Alexithymia is a personality trait with significant clinical impact worldwide. It is a relevant transdiagnostic risk factor for a wide range of psychopathologies, including depression, anxiety, eating and substance use disorders, and other psychosomatic conditions. This underscores the importance of having validated instruments to measure alexithymia, particularly brief scales suitable for quick and practical applications. The Perth Alexithymia Questionnaire (PAQ-S) has shown promising results in this context. However, few cross-cultural studies have validated its use, which is the aim of the present study. To this end, a sample of 2535 university students was recruited (mean age = 20.59 years; SD = 2.04; 26.75% males and 73.25% females) from Spain (n = 388), Italy (n = 376), Lebanon (n = 487), Nigeria (n = 561), Türkiye (n = 410), and Ukraine (n = 313). The PAQ-S and the Type D Personality Scale (DS-14) – designed to assess Negative Affectivity (NA) and Social Inhibition (SI) – were administered. The Classical Test Theory (CTT) and Network Analysis (NwA) were applied. The confirmatory factor analysis yielded satisfactory results in all cases, with an adequate internal consistency. Metric invariance was obtained between genders and cultures. Additionally, several of the analysed countries presented strict invariance. Therefore, the data obtained in these countries can be compared and their results extrapolated between them. The NwA supports the data obtained through the CTT, as well as the independence of alexithymia, NA, and SI constructs. Hence, the scale proved to be useful for its intended aim and may be useful to monitor alexithymia in large-scale health campaigns.

To examine the impact of the Canadian Health Advanced by Nutrition and Graded Exercise (CHANGE) program on the reversal of one or more metabolic syndrome (MetS) criteria among community members with MetS and define the significant predictors of upholding individual MetS criterion from 2020 to 2023. The program enrolled 278 community members with/or at risk of MetS. Participants followed regular physical activity and a Mediterranean diet for 12 months with the assistance of a registered dietitian and a kinesiologist. A licensed practical nurse and/or registered nurse measured participants' weight, height, waist circumference, and blood pressure and withdrew blood samples for laboratory investigations. Physical activity, physical fitness, Mediterranean diet score (MDS), anthropometric measurements, and laboratory investigations were assessed at the baseline and every three months. Descriptive statistics were calculated, and binary logistic regression analysis was performed to define the significant predictors of upholding each criterion of the MetS. Participants' mean age was 60.5 ± 11.7 years, and 74.8% were females. Participants with MetS decreased by 5.04% by the end of the program. The percentage of participants with each MetS criterion showed a significant decrease at the end of the study, except for low HDL, which remained with no change. Moreover, the mean of physical activity, physical fitness tests, and MDS scores showed a significant increase after the 12 months of study. Compared to baseline, daily sedentary and screen times showed a significant decrease at the end of the program (8.6 vs. 7.2 and 3.2 vs. 2.6 hours, respectively). Logistic regression analysis revealed that age, female gender, low educational attainment, physical activity, physical fitness, and screen time were significant predictors for upholding one or more MetS criteria. MetS criteria can be reversed following the CHANGE program. Sociodemographic and lifestyle features are significant predictors for upholding MetS criteria. The program is cost-effective considering its low cost and could lead to significant savings on healthcare costs. Further studies among different communities are recommended to confirm the generalizability of the results.

IntroductionEmployee exposure to specific risks often increases work-related stress, negatively impacting their effectiveness and potentially leading to illnesses, mistakes, or accidents.ObjectiveWe aimed to determine the psychosocial risks experienced by nurses in tertiary hospitals and their association with attitudes toward safety and the occurrence of medication errors.MethodsA cross-sectional study was conducted between September 30, 2022 and December 31, 2023 in four Greek tertiary hospitals (Evangelismos, Nikaia “Agios Panteleimon”, University Hospital of Larissa, and “G. Papanikolaou”). The study involved 514 nurses aged 20–67, employed for at least 12 months, fluent in Greek, and completing questionnaires on stress, burnout, and medication errors. The questionnaire used in the study included demographic information of the nursing staff (age, gender, marital status, work experience, and education level), characteristics of the nursing unit (medical, surgical, long-term care unit, Intensive Care Unit), the COPSOQ III (Copenhagen Psychosocial Questionnaire Version III), the HSOPSC (Hospital Survey on Patient Safety Culture), and the questionnaire for Investigating Nursing Errors in Medication Administration.ResultsNurses exposed to psychosocial risks, such as bullying and high demands, reported increased medication errors. Supportive work environments with sufficient staffing and collaborative culture significantly mitigated these risks. Factors such as “Staffing” and “Handoffs” partially mediated the relationship between demands and errors. Thus, targeted interventions to reduce bullying and enhance teamwork are essential. Continuous education emerged as crucial for improving safety and performance.ConclusionThe study underscores the necessity of social support, job autonomy, and work-life balance as critical factors in reducing stress and improving the quality of care. Specific strategies are proposed to enhance nurses' mental health and improve working conditions.

