Positive Health Effects Research Articles

LC-QToF-Based Metabolomics Identifies Aberrant Tissue Metabolites Associated with a Higher-Fat Diet and Their 'Reversion to Healthy' with Dietary Probiotic Supplementation.

Over 33% of Americans are labeled as obese, leading the World Health Organization to designate obesity as a major public health problem. One consequence of obesity is the development of metabolic syndrome, a condition which has been correlated to an increased risk for developing cardiovascular disease and Type 2 diabetes. Prolonged ingestion of a higher-fat diet, one cause of obesity, results in alterations to the gut microbiome. These alterations are implicated to have a profound role in the evolution and progression of obesity-linked diseases. Probiotics are associated with positive health effects such as limiting pathogen colonization, aiding in digestion, and vitamin synthesis. Using Ossabaw pigs as a model for obesity, and in conjunction with our previous research, we performed an in-depth, nontargeted, metabolomic analysis on select organs to elucidate the effects of dietary supplementation with the probiotic Lacticaseibacillus paracasei. We focused our analysis on the effects of probiotic supplementation on a higher-fat (obesogenic) diet and a nutritionally balanced diet. Notably, our findings reveal that the brain cortex is highly sensitive to dietary influencers, and with probiotic supplementation, several aberrant metabolites associated with a higher-fat diet revert to healthy levels, thus demonstrating the potential for a probiotic intervention for obesity-linked disease.

This site is closed! The effect of decommissioning mining waste facilities on mortality in the long run

Mining is typically linked to industrial development. However, waste generated by mineral extraction is a major source of environmental deterioration. This poses a trade-off between preserving the environment and fostering growth. We assess the long-run consequences of reduced exposure to mining waste on health by exploiting municipality-level variation in the staggered closure of facilities that treat and store mining waste in Italy over the course of five decades. We find that shutting down waste facilities decreases decadal mortality by 126 deaths per 100,000 inhabitants (i.e., by nearly 15%), while also improving the literacy and employment rates of the resident population. Our results point to positive health effects dominating potentially negative wealth effects.

Compositional isotemporal substitution analysis of physical activity, sedentary behaviour and cardiometabolic biomarkers in US adults: A nationally representative study

ABSTRACT Substantial evidence links physical activity and sedentary behaviour (SB) with cardiovascular health. However, studies usually examine time-use behaviours independently, rather than considering daily activities as a 24-hour time-use composition. This study aimed to use compositional data models to investigate how time reallocations from SB to moderate-to-vigorous physical activity (MVPA)/ light physical activity (LPA) were associated with changes in cardiometabolic biomarkers. Compositional isotemporal substitution analysis was conducted using data from a representative cross-sectional sample of adults aged 20 years or older (n = 5213 full sample; n = 2221 fasting subsample) from the 2003–2004 and 2005–2006 cycles of the National Health and Nutrition Examination Survey. Overall as well as gender- and age-specific estimates were obtained for reallocating time between the behaviours associated with cardiometabolic outcomes. Replacing SB with MVPA was associated with decreased levels of C-reactive protein (CRP), white blood cells (WBCs), red blood cell distribution width (RDW), insulin, insulin resistance homeostasis model assessment (HOMA-IR) and 2-hour glucose, and increased high-density lipoprotein cholesterol (HDL-C), except for WBCs in older adults, insulin and HOMA-IR in females and older adults, 2-hour glucose in young and older adults, and HDL-C in older adults. Substituting LPA for SB resulted in lower CRP in older adults, lower RDW in males and older adults, lower insulin in young and middle-aged adults, lower HOMA-IR in females and middle-aged adults, and higher HDL-C in males and young adults. Our findings provide new evidence for the potential benefits of LPA and MVPA in cardiovascular health and help make population-specific recommendations for physical activity. Highlights Shorter sedentary behaviour (SB) time and longer active behaviours time are associated with a lower cardiovascular disease risk profile. Although replacing SB with MVPA has stronger positive health effects, LPA, as a simpler and more feasible activity, may has greater potential in promoting cardiovascular health. The expected changes in cardiometabolic biomarkers caused by time reallocations from SB to MVPA/LPA vary with gender and age, and physical activity guidelines with specific recommendations should be tailed to the subpopulations.

