Background/Objectives: Mental health conditions such as anxiety, depression, and stress remain among the leading global causes of disability. Mindfulness-Based Interventions (MBIs) have gained increasing attention as effective non-pharmacological strategies for reducing psychological distress. Methods: This systematic review examined 30 randomized controlled trials and quasi-experimental studies involving over 24,000 participants to evaluate the impact of MBIs on mental health outcomes, with a specific focus on the contribution of gratitude-based components. Results: Studies varied in terms of population, duration, and format, with most demonstrating moderate to strong effects on symptom reduction, particularly in programs lasting 8 to 12 weeks. A random-effects meta-analysis was conducted, yielding a pooled effect size of Hedges’ g = −0.45, indicating a moderate improvement in psychological outcomes. Subgroup analyses revealed slightly stronger effects for anxiety (g = −0.56) than depression (g = −0.45). Gratitude-integrated MBIs demonstrated modestly enhanced emotional benefits, suggesting a synergistic role in improving well-being. Conclusions: The review found low evidence of publication bias and acceptable risk of bias, supporting the moderate results. The findings underscore the value of MBIs, particularly those integrating gratitude, as scalable, cost-effective interventions in clinical and educational settings.

Background: Safety climate is widely used to explain and prevent occupational accidents in industrial settings; however, the field remains conceptually fragmented, with multiple measurement instruments coexisting without consensus on the core dimensions that define the construct, limiting the comparability of findings and the effectiveness of organizational interventions. Objectives: This study aims to identify, organize, and synthesize the determinants of safety climate reported in validated instruments applied in industrial settings through a systematic literature review. Methods: The review was conducted in accordance with the PRISMA 2020 guidelines, with searches performed in the Scopus and Web of Science databases, resulting in the inclusion of 27 empirical studies published between 2015 and 2025. Dimensions reported in the instruments were extracted, grouped by conceptual similarity, and integrated into a common structure. The synthesis examined determinant recurrence across instruments and interpreted the findings in light of the psychometric quality of the measures, as assessed using the COSMIN framework. Results: The results indicate that despite the diversity of scales, safety climate determinants derived from measurement instruments consistently converge into four domains: Health and Safety Management, Organizational Safety Resources, Worker Involvement, and Working Conditions. The convergence of these domains across independent instruments, considered alongside the methodological robustness of their validation procedures, indicates a conceptually coherent structural core predominantly supported by instruments with confirmatory structural validation. Conclusions: By integrating conceptual structure and measurement quality, this study contributes to reducing fragmentation in the literature and provides an empirical basis for the development, adaptation, and selection of safety climate instruments, with direct implications for research and safety management in industrial environments.

Background: Cardiorespiratory fitness is frequently impaired in survivors of pediatric acute lymphoblastic leukemia (ALL), limiting their functional performance. While aerobic exercise is recommended, evidence is needed to guide the prescription of specific training protocols in this population. Objective: This study sought to compare the efficacy of constant-load (CL-AEx) and graded aerobic exercise (G-AEx) protocols on cardiorespiratory fitness and functional capability in pediatric survivors of ALL. Methods: Seventy-two pediatric ALL survivors were allocated to CL-AEx, G-AEx, or a control group. Cardiopulmonary fitness [peak oxygen consumption (peak VO2), peak minute ventilation (VE), ventilatory equivalent for oxygen (VE/VO2), respiratory exchange ratio (RER), peak oxygen pulse (peak O2P), maximum heart rate (max HR), and one-minute heart rate recovery (HHR1)] and functional performance [six-minute walk test (6MWT), 4x10-m shuttle run test (4x10-mSRT), and timed up down stairs (TUDS)] were assessed at pre- and post-intervention. Results: The G-AEx group exhibited significantly enhanced cardiorespiratory and functional outcomes compared to both the CL-AEx and control groups (all p < 0.05). The G-AEx group demonstrated more pronounced improvements, showing significant increases in peak VO2, VE, VE/VO2, peak O2P, and HHR1, alongside a more efficient RER. Functionally, the G-AEx intervention led to superior improvements in 6MWT distance, and significantly faster completion times in the 4x10-mSRT and TUDS, highlighting multi-domain functional gain. Conclusions: In pediatric survivors of ALL, G-AEx demonstrated superior improvements in cardiorespiratory fitness and functional performance compared to CL-AEx over 12 weeks. These findings suggest that G-AEx is an effective modality for addressing acute physical deconditioning in this population. Incorporating G-AEx into clinical rehabilitation may enhance immediate physiological and functional recovery during the survivorship phase.

