Context Of Health Research Articles

An Empirical Study on Social Anxiety in a Virtual Environment through Mediating Variables and Multiple Sensor Data

Social anxiety disorder is a psychological condition characterized by excessive nervousness in social situations, such as interpersonal interactions. Exposure therapy has shown benefits in its treatment, and virtual reality (VR) technology has gained much attention for reducing physical and psychological distance and providing additional quantitative evidence from the data generated by standard VR devices (e.g., head-mounted display). Clinical psychology studies have highlighted the importance of mediating variables of social anxiety; however, existing VR-based social anxiety studies have neglected such variables with respect to user experience and data analysis in the context of VR, although these variables could provide insights into the design and use of VR for the treatment of social anxiety. In this study, we focused on two representative mediating variables of social anxiety: (1) the gap between self-presentation motivation and expectancy , and (2) self-focused attention . We used sensor data (e.g., head movement, eye movement, eye gaze, and psychological signals) to investigate the impact of these variables on users' anxiety responses in VR. We developed <u>VR</u>-based <u>S</u>ocial Anxiety Support <u>T</u>ool (VRST) that reflects the theoretical design elements of effective anxiety provocation. Based on the results of a user study with 30 participants, we confirmed that the mediating variables were associated with social anxiety in the VR environment. We also found that the mediating variables were associated with eye gaze, eye pupil, head movement, and body temperature. Our study results provide researchers, designers, and practitioners with empirical evidence and implications for the use of VR technology and sensor data in the mental health context.

Designing the Contemporary Implementation of Traditional knowledge and Evidence (CITE) framework to guide the application of traditional knowledge in contemporary health contexts: a Delphi study

Designing the Contemporary Implementation of Traditional knowledge and Evidence (CITE) framework to guide the application of traditional knowledge in contemporary health contexts: a Delphi study

Exploring Patient-Generated Annotations to Digital Clinical Symptom Measures for Patient-Centered Communication

Patients' self-reports are crucial for effective care management of clinical conditions involving subjective symptoms. While patients often value the ability to bring in different forms of self-report data to convey their lived experiences, they often struggle to make their data practically usable in clinical settings. To better center patient needs in communicating illness experiences in clinical contexts, we explore the idea of patient annotations to digital clinical self-report measures, specifically in the context of discontinuing antidepressants. Through interviews with 20 patients with AT Annotator, a digital aid to introduce the concept of annotations, we found that participants perceived annotations to digital clinical measures as a means to enrich self-report measures and reduce the cognitive and emotional burden of logging. However, concerns were raised regarding potential disruptions in patient-provider relationships and the sensitive and complex nature of mental health contexts. We discuss opportunities for annotations to promote patient-centered communication by balancing with clinical practicality and incorporating customization support for patients' communication needs.

Geosocial Tools for Community Diagnosis and Health Promotion.

Growing research highlights the role of local community contexts in health and well-being. Communities function as central arenas for health promotion as individuals and community spaces interact in daily life. To better communicate the linkages between community and health, we demonstrate the use of a set of geosocial tools for community diagnosis and health promotion, conceptually grounded in the framework of geosocial embeddedness, using data from community surveys and participatory research conducted with local inhabitants to engage their competency. Through a web-based interactive map generated using a geographic information system, we identified public territories in the municipality where greater policy attention is needed to enhance health. Through an intersectional matrix produced using multilevel analysis, we identified precise social groups by intersectional categories that are most at risk of loneliness for targeted intervention. A health radar chart on multidomain indicators illustrated information on group dynamics and longitudinal comparisons for health promotion. Overall, these tools offered not only diagnoses of the most vulnerable social groups for tailored interventions but also insight for policymakers to improve infrastructure and material resources to promote health. We conclude that geosocial tools offer a promising approach toward sharpening health communication and improving health in the community.

The Hanuman Chalisa: A Timeless Hymn of Strength, Devotion, and Health Benefits

The Hanuman Chalisa is a powerful hymn that fosters strength, mental well-being, and leadership. Research indicates that reciting it may provide health benefits, such as reduced blood pressure and improved mental health. Future studies should examine its impact across diverse demographics and its role in modern wellness practices, highlighting its importance in both spiritual and health contexts.

