Abstract:

Background/Objectives: Rural and underserved adults face barriers to hypertension (HTN) self-management, and in-person lifestyle education programs in academic medical settings may have limited reach This pilot study evaluated a publicly available HTN self-management app (iOS/Android) with respect to feasibility, perceived usefulness, user satisfaction, and user-entered metrics relevant to HTN and lifestyle management. Methods: We conducted an internet-based, single-arm pilot of a mobile app available in commercial app stores. Adults aged ≥19 years who downloaded the free app and reported HTN self-enrolled via in-app registration and electronic consent; no direct recruitment or compensation was provided. Outcomes included an in-app questionnaire (HTN history, perceived BP status, concern, and a key self-management behavior) and app engagement/health-entry data (registration counts; use of tracking features; distributions of user-entered metrics). Results: From June 2020–July 2025, 819 users completed the in-app questionnaire; five were excluded as spam (N=814). Responses clustered in 2021 (76.8%), and completion time was brief (median 91 s; IQR 65–131). Most respondents reported hypertension for >2 years (57.3%; 21.5% unsure). Perceived BP was “normal” (42.1%), “borderline” (24.8%), or “high” (15.2%), with 15.0% unsure. For a key self-management behavior, only 21.8% reported measuring their blood pressure “usually/always,” while 24.8% reported never measuring their blood pressure. More than half were at least somewhat concerned about their BP (56.6%). Conclusions: In a largely rural, southeastern context, this publicly available HTN app demonstrated feasible low-touch uptake and captured user-entered self-management data, though sustained tracking occurred in a subset of users. Findings support further pragmatic testing focused on engagement, equity, and integration into nurse-led care workflows.

Abstract: Background: There is a growing interest in the effects of coffee consumption on the human health. This study was conducted to identify a causal relationship between the coffee consumption and the risk of metabolic syndrome (MetS). Methods: We analyzed the data of the 5th Korea National Health and Nutrition Examination Survey in 2010 for the current study. Results: The risk of MetS, high triglyceride (TG) and low high-density lipid-cholesterol (HDL-C), was significantly lower in the female subjects with a daily amount of coffee consumption of ≥ 3 cups as compared with those with a daily amount of coffee consumption of < 1 cup. There was a significant dose-response inverse correlation between the amount of coffee consumption and the risk factors of MetS (high TG and low HDL-C) after the adjustment of multiple confounding factors (P=0.015 and 0.011, respectively). There was also a modest dose-response relationship between the amount of coffee consumption and MetS (P=0.056). There was no significant correlation between the amount of coffee consumption and MetS in the male subjects. Conclusions: The coffee consumption might have a beneficial effect in lowering the risk of MetS. The current results suggest that it would be mandatory to consider individuals’ recognition of health impacts of coffee consumption.

Abstract: Background: Occupational use of pyrethroid insecticides indoors remains widespread due to their effectiveness and perceived safety compared with older pesticide classes. However, enclosed workplaces with central heating, ventilation, and air-conditioning (HVAC) systems—especially those with wall-to-wall carpeting and dust-accumulating surfaces—can sustain residue persistence and repeated low-dose exposure far beyond the spray event. No evidence-based or standardized guidelines currently define safe spray-ing frequency, residue decay intervals, or ventilation requirements for such environ-ments, representing a major regulatory and research gap; Objective: This review intro-duces the concept of the occupational indoor pyrethroid exposome—the cumulative exposure environment created by recurrent spraying, residue persistence, and resuspension—and identifies mechanistic links to thyroid, neurological, cardiovascular, hepatic, and immune toxicity; Methods: A structured literature review was conducted across biomedical and environmental databases. Included studies addressed (i) indoor pyrethroid use and resi-due persistence in dust or surfaces; (ii) resuspension and HVAC-mediated redistribution; (iii) human biomonitoring and health outcomes; and (iv) mechanistic data related to en-docrine, hepatic, neurological, cardiovascular, and immune effects. Only peer-reviewed studies were analyzed; Results: Evidence shows that pyrethroid residues persist in indoor dust and textile reservoirs, leading to chronic, low-dose exposure through resuspension and contact transfer. Mechanistic findings indicate that voltage-gated sodium channel modulation, mitochondrial dysfunction, oxidative stress, and inflammatory signaling act as convergent pathways linking chronic exposure to neuroexcitation, endocrine disrup-tion, hepatic enzyme induction, vascular dysfunction, and immune dysregulation. Limited occupational data highlight a consistent association between long-term indoor spraying and elevated biomarkers of hepatic and thyroid stress; Conclusions: The absence of clear occupational safety standards for indoor pyrethroid use constitutes a major gap in pesti-cide regulation and workplace health protection. Integrating residue monitoring, ventila-tion assessment, and mechanistic biomarkers into occupational risk frameworks is essen-tial to guide safe spraying intervals, improve exposure surveillance, and prevent chronic multisystem toxicity among workers in enclosed environments. This framework not only supports the development of evidence-based occupational pesticide safety standards and improved ventilation policies in enclosed workplaces, but also highlights a critical regu-latory gap — the current absence of any evidence-based guidelines defining safe frequen-cy or interval for indoor pyrethroid spraying.