Despite federal legislation intended to increase the prescribing of buprenorphine as medication for opioid use disorder (MOUD), such as the Drug Addiction Treatment Act (DATA) of 2000, most providers have continued to prescribe to some patients or to not prescribe at all. We aimed to determine the continuing barriers and supports needed for expanding buprenorphine prescribing and compared barriers experienced by emergency department (ED) physicians with those in other practice settings, given the unique aspects of the ED practice setting. We obtained survey data from August through November 2021 from 412 X-waivered Illinois physicians licensed to prescribe buprenorphine as MOUD, 95 (23.1%) of whom worked primarily in a hospital-based ED. Survey questions included: 1) Professional background, practice characteristics, and prescribing practices; 2) barriers to prescribing buprenorphine; 3) barriers to expanding prescribing; and 4) training/additional supports needed to facilitate buprenorphine prescribing. We used bivariate crosstabulations and multivariable OLS and binary logistic regressions to compare the responses of physicians practicing in the ED versus other practice settings and to compare physicians who prescribed buprenorphine in the past year with those who had not. There were few statistically significant differences among the examined subgroups indicating general agreement regardless of practice setting and prescribing status. The most frequently perceived barrier was having an inadequate community-based behavioral health treatment system to which OUD patients could be referred. Insurance reimbursement, difficulties building practice- and community-based systems to support buprenorphine prescribing, and challenges knowing where and how to refer patients for follow-up and ongoing support services were also prominent concerns. Based on study findings, efforts to expand buprenorphine for OUD might focus on providing support to make and manage treatment referrals and expanding the availability of community-based behavioral healthcare services. Building networks of care could potentially have a greater impact on MOUD availability than increasing the number of practitioners trained to prescribe buprenorphine.

Nurse migration from low- and middle-income countries to high-income nations is a significant global phenomenon. This study aimed to examine the opportunities and challenges faced by Albanian nurses during their work integration after migrating to Germany. A descriptive cross-sectional quantitative study was conducted using convenience sampling with a snowball recruitment technique. A total of 162 Albanian nurses working in Germany, mostly female and married, participated in the survey. The findings revealed that the overall integration process was satisfactory, particularly regarding the recognition of professional qualifications, respect from colleagues, patients, and families, career opportunities, and autonomy at work. The host institutions supported integration through mentorship programs, language training, procedural training, and education on the German healthcare system. However, nurses reported challenges in medical terminologies, telephone communication, and healthcare documentation. The participants expressed the need for more comprehensive pre-departure information to facilitate smoother transitions. The study highlights the pivotal role of managers and institutions in the integration process and in creating inclusive and equitable work environments. Germany serves as a model for implementing effective integration activities for migrant nurses. Albania must adopt stronger strategies to retain nurses within the country and enhance its human capital by improving the working conditions and providing career development opportunities. Future research is recommended to explore the integration processes of Albanian nurses across other European countries. Subsequent studies should concentrate on identifying and addressing potential barriers to integration while fostering opportunities for collaboration between the origin and destination countries. Such research can contribute to academic, political, and social frameworks that enhance the migration experience for migrant nurses.

