Health Well-being Research Articles

Synthetic Biology-Enabled Engineering of Probiotics for Precision and Targeted Therapeutic Delivery Applications

Probiotics, defined as live microorganisms that offer health benefits when consumed in adequate amounts, have traditionally been used to maintain gastrointestinal (GI) health. They are effective in managing conditions such as inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), and antibiotic-associated diarrhea. Recent research, however, has expanded their potential applications beyond the GI tract to include immune modulation, metabolic regulation, and mental health support. Despite these advances, conventional probiotics face limitations such as instability in harsh environments, lack of precise targeting, and ineffective control over drug release. This review explores the application of synthetic biology in addressing these limitations, emphasizing how tools such as CRISPR-Cas systems, synthetic gene circuits, and plasmid-based mechanisms enhance the stability, functionality, and specificity of engineered probiotics for therapeutic delivery. Applications of synthetic biology-enabled probiotics are examined across a range of health contexts, including GI health, cancer therapy, metabolic disorders, immune modulation, and mental well-being. Synthetic biology tools provide precise genetic modifications that improve the stability, viability, and functionality of engineered probiotics, enabling more targeted therapeutic delivery. Additionally, technologies such as encapsulation support probiotic survival, while gene circuits allow programmable, stimulus-responsive therapeutic release. As synthetic biology continues to advance, the development of programmable probiotics holds promise for personalized, targeted medicine, positioning probiotics as living therapeutics and patient-friendly alternatives to conventional therapeutic delivery systems.

The dietary phytochemical index and its relation to polycystic ovary syndrome: a case-control study.

Polycystic ovary syndrome (PCOS), a hormonal disorder affecting women of reproductive age, can be significantly impacted by diet. This study explores the relationship between a diet rich in phytochemicals, measured by the Dietary Phytochemical Index (DPI), and PCOS, along with associated health markers. A case-control study design was implemented with 480 individuals diagnosed with PCOS based on the Rotterdam criteria, paired with 480 controls matched in terms of age and BMI. The evaluation encompassed dietary intake, anthropometric measurements, and hormonal/metabolic markers. Additionally, the DPI score was determined based on the consumption of phytochemical-rich foods. The study also examined PCOS-related complications like acne and irregular menstrual cycles, as well as mental health using the Beck Depression Inventory (BDI-II) scores. Women with PCOS had significantly lower DPI scores (32.42 vs 43.87, p < 0.001) compared to the control group, indicating a less phytochemical-rich diet. The DPI scores coincided with higher levels of hormones typically associated with PCOS, including Luteinizing Hormone (LH), Dehydroepiandrosterone Sulfate (DHEA-S), and testosterone. Additionally, these scores were associated with markers of metabolic dysfunction such as C-reactive Protein (CRP), Fasting Blood Sugar (FBS), and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), while positively correlating with Sex Hormone-Binding Globulin (SHBG) (all p < 0.050).). Higher DPI scores were associated with a significantly reduced risk of PCOS (OR: 0.13, 95% CI: 0.08, 0.23, P for trend: 0.001) and its complications, including acne and irregular menstrual cycles. Interestingly, a positive association emerged, suggesting better mental health (lower BDI-II scores) with higher DPI scores. In conclusion, this study indicates that lower DPI scores are associated with a higher incidence and severity of PCOS, suggesting that a phytochemical-rich diet could potentially benefit the management of PCOS by enhancing hormonal profiles, metabolic health, and mental well-being in women.

The effects of psychological flexibility and night shifts on mental health and well-being in nurses.

