Abstract: Background: A large number of guideline recommendations have been developed by local-, state- and national-level health organisations available to promote the healthy eating and physical activity of children attending early childhood education and care (ECEC) settings. However, the evidence supporting these recommendations is often not well-described. An examination of the current evidence is needed to support decision-makers to understand and prioritise practices for implementation.Aim: To describe a novel systematic evidence-mapping process which: i) examines the evidence-base underpinning ECEC-based healthy eating and physical activity practice elements; and ii) classifies practice elements according to the World Health Organization (WHO) Standards for Healthy Eating, Physical Activity, Sedentary Behaviour and Sleep in Early Childhood and Care Settings to examine alignment with current global guidelines. Methods: We undertook a two-stage, five-step systematic process. Stage 1 involved identifying the existing ECEC-based guideline recommendations and randomised controlled trial evidence which evaluated child diet and physical activity outcomes. Stage 2 involved conducting a secondary data analysis and synthesis of the evidence underpinning practice elements by: extracting practice elements of RCTs and mapping these to existing guideline recommendations, where possible, or included these as additional practices; using vote-counting approaches and a framework to assess the evidence underpinning each practice element; and, classifying practice elements according to the WHO Standards for Healthy Eating, Physical Activity, Sedentary Behaviour and Sleep in Early Childhood and Care Settings. Results: We found 16 healthy eating (e.g. Educators discuss the food served with children) and 19 physical activity (e.g. Educators embed physical activity into educational activities) practice elements were assessed as likely beneficial. Most of these mapped to WHO Standard 2: Creating supportive environments. Seven practice elements were assessed as possibly beneficial, two as possibly not beneficial and none as not beneficial. There was insufficient evidence to assess 39 practice elements. Conclusions: This study provides insights into the evidence underpinning practice elements included in ECEC-based healthy eating and physical activity guidelines, identifies evidence-based practice elements not included in existing guidelines and highlights opportunities where evidence can be strengthened.

Abstract: Purpose: In order to better understand the relationship between nutrition and brain health, we compared different studies and their results to evaluate the significant association between diet and preventing psychological & neurological disorders such as: Alzheimer’s disease, depression or how different diet patterns can influence mental and brain health. Method: This research includes a descriptive and retrospective study, including a number of 280 subjects of both sexes and different ages, who accomplished a proposed survey. A statistical analysis was made targeting a variety of parameters that indirectly reflects the impact of diet on mental health. Results: General health– 46,8% of subjects confirm the presence of a high impact on general health (131 cases), followed by the category thinking that chose the presence of a very high impact (114 cases, 40,7%). Physical health – in this case the statistical analysis highlighted equal percentages among high (127 cases, 45,4%) and very high impact (126 cases, 45,0%) on physical health. Mental health – 43,6% of subjects consider that adopting a healthy diet is followed by a significant impact mostly on mental health (122 cases, 43,6%). Focus capacity– 43,2% of subjects consider that healthy alimentation has a significant effect on the ability to focus (121 cases). The ability to memorise – similarly to the previous section, the analysis indicated in the previous item that diet has a high impact on the capacity to memorise (109 cases, 38,9%). Good disposition – the major impact is shown is shown on this aspect as well (125 cases, 44,6%). Conclusion: Over 70% of the subjects involved in this research paper have healthy eating behaviours in correlation with the high percentage of patients without any neuro-degenerative or mental health disorders. Most of the subjects consider that healthy nutrition has a significant impact on health in all its forms (general, mental, physic), but not all of them have healthy food habits, nor use their knowledge. Promising results show that healthy nutrition positively contributes in alleviating focus or learning capacity. There has been a distinctive link between daily caffeine consumption which is associated with an unhealthy diet and unhealthy diet behaviours. 24,6% of subjects with an unhealthy diet and 4,9% of those with relative healthy diet agree daily consumption of soda drinks. Negative feelings, with a significant emotional impact were reported in most of the cases or in superior proportions in subjects with an unhealthy diet (prevailing or intermittent), proving that unhealthy habits might have an important effect on mental health, while exacerbating mental health disorders.

