impact of individuals’ different coping behaviors—triggered by changes in their psychological security due to public information and external environmental changes—on the spread to infectious diseases, the model will place greater emphasis on quantifying psychological factors to make it more aligned with real-world situations. Methods: To better understand the interplay between information dissemination and disease transmission, we propose a two-layer network model that incorporates psychological safety factors. Results: Our model reveals key insights into disease transmission dynamics: (1) active defense behaviors help reduce both disease spread and information diffusion; (2) passive resistance behaviors expand disease transmission and may trigger recurrence but enhance information spread; (3) high-timeliness, low-fuzziness information reduces the peak of the initial infection but does not significantly curb overall disease spread, and the rapid dissemination of disease-related information is most effective in limiting the early stages of transmission; and (4) community structures in information networks can effectively curb the spread of infectious diseases. Conclusions: These findings offer valuable theoretical support for public health strategies and disease prevention after government information release. Full article