Examining mental health among nurses in the later stages of the COVID-19 pandemic could offer valuable information for addressing these symptoms in the long term. Therefore, the current study aimed to assess the mental health and well-being of Chinese nurses, as well as investigate the impact of psychological flexibility and night shifts on this relationship. In cross-sectional, hospital-based, multicenter study, 422 Chinese nurses were selected by multistage stratified cluster random sampling. The mental health status, psychological flexibility, and wellbeing were assessed via 12-item General Health Questionnaire (GHQ-12), Chinese version of Personalized Psychological Flexibility Index, and Chinese version of the 5-item WHO Well-Being Index, respectively. To examine the proposed theoretical model, we conducted structural equation modeling using SPSS Amos 26 version. The age, gender, night shift, psychological flexibility, mental health, and well-being data were entered into the model. Pearson correlation and chi-square were used to explore the correlation between variables. The high night shifts, being young and low psychological flexibility significantly had a direct effect on worse mental health (night shifts: ES, 95% CI: 0.619, 0.328-0.725; age: ES, 95% CI: 0.542, 0.226-0.993; psychological flexibility: ES, 95% CI: 0.675, 0.369-1.466). The low psychological flexibility and worse mental health were able to directly effect on worse wellbeing (psychological flexibility: ES, 95% CI: 0.419, 0.757-1.519; mental health: ES, 95% CI: 0.719, 1.109-2.607). In addition, psychological flexibility through the mediation of mental health also had an indirect effect on wellbeing (ES, 95% CI: 0.269, 0.957-2.165). Being young, having more night shifts and having less psychological flexibility can be related to the deterioration of mental health and well-being in nurses. Therefore, it is recommended that nurses use the shift routine program with the least focus on the night shifts. Also, interventions to teach younger nurses how to face work stress and interventions to improve the psychological flexibility of all nurses are needed.

Human-computer interactions with farm animals—enhancing welfare through precision livestock farming and artificial intelligence

While user-centered design approaches stemming from the human-computer interaction (HCI) field have notably improved the welfare of companion, service, and zoo animals, their application in farm animal settings remains limited. This shortfall has catalyzed the emergence of animal-computer interaction (ACI), a discipline extending technology’s reach to a multispecies user base involving both animals and humans. Despite significant strides in other sectors, the adaptation of HCI and ACI (collectively HACI) to farm animal welfare—particularly for dairy cows, swine, and poultry—lags behind. Our paper explores the potential of HACI within precision livestock farming (PLF) and artificial intelligence (AI) to enhance individual animal welfare and address the unique challenges within these settings. It underscores the necessity of transitioning from productivity-focused to animal-centered farming methods, advocating for a paradigm shift that emphasizes welfare as integral to sustainable farming practices. Emphasizing the ‘One Welfare’ approach, this discussion highlights how integrating animal-centered technologies not only benefits farm animal health, productivity, and overall well-being but also aligns with broader societal, environmental, and economic benefits, considering the pressures farmers face. This perspective is based on insights from a one-day workshop held on June 24, 2024, which focused on advancing HACI technologies for farm animal welfare.

Effective Communication of System-Level Events for Hospital System Health and Nurse Well-Being: A Qualitative Study

Many injuries and deaths occur yearly in the United States due to preventable errors; however, documented harm is lower in hospitals with Magnet® designation from the American Nurses Credentialing Center (Silver Spring, MD, USA). This manuscript illustrates insights from Magnet® and non-Magnet® nurses and nursing leaders regarding what impacts hospital system health, how those factors are communicated, and how hospital system health impacts patient safety. A qualitative descriptive approach was used with semi-structured interview questions. Within-methods data triangulation was applied to transcribed interviews using thematic analysis, application of the Goodwin statistic, and natural language processing (NLP). Thematic analysis revealed the four main themes of Healthy Systems, Unhealthy Systems, Patient Safety, and Nurse Well-Being. NLP revealed non-Magnet® leaders and nurses scored highest for anxiety, anger, and sadness, in contrast to Magnet® participants who had the highest levels of positive emotion. Key findings from the Magnet® participants revealed that poaching employees and placing people in the wrong positions harm hospital system health and patient safety. The use of within-methods data triangulation illuminated the contextual depth of the participants’ speech, revealing the alarming emotional state that non-Magnet® nurses and leaders are facing. Healthcare staff’s wellness must be prioritized to cultivate environments that provide safe care.