Objective: The aim of this retrospective study was to evaluate clinical and laboratory characteristics in adult patients with neuroinvasive West Nile virus (WNDD). We also studied the phylogeny and molecular characteristics of some of the WNV strains. Methods: A retrospective analysis was conducted at “Annunziata” Hub Hospital, a secondary referral facility in Calabria region, in Southern Italy. Sample pre-processing, sequencing and bioinformatic analyses were carried out at IRCCS Sacro Cuore Don Calabria Hospital in Negrar di Valpolicella, Verona, Veneto region in North-East Italy. Results: Nine cases of WNDD were analyzed, involving eight males and one female, with a mean age of 70.33 years (range 60–85). The overall average hospital stay was 20.6 days (range 6–46). Six patients made a full recovery after a mean of 35.3 days of acute care. Thirty-day mortality rate was 23%. VNDD in some of our patients manifested itself in the form of cerebral hemorrhage (ICH) in three patients, causing lethality in two patients and other unusual manifestations, such as Guillain–Barré syndrome with fatal outcome and severe facial palsy. Phylogenetic analysis shows that our sequences are closely related to other southern-Italian and cluster with Central–Southern–Eastern European sequences, while being evidently separated from northern Italian and Central–Western European ones, belonging to the sub-lineage 2a of the WNV-2, clustering with sequences from the Central–South–Eastern clade, mainly to Hungary. Conclusions: Cerebrovascular complications of WNE may be an important clinical manifestation of WNV neuroinvasive infection. Preliminary data do not allow us to determine whether our strains, closely related to other southern-Italian and cluster with Central–Southern–Eastern European sequences, really presented an increased neurovirulence.

Background/Objectives: Coping with death is an essential yet challenging aspect of nursing. In Ecuador, limited training and cultural factors may influence how nurses face the process of death and dying. This study aimed to explore nurses’ perspectives and highlight the degree of congruence between the numerical and discursive data provided by participants. Methods: A sequential explanatory mixed-methods design (QUAN → qual) using questionnaires and qualitative interviews was employed. The quantitative phase included 497 nurses who completed the Bugen Coping with Death Scale and the qualitative phase involved semi-structured interviews with 18 nurses. Quantitative data were analysed descriptively, while qualitative data underwent thematic analysis. Integration occurred at the methodological level—through the building of the qualitative data collection instrument—and at the levels of analysis and interpretation. Results: Nurses demonstrated moderate coping levels on the Bugen Coping with Death Scale. Although many reported being comfortable discussing death, qualitative data revealed substantial emotional distress and limited preparedness—particularly when facing their own mortality or the death of loved ones. Nurses expressed fear of suffering, sadness, and helplessness, especially when caring for dying children or young mothers. Communication with patients and families at the end of life emerged as a major challenge. Spirituality was identified as a key coping resource. Conclusions: Coping with death remains a complex and emotionally demanding process for nurses in Ecuador. Continuous education, emotional support, and training in spiritual and psychological dimensions of care are essential to strengthen nurses’ resilience and enhance the quality of care.

Background: The mother’s bond with her newborn is important for the child’s development and their relationship. Midwives are well placed to witness first-hand the beginning of this relationship. Objectives: This study examined, based on mothers’ perceptions, the contribution of midwives to the development of the bond with their baby from pregnancy to the first postnatal months. Methods: We conducted a descriptive qualitative interpretative study in Quebec, Canada (from 2022 to 2025), with 10 primiparous mothers who were cared for by midwives in a model of continuity of care, and gave birth in a birth center, at home, or in a hospital. Semi-structured retrospective interviews were conducted between two and four months after childbirth, and were complemented by interviews with two midwives. Results: Most participants developed a bond with their baby during pregnancy. They discussed their midwifery care and what they felt were significant elements in the development of their bond with the baby. Midwives encouraged them to develop this bond through their approach and various means: letting them feel the fetus during palpation, talking to it, encouraging mothers to do the same, and reinforcing the bond throughout pregnancy. The birth and first moments after birth were also key moments for promoting contact between mother and baby. Midwives were also creative in promoting bonding in more difficult situations, such as when a transfer to the hospital for delivery was needed. Conclusions: Midwives play an important role in initiating and developing the mother–child bond during pregnancy, especially if they practice within a model of relational continuity.

Objective: The aim of this study was to investigate the association between dental caries and multidimensional poverty in Colombia using data from the National Oral Health Survey (ENSAB IV, Spanish acronym). Methods: A cross-sectional analytical study was conducted using data from 20,534 individuals in six regions of the country. Dental caries was assessed using the ICDAS system, and multidimensional poverty was measured using a proxy Multidimensional Poverty Index (MPI) adapted from the method adjusted for Colombia. Descriptive analyses and bivariate comparisons were carried out, and Poisson regression models adjusted for sociodemographic variables were applied. Results: Households containing at least one member with caries had a higher incidence (59.9%) and intensity (46.7%) of multidimensional poverty compared to those without caries (52.6% and 45.6%, respectively). Significant associations were identified between caries and deprivation in education (low educational attainment: RR = 1.27), child labor (RR = 1.16), unemployment (RR = 1.04), lack of health insurance (RR = 1.09), and inadequate housing conditions (RR = 1.19). The model that analyzed the presence of caries in a household and multidimensional poverty, when controlled for housing conditions, confirmed a positive association between the MPI and the presence of caries (IRR = 1.08; 95% CI: 1.050–1.107; p-value < 0.001). A female head of household and rural residence were also identified as variables associated with the presence of caries in a household. Conclusions: The presence of a household member with dental caries is significantly associated with multidimensional poverty in Colombia. This study highlights the need to consider oral health as a sensitive indicator of structural inequality and proposes its inclusion in social progress metrics. The findings support the design of comprehensive public health strategies that address the social determinants of oral health, especially in vulnerable populations.