Abstract: Background/Objectives: Crohn's disease (CD), is a chronic, inflammatory, and fluctuating condition, that affects the lives of patients significantly. Research on chronic illnesses has consistently shown that social support, especially the specific source from which it is received, plays a crucial role in helping individuals adapt to their condition as well as reduce perceived stress levels. The same can be said for a patient's sense of control over their disease. This study had two main objectives: (1) examine the roles of perceived stress, perceived social support, received social support, different sources of social support, and health-related locus of control at various stages of CD; and (2) analyse how these variables relate to, and potentially influence, the occurrence of CD flare-ups. Methods: A cross-sectional observational study was conducted on a total sample of 160 individuals diagnosed with Crohn's disease, either in an active or inactive phase. The instruments used included the Perceived Stress Scale (PSS), the Social Support Questionnaire (assessing both perceived and received social support from multiple sources: family, friends, health professionals, and peers), and the Health Locus of Control Scale. All instruments used were validated beforehand. The Student's t-test was used to explore significant differences between groups, and binary logistic regression was utilised to identify variables that act as predictors for the occurrence of CD flare-ups. Results: Higher levels of total perceived social support, especially from friends and health professionals, together with a stronger internal health locus of control, were found to be significantly related to a lower likelihood of CD flare-ups. To the contrary, high levels of stress were associated to a greater likelihood of CD flare-ups. Conclusions: We suggest that programmes or initiatives aimed at improving the quality of life, disease management and clinical stability of individuals with Crohn's disease (CD), be put into place. These initiatives would help to increase the protective effects of social support, strengthen an internal health locus of control, as well as both reduce and effectively manage stress.

Abstract: Background: Physical functioning is traditionally assessed and presented as self-reported measures, which have shown either improvement or stability during the last decades at population level. On the other hand, objectively measured, performance-based measures of physical functioning have indicated increased body weight and decreased physical fitness. Therefore, there is a need for objective, measured total physical functioning index (MePFIX). Methods: The MePFIX was developed from the data of 5238 working-aged adults (60% women) who took part in the FINFIT studies from years 2017 and 2021. The outcomes of measured body composition, cardiorespiratory fitness, muscular fitness, physical activity, stationary behavior, and time in bed were used to create the MePFIX. Results: The best performing index contained the fol-lowing measures: waist circumference, estimated maximal oxygen consumption, modified push-up, mean of daily 1-minute metabolic equivalent, high-movement time in bed, lying and reclining during waking hours >20-min bouts, standing, daily step count, moderate-to-vigorous physical activity in absolute terms, and light physical activity relative to fitness. Conclusions: The developed MePFIX is based on population-based data, containing measured outcomes of body composition, cardiorespiratory fitness, muscular fitness, physical activity, sedentary behavior and time in bed. The index could serve as an objective indicator of physical functioning among the target population. The MePFIX can be used as a figure of merit of measured physical functioning for research community and policy makers both at cross-sectional and at longitudinal analyses.

Abstract: In Europe, the practice of swimming in surface water not officially designated as swimming water (wild swimming) appears to have increased in recent years. This prospective case study focuses on the watershed of the German-Dutch Vecht river. During the hot summers of 2018 to 2020, between 29,000 and 37,000 people a year sought cooling in the streams, rivers and canals of this catchment area, into which 52 sewage treatment plants discharge. As a result, 85% of the wild swimmers in the area swam in surface waters that do not comply with the European Bathing Water Directive. Between 2016 and 2020, at least eight outbreaks of gastroenteritis (GE) potentially linked to wild swimming occurred in the region. Most GE outbreaks have been associated with waters containing the highest concentrations of sewage effluent. A total of 1,201 people participated in activities associated with the outbreak of whom at least 107 (11%), mostly children who had been involved in intensive water-based activities, became infected. Considering the rising number of heat waves, it seems likely that the practice of wild swimming will gain in popularity. Because of the deterioration in water quality resulting from climate change, including higher temperatures, droughts and heavy rainfall, the risk of ingesting pathogens during wild swimming is set to increase. This could result in the emergence of further outbreaks. The key issue is to identify ways to mitigate the potential biological risks associated with wild swimming. Potential prevention strategies, including surveillance of outbreaks and pathogens, hazard warnings and improved sewage treatment, were assessed in terms of their effectiveness, cost and social acceptability. Targeted awareness raising, outbreak surveillance, adaptation of prevention manuals, and promoting safe alternatives for water recreation are expected to be relatively easy to apply, effective, socially acceptable and not very costly.