Abstract: Background/Objectives: Cognicise (multicomponent exercise) and Chlorella (microbial food) improve cognitive function independently. However, their combined effect and underlying mechanisms, including antioxidant capacity and metabolite fluctuations, remains unelucidated. We investigated the effect of multicomponent exercise combined with Chlorella intake on cognitive function in community-dwelling older adults and assessed changes in reactive oxygen species (ROS), free radical scavenging activity, and blood metabolites. Methods: In this double-blind comparative study conducted over 6 months, 16 older adults randomly received either Chlorella (Ex+C group) or a placebo (Ex+P group) alongside performing multicomponent exercise. Cognitive function (memory, attention, executive, and information processing) was assessed using the National Center for Geriatrics and Gerontology-Functional Assessment Tool. The scavenging activity against various ROS and free radicals was measured, and a comprehensive metabolomic analysis was performed. Results: A significant interaction was observed for information processing function, improving significantly in both groups post-intervention. The Ex+P group showed a significant executive function decline; no such change was observed in the Ex+C group. The Ex+C group exhibited significantly improved OH· scavenging activity post-intervention. Free radical scavenging activity increased in both groups. Metabolomic analysis revealed significant changes in 29 and 25 metabolites in the Ex+C and Ex+P groups, respectively, between before and after the intervention. Conclusions: Combining multicomponent exercise and Chlorella intake may increase metabolites, thereby improving the scavenging activity of ROS and free radicals. This approach can improve information processing ability while preventing the significant executive function decline of exercise alone.

Abstract: In a sentinel health event investigation of a back disorder claim, the vibration exposure and ergonomic function of a modified suspension seat were assessed. (1) Background: In a forensic occupational injury investigation an after-market altered operator seat in a railroad rail-track tamper machine was evaluated. (2) Methods: Detailed whole-body vibration (WBV) exposure measurements were conducted according to current applicable technical standards and guidelines (i.e., ISO 2631-1; 1997) on a 09-16 DYNACAT Continuous Action Tamper with Stabilizer during routine track repair services. The modified Grammer Mfg. suspension operator seat was evaluated for performance and ergonomic features (i.e., adjustability, posture, and suspension quality); (3) Results: The tested seat appeared to underperform and was overloaded with the aftermarket control devices, attachments and modifications. The suspension system's end-stopper was damaged. The seat system had excessive play and wobbles; it was not firmly braced and attached. The vector sum (av) results ranged from 0.26 m/s² (no tamping) to maximal 0.55 m/s² (tamping). The seat transfer (SEAT) analysis showed magnification of vibration input and variable performance of the suspension depending on operational tasks. (4) Conclusions: The modified suspension seat underperformed and seemed to magnify and worsen the vibration, jolts and shock exposures of the seated operator. The heavy and bulky seat modifications likely limited the suspension function. The malfunctioning seat was more likely than not a contributing factor in the pathogenesis of the spinal disorders for the injured machine operator.