A 2024 inventory of test methods relevant to thyroid hormone system disruption for human health and environmental regulatory hazard assessment

Thyroid hormone system disruption (THSD) is a growing concern in chemical hazard assessment due to its impact on human and environmental health and the scarce methods available for assessing the THSD potential of chemicals. In particular, the general lack of validated in silico and in vitro methods for assessing THS activity is of high concern. This manuscript provides an inventory of test methods relevant to THSD. Building on the Organisation for Economic Co-operation and Development (OECD) Guidance Document 150 and recent international developments, we highlight progress in in silico and in vitro methods, as well as in vivo assays. The provided inventory categorizes available methods according to the levels of the OECD Conceptual Framework, with an assessment of the validation status of each method. At Level 1, 12 in silico models that have been statistically validated and are directly related to THSD have been identified. At Level 2, 67 in vitro methods have been listed including those assessed in key initiatives such as the European Union Network of Laboratories for the Validation of Alternative Methods (EU-NETVAL) validation study to identify potential thyroid disruptors. At Levels 3-5, THSD-sensitive endpoints are being included in existing fish-based OECD Test Guidelines to complement amphibian assays. In total, the inventory counts 108 entries comprising established methods (e.g., OECD Test Guidelines) as well as citable methods that are under further development and in some cases are ready for validation or in the initial stages of validation. This work aims to support the ongoing development of strategies for regulatory hazard assessment, such as integrated approaches to testing and assessment (IATAs), for endocrine disruptors, addressing critical gaps in the current testing landscape for THSD in both human and environmental health contexts.

‘We are changed yet the same…we can make a difference’: using a critical, creative, collaborative inquiry process to understand and develop professional artistry in nursing

ABSTRACT Professional practice in health and social care is embodied by the practitioners concerned, embedded in practice contexts and creative in nature. It is therefore complex to investigate, understand and develop. Current health and social care contexts can present practitioners with increasingly constraining circumstances and spaces that can feel closed instead of open to exploration and development of practice. The collaborative, critical and creative inquiry methodology presented here was developed among nurses practising in such challenging circumstances. It enables nurses and other health and social care practitioners to reveal, explore and develop their embodied practices, systematically and collaboratively, amid busy daily practice situations. However ‘small’ the space they are in, the process described here can help practitioners to enlarge their space for becoming. The iterative cycle and the use of participatory arts help illuminate otherwise hidden and difficult to articulate aspects of practice, enable the involvement of stakeholders in coming to new understandings and lead to an expanded view of professional practice and its potential for transformation. The purpose of this paper is threefold. First, to present the methodology, methods and lessons learned during the doctoral study in which this approach was developed. Second, to reveal the professional artistry of facilitating this space for becoming and of supporting professionals to reveal their own and others’ professional artistry. Lastly, to offer inspiration and a guide for others considering similar participative inquiry work and to encourage debate and critique of the approach taken.

Development of a group-based behaviour change intervention for people with severe obesity informed by the social identity approach to health.

Interventions to support behaviour change in people living with chronic health conditions increasingly use patient groups as the mode of delivery, but these are often designed without consideration of the group processes that can shape intervention outcomes. This article outlines a new approach to designing group-based behaviour change interventions that prioritizes recipients' shared social identity as group members in facilitating the adoption of established behaviour change techniques (BCTs). The approach is illustrated through an example drawn from research focused on people living with severe obesity. A prioritization process was undertaken in collaboration with stakeholders, including behaviour change experts, clinicians, and a former patient to develop an evidence-based, group intervention informed by the social identity approach to health. Three phases of development are reported: (1) identification of the health problem; (2) delineation of intervention mechanisms and operationalization of BCTs for group delivery and (3) intervention manualization. The fourth phase, intervention testing and optimization, is reported elsewhere. A group-based behaviour change intervention was developed, consisting of 12 group sessions and 3 one-to-one consultations. The intervention aimed to support the development of shared social identity among recipients, alongside the delivery of evidence-based BCTs, to improve the likelihood of successful intervention and health outcomes among people living with severe obesity. A manualized intervention, informed by the social identity approach to health, was systematically designed with input from stakeholders. The development approach employed can inform the design of behavioural interventions in other health contexts where group-based delivery is planned.