Abstract: Background: Exclusive breastfeeding (EBF) is crucial for infant health, yet maternal mental health significantly influences breastfeeding practices. This study investigates the relationships among postpartum depression (PPD), maternal dietary diversity, and exclusive breastfeeding in Kinshasa, Democratic Republic of the Congo. Methods: A cross-sectional study was conducted with mothers of infants aged 0–6 months. Data collection used various tools, primarily the 24-hour dietary recall method to assess dietary intake and exclusive breastfeeding (EBF) status. EBF prevalence was evaluated using three metrics: the EBF-24H method (percentage of infants exclusively breastfed in the previous 24 hours), maternal self-declaration of breastfeeding practices, and the EBF-SB method (breastfeeding since birth). The Breastfeeding Self-Efficacy Scale—Short Form (BSES-SF) measured mothers' confidence in their breastfeeding abilities. Maternal education, antenatal care sessions, mental health status, husband support were also collected. Structural equation modeling (SEM) was employed to analyze the interactions among these variables. Results: The proportion of infants in the study sample who were exclusively breastfed was 29.1% (95% CI: 26.0–32.3%). Breastfeeding self-efficacy is positively influenced by nutritional advice during pregnancy, with a coefficient of 2.25 (p = 0.044). The husband’s support in exclusive breastfeeding positively correlates with both breastfeeding self-efficacy (coefficient = 0.26, p = 0.002) and EBF (coefficient = 0.0058, p = 0.058). A significant negative relationship exists between child age and EBF (coefficient = −0.0847, p < 0.001). Conversely, religion positively influences EBF (coefficient = 0.0441, p = 0.029). There is a noteworthy negative effect of mother’s education on EBF (coefficient = −0.1490, p = 0.006). Conclusions: This study highlights the multifaceted challenges faced by mothers in Kinshasa regarding exclusive breastfeeding. By prioritizing maternal mental health, as well as the roles of husband support and nutritional advice during pregnancy, we can create a more supportive framework for breastfeeding practices. Future research should explore longitudinal approaches to understand the long-term effects of PPD and the roles of husband support and nutritional advice during pregnancy on breastfeeding and infant health, as well as the potential benefits of integrated maternal health programs that address both psychological and nutritional needs.

Abstract: Background: The high prevalence of overweight and obesity in Singapore necessitates scalable primary prevention strategies. This study evaluated the short-term effectiveness of FitterLife, a 12-week, digitally delivered, group-based behavioural weight management programme targeting at-risk adults without diabetes or hypertension in the community. Methods: In a retrospective matched cohort study, we compared 306 FitterLife participants (enrolled from October 2021 to January 2025) with 5,087 controls identified from a population health data mart, matched on age, sex, ethnicity, and baseline body mass index (BMI). The primary outcome was achieving ≥5% weight loss or a ≥1 kg/m² BMI reduction at 12 weeks. Programme effectiveness was analysed using propensity score matching (1:1) and inverse probability weighted regression. Mixed-effects models assessed weight/BMI trajectories and modified Poisson regression identified behavioural factors associated with success. Results: After matching, FitterLife participants were more likely to achieve the weight loss target than controls (45.7% vs 13.7%, coefficient=0.32, 95% confidence interval [CI]: 0.26-0.38) and were over three times as likely to succeed (Adjusted incidence rate ratio [aIRR]=3.37, 95% CI: 2.87-3.93). The programme group showed significant reductions in weight (-2.23 kg, 95% CI: -2.57 to -1.90) and BMI (-0.86 kg/m2, 95% CI: -0.95 to -0.73) at the end of programme. Higher session attendance and improved behavioural factors were associated with success. Conclusions: FitterLife was effective in achieving clinically significant short-term weight loss in a real-world setting. The findings demonstrate the potential of a scalable, behavioural theory-informed, virtual group model as a viable primary prevention strategy within national chronic disease management efforts.