FEITOS E PERFIL POPULACIONAL DE IDOSOS NA PRÁTICA DE ATIVIDADES FÍSICAS EM PORTO VELHO – RONDÔNIA

The elderly population has been growing significantly over the years, and with this, there has also been a growing concern about ensuring that these individuals have an active and healthy life. Physical activity is one of the main ways to promote health and quality of life in old age, as it can prevent and treat various health conditions, in addition to improving physical and cognitive function. Based on this, this article aims to analyze the importance of physical activity for health and the benefits that the activity provides to the elderly. The study is descriptive and quantitative in nature and was carried out in the city of Porto Velho, Rondônia, at the Physiotherapy Clinic of the São Lucas Educational Center and SESC/RO Social Service of Commerce Rondônia. It is important to note that the study included male and female elderly people, aged 60 years and older. In addition, two questionnaires were used to produce the data: one about general information based on daily habits and a description of physical exercises and the benefits achieved. Complementary data information about risk factors, weight, height and lifestyle changes. It is worth noting that a sociodemographic questionnaire was applied, along with a functional test scale to assess the physical fitness of the elderly, the Berg Balance Scale and the Modified Baecke Questionnaire for the Elderly. And the guardians signed the free and informed consent form (ICF). The data were collected through the evaluation instruments that were tabulated in the Microsoft Excel program for statistical analysis. The research evaluated 60 participants, predominantly women (93.3%), aged between 60 and 90 years, most living in the urban area. In terms of health, 31 of the participants reported regular perception and 62% had 2 to 3 comorbidities. The majority did not smoke (58 participants) and did not consume alcohol (52 of the 60 participants). Regarding Covid-19, 31 had been infected, but only 1 required intubation. On the Berg Scale, 98.3% of the elderly demonstrated good balance when standing for 2 minutes without support, and 44 of 60 were able to pick up objects from the floor independently. However, 60% suffered two or more falls and 40% reported moderate or extreme fear of falling, while 30% had difficulty standing on one leg for 3 seconds or more. These data reveal a predominance of good functional capacities, but with significant limitations in relation to falls and comorbidities. The completion of this study contributed to a greater understanding of the importance of physical activity in the lives of the elderly, considering that physical activity is an element that can contribute to the promotion of health, physical and mental well-being and functional capacity of the elderly, demonstrating that regular exercise not only improves muscle strength and balance, but also significantly reduces the risk of falls, one of the main challenges faced by this population. The data obtained highlight the need for interventions that encourage physical activity, since many elderly people consider themselves active, but only a minority performs exercises regularly. Therefore, the implementation of physical exercise programs is essential to prevent chronic diseases, improve quality of life and promote functional independence among the elderly, contributing to healthy and active aging.

Preliminary Functional Analysis of the Gut Microbiome in Colic Horses

The gut microbiome plays a critical role in maintaining horse health, influencing digestion, immunity, and overall well-being. However, in certain conditions like colic, there is evidence of significant alterations in the microbial community. To analyze the composition of the fecal microbiome and the enriched predicted metabolic functions of horses with colic compared to a control group, 14 horses with colic and 14 control horses were recruited. From a stool sample, DNA extraction was carried out for subsequent 16S rRNA metagenomic analysis. The composition of the microbiome was analyzed from the sequences of each sample using the QIIME version 1.8.0 and DADA2 version 1.22 programs. PICRUSt2 was used to predict metabolic functions. Statistical analyses were performed with the Mann–Whitney U test from the Python scipy v1 package. The gut microbiomes of both groups were dominated by Firmicuteota, Bacteroidota, and Pseudomonadota phyla. Colic in horses was associated with reduced diversity, reduced abundance of Fibrobacter, and an increase in Streptococcus. The abundance of Firmicuteota was negatively correlated with Pseudomonadota and Actinobacteriota. The equine colic microbiome was predicted to be enriched in aerobic respiration pathways and fatty acid and amino acid degradation. These observations indicate discrete but important differences in the gut microbiome of colic horses.

A Mixed Methods Assessment of an Online Mental Health and Resilience Program for Agricultural Sector Students

ABSTRACT Financial, environmental, and socio-cultural challenges affect the mental health and wellbeing of those working and living on-farm. Education programs can help in improving mental health and overall wellbeing, but most of these programs are offered to established farmers in a face-to-face format, leading to a gap in offerings to many subgroups, including young agricultural entrants. To address these gaps, this paper assesses the value of an online mental health and resilience education program for young agricultural entrants. An explanatory sequential mixed methods approach was applied. Firstly, a quantitative survey was conducted with 172 first year agricultural tertiary students, aged 18–20, to assess the knowledge and skills gained due to program participation. Regressions and propensity score matching were used to determine the effect of program participation. Subsequently, seven interviews were conducted with program participants to provide insights into their experiences of the program. Thematic coding was applied to analyze the qualitative data. Findings from the quantitative survey show a significant increase in mental health knowledge and skills amongst program participants compared to participants in the control group. The qualitative interviews show the ability to work through the material in their own time and space, creates a safe environment for online students. Other mechanisms contributing to learning are using “normal language”, a peer voice in communicating wellbeing, and building on learnings in previous education. This paper addresses a gap in literature by being the first study to evaluate online mental health education for agricultural tertiary students. It provides educators and other program designers with valuable information for future program design to support the wellbeing of young agricultural workers.