Abstract: The aim of this study was the validation of the published method for the estimation of the personal maximum manual handling weight limit (PMHWLmax) [1] which is based on the personal body weight, as a reference to general population percentiles anthropometrics. For this purpose, an experiment was designed, were a repetitive process of transferring progressively increasing loads, was performed, with the aim of identifying through EMG recording of the erector spinae muscle, the load that brings about the first distinct quantity change in muscle activation and fatigue, compared to the preceding trials and afterwards the matching of the specific load value with the body weight of the participant

Abstract: Background/Objectives: Soccer is a team sport that places significant physical demands on players. Players cover greater distances at higher speeds, and the number of high-intensity movements is increasing. The present study analyzed the locomotor and mechanical variables of Hungarian second division professional soccer players over three seasons (2022/23, 2023/24, 2024/25), using Catapult Vector S7 and processing data from 94 matches. Methods: We included 94 matches in the study (2022/23: N=38; 2023/24: N=29; 2024/25: N=27), in which only the data of players who played the entire matches were analyzed, excluding red card matches. Performance data was collected using Catapult Vector S7 10 Hz GNNS system. Results: The median average distance covered decreased continuously from the 2022/23 season (10.210 m) to the 2024/25 season (9.795 m) (H (2) = 14.14, p&lt;0.001, Rank ε² = 0.152, medium effect size). The median Player Load decreased from 1002 (2022/23 and 2023/24) to 846 in the 2024/25 season (H (2) = 55.64, p&lt;0.001, Rank ε² = 0589, very large effect size). The median acceleration-deceleration effort (Accel + Decel) decreased from 220.8 (2022/23) to 199.0 (2024/25) (H (2) = 26.81, p&lt;0.001, Rank ε² = 0.288, effect size). Conclusion: There was a significant seasonal decrease in match load variables. The most pronounced decrease occurred in the mechanical indicator. These results may provide useful insights into the physical demands of matches.

Abstract:

Diabetes mellitus is a serious chronic disease whose main characteristic is hyperglycemia (increased blood glucose), accompanied by changes in lipid and protein metabolism. For individuals with diabetes mellitus, physical activity provides significant benefits and is an essential tool for metabolic management. Daily step counting, measured with AI support through wearable devices, can be an important metric of physical activity for the prevention and treatment of this disease if performed regularly and respecting a minimum daily amount. Objective: To investigate the association between daily steps and diabetes and to determine what minimum amount should be performed daily for a protective effect in participants of the Longitudinal Study of Adult Health. Methods: The study was cross-sectional and participants from the 2nd segment (2016-2018) were analyzed, with a sample of 12,636 participants. The dependent variable was diabetes, assessed by laboratory tests, and the independent variable was daily steps counting, assessed by accelerometry. The associations between the dependent and independent variables were analyzed using logistic regression. The odds ratio with 95% CI was estimated. Results: An association was found between daily steps and diabetes (OR = 0.76, CI = 0.70-0.83), in addition to the cutoff point of 6,880 with area under the ROC curve = 0.58 (CI = 0.57-0.59). Conclusion: Based on the results found in this study, we can conclude that the number of daily steps has a protective effect against diabetes, especially in men and women with abdominal obesity and in men with moderate/vigorous leisure-time physical activity.

Abstract:

Background/Objectives: Despite extensive research on nurses' knowledge and attitudes toward pain management globally, limited evidence exists regarding the actual implementation of multimodal pain management practices among Vietnamese nurses. This study aimed to (1) assess nurses' implementation of pharmacological and non-pharmacological pain management interventions, (2) examine the relationships among knowledge, attitude, and practice (KAP), and (3) identify predictors of competent practice with attention to the relative contributions of formal training versus clinical experience. Methods: A cross-sectional survey was conducted among 230 nurses from two tertiary public hospitals in Ho Chi Minh City, Vietnam, between April and June 2024. Pain management knowledge, attitudes, and practices were assessed using validated instruments. Independent samples t-tests compared trained versus untrained nurses. Multiple linear regression identified predictors of practice competency. Effect sizes (Cohen's d) quantified the magnitude of training effects. Results: Nurses demonstrated moderate-to-good competency, with pharmacological interventions (M = 3.74) implemented more consistently than non-pharmacological interventions (M = 3.48, p < 0.001). Trained nurses significantly outperformed untrained nurses across all domains with large effect sizes (Cohen's d = 1.34–1.54). A clear hierarchy emerged in non-pharmacological practice: environmental (M = 4.01) > physical (M = 3.69) > cognitive-behavioral (M = 3.27) > spiritual (M = 2.60). Strong KAP correlations were observed (r = 0.70–0.85, p < 0.001). Prior training was the strongest predictor of both pharmacological (β = 1.31, p < 0.001) and non-pharmacological practice (β = 0.58, p < 0.001), while clinical experience showed no significant effect (p > 0.40). Conclusions: This study provides novel evidence that formal training—not clinical experience—drives competent pain management practice among Vietnamese nurses, with large effect sizes demonstrating practical significance. The strong KAP relationships support targeted educational interventions addressing knowledge gaps to improve practice. These findings have direct implications for nursing education policy in Vietnam and similar healthcare settings.