Regulatory effect of moderate Jiang-flavour baijiu (Chinese liquor) dosage on organ function and gut microbiota in mice

Chinese baijiu, an ancient fermented alcoholic beverage, contains ethanol and a variety of compounds. One of the most popular types of Chinese baijiu is Jiang-flavor baijiu. To investigate the effects of Jiang-flavor baijiu on organ function and gut microbiota, we developed a moderate drinking mouse model and studied its effects on the liver, kidney biomarkers, memory function, and gut microbiota. The results showed that ethanol caused more hepatic steatosis, liver and kidney damage, and memory impairment than Jiang-flavour baijiu consumption. Furthermore, Jiang-flavor baijiu altered the gut microbiota by increasing the abundance of beneficial taxa such as Lactobacillus and Akkermansia, whereas ethanol increased the abundance of harmful bacteria such as Prevotella and Mucispirillum. Our findings provide preliminary evidence that moderate dose Jiang-flavor baijiu regulates gut microbiota and organ function and provide a theoretical foundation for future research on the positive health effects of particular varieties of Chinese baijiu.

The health impacts of two policies regulating SO2 air pollution: Evidence from China

In developing countries widespread air pollution poses a major threat to public health calling for effective environmental regulation. This paper adds to the limited literature on the health impact of different environmental regulations. Using data from eight waves of the China Health and Nutrition Survey (1993–2015), we employ a difference-in-differences model to investigate the health impact of two policies combatting SO2 air pollution: the command-and-control environmental regulation represented by the Two Control Zones (TCZ) and the market-oriented environmental regulation represented by the SO2 Emissions Trading Scheme (ETS). The main findings are that the TCZ policy resulted in a 39% reduction in the 4-week prevalence of air pollution-related diseases through channels such as reducing industrial SO2 emissions and industrial fumes emissions, and increasing individuals' amounts of physical exercise. In contrast, the ETS had no positive health effects, likely due to imperfect market mechanisms and environmental policy uncertainties. The health impact of the TCZ was most pronounced for respiratory illnesses, and was increasing over the period during which the policy was implemented. The positive health impact is stronger for outdoor, less educated, and lower income workers. Residents in Eastern regions and urban areas (especially the rural hukou holders living there) benefitted more from the environmental regulation.

SUBTROPIC PERSIMMON FRUIT – A SOURCE OF ANTIOXIDANTS

antioxidants are substances that inhibit oxidation and are able to neutralize the oxidative effect of free radicals. Dietary-derived antioxidants are now increasingly being researched for their positive health effects, including their role in the prevention of various diseases. In general, plant antioxidants receive a lot of attention as they can be consumed for longer periods of time without any side effects. Fruits are an important component of the human diet and play an important role in maintaining health. This is due to the presence of bioactive components that have a beneficial effect on human physiology. A number of plants have gained popularity as useful food items. Among them, persimmon (Diospyros kaki L.) can be distinguished, the fruits of which are nutritious and have strong antioxidant activity. This review summarizes data on the types of persimmon, its properties and methods of use.

Effects of Isoflavone-Rich NADES Extract of Pueraria lobata Roots and Astaxanthin-Rich Phaffia rhodozyma Extract on Prostate Carcinogenesis in Rats.

Prostate cancer (PCa) is one of the most common male malignancies worldwide. In the current study, we evaluated the effects of a natural deep eutectic solvent (NADES) extract of Pueraria lobata roots rich in isoflavones (ISF) and Phaffia rhodozyma extract rich in astaxanthin (ASX) on an N-methyl-N-nitrosourea plus testosterone PCa model in rats. ISF consisted of puerarin, daidzein, genistein, formononetin and other polyphenols, while ASX contained lipids and unsaturated species in addition to astaxanthin. Extracts were administered through a whole promotion period in daily doses shown by our group to successfully inhibit benign prostate hyperplasia (BPH) development - 200 mg/kg for ISF and 25 mg/kg for ASX. Though a similar effect was found for BPH processes accompanying PCa induction, the incidence of PCa in animals treated with placebo, ISF and ASX was 37%, 37% and 41%, respectively, showing no chemopreventive activity of ISF and ASX. PCa development was associated with a decrease in the Ca/Mg ratio in serum and an increase in prostate tissue. Treatment with both extracts produced a normalization effect on Ca balance in serum, which, combined with a decrease in the prostatic index, suggests some positive health effects of ISF and ASX.

The effect of equalization of public health services on the health China's migrant population: Evidence from 2018 China Migrants Dynamic Survey.