The Impact of Parental Depressive, Anxiety, and Stress Symptoms on Adolescents’ Mental Health and Quality of Life: The Moderating Role of Parental Rejection

Background/Objectives: Parental internalizing issues, particularly maternal mental health, can significantly influence adolescents’ mental health by altering parenting behaviors and roles. This study explores the role of parental rejection in moderating the relationship between parental depressive, anxiety, and stress symptoms and adolescents’ mental health and quality of life. Methods: One hundred thirty eight mothers (mean age: 47.96, SD = 5.06 years) and 68 fathers (mean age: 51.07, SD = 5.53 years) of adolescents aged 12–18 completed measures on mental health, parental rejection, and adolescent well-being. Results: Maternal rejection was found to moderate the relationship between maternal anxiety symptoms and adolescents’ quality of life, as well as between maternal anxiety symptoms and adolescents’ mental health problems. Paternal rejection moderated the relationship between paternal stress symptoms and adolescents’ mental health. However, parental rejection did not moderate the relationship between parental depression and adolescents’ quality of life or mental health. Conclusions: These findings highlight the distinct roles of maternal and paternal rejection in adolescent development and suggest that parental mental health, particularly anxiety and stress, has a significant impact on adolescent well-being. Future studies should consider the influence of both parents and focus on longitudinal effects. These results emphasize the need for interventions addressing parental rejection to improve adolescent outcomes.

Regional Differences in Job Satisfaction among Chinese Social Workers: The Mediating Effect of Attitudinal Professionalism.

Job satisfaction is a vital factor associated with better physical health and subjective well-being among social workers. This study aims to explore the job satisfaction of social workers from China's Mainland and Macao and the role of attitudinal professionalism on regional differences. A cross-sectional survey collected data from 292 social workers in Mainland and 108 from Macao one year after the outbreak of COVID-19; 72 percent were female, less than half were married (44.8 percent), the average age was 32.64 years old, and the average working time was 6.07 years. Data were analyzed using descriptive statistics, independent t tests, and mediation analysis. Results indicated that Mainland social workers reported a significantly higher level of job satisfaction and attitudinal professionalism than Macao social workers. Moreover, attitudinal professionalism helped explain the regional difference in job satisfaction. The evidence from this study highlights the need to nurture professional beliefs and values among social workers, especially for Macao social workers, and also underscores the importance of developing continuing education programs to enhance social workers' identification with and commitment to the profession. We also need to improve financial compensation and social status for Mainland social workers to sustain their professionalism.

Evaluating the impact of rock climbing on mental health and emotional well-being in adolescents

BackgroundRock climbing (RC) has gained attention as a therapeutic tool in psychiatric settings that merges physical exertion with mental engagement. It has potential to enhance mental health, through improved self-efficacy and social interaction, making it a novel intervention for addressing anxiety, depression, and behavioral issues in adolescents. This study aimed to investigate the effects of RC as a physical activity on anxiety, depression, and emotional and behavioral problems in adolescents.MethodsThe current study included 57 athletes aged 14.5 ± 1.7 years and 91 adolescents aged 13.6 ± 1.2 years, matched for age and gender, who were not professionally involved in sport. In addition to the socio-demographic form, a detailed psychiatric assessment was carried out by the child psychiatrist; using the Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime Version (K-SADS-PL) to detect psychiatric conditions. The Revised Child Anxiety and Depression Scale-Child Version (RCADS-CV) and the Strengths and Difficulties Questionnaire (SDQ) were also administered to the adolescents in the study.ResultsIn the comparative analysis of the RCADS-CV outcomes between the athlete and control groups, the athletes demonstrated notably lower scores for both Separation Anxiety Disorder (SAD) and Generalized Anxiety Disorder (GAD), yielding p-values of &amp;lt; 0.001 and 0.031, respectively. Although the mean scores for social phobia, OCD, panic disorder, and MDD were lower in the athlete group, the differences were not statistically significant (p &amp;gt; 0.05). In the correlation analysis, a moderately significant correlation was found between the duration of doing sport and the scale scores for SAD (p:0.010), OCD (p:0.014), and panic disorder (p:0.016). There was no significant difference between groups in terms of SDQ scores.ConclusionThese results suggest that RC, through its unique combination of physical exertion and mental focus, may offer protective benefits against certain anxiety disorders among adolescents. Further studies should be conducted to explore the potential use of RC as a preventive program for both healthy adolescents, as well as those with psychiatric disorder.