NpmC, a novel A1408 16S rRNA methyltransferase in the gut of humans and animals

16S rRNA methyltransferases that act on residue A1408, NpmA and NpmB, confer high-level resistance to virtually all the aminoglycosides, but their reports are scarce. Analysing metagenomic projects in a One Health context, we identified in human and animal gut microbiomes from China and Canada a novel gene, npmC, that shares an identity of 91.5% with npmA, and up to 92.7% at amino acidic level. The protein encoded by this gene presents the conserved motifs required for A1408 methylation. Expression of the gene resulted in high-level of resistance to 4,5-disubstituted 2-deoxystreptamine (2-DOS) and to 4-monosubstituted 2-DOS aminoglycosides, as well as a moderate resistance to 4,6-disusbstituted 2-DOS aminoglycosides, including the last resort aminoglycoside plazomicin. Methylation at residue A1408 was further confirmed by mass spectrometry assays. The analysis of the npmC gene background revealed that its genetic context is associated to different insertion sequences that could mobilise it. Similarities in the genetic context between npmC and npmA suggest that they share a common ancestor. The immediate genetic context of this methyltransferase suggests high relationship to the Eubacteriales order. This finding enlarges the list of the true pan-aminoglycoside 16S rRNA methyltransferases, that threaten the usefulness and development of next-generation aminoglycosides.

Feasibility of Sexual Health and Contraceptive Web Services for Adolescents and Young Adults: Retrospective Study of a Pilot Program on Reunion Island.

Sexual health indicators for adolescents and young adults (AYAs) aged between 13 and 25 years are particularly poor on Reunion Island. Access to accurate information as well as sexual health and contraceptive services are vital to maintaining sexual well-being. Teleconsultations offer a promising approach to addressing the sexual health and contraceptive needs of AYAs who are more susceptible to engaging in unprotected sexual intercourse. However, the literature on digital sexual health services for this demographic group is limited. This study aims to describe the feasibility of a pilot sexual health and contraceptive teleconsultation web service used by AYAs on Reunion Island. A descriptive, retrospective study was conducted at the Reunion Island University Hospital Center using a convenient sample. Eligible participants were informed about the program through various communication channels, including seminars for health care professionals, radio broadcasts, posters, flyers, press articles, videos, and social media posts. AYAs accessed a web-based platform named SEXTUOZE from December 15, 2021, to September 30, 2022, that offered sexual health information and teleconsultations. Data collected included participant and teleconsultation characteristics, patient satisfaction, and the quality of completeness of medical records. A total of 22 teleconsultations were scheduled and 7 were completed, all via synchronous video communication (duration: median 35 min). Overall, 4731 sessions were generated on the SEXTUOZE website. Reasons cited for accessing the web services were to seek sexual health advice (8/22, 36%), receive an initial birth control prescription (12/22, 55%), and inquire about condom prescriptions (2/22, 9%). While teleconsultation use for sexual health was initially low, it rose toward the end of the study period. Considering all elements of the implementation theory, future research should design interventions that not only are more operative and tailored but also ensure their adoption and sustainability in various health contexts.

Polyphasic identification of Vibrio species from aquatic sources using mass spectrometry, housekeeping gene sequencing and whole genome analysis

Accurate bacterial identification is essential for determining the causative agent of an infection, thus facilitating appropriate treatment and management strategies in both human and animal health contexts. Some species in the Vibrio genus are recognized pathogens, associated with a variety of infections. However, identification of these bacteria is oftentimes controversial. Therefore, we aimed to evaluate different identification approaches in terms of their reliability in distinguishing Vibrio species. To achieve this, we selected a set of 40 Vibrio isolates previously recovered from water and floating plastic samples in a large bay environment and identified them employing MALDI-TOF mass spectrometry, and rrs and pyrH gene sequencing. A subset of isolates was also submitted to whole genome sequencing. Overall, MALDI-TOF was found to be a fast-screening methodology for identification, notably at genus-level. However, for better species discrimination, pyrH gene sequencing stood out as a more reliable tool in contrast to rrs gene sequencing and MALDI-TOF, as corroborated by whole genome sequencing analysis.