China has implemented an equalization of public health Services policy for migrants in 40 pilot cities since 2013. The main objective of this study is to explore the effect of this migrant-based reform policy on the health status of the migrant population in China. Using the China Migrants Dynamic Survey (CMDS), we included 152,000 migrants aged 15 years or over in 2018. Standardized questionnaires were used to collect socio-economic information and self-reported health status. The Associations between the equalization of public health services and health status were estimated using Multiple regression estimation models and Propensity Score Matching (PSM) methods. Public health equalization reform in China has a significant and positive effect on the health status of the migrant population (β = 0.033, p < 0.001). Compared to males, higher income, under 60 years of age, inter-provincial mobility, and migrants those already living in urban areas, the equalization of public health Services had shown more significant positive effects on the groups who were inter-provincial migration (β = 0.055, p < 0.001), females (β = 0.055, p < 0.001), having low-income (β = 0.077, p < 0.001), aged over 60 years old (β = 0.191, p < 0.001), and living in rural areas (β = 0.038, p < 0.001). And multiple robustness tests prove that the above results are reliable. Our findings confirmed the positive health effect of the equalization of public health services reform on china's migrant population, especially among vulnerable groups such as those in low income groups, in rural areas and females. And we recommend that it is necessary to further promote the practices and experiences of the pilot cities. First, strengthen health education for the mobile population and improve their health literacy. Second, further increase the financial investment to improve the coverage of public health services and the equity in resource allocation among regions. Last, strengthen the information-based management of the migrant population and prevent and control infectious diseases.

Stakeholder contributions to commercialization and market creation of a radical innovation: bridging the micro- and macro levels

PurposeSuccessful commercialization is crucial to innovative firms, but further investigation is needed on how diverse stakeholders can contribute to the commercialization of a radical innovation that requires particular market creation support. This paper aims to, therefore, analyze the key stakeholders and their contributive activities in commercialization and market creation, particularly in the case of radical innovations.Design/methodology/approachThis study relies on qualitative research design including interviews with key stakeholders, such as regulators, scientists, experts, licensing partners, core company representatives and extensive secondary data. This single-case study concerns a functional food product, which is a radical innovation requiring the development of a novel product category positioned between the food and medicine categories in global market settings. Since its market launch in 1995, the involvement of multiple stakeholders was needed for its successful commercialization in over 30 countries.FindingsResults uncover the contributions of diverse stakeholders to commercialization and market creation, particularly of radical innovation. Stakeholders performed market creation activities such as regulating the marketing and labeling of food products, conducting safety assessments, revealing and validating the positive health effects of the novelty and raising awareness of healthy living and cardiovascular health. The commercialization activities included distributing the products overseas, applying the ingredient to different food products and making the products available for users.Research limitations/implicationsThis single-case study provides an overview of the positive stakeholder activities with contributions to market creation and commercialization of functional food innovations. Although the user perspective was not included in the empirical part of this study because of our focus on B2B actors, users of the innovation can contribute to R&D activities to a great extent.Originality/valueThe developed framework of stakeholders’ contributive activities in radical innovation commercialization and market creation contributes to literature discussing market creation as well as commercialization within the marketing and innovation management research fields. This work also generates practical advice for managers who commercialize (radical) innovations.

Chemistry, Occurrence, Properties, Applications, and Encapsulation of Carotenoids-A Review.

Carotenoids are natural lipophilic pigments and antioxidants that are present in many fruits and vegetables. The consumption of carotenoids is correlated with positive health effects and a decreased risk of several chronic diseases. Provitamin A carotenoids (β-carotene, α-carotene, γ-carotene, and β-cryptoxanthin) are essential for the development and maintenance of sight. β-carotene, α-carotene, zeaxanthin, β-cryptoxanthin, lutein, and lycopene have high antioxidant activity and promote free radical scavenging, which helps protect against chronic diseases. However, carotenoids are chemically unstable and prone to oxidation in the presence of light, heat, oxygen, acids, and metal ions. The use of carotenoids in the food industry is limited due to their poor solubility in water, bioavailability and quick release. Encapsulation techniques, such as microencapsulation, nanoencapsulation and supercritical encapsulation, are used to overcome these problems. The objective of this paper is to describe the characteristics and potential health benefits of carotenoids and advances in encapsulation techniques for protecting and enhancing their solubility or bioavailability.