Predictors of Engagement in Multiple Modalities of Digital Mental Health Treatments: Longitudinal Study.

Technology-enhanced mental health platforms may serve as a pathway to accessible and scalable mental health care; specifically, those that leverage stepped care models have the potential to address many barriers to patient care, including low mental health literacy, mental health provider shortages, perceived acceptability of care, and equitable access to evidence-based treatment. Driving meaningful engagement in care through these platforms remains a challenge. This study aimed to examine predictors of engagement in self-directed digital mental health services offered as part of an employer-based mental health benefit that uses a technology-enabled care platform. Using a prospective, longitudinal design, we examined usage data from employees who had access to an employer-sponsored mental health care benefit. Participants had access to a digital library of mental health resources, which they could use at any time, including daily exercises, interactive programs, podcasts, and mindfulness exercises. Coaching and teletherapy were also available to. The outcome was engagement with the self-directed digital mental health resources, measured by the number of interactions. Poisson regression models included sociodemographic characteristics, patient activation, mental health literacy, well-being, PHQ-9 and GAD-7 scores at baseline, primary concern for engaging in treatment, and the use of coaching or teletherapy sessions. In total 950 individuals enrolled in the study, with 38% using any self-directed digital mental health resources. Approximately 44% of the sample did not use the app during the study period. Those using both self-directed digital and 1:1 modalities made up about one-quarter of the sample (235/950, 24.7%). Those using only coaching or therapy (170/950, 17.9%) and those using only self-directed digital mental health resources (126/950, 13.3%) make up the rest. At baseline, these groups statistically significantly differed on age, PHQ-9, GAD-7, MHLS, and primary concern. Receipt of coaching and teletherapy was associated with the number of self-directed digital mental health resources interactions in adjusted Poisson regression modeling. Use of any coach visit was associated with 82% (rate ratio [RR] 1.82, 95% CI 1.63-2.03) more self-directed digital mental health resource interactions while use of any teletherapy session was associated with 80% (RR 1.80, 95% CI 1.55-2.07) more digital mental health resources interactions (both P<.001). Each additional year of age was associated with increased digital mental health resources interactions (RR 1.04, 95% CI (1.03-1.05), and women had 23% more self-directed digital resources interactions than men (RR 1.23, 95% CI 1.09-1.39). Our key finding was that the use of coaching or teletherapy was associated with increased self-directed digital mental health resource use. Higher self-directed digital resource engagement among those receiving coaching or therapy may be a result of provider encouragement. On the other hand, when a participant engages with 1 modality in the platform, they may be more likely to begin engaging with others, becoming "super users" of all resources.

Integrating mental health and psychosocial support into economic inclusion programming for displaced families in Ecuador