Sleep: The Silent Hero in Cardiometabolic Health

The essential role of sleep in overall health is increasingly recognized, yet it remains underemphasized in both clinical and public health contexts. Despite extensive research linking poor sleep health to chronic conditions such as cardiovascular disease, type 2 diabetes, and cognitive decline, sleep health is not routinely assessed or integrated into standard care practices. Sleep problems, including insomnia, sleep apnea, and poor sleep quality, are prevalent globally, affecting over 30% of the population and contributing to significant public health burdens like cardiometabolic disease, mental health disorders and multimorbidity. The economic implications are substantial, with insufficient sleep imposing significant societal and financial costs worldwide. Recognizing this, recent initiatives like the American Heart Association’s inclusion of sleep in the Life’s Essential 8 framework highlight the importance of sleep in cardiometabolic health. Integrating sleep into clinical and public health strategies is crucial, due to the wide-ranging impact of sleep on cardiometabolic health. Social, environmental, and demographic factors also play significant roles in sleep health, with lower socioeconomic groups and women often experiencing poorer sleep, further exacerbating health disparities. Adopting a life course approach and promoting healthy sleep behaviors early in life are essential for mitigating long-term cardiometabolic risks. Effective evidence-based strategies for improving sleep behaviors and cardiometabolic health, beyond addressing sleep disorders, include prioritizing sleep hygiene, managing stress, promoting physical activity, maintaining a healthy diet, and reducing substance use, all of which contribute to overall well-being. In conclusion, incorporating sleep health into routine cardiometabolic risk stratification, prevention, and management is essential for improving overall health outcomes.

Exploring Serum Ferritin's Connection to the Acute Phase Response in Zoo-Managed African Rhinoceroses.

Despite serum ferritin's potential as an iron status indicator, its concentrations vary significantly throughout a black rhinoceros's (Diceros bicornis) life, sometimes irrespective of iron load. We explored acute phase response-related biomarkers, serum amyloid A (SAA) and ceruloplasmin (Cp), to better understand the mechanisms influencing serum ferritin changes in managed black rhinoceroses. The objective was to evaluate the relationships between circulating levels of ferritin, SAA, and Cp in black and white rhinoceroses (Ceratotherium simum). We analyzed banked serum samples collected serially from 11 black (n = 222) and 7 white (n = 134), rhinoceroses (rhinos) and classified samples based on SAA values: clinically healthy (< 1 mg/L), subclinical (1-7 mg/L), or clinically abnormal (> 7 mg/L). In black rhinos, serum ferritin was not different between health status categories (p = 0.5292), nor was it correlated with SAA (p = 0.4164). However, Cp activity was significantly lower in clinically healthy sera (p < 0.0001) and had a moderate positive association with SAA (r = 0.477, p < 0.0001). Among the white rhino samples, only five had SAA values greater than 1 mg/L, limiting the assessment of ferritin and Cp activity in the health context. Minor, yet significant, relationships were observed between serum ferritin and Cp activity, negative in black rhinos (r = -0.206; p = 0.0022) and positive in white rhinos (r = 0.289, p = 0.0008). Cp activity may aid in diagnosing illness in black and white rhinos, based on values observed in sera collected near the time of death. However, acute inflammatory processes do not appear to be one of the primary drivers of the high ferritin concentrations detected in some black rhinos.

Understanding the clinical and environmental drivers of antifungal resistance in the One Health context.

Antifungal drugs have had a tremendous impact on human health and the yields of crops. However, in recent years, due to usage both in a health setting and in agriculture, there has been a rapid emergence of antifungal drug resistance that has outpaced novel compound discovery. It is now globally recognized that new strategies to tackle fungal infection are urgently needed, with such approaches requiring the cooperation of both sectors and the development of robust antifungal stewardship rationales. In this review, we examine the current antifungal regimes in clinical and agricultural settings, focusing on two pathogens of importance, Candida auris and Aspergillus fumigatus, examining their drivers of antifungal resistance, the impact of dual-use azoles and the impact agricultural practices have on driving the emergence of resistance. Finally, we postulate that a One Health approach could offer a viable alternative to prolonging the efficacy of current antifungal agents.

Correlation of IGF2 levels with sperm quality, inflammation, and DNA damage in infertile patients.