Abstract: Diabetes is a widespread and growing global health concern, particularly in low- and middle-income countries. Standardized treatment protocols have shown limitations in addressing the complex needs of individuals living with the condition, reinforcing the need for more tailored therapeutic approaches. In contrast, personalized medicine presents significant potential to improve diagnostic and treatment efficiency by considering patients' individual characteristics. To evaluate the applicability and impact of personalized medicine in diabetes management, a literature review was conducted using the Web of Science, Scopus, and PubMed electronic databases. Analysis of the selected studies revealed that patients treated with personalized strategies demonstrated better glycemic control, greater treatment adherence, and a lower incidence of complications. Moreover, studies indicate a reduction in long-term costs due to fewer hospitalizations and adverse events. Personalized medicine emerges as a promising alternative to overcome the limitations of the conventional approach in diabetes treatment. Despite implementation challenges such as costs, technological infrastructure, and professional training, the clinical and economic benefits suggest that this approach is likely to become increasingly consolidated in the coming years.

Abstract: Respiratory infections are a leading cause of sickness and death in Australia. In Australia, an adult- and pediatric-funded immunization program has been established for the prevention and control of vaccine preventable respiratory infections (VPRI), including pneumococcal disease (PD), influenza A/B, respiratory syncytial virus (RSV) infection, and COVID-19. This narrative review outlines the current Australian adult and pediatric immunization guidance for VPRIs and the literature underlying current risk group recommendations, including the clinical and economic burden of VPRIs, vaccination effectiveness, and coverage. Gaps in current risk group definitions, as well as additional risk groups that could be included in vaccine recommendations, are also discussed. Further research is needed to determine the optimum age for vaccination in adults which may enable alignment of age recommendations across different VPRIs. The presence of multiple risk factors, known as risk stacking, has been shown to increase the risk of severe disease for several VPRIs emphasizing the importance of vaccinating individuals with multiple risk factors. Further research is necessary to determine the effectiveness of vaccines in older adults and to develop more effective vaccines for high-risk pediatric groups, such as those with compromised immunity or for children who have undergone hematopoietic stem cell transplantation.

Abstract: Aquatic environments have been a critical source of nutrition for millennia, with wild capture fisheries supplying protein and essential nutrients to populations worldwide. In recent decades, however, a notable shift has occurred with the expansion of aqua-culture, which now represents one of the fastest-growing sectors in food production. Aquaculture plays a key role in mitigating the depletion of wild fish stocks and ad-dressing issues related to overfishing. Despite its potential benefits, the sustainability of both wild and farmed aquatic food systems is increasingly challenged by anthropogenic pollution. Contaminants originating from agricultural runoff, industrial discharges, and domestic effluents enter freshwater systems and eventually reach marine environ-ments, where they may be transported globally through ocean currents. Water is an indispensable input not only for the cultivation of aquatic organisms but also across the broader agri-food sector. Consequently, maintaining water quality is paramount to food safety, environmental integrity, and long-term food security. In ad-dition to conventional seafood products such as fish and shellfish, foods such as those derived from microalgae are gaining attention in Western markets for their high nutri-tional value and potential functional properties. These organisms have been consumed traditionally in Asia for generations and are now being explored as sustainable foods and ingredients as an alternative source of protein. Contaminants of concern in aquatic food products include residues of agrochemicals (e.g., pesticides, veterinary pharmaceuticals), persistent organic pollutants (POPs) such as dioxins, polychlorinated biphenyls (PCBs), and per- and polyfluoroalkyl substances (PFAS), as well as brominated flame retardants, heavy metals (e.g., mercury, cadmium, lead), and inorganic arsenic. In parallel, public and scientific attention has intensified around plastic pollution, particularly microplastics and nanoplastics, which are in-creasingly detected in aquatic organisms and are the subject of ongoing toxicological and ecological risk assessments. While the presence of these chemical hazards neces-sitates robust risk assessment and regulatory oversight, it is essential to balance these concerns against the documented health benefits of aquatic foods, which are rich in omega-3 fatty acids, high-quality proteins, vitamins, and trace elements. Furthermore, beyond direct human health implications, the environmental impact of pollutant sources must be addressed through integrated management approaches to ensure the long-term sustainability of aquatic ecosystems and the food systems they support.