BackgroundPoverty is a key social determinant of mental health among forcibly displaced persons. This study aimed to design and pilot test a strategy to integrate existing mental health and economic inclusion interventions for displaced families in Ecuador.MethodsWe conducted a series of qualitative interviews (n = 30), focus groups (n = 6), and workshops (n = 3) to develop a set of strategies for integrating cross-cutting and focused mental health and psychosocial support (MHPSS) strategies into an existing economic inclusion program for displaced families in Quito. We non-randomly assigned two field offices in Quito to (1) integrate cross-cutting strategies focused on improving economic outcomes or (2) integrate both those cross-cutting strategies plus focused MHPSS strategies into an economic inclusion program. We measured site-level implementation outcomes (adoption, appropriateness, acceptability, feasibility, fidelity, reach, retention, usability) and participant-level psychosocial (wellbeing, depressive symptoms, anxiety symptoms, functioning) and economic inclusion outcomes (financial resources, diet diversity, social capital/networks, self-reliance) over six months. We conducted a mixed-methods analysis to explore the acceptability and feasibility of the integration strategies and the ability to evaluate their effects in a future cluster randomized trial.ResultsWe developed a toolkit that included 10 strategies for integrating MHPSS into economic inclusion interventions. Fifty displaced persons participating in an existing economic inclusion program (25 per study condition) were enrolled and 88% remained in the study through the six-month follow-up. Participants and implementers reported that the integration strategy was appropriate, acceptable, feasible, and usable. Implementers, including people without prior experience in delivering mental health services, were able to deliver the intervention with high fidelity. Integration of focused MHPSS intervention components into an economic inclusion program appeared to improve MHPSS outcomes, the strength of social capital and networks, and engagement in economic and other programs.ConclusionsThis study provides preliminary evidence of the acceptability and feasibility of integrating MHPSS into economic inclusion programs for displaced people. We found evidence supporting evaluation methods that can be employed in a future study to definitively test the added value of integrated approaches to mental health and economic wellbeing for displaced persons.

Psychological Responses to Home-Working Practices: A Network Analysis of Relationships with Health Behaviour and Wellbeing

Working at home, rather than in the workplace, has been suggested to affect office-based workers’ health and wellbeing. This exploratory, cross-sectional study sought to identify discrete psychological responses to home-working practices and investigate their relationship with engagement in health-related behaviours and wellbeing. A sample of 491 home-workers completed a survey assessing ten psychological responses to home-working (e.g., the ability to ‘switch off’ from work), ten health behaviour indices (e.g., sleep trouble), and seven wellbeing indices. Network Analysis modelled relationships between these variables. Results showed four clusters of psychological responses to home-working practices (representing ‘home-working independence’, ‘home-work transition’, ‘daily work pressure’, and ‘work-day forecasting’). Variables within these clusters linked to health behaviour and wellbeing: perceptions of workload manageability, ability to switch off from work, homeworking autonomy, and planning and organising a home-working day had cascading influences on indicators of health, health behaviours, and wellbeing. The findings point to a complex system of potential health and wellbeing consequences of working from home. Further evidence is needed to establish truly causal relationships; nonetheless, our findings call for the development of public health initiatives and organisational policies to support the adoption of home-working practices to benefit the health and wellbeing of home-workers.

Microplastic pollution unveiled: the consequences of small unregulated dumping in villages, spanning from soil to water.

Microplastic contamination in soil ecosystems is a major environmental concern in the world. The current study aims to explore the extent of microplastic pollution in unregulated village dumpsites in India, focusing on the movement of these pollutants from soil to aquatic environments. Soil samples from eight distinct sites (A to H) in six villages were analyzed for various properties, including pH, bulk density, porosity, water retention capacity, hydraulic conductivity, and particle size distribution. The attenuated total reflection-Fourier-transform infrared spectroscopy (ATR-FTIR) method was used to identify prevalent plastic types. The research classifies microplastics by their shape and color, identifying a wide range of particles such as sheets, fibers, foams, fragments, and films. The study also examines the presence and concentration of microplastics in both soil and sediment samples. It was found that PE and PP microplastics are significantly present across different size fractions. Sample A contains a variety of items in the 1-5mm size range, mainly PE, while the 0.3-1mm fraction is largely PP. Samples B to H are mostly composed of PE microplastics in different forms. Sample F is unique with a mix of PE, EPS, and a higher amount of red and blue foam particles in the 0.3-1mm fraction. Microplastics were quantified using stereomicroscopy, revealing concentrations between 80 and 840 numbers per kilogram in soil and 20 to 60 numbers per kilogram in sediments. The findings emphasize the widespread nature of microplastic pollution across ecosystems and the importance of developing effective strategies for monitoring and mitigating their impact on environmental health and human well-being.

A Costly Cure: Understanding and Addressing Financial Toxicity in Cardiovascular Disease Health Care Within the Domain of Social Determinants of Health.