The Relationship between Daily Spiritual Experiences and the Dimensions of Spiritual Care Competence in Nursing Students: The Dimension of Professionalization and Improvement of the Quality of Spiritual Care.

Daily spiritual experiences and spiritual care competence have positive health effects on patients and form an integral part of the nursing profession. This study was conducted to determine the relationship between daily spiritual experiences and the dimensions of spiritual care competence in nursing students. This cross-sectional study was conducted on 401 nursing students in their last year of the program. The participants were selected from nursing schools in Tehran Province, Iran, in the academic year 2019-2020. The required data were extracted using a demographic information questionnaire, the Daily Spiritual Experiences Scale (DSES), and the Spiritual Care Competence Scale (SCCS). The collected data were analyzed in SPSS software at the significance level of 0.05. The mean (SD) of daily spiritual experiences and total spiritual care competence was 67.15 (16.33) and 101.77 (16.26), respectively. The personal support and patient counseling dimensions had the highest mean (SD) [22.10) 4.80)]. Among all these dimensions of spiritual care competence, only professionalization and improvement of the quality of spiritual care were predictors of the students' daily spiritual experiences (p < 0.05). The professionalization dimension of spiritual care competence was identified as a predictor of daily spiritual experience in nursing students. Therefore, the researchers recommend the highlighting of this dimension in nursing programs to promote the students' spiritual care competence.

Dut meyvesinin fitokimyasal profili ve farmakolojik özellikleri

The fruits of Morus species from the Mulberry family (Moraceae) are traditionally consumed widely due to their positive effects on health. The interest about its health effect are increasing due to its rich content of bioactive components (flavonol, anthocyanin, flavanonol, phenolic acids, alkaloids), minerals (potassium, calcium, sodium, and magnesium), vitamins (vitamin B1 and folic acid), oils (linoleic acid, palmitic acid, oleic acid) and melatonin. In vitro and in vivo studies indicated that the fruits have positive health effects such as anti-diabetic, antioxidant, neuroprotective, hypolipidemic, anti-obesity, anti-inflammatory, hepatoprotective, antiparkinsonian, anti-tumor/anti-cancer, antimicrobial and immune-enhancing effects due to the bioactive components. In addition, mulberry fruit are traditionally consumed for their diabetes, hypertension, liver, kidney damage, and eye improvement effects. However, there is only limited clinical studies about the pharmacological properties of mulberry fruits whereas more in vitro research are present. In this review, the phytochemical profile, in vitro and in vivo pharmacological properties of Morus alba, Morus rubra, and Morus nigra fruits were investigated.

The potential of mobile health applications to improve couples' fertility: a systematic review and meta-analysis of randomized controlled trials

The purpose of this systematic review was to examine the safety and effectiveness of mobile health applications in couples with infertility. Nineteen databases were searched from their inception to August 2022. Only randomized controlled trials (RCTs) in which mobile health was used as an intervention in infertile couples were included. A quantitative analysis of RCTs was employed using RevMan software. Study selection, data extraction and validation were performed by two independent reviewers according to the guidelines. The Cochrane criteria for risk-of-bias were used to evaluate the methodological quality of the trials. Eight RCTs met the inclusion criteria. Among the eight RCTs, two RCTs were from the Netherlands and the remaining six RCTs were from China. Meta-analysis showed that mobile health interventions in infertile couples in China were found to be superior to usual care in terms of clinical pregnancy rate (p = 0.001), psychological status (SAS (Self-Rating Anxiety Scale): p &lt; 0.001; SDS (Self-Rating Depression Scale) p &lt; 0.001;), infertility knowledge levels (p &lt; 0.001), quality of life (p &lt; 0.001), and serum levels of 5-hydroxytryptamine (p &lt; 0.001). The effects on intervention groups using mobile health interventions in the Netherlands were not superior to the control groups that used usual care in terms of improving dietary factors (p &gt; 0.05). In general, the positive effect of mobile health on improving clinical pregnancy rate, psychological status, infertility knowledge levels, quality of life and satisfaction with information was better than that of usual care. Mobile health interventions could be a viable supplement to the usual care for infertile couples. However, more high-quality RCTs need to be included in the future to provide additional evidence of the positive effects of mobile health in infertile couples.