Insulin-like growth factor 2 (IGF2) is a critical endocrine mediator implicated in male reproductive physiology. To investigate the correlation between IGF2 protein levels and various aspects of male infertility, specifically focusing on sperm quality, inflammation, and DNA damage, a cohort of 320 male participants was recruited from the Women's Hospital, Zhejiang University School of Medicine (Hangzhou, China) between 1st January 2024 and 1st March 2024. The relationship between IGF2 protein concentrations and sperm parameters was assessed, and Spearman correlation and linear regression analysis were employed to evaluate the independent associations between IGF2 protein levels and risk factors for infertility. Enzyme-linked immunosorbent assay (ELISA) was used to measure IGF2 protein levels in seminal plasma, alongside markers of inflammation (tumor necrosis factor-alpha [TNF-α] and interleukin-1β [IL-1β]). The relationship between seminal plasma IGF2 protein levels and DNA damage marker phosphorylated histone H2AX (γ-H2AX) was also explored. Our findings reveal that IGF2 protein expression decreased notably in patients with asthenospermia and teratospermia. Correlation analysis revealed nuanced associations between IGF2 protein levels and specific sperm parameters, and low IGF2 protein concentrations correlated with increased inflammation and DNA damage in sperm. The observed correlations between IGF2 protein levels and specific sperm parameters, along with its connection to inflammation and DNA damage, underscore the importance of IGF2 in the broader context of male reproductive health. These findings lay the groundwork for future research and potential therapeutic interventions targeting IGF2-related pathways to enhance male fertility.

Digital Mental Health Interventions for Adolescents in Low- and Middle-Income Countries: Scoping Review.

Digital mental health interventions (DMHIs) are increasingly recognized as potential solutions for adolescent mental health, particularly in low- and middle-income countries (LMICs). The United Nations' Sustainable Development Goals and universal health coverage are instrumental tools for achieving mental health for all. Within this context, understanding the design, evaluation, as well as the barriers and facilitators impacting adolescent engagement with mental health care through DMHIs is essential. This scoping review aims to provide insights into the current landscape of DMHIs for adolescents in LMICs. The Joanna Briggs Institute scoping review methodology was used, following the recommendations of the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews). Our search strategy incorporated 3 key concepts: population "adolescents," concept "digital mental health interventions," and context "LMICs." We adapted this strategy for various databases, including ACM Digital Library, APA PsycINFO, Cochrane Library, Google Scholar (including gray literature), IEEE Xplore, ProQuest, PubMed (NLM), ScienceDirect, Scopus, and Web of Science. The articles were screened against a specific eligibility criterion from January 2019 to March 2024. We analyzed 20 papers focusing on DMHIs for various mental health conditions among adolescents, such as depression, well-being, anxiety, stigma, self-harm, and suicide ideation. These interventions were delivered in diverse formats, including group delivery and self-guided interventions, with support from mental health professionals or involving lay professionals. The study designs and evaluation encompassed a range of methodologies, including randomized controlled trials, mixed methods studies, and feasibility studies. While there have been notable advancements in DMHIs for adolescents in LMICs, the research base remains limited. Significant knowledge gaps persist regarding the long-term clinical benefits, the maturity and readiness of LMIC digital infrastructure, cultural appropriateness, and cost-effectiveness across the heterogeneous LMIC settings. Addressing these gaps necessitates large-scale, co-designed, and culturally sensitive DMHI trials. Future work should address this.

Significant Microbial Pathogenesis Perspective of Biliary Diseases.

This review explores various biliary tract diseases caused by different organisms, in-cluding cholelithiasis, hepatolithiasis, and choledocholithiasis. The biliary tract's primary func-tions include collecting, storing, concentrating, and delivering bile juice produced by the liver. Neurohormonal systems involving the vagus and splanchnic nerves, alongside cholecystokinin, regulate gallbladder movement during fasting and digestion. Under normal conditions, bile acids play a crucial role, with approximately 95% being reabsorbed by the intestinal epithelium and returned to the liver via the portal vein system. The liver, often hailed as a miracle worker, de-toxifies, purifies, and regenerates, performing essential functions in the body. Recent research indicates that the gallbladder, akin to the intestine, harbors a diverse microbiota. Additionally, the biliary mucosa features chemical, mechanical, and immunological barriers that promote im-munological tolerance. Hepatotoxicity remains a significant global health concern and a leading cause of mortality. Providing clear and accurate information on liver toxicity is critical, especially in the context of medication safety and public health. By refining these elements, this review can effectively convey the complexity and importance of biliary tract diseases and liver function in health and disease contexts.