Cardiovascular disease (CVD) represents a significant financial burden on patients and families, compounded by both direct and indirect healthcare costs. The increasing prevalence of CVD, coupled with the rising costs of treatment, exacerbates financial toxicity-defined as the economic strain and associated physical, emotional, and behavioral consequences on patients. This review explores the scope of financial toxicity in CVD care, detailing its prevalence, associated risk factors, and the complex interplay with social determinants of health such as income, insurance status, and comorbidities. Drawing from models in oncology, we highlight key interventions aimed at mitigating financial toxicity, including patient counseling, financial navigation, and enhanced patient-physician cost discussions. By adopting these approaches, healthcare providers can better support patients with CVD in managing both their health and financial well-being, potentially improving clinical outcomes. Future research is needed to develop standardized assessment tools for financial toxicity in CVD and implement system-wide mitigation strategies.

Body Positivity, Physical Health, and Emotional Well-Being Discourse on Social Media: Content Analysis of Lizzo's Instagram.

Weight stigma is a fundamental cause of health inequality. Body positivity may be a counterbalance to weight stigma. Social media is replete with weight-stigmatizing content and is a driver of poor mental health outcomes; however, there remains a gap in understanding its potential to mitigate the prevalence and impact of harmful messaging and to promote positive effects on a large scale. We selected musical artist Lizzo, whose brand emphasizes body positivity and empowerment, for an instrumental case study on the discourse on social media and specifically Instagram. We focused on 3 domains, including body positivity, physical health, and emotional well-being. These domains challenge social norms around weight and body size and have the potential to positively affect the physical and psychological health of people with diverse body sizes. We evaluated posts by Lizzo, comments from Instagram users, and replies to comments over a 2-month period (October 11 to December 12, 2019). Two coders rated Lizzo's posts and Instagram users' comments for their sentiments on the 3 domains. Replies to Instagram users' comments were assessed for their reactions to comments (ie, did they oppose or argue against the comment or did they support or bolster the comment). Engagement metrics, including the number of "likes," were also collected. The final sample included 50 original posts by Lizzo, 250 comments from Instagram users, and 1099 replies to comments. A proportion of Lizzo's content included body positive sentiments (34%) and emotional well-being (18%); no posts dealt explicitly with physical health. A substantial amount Instagram users' comments and replies contained stigmatizing content including the use of nauseated and vomiting emojis, implications that Lizzo's body was shameful and should be hidden away, accusations that she was promoting obesity, and impeachments of Lizzo's health. In spite of the stigmatizing content, we also discovered content highlighting the beneficial nature of having positive representation of a Black woman living in a larger body who is thriving. Moreover, analysis of the discourse between users illustrated that stigmatizing expressions are being combated online, at least to some degree. This study demonstrates that Lizzo has exposed millions of social media users to messages about body positivity and provided more visibility for conversations about weight and shape. Future research should examine the extent to which body positive messages can lead to greater acceptance of individuals living in larger bodies. Instagram and other social media platforms should consider ways to reduce body-shaming content while finding ways to promote content that features diverse bodies. Shifting the landscape of social media could decrease stereotypes about weight and shape while increasing dialog about the need for greater acceptance and inclusion of people with diverse bodies.

Kidnapping-Induced Trauma and secondary stress in armed conflicts: a comparative study among women in hostage families, volunteers, and the General Population

BackgroundExposure to armed conflict negatively impacts health. However, there is limited data on secondary stress from ambiguous loss contexts, such as kidnapping. In this study we aimed to quantify changes in modifiable health behaviors and well-being among women in hostage families and hostage crisis volunteers versus the general female population within the first two months of the 2023 Israel-Hamas war.MethodsA cross-sectional online survey was conducted on 318 Hebrew-speaking women aged 18–75 in Israel comparing: (1) a general population sample (n = 245); (2) hostage crisis volunteers (n = 40); and (3) hostage family members (n = 33). Participants provided demographic information, details on chronic illnesses, and responded to Likert-scale questions covering self-rated health, mental health, and lifestyle habits before the conflict and in current state.ResultsHostage family members reported the most severe health impacts, followed by volunteers. Fair/poor physical health status increased significantly in all groups during the war, with hostages’ families reporting the highest rate (61.6%). Mental health deterioration was more pronounced among hostages’ families, with 84% expressing a need for mental health support. Hostages’ families also reported the highest rates of sleep problems, reduced adherence to a healthy lifestyle, and weight loss. Mental and physical health declined significantly across the exposed groups, as measured by multiple assessments, with hostage families experienced the most pronounced impairments across various domains of well-being.ConclusionsThis period of conflict severely harmed the well-being of all women in the study population. Women from all three groups - hostage families, volunteers, and those from the general population - experienced health deterioration due to varying levels of stress and exposure to conflict-related factors. Hostage families faced the greatest impact with nearly all members of this group showing significant health damage. Long-term support is needed to help restore post-conflict health for all affected women. Further research may be needed to determine the most effective interventions for addressing these impacts across the different groups.