The potential impacts of using bio-based building materials on human health and wellbeing

When selecting building materials, health and wellbeing are aspects that are frequently neglected. It has been discovered that traditional materials are a source of hazardous emissions that have a negative impact on the health of individuals. On the other hand, Bio-based Building materials are increasingly being used instead of conventional materials as the construction sector aims to be more sustainable. However, these materials’ potential impacts on human health and wellbeing are also a source of worry. As a result, the purpose of this study is to present a comprehensive review of pertinent scientific research, with a focus on comparative studies that shed light on the effects of using bio-based building materials. Considering both positive and negative health effects, with a focus on indoor environment quality, indoor contaminants, and psychological health and well-being. The results highlight the need for more study and provide insightful information about how using bio-based building materials affects individuals’ health and well-being.

The Negative Role of Formula Milk Advertisements in Media and its Consequences

Breast milk is secreted by the mammary gland of lactating mothers and is the cheapest sole nutrient source for feeding breastfed infants. Its protein, fat and carbohydrate contents are adequate from the quantitative and qualitative aspects for the growth and development of breastfed infants during the first six months of life. Additionally, it is a rich source of specific antibodies, hormones and immunoglobulins, which protect breastfed infants from many infectious diseases and possess positive health effects. The last decades witnessed the industrial production of breast milk substitutes, which are inferior in their quality compared to breast milk and more expensive. In 1981, an International Code was adopted by the World Health Assembly (WHA) to reduce inappropriate marketing and protect breastfeeding. Marketing of breast-milk alternatives such as many infant formulas are promoted to the consumers via a wide range of media coverage including newspapers, online communications and business websites. Such advertisement affects negatively cultural expectations by portraying supplement consumption as widespread, and cutting-edge. The expansion in the marketing and consumption of such products may be associated with deterioration in the nutritional and health status of infants and young children belonging to low-income households. In a research study published in 2003, ten million babies die before reaching their fifth birthday of life worldwide. Breastfeeding proved an especially successful strategy, with the potential to save 1.3 million lives. Formula use is associated with a higher likelihood of premature deaths and hospitalization

A Sled Dog Model for Positive Health Effects of Weight Management and Exercise

Obesity is a significant risk factor for metabolic syndrome and type II diabetes. Physical activity and/or dietary modification can reduce the incidence of obesity. Marginal fitness levels limit the efficacy of exercise training, and most humans choose from a wide range of dietary strategies to lose weight. Despite these limitations, exercise in the absence of weight loss may offer protective benefits against the development of metabolic syndrome and type II diabetes. To examine the benefits of exercise training with and without weight loss, we measured changes in metabolic indices in conjunction with moderate body weight gain, exercise training with no intended change in body weight, and exercise training with bodyweight reduction in a healthy canine model. We measured glucose transporter type 4 on peripheral blood mononuclear cells, plasma glucose, hemoglobin A1c, tumor necrosis factor-alpha, interleukin 6, and insulin levels before, during, and after weight gain, exercise, and weight loss. Weight gain increased plasma glucose, while exercise increased glucose transporter by 4% in peripheral blood mononuclear cells. We also observed changes to plasma glucose, glucose transporter 4, and tumor necrosis factor-α which may be indicative of reduced insulin sensitivity with exercise and weight loss, potentially due to the high energy demand coupled with low caloric availability.

Comparative urine metabolomics of mice treated with non-toxic and toxic oral doses of (-)-epigallocatechin-3-gallate.

The green tea polyphenol, (-)-epigallocatechin-3-gallate (EGCG), has been studied for its potential positive health effects, but human and animal model studies have reported potential toxicity at high oral bolus doses. This study used liquid chromatography-mass spectrometry-based metabolomics to compare the urinary EGCG metabolite profile after administration of a single non-toxic (100 mg kg-1) or toxic (750 mg kg-1) oral bolus dose to male C57BL6/J mice to better understand how EGCG metabolism varies with dose. EGCG metabolites, including methyl, glucuronide, sulfate, and glucoside conjugates, were tentatively identified based on their mass to charge (m/z) ratio and fragment ion patterns. Partial least squares discriminant analysis (PLS-DA) results showed clear separation of the urine metabolite profiles between treatment groups. The most differentiating metabolites in the negative and positive ion modes were provisionally identified as di-glucuronidated EGCG quinone and di-glucuronidated EGCG, respectively. The presence of EGCG oxidation products at toxic dose is consistent with studies showing that EGCG toxicity is associated with oxidative stress. Relative amounts of methylated metabolites increased with dose to a lesser extent than glucuronide and sulfate metabolites, indicating that methylation is more prominent at low doses, whereas glucuronidation and sulfation may be more important at higher doses. One limitation of the current work is that the lack of commercially-available EGCG metabolite standards prevented absolute metabolite quantification and identification. Despite this limitation, these findings provide a basis for better understanding the dose-dependent changes in EGCG metabolism and advance studies on how these differences may contribute to the toxicity of high doses of EGCG.