Abstract: Background: Field-based functional fitness tests are widely used to assess exercise capacity, yet their acute physiological responses in clinical populations remain incompletely characterized. This study examined acute cardiopulmonary responses to a two-minute step test (2MST) in adults with cardiovascular risk factors. Methods: A total of 239 adults (155 women, 84 men) with cardiovascular risk factors completed the 2MST. Pulmonary function (FVC, FEV₁, PEF), oxyhemoglobin saturation (SpO₂), and heart rate were assessed before and immediately after the test. Analyses were performed overall and stratified by sex, age, and tertiles of step count. Results: Following the 2MST, small but significant increases in FVC and FEV₁ were observed across sex and age groups (p < 0.05). Improvements in PEF were most evident in younger men. Participants with lower baseline stepping performance showed greater increases in SpO₂, particularly women, with improvements of up to approximately 1.7 percentage points. Heart rate increased by approximately 25 beats per minute during exercise and did not differ significantly across performance tertiles after adjustment. Conclusions: The two-minute step test elicits measurable acute cardiopulmonary responses in adults with cardiovascular risk factors. Beyond its role as a functional fitness assessment, the 2MST provides a brief physiological stimulus associated with improved oxygenation, particularly in individuals with lower baseline functional capacity.

Abstract:

The purpose of this study was to examine the validity of a Garmin wrist-based device for estimating heart rate, energy expenditure, and step count during incremental treadmill exercise in college-aged individuals. Eighteen males and females (mean ± SD age = 23.2 ± 4.9 years) volunteered to complete an incremental treadmill test with the Garmin Vivoactive 4 device and criterion methods (electrocardiogram, indirect calorimetry, and video recording) measuring heart rate, energy expenditure, and step count. Mean absolute percent error (MAPE), simple linear regression, and Bland-Altman plots were used to assess accuracy. Acceptable accuracy was defined as MAPE < 5% for heart rate and < 10% for energy expenditure and step count. Statistical significance was set at α < 0.05. The MAPE (±SD) values were 13.0 (±10.1), 19.1 (±15.0), and 4.6 (±5.3)% for heart rate, energy expenditure, and step count, respectively. The Bland-Altman regression analyses illustrated proportional bias was present for estimations of heart rate (r = 0.591, p < 0.001) and step count (r = 0.516, p = 0.028), but not energy expenditure (r = 0.351, p = 0.153). These findings indicated that the Garmin Vivoactive 4 provided acceptable accuracy metrics for step count, but not heart rate or energy expenditure.

Abstract: Background: Dementia and Type 2 diabetes (T2D) represent two of the most pressing global public health challenges of our time, both exacerbated by physical inactivity. These conditions disproportionately affect Global Majority populations, who experience earlier onset, higher prevalence, and poorer access to culturally appropriate preventive care. However, conventional research and interventions often overlook the sociocultural and structural factors that underpin this disparity. This study synthesises current evidence to understand how these three conditions intersect and to identify equitable pathways for prevention and support. Methods: A meta-narrative review approach was employed, guided by the framework of Greenhalgh et al. (2005), to integrate evidence from diverse research traditions. Databases including MEDLINE, CINAHL, PsycINFO, and Web of Science were searched. Five meta-narratives were identified: biomedical and epidemiological, public health, health disparities, sociocultural and behavioural, and intervention science. Cross-narrative synthesis produced a conceptual framework linking upstream determinants, lifestyle factors, and disease outcomes. Results: The review revealed that structural inequities such as deprivation, environmental barriers and sociocultural factors including stigma, gendered norms, limited access to culturally appropriate facilities that restrict physical activity (PA) opportunities within Global Majority communities. These constraints elevate T2D and dementia risk through biological pathways involving insulin resistance, vascular injury, and neuroinflammation. Community-based participatory research (CBPR) interventions particularly those delivered in trusted cultural, or faith settings emerged as effective strategies to improve PA, glycaemic control, and cognitive wellbeing. Conclusion: This synthesis reframes dementia and diabetes as interlinked within a wider syndemic driven by structural and sociocultural inequities. The proposed framework underscores the importance of culturally grounded, community-led approaches to promote brain health, reduce risk, and achieve equitable healthy ageing among Global Majority populations.