India’s Vaccine Diplomacy and Global Health Governance: A Soft Power Approach in the Context of Public Policy and Religious Values

Research Problem: India's vaccine diplomacy during the Covid-19 pandemic has not only emerged as a significant tool of soft power but also involves moral and ethical dimensions closely tied to religious values and public policy. In the midst of a global crisis, the interaction between India’s vaccine diplomacy and the religious and public policy frameworks of recipient nations requires deeper exploration. Research purposes: This article aims to analyze the role of India’s vaccine diplomacy in relation to public policy and religious values in recipient countries, examining how India’s global health initiatives influence moral and ethical perceptions of vaccine distribution, fairness, and international solidarity. Research methods: The study employs policy analysis through a comprehensive literature review, focusing on the relationship between vaccine diplomacy, public policy, and responses from religious communities in the recipient countries. It also explores the ethical and spiritual dimensions of India’s health diplomacy approach and its impact on public health policies. Results and Discussion: The findings reveal that India’s vaccine diplomacy, through initiatives like "Vaccine Maitri," not only strengthens political ties with neighboring and global countries but also interacts with religious value systems, influencing public acceptance of vaccines. Moral values such as solidarity and justice, integral to many religious traditions, reinforce positive responses to the vaccine initiatives. Additionally, in some nations, religious communities have played a significant role in promoting vaccine acceptance by framing the health response in moral terms. Research Implications and Contributions: This research highlights the importance of integrating religious values into public health policy, particularly in global health contexts. Vaccine diplomacy rooted in moral solidarity and universal ethical principles, aligned with religious values, has the potential to enhance international cooperation and reduce vaccine hesitancy. Thus, this study contributes to understanding how religion and public policy can collaborate effectively in addressing global health challenges.

Digital divide in access and use of digital health technologies: what do we know from Germany?

Abstract Even though Germany is an industrialised country, health inequalities exist between individuals or population groups due to unequal access to scarce social resources such as money or knowledge. This case study illustrates the extent of the digital divide in access and use of digital health technologies. Data from the Liter@te study, in which 96 adults aged 18-64 years with low reading and writing skills living in Germany were asked about their digital health technology use and their digital health literacy, were compared with two parallel conducted population surveys in Germany (i.e., nationwide telephone survey on digitalisation and health with 1020 internet users aged 18 years and above, online survey on digitalisation in health care with 1839 adults aged 18-80 years insured at a statutory health insurance company). Adults with low reading and writing skills used digital devices in the health context such as computers (23% vs. 71%) or activity trackers (21% vs. 35%) less frequently than the general population, whereas no differences were reported in the use of smartphones (79% vs. 70%). In addition, 18% of adults with low reading and writing skills and 4% of the general population stated that they do not use digital health technologies. Other digital health technologies such as online appointment scheduling (25% vs. 81%) or health websites (32% vs. 45%) were also used less frequently by adults with low reading and writing skills compared to the general population. Participants in the Liter@te study who do not use digital health technologies reported more frequent access problems (e.g., no suitable device, technical problems, poor internet connection) than participants in the population survey. 35% of participants in the Liter@te study have a low digital health literacy (eHEALS score between 8-19/40 points), compared to only 8% in the population survey.

3.M. Skills building seminar: Culture, Arts and Mental Health

Abstract Improving mental health is a challenge, not only for the health sector, so research into innovative ways to improve mental health in the community is necessary. The WHO Regional Office for Europe together with its expert group on the cultural contexts of health and well-being promote a culturally grounded approach to enrich policies related to health and well-being. The cultural contexts of health and well-being argues that incorporating cultural issues into policy-making is critical to the development of adaptive, equitable and sustainable health care systems, and to making general improvements in many areas of population health and well-being. Population health and well-being are influenced by actions external to health care systems, also. By health-in-all-policies approach it is given an understanding of how policies in non-health domains can foster or constrain a culture and art for health. Social prescribing and art-for -health activities are important tool for improvenment mental health. This skils building seminar will discuss some good practice and examples, and also cooperation with experts from cultural sector in the mental health field. Key messages • The innovative concept of cooperation between Culture and Health institutions brought positive experiences and impressions to all participants who used ‘culture on prescription’. • The integration of arts into healthcare and community settings offers a holistic approach to promoting health and fostering well-being.