The mediating role of coping in the relationship between perceived health and psychological wellbeing in recurrent urinary tract infection: the rUTI Illness Process Model

ABSTRACT Background: Recurrent urinary tract infection (rUTI) is associated with significant symptom and quality of life burden. Given the unique challenges in diagnostics and management, healthcare disillusionment and stigmatisation which distinguish rUTI from other urological conditions, specific identification of the key illness processes experienced by this patient population is required. This study aimed to identify the unique illness processes and perceptions that contribute to quality of life in rUTI, through perceived health status, psychological wellbeing, and coping. Methods: An international sample of adults living with rUTI (N = 389, 96.9% female) completed a cross-sectional survey comprising the following standardised questionnaires: the EuroQoL EQ-5D-5L, Patient Health Questionnaire 9 (PHQ-9), Generalised Anxiety Disorder 7 (GAD-7), Connor-Davidson Resilience Scale–10 (CD-RISC-10), Pain Catastrophising Scale (PCS). Sociodemographic characteristics were also assessed. Structural equation modelling was conducted to identify the underlying constructs which contributed to psychological wellbeing in rUTI, establishing the ‘rUTI Illness Process Model’. Results: The positive relationship between ‘perceived health status’ and ‘psychological wellbeing’ was partially mediated by ‘rUTI coping’, after controlling for the impact of household income and age (p < .001). The model demonstrated a large effect size (R 2 = .81) and good local and global fit. Overall, rUTI coping skills, boosted by resilience and weakened by pain catastrophising, contribute to a significant proportion of the positive relationship between perceived health status and psychological wellbeing in rUTI. A uniquely vulnerable patient phenotype emerges from this new research, with patients who are younger and/or of lower socioeconomic status at greater risk of poorer rUTI health outcomes and psychological wellbeing, potentially requiring further support. Conclusions: The rUTI Illness Process Model establishes the crucial need to clinically characterise the individualised illness perceptions and metacognitive strategies held by people living with rUTI, revealing that patient-centred interventions targeting illness perceptions and coping strategies require prioritisation to enhance patient outcomes and the patient experience of living with rUTI.

Динамика восприятия болезни и саморегуляции у пациентов с морбидным ожирением через три месяца после бариатрической хирургии

&lt;p&gt;&lt;strong&gt;Background&lt;/strong&gt;. Obesity has reached epidemic proportions throughout the world. Bariatric surgery (hereinafter - BS) is most effective in the treatment of morbid obesity (hereinafter - MO), however, it does not lead to the same results in all patients, since psychological factors play an important role in the outcome of treatment. The gap in scientific knowledge is the underestimation of the patient&amp;rsquo;s role in the treatment process, the lack of information about how he perceives medical treatment and manages the disease, how ideas about the disease change over time after surgery. &lt;strong&gt;Aim of the work&lt;/strong&gt;: study of the dynamics of ideas about the disease and related parameters of self-regulation of the disease in patients with MO before surgery and three months after BS. &lt;strong&gt;Materials and methods.&lt;/strong&gt; Sixty-three patients with MO were examined using a specially selected package of methods before BS and three months after it. The following methods were used in the study: brief illness perception questionnaire; Hospital anxiety and depression scale; Ways of coping questionnaire; Medication adherence report scale; Scales of psychological well-being.&lt;strong&gt; Results&lt;/strong&gt;. Compared with the preoperative stage, three months after BS, patients perceived MO as a less life-threatening disease that has fewer negative consequences for their health and emotional well-being. Their controllability of the disease and the likelihood of curability of obesity after BS have increased. &lt;strong&gt;Conclusions&lt;/strong&gt;. Three months after the operation, positive dynamics in the perception of MO and related parameters of self-regulation were revealed. The knowledge gained can be widely used in medical practice as targets for psychological interventions.&lt;/p&gt;