IntroductionCancer is a global health problem; the presence of secondary symptoms such as sarcopenia in cancer patients is relatively common. Physical activity (PA) is notable for its protective role against sarcopenia; however, there is currently no bibliometric analysis of research related to cancer, sarcopenia, and physical activity.MethodsA search on the Web of Science (WoS) Core Collection database was performed on this topic, and a bibliometric analysis of the identified publications was performed using traditional bibliometric laws.Results121 publications were found. Annual publications presented an exponentially growing trend from 2012 to 2023 (R2 = 91%). The United States of America was the country with the most documents worldwide. Newton, R. U. and Galvao, D. A. were highlighted as the most prolific and prominent co-authors. The Cancers and Journal of Cachexia, Sarcopenia and Muscle were the journals with the highest number of published documents. 36 papers, having 37 or more citations, were the most cited papers. The author keywords and keywords Plus® identified thematic clusters related to research on this topic, such as cancer, physical activity, aging, muscle, skeletal muscle, osteoporosis, malnutrition, body composition, cachexia, survival, and frailty.ConclusionResearch on cancer, sarcopenia, and physical activity has followed an exponential growth trend, which reveals growing interest in the topic. Significant authors and collaborative groups in the field were identified, as well as the journals and countries with the highest number of publications and the research trends most followed by researchers.

BackgroundType 2 diabetes (T2D) is a prevalent global health problem largely caused by lifestyle factors, including poor diet and physical inactivity. With the increasing incidence of T2D, effective prevention strategies are urgently needed. This review examines the role of different dietary patterns and exercise regimens in the prevention and management of T2D, focusing on their effects on glycemic control, insulin sensitivity, and cardiovascular health.MethodsA narrative review was conducted synthesizing evidence from clinical trials, cohort studies, and meta-analyses. The review focused on the effects of low-carbohydrate diets (LCDs), Mediterranean diets (MDs), plant-based diets, high-protein diets (HPDs), and various exercise regimens, including aerobic, resistance, and high-intensity interval training (HIIT).ResultsDietary interventions, particularly MD and plant-based diets, are associated with improved glycemic control and reduced risk of developing T2D. LCDs show short-term benefits for weight management and HbA1c reduction, although adherence remains a challenge. HPDs show mixed results, with some benefits for lipid profiles but inconsistent effects on glycemic control. Exercise programs, especially combined aerobic and resistance training, significantly improve glycemic control, insulin sensitivity, and cardiovascular risk factors. HIIT emerges as an effective option for improving metabolic health in individuals at risk for or living with T2D.ConclusionsA combination of dietary modification and physical activity, particularly Mediterranean and plant-based diets coupled with combined aerobic and resistance exercise, appears to be the most effective strategy for the prevention and management of T2D. Future research should focus on personalized approaches that integrate both diet and exercise to tailor interventions to individual patient needs.

Indoor radon exposure poses significant health risks and has prompted testing and mitigation programs in regions such as Europe, North America, Japan, and South Korea. However, African countries have not adopted similar measures on a comparable scale. Limited research on radon exposure in Africa can be attributed to a lack of awareness among policymakers and the public, insufficient expertise in radiation protection and measurements, and restricted access to resources such as laboratories and testing equipment. This review examines existing research articles on radon exposure conducted in African countries, focusing on the efforts made by specific nations, such as Tunisia and Sudan, to address this issue. It analyzes the scope, scale, and impact of these initiatives compared to global efforts in managing radon exposure risks. The findings reveal that the study of radon exposure in Africa is still in its early stages, with limited progress and modest initiatives compared to other regions. While some efforts have been made, they are insufficient to effectively address the significant health risks associated with radon exposure. There is an urgent need for African policymakers and researchers to prioritize radon exposure as a public health issue. Developing frameworks, standards, and mitigation strategies is essential to reduce risks in homes and workplaces. This review emphasizes the importance of addressing radon exposure in African countries and offers recommendations to guide future research and policy development.

Current disaster medicine programs and simulation exercises often fail to adequately incorporate crucial elements such as situational awareness and a disaster mindset. This gap in training can significantly impact the effectiveness of healthcare professionals' responses during real-world disasters and public health emergencies. In this review, we examined the literature to explore the critical role of situational awareness and a disaster mindset in enhancing healthcare provider preparedness for disaster events, proposing the integration of innovative technologies, such as virtual and augmented reality, to create immersive simulations that foster situational awareness and a resilient disaster mindset. Addressing this educational gap will improve healthcare professionals' confidence and optimize patient outcomes during crises.