Abstract:

Background: The prevalence of chronic hepatitis B virus (HBV) infection is estimated at approximately 3% in Korea, and it is also accompanied by extra-hepatic manifestations as well as chronic hepatitis. Of these, HBV glomerulonephritis occurs due to the immune complex deposit; it is a serious condition that may cause renal failure. Methods: We analyzed the data obtained from adults aged 19 years or older who participated in the KNHANES V-2 and 3 (2011 and 2012) and VI-1 and 2 (2013 and 2014), for which we estimated the prevalence of HBV infection and compared albuminuria and spot urine ACR between the HBV infection group and the control group. Results: A total of 20,024 subjects were enrolled in the current study. The prevalence of HBV infection was 3.8%. There were no significant differences in the prevalence of albuminuria (5.6±1.0 % vs. 6.9±0.2 %, respectively) (P=0.233) and spot urine ACR (22.23±8.95 vs. 17.87±1.05 mcg/mg, respectively) (P=0.629) between the HBV infection group and the control group. In addition, according to a subgroup analysis, there was also no significant difference in the prevalence of albuminuria between the HBV infection group, accompanied by chronic diseases such as HTN, DM, metabolic syndrome and dyslipidemia, and the control group. Conclusions: Based on our results, it can be concluded that only a regular follow-up rather than a meticulous monitoring of microalbuminuria would be sufficient in the subjects with HBV infection.

Abstract:

Background/Objectives: Palliative care (PC) has traditionally focused on patients with cancer and their families. However, individuals living with advanced non-malignant chronic diseases and their caregivers face comparable challenges that significantly affect their quality of life. This study aimed to explore the PC needs of patients with advanced non-malignant chronic conditions through the lived experiences of both patients and their informal caregivers. Methods: Semi-structured interviews were conducted with eight patients and nine caregivers recruited via the Municipality of Katerini “Help at Home” program (Jan–Mar 2025). Interviews were audio-recorded, transcribed verbatim (in Greek), and analysed inductively using thematic analysis. Ethical approval was obtained from the International Hellenic University (Ref. No. 18/22.12.2022), and official consent was gained from the Municipality of Katerini (Approval Ref. No. 7803-/30/01/2025). Results: Five themes emerged: (1) Basic daily care and physical support; (2) Psychosomatic and emotional impact; (3) Social withdrawal and role change; (4) Support systems and sources of resilience; and (5) Experience with the healthcare system and organized care. Participants highlighted urgent needs for home-based physiotherapy/nursing, caregiver respite, and psychological support. Resilience—expressed through family bonds, spirituality, and adaptive coping—also emerged as a cross-cutting dimension influencing how these needs were experienced across all domains. Conclusions: These findings document complex, interlinked needs among patients with advanced non-malignant chronic conditions and their caregivers and support the development of community-based, integrated PC services. Larger, multicenter studies and the development/validation of a needs-assessment tool are recommended.

Abstract:

Queuing theory and the Erlang equation are directly applicable to small hospital departments such as maternity and pediatrics. Bed capacity tables can be easily generated linking annual births/admissions to the required available beds, using expected births/admissions and length of stay (LOS). Two bed calculators are provided. For example, in maternity the total bed days includes any admissions during pregnancy and after birth, i.e., excluding the time spent in the birthing unit. It is emphasized that bed days must be calculated using real time length of stay as opposed to the usual midnight figure. The bed occupancy margin is directly linked to size and not ‘efficiency’. Based on the Erlang B equation which links available beds, occupied beds and turn-away, a figure of 0.1% turn-away has been chosen as the minimum acceptable number of beds, i.e., only 1 in a thousand admissions suffer a delay before a bed can be found. Two bed calculators are provided which can be used for obstetric, maternity, midwife-led, birthing wards and neonatal unit bed capacity. Specific issues relating to neonatal critical care bed capacity are highlighted. The negative effects of turn-away are likely to be context specific, hence, critical care > theatres > birthing unit > maternity unit. The far greater uncertainty regarding future births is discussed along with the variable nature of seasonality in births. For pediatrics much of bed demand is also influenced by the trend in births. Suggestions are made for a pragmatic approach to bed planning. Evidence is presented which suggests that for maternity (and other relative short stay admissions) the majority of overhead/indirect costs and most staffing costs should be apportioned based on admissions, and not LOS. Apportionment based on LOS creates the spurious illusion that LOS is the major cost driver and that reducing LOS will immediately save costs. Several lines of evidence point to the minimum cost per patient in maternity (antenatal + postnatal) lying greater than 30 beds (plus associated labor/birthing beds), and the minimum economic size around 12 beds. Around 30 beds probably mark the point where it is possible to make small cost savings by reducing LOS. Allocating total organizational costs to individual units and then to patients is far less precise than is realized and can be done in different ways which all heavily rely on the steady-state assumption. The real world of daily arrivals, case mix and clinical severity is never in steady state. Below 20 to 30 beds Poisson statistical plus environment induced randomness in daily arrivals imply that staff costs become increasingly fixed irrespective of LOS. When bed availability is the bottleneck then reducing LOS may increase throughput per bed and increase income, however, is this for the benefit of the patient or for the benefit of the organization, and does it lead to higher unanticipated total costs including patient harm? Finally, a list of nine ‘never do this’ catastrophic pitfalls are given for doctors to identify dubious capacity advice from managers and external ‘experts’.

Abstract: Background: In recent years, virtual consultations have emerged as a crucial approach for continuity of chronic care provision, indicating a promising avenue for the future of smart healthcare systems. However, reversions to in-person care highlight persis-tent limitations, despite notable advantages of remote modalities. In parallel, recent developments in artificial intelligence (AI) indicate the potential to enhance remote chronic care, but user perceptions of such assistance and the corresponding human factors remain underexplored. Objective: This mixed-methods study aims to better understand the virtual consulta-tion experiences and attitudes toward AI assisted tools in remote care among patients with noncommunicable chronic conditions and their healthcare professionals (HCPs). It conducts an in-depth examination of the associated human-computer interaction and usability elements of virtual consultations and of potential AI assistance. Methods: Public and Patient Involvement was integrated to run pilots and refine documentations. Semi structured interviews with patients (n=10), focus groups with HCPs (n=15), and an online survey (n=83) were conducted. Qualitative data was ana-lysed through a reflexive thematic approach. The survey comprised the Telehealth Usability Questionnaire (TUQ) and bespoke items on user AI views, and the data was used to triangulate the qualitative findings. Nonparametric Kruskal–Wallis tests and ε² effect sizes compared TUQ and AI views scores between current and former virtual consultation user groups. Results: Seven themes emerged from the qualitative data, which were supported by the quantitative findings. The mean TUQ total score of 90.6 (SD=15.0) indicates high usa-bility and user satisfaction, and there were no significant group differences (p >0.05; ε² = 0.002–0.032). There was a clear preference for hybrid models, while a lack of em-pathy was identified during remote interactions. Users were cautiously open to AI as-sistance, contingent upon transparency, human oversight, and data integrity. Views on AI assistance did not differ significantly across groups (p >0 .05; ε² = 0.005–0.065). Conclusion: Virtual consultations for chronic conditions are widely usable and ac-ceptable, particularly through hybrid approaches. Addressing empathic engagement, holistic patient status, and transparent AI integration can enhance clinical quality and user experiences during remote interactions. This study has also identified evi-dence-based assistive AI features that can potentially enhance virtual consultations. These insights can inform the co-design of evidence based virtual care platforms, poli-cies and supportive AI tools to sustain remote chronic care delivery.

Abstract: The principles of regeneration are found in different types of cultures, from long time ago. As an interdisciplinary field of research, regenerative medicine, play a great role in tissues and organs damaged reparation with a higher potential in transplantation if necessary. The definition of stem cells can be extended. From this point of view, we can mention taking in consideration the idea in which it is known that these cells form the base of the building body.