Background/Objectives: Pharmacopuncture and physical therapy are commonly used to treat adhesive capsulitis (AC); however, their comparative cost-effectiveness is unclear. In this study, we aimed to investigate their cost-effectiveness for patients with AC. Methods: We conducted an economic evaluation alongside a 12-week, multicenter, pragmatic randomized controlled trial in four Korean medicine hospitals in South Korea. Patients with limited range of motion and pain score (numeric rating scale score ≥ 5) were randomized into a pharmacopuncture therapy or physical therapy group at a ratio of 1:1. Interventions were administered twice weekly for 6 weeks, with a follow-up of up to 12 weeks. Quality-adjusted life years were calculated using the EuroQol-5 Dimension 5 Level (EQ-5D-5L) and Short Form-6 dimension. Costs from societal and healthcare system perspectives were analyzed. Results: In total, 50 participants (pharmacopuncture therapy: 24; physical therapy: 26) were included. The differences in quality-adjusted life years between the groups were 0.014 and 0.013 when calculated using the EQ-5D-5L and Short Form-6-dimension scores, respectively. The costs from the societal perspective were significantly lower, whereas medical costs were higher, in the pharmacopuncture therapy group. Pharmacopuncture was the dominant treatment from the societal perspective. From the healthcare system perspective, the incremental cost-effectiveness ratios of pharmacopuncture to physical therapy were $4386 and $4790 when calculated using the EQ-5D-5L and Short Form-6-dimension scores, respectively. Sensitivity analyses confirmed the results. Conclusions: Pharmacopuncture therapy is more cost-effective for patients with AC than physical therapy. In this pilot study, pharmacopuncture may represent a potentially cost-effective treatment compared with physical therapy for patients with adhesive capsulitis, and the feasibility of conducting a full-scale study was confirmed.

Background/Objectives: Job satisfaction and work-related quality of life (WRQoL) are essential determinants of nurses’ well-being, performance, and retention. Differences between school and clinical nursing environments may influence these outcomes, yet comparative evidence from Greece remains limited. This study aimed to assess and compare job satisfaction and WRQoL among school and clinical nurses and identify factors associated with professional well-being and turnover intention. Methods: A quantitative cross-sectional study was conducted between November 2024 and January 2025 among 165 nurses employed in Greek public hospitals and schools. Data were collected using demographic questions, the Job Satisfaction Survey (JSS), and the Work-Related Quality of Life (WRQoL) scale. Statistical analyses included descriptive statistics, independent group comparisons, correlation analysis, and multiple linear regression. Results: Moderate levels of job satisfaction (M = 125.10) and WRQoL (M = 75.27) were observed overall. School nurses reported significantly higher scores in both job satisfaction and WRQoL compared to clinical nurses (p < 0.001). Clinical nurses expressed a greater intention to transition to school nursing. Lowest satisfaction levels were related to salary, promotion, and fringe benefits, while supervision, coworkers, and nature of work scored highest. Strong positive correlations were found between job satisfaction and WRQoL dimensions. Regression analysis indicated that general well-being, job and career satisfaction, and working conditions significantly predicted job satisfaction, explaining 54.7% of its variance. Conclusions: Professional well-being among nurses is primarily shaped by workplace conditions rather than demographic factors. Interventions focused on improving compensation, career progression, and work environments are critical for enhancing job satisfaction and sustaining the nursing workforce.

Background: Sleep quality and mental health are important concerns for esports competitors. However, epidemiological data regarding sleep quality and psychological distress among high-level esports players remain limited. Objective: This study aimed to examine sleep quality and mental health status among high-level esports competitors in Japan and to identify factors associated with psychological distress. Methods: This cross-sectional study included 275 competitors (269 males, 3 females, and 3 who did not report sex) participating in the 2023 National Prefectural Esports Championship. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), psychological distress using the Kessler Psychological Distress Scale (K6), and depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9). Multivariable logistic regression analyses were performed to identify associated factors. Results: The response rate was 61.8% (275/445). Poor sleep quality (PSQI > cut-off) was observed in 38.5% of competitors. Based on the K6, 24.4% reported psychological distress above the mild threshold, and 29.5% reported mild or greater depressive symptoms according to the PHQ-9. Overall mental health levels were comparable to those reported in previous studies of general populations. Nighttime esports training was significantly associated with psychological distress (adjusted odds ratio 3.80; 95% confidence interval 1.50–9.64; p = 0.005). Conclusions: More than one-third of Japanese esports competitors experience poor sleep quality, and approximately one-quarter report mild or greater psychological distress. Nighttime esports training may be an important factor associated with mental health among competitors. Further longitudinal studies are warranted to clarify temporal relationships and to examine whether reducing nighttime training is associated with improved mental health outcomes among esports competitors.