Em Movimento pela Promoção pela Saúde

INTRODUCTION Workplaces are considered by the World Health Organization as one of the priority places for the development of health promotion actions, namely within the scope of work practices and healthy lifestyles (such as healthy eating, the practice of physical activity, prevention of obesity, professional stress, musculoskeletal injuries, among others). MATERIALS AND METHODS A review of guidelines and scientific articles related to health promotion was carried out, namely on physical activity in an occupational context. Pubmed, UpToDate and Clinical Key, World Health Organization and the Direção-Geral da Saúde were used as the main data sources and the research was carried out using the MeSH terms: “physical activity, health promotion, occupational health”. Publications between the year 2000 and 2022 written in English, Portuguese or Spanish were included. OBJECTIVE A review of the current scientific literature on physical activity is carried out in order to contribute to the implementation and improvement of policies aimed at promoting health in the workplace, thus increasing its potential benefits. DISCUSSION In light of new scientific evidence, all physical activity, regardless of the continuous duration of each practice period, has positive health effects. This implies an adaptation in the way of communicating about physical activity and in the way it is perceived, naturally translating a greater flexibility of behaviors and the potential for their integration, in different moments and contexts. CONCLUSION The recent characterization of physical activity as something easy to integrate into everyday life, regardless of its duration, brings a new vision in the approach to promoting physical activity, imposing the adaptation of strategies and policies that promote this área, namely at occupational level. KEY-WORDS: physical activity, health promotion, public health, occupational health, prevention, work.

A Framework to Facilitate Advanced Mixed Methods Studies for Investigating Interventions in Road Space for Cycling

Cycling mobility contributes to better livability in cites, helps societies to reduce greenhouse gas emissions and their dependency on fossil fuels, and shows positive health effects. However, unattractive conditions, primarily inadequate infrastructure, hinder the further growth of cycling mobility. As interactions of cyclists with the (built) environment are complex, assessing potential impacts of an intervention aimed at improving physical conditions is not trivial. Despite a growing body of literature on various facets of cycling mobility, assessments are widely limited to a single method and thereby either focus on one detailed aspect or on one perspective. While multi-method and mixed methods studies are emerging, they are not embedded into a structured, integrated framework for assessing systemic effects of interventions yet. Therefore, we propose a conceptual integration of several relevant methods such as questionnaires, interviews, GIS analyses and human sensing. In this paper, we present a generic, extensible framework that offers guidance for developing and implementing case-specific mixed methods designs for multifaceted assessments of interventions. The framework supports domain experts and researchers across different stages of conducting a study. Results from this research further indicate the added value of mixed methods studies compared to single-method approaches.

Understanding Patient-Provider Interaction, Treatment Acceptance, and Outcomes in Medically Unexplained Symptoms.

Medically unexplained symptoms (MUS) is an umbrella term used for chronic and often disabling health symptoms and conditions that remain unexplained after standard medical examinations, testing, and/or appropriate workup. Patients with MUS tend to receive little to no treatment but remain distressed, stigmatized, and disabled by symptoms and iatrogenic factors. A qualitative phenomenological study was conducted to explore daily challenges and psychosocial and iatrogenic factors affecting the management of MUS. The analysis of the interviews revealed that MUS could cause significant distress to patients, impairing their functioning and leading to permanent disability. Conventional healthcare cannot meet the medical needs of these patients and might be a potential source of harm to them. It should be noted that confirmation of conditions associated with clinically significant psychiatric premorbidity was not provided. Inconsistent diagnostic criteria, lack of proper training and research, diagnostic overshadowing, and implicit bias in healthcare professionals can lead to negative patient outcomes and the overuse of alternative or non-evidence-based services. Guidance, practice-based improvement ideas, and suggestions specific to improving patient-provider relationships can be applied to generate positive health effects.