Abstract: Background/Objectives: 40-Hz sensory stimulation is being explored as an everyday, non-pharmacological approach for cognitive-health applications, but sustained use depends on acceptability and implementable delivery/UX. We examined user-perceived acceptability and implementation considerations for a 40-Hz sine-wave–integrated soundscape intervention. Methods: Eleven adults aged ≥40 years in Seoul, Republic of Korea were assigned to waves or forest soundscapes (between-participants) and completed a within-participant comparison of 40-Hz–OFF (soundscape-only) versus 40-Hz–ON (soundscape plus an additively layered 40-Hz sine wave). Each condition comprised seven cycles of 50 s playback and 10 s silence (~7 min) with a 10 min washout. Participants completed a session-end 7-point Likert appraisal of the 40-Hz–ON stimulus and a semi-structured interview. Interview transcripts were analyzed using thematic analysis and interpreted using the Theoretical Framework of Acceptability and Proctor et al.’s implementation outcomes as sensitizing frameworks. Results: Likert appraisals indicated mid-to-high comfort and immersion (medians = 5) and moderate calmness (median = 4), with relatively low unpleasantness (median = 2). Perceived artificiality varied widely (range 1–7) and overall preference was moderate (median = 4). Interviews showed heterogeneous detectability of 40-Hz inclusion; acceptability depended on whether the layered component blended naturally or was perceived as mechanical/rumbling. Participants highlighted context fit (e.g., bedtime versus morning routines), “backgroundability,” and low-friction automation (timers/scheduling) as key sustainability factors, while emphasizing acoustic safeguards such as gentle onset and conservative default levels. Conclusions: A 40-Hz sine-wave–integrated soundscape can be acceptable, but responses are heterogeneous and sensitive to timbral salience and usage context. Scalable delivery should incorporate space-oriented playback options, simplified automation, acoustic safeguards, and coherence-focused guidance with appropriate disclaimers.

Abstract: Background and Objectives: Formal education in Africa is becoming increasingly influ-enced by the traditional media consumption, ranging from television and radio to in-ternet usage. This study aims to determine the effects of traditional media consump-tion on health literacy in provinces with high illiteracy. Materials and Method: The study adopted a retrospective cross-sectional study design using the 2016 South Afri-can Demographic Survey Data to analyse the factors affecting health literacy. Partici-pants were selected using a stratified two-stage sampling method to ensure national and provincial representativeness. A total of 1 982 participants aged 15 – 29 years who met the inclusion criteria were included for further analysis. Pearson’s Chi-square test was used to test for association between health literacy and media consumption. Mul-tivariate logistic regression was used to determine the effects of traditional media consumption on health literacy, p ≤ 0.05 was considered statistically significant. STATA version 16.1 (StataCorp, LLC, College Station TX, USA) was used for analysis. Results: The results showed that media consumption emerged as a strong predictor, in-dividuals who reported watching television had increased odds of health literacy (OR = 2.67; 95% CI: 1.55 - 4.61; p < 0.001). Similarly, internet use was positive predictor of health literacy (OR = 3.11; 95% CI: 1.76 - 5.52; p < 0.001. Other variables such as educa-tional level also emerged as a significant predictor, individuals with secondary school education had significantly higher odds of health literacy compared to those with lower educational levels (OR = 17.10; 95% CI: 4.20 - 69.63; p < 0.001). Conclusion: This study highlights the critical role media consumption plays in shaping health literacy outcomes among the youth, particularly in provinces with high illiteracy rates. By us-ing media platforms strategically and ensuring equitable access, educators, health practitioners and policymakers can unlock new pathways to health literacy, fostering a more informed, empowered, and connected society.

Abstract: Research shows that dual-task balance performance deficits serve as indicators which help predict future falls among elderly people. The research investigated how fallers (people who experienced two or more falls per year) performed compared to non-fallers during single and dual-task balance assessments. The research involved 24 community-dwelling participants between 65 and 80 years old who completed Balance Error Scoring System (BESS) and Timed Up-and-Go (TUG) tests while performing serial-7 subtraction.The study results showed that fallers made more BESS errors (M=18.4±4.2 vs. 11.2±3.1) and their dual-task TUG times were longer (M=14.8±2.1s vs. 11.2±1.5s) than non-fallers. The dual-task performance of fallers showed a significant decline of 25.4% compared to non-fallers who experienced a 12.1% decline (F(1,22)=8.92, p=.007, η²=.29).The research findings indicate that fallers experience more significant cognitive-motor interference which supports dual-process models. The research supports the need for motor-cognitive screening and training programs to prevent falls.