Abstract: Background: It is unclear whether histologic subtypes are associated with site-specific metastases or impact overall survival. Thus, the objective of this study was to evaluate metastatic patterns according to four histologic subtypes of non-small cell lung cancer (NSCLC) and assess their impact on overall survival. Study Design: In this observational study 290,313 patients from 2004 to 2017 with metastatic NSCLC were identified from the National Cancer Database and categorized by histologic subtype. Multivariable logistic regression was performed to assess the association between histologic subtype and specific single-site and multiple-site metastatic patterns. Multivariable Cox proportional hazard models were used in survival analysis. Results: Metastatic site patterns and histologic subtypes significantly affected overall survival (OS). In multivariate analysis, histologic subtypes correlated with distinct metastatic patterns. In single site metastasis median survival time from longest to shortest was lung, brain, bone, and liver across adenocarcinoma (AD), squamous cell carcinoma (SCC), and adenosquamous cell carcinoma (ADS). In dual-site metastatic disease longest median survival time was brain and bone across AD and large cell carcinoma (LCC) and lung and bone across SCC and ADS. Conclusion: NSCLC histologic subtypes are associated with distinct metastatic patterns and may confer prognostic importance.

Abstract:

Background and Objectives: The Quick Speech-in-Noise test is a widely used clinical tool for assessing an individual’s ability to understand speech in the presence of background noise. Building on this framework, the present study aimed to develop a Speech-in-Noise Test for European Portuguese (SiN-EP), specifically adapted for native speakers of European Portuguese. The goal was to create a reliable and linguistically appropriate tool to evaluate speech perception under realistic listening conditions. Materials and Methods: The development of the SiN-EP involved several stages. Sentences were drafted to reflect natural speech patterns and reviewed by native speakers for clarity and grammatical correctness. Selected sentences were recorded by a female native speaker in a controlled environment. The recordings were then combined with multi-talker babble noise at varying levels to simulate different listening situations, ranging from easy to challenging. A pre-test was conducted in a free field setting at 65 dB SPL with fifteen young adults with normal hearing. Participants listened to and repeated each sentence, and their responses were used to refine the test materials. Results: Participants understood the sentences clearly and consistently across all listening conditions, showing that the SiN-EP effectively reflects speech perception in noise. The final version included thirteen lists of six sentences, carefully designed to maintain natural phonetic balance and realistic speech structure. Conclusion: The SiN-EP represents a significant advancement in evaluating speech understanding in noise for Portuguese-speaking populations. This standardized and linguistically adapted test provides valuable information about auditory performance and supports both clinical assessments and research on hearing and auditory processing challenges.

Abstract: Cancer is one of the biggest health burdens for women in the Middle East and North Africa (MENA), with the incidence of breast, cervical and colorectal cancer on the rise. Although preventive measures such as the HPV vaccination and population-based screening are available, access to them remains very unequal. Women in rural, low-income and refugee communities face additional barriers, cultural stigmatisation, low health literacy, gender norms and fragile health systems, leading to delayed diagnoses and poorer outcomes. This review summarises the results of 724 peer-reviewed publications to assess the current situation of cancer screening in MENA and Mediterranean countries. The studies were categorised along four dimensions: Cancer type (breast, cervical, colorectal), behavioural constructs (awareness, uptake, education), population vulnerability (e.g. migrants, refugees, low literacy groups) and geographical context (indigenous MENA population vs. diaspora communities). The results show large inequalities in access and participation due to fragmented policies, socio-cultural resistance and infrastructure gaps. Nevertheless, promising approaches are emerging: community-led outreach, mobile screening programmes, AI-assisted triage and culturally appropriate digital health interventions. Comparisons between the local and diaspora populations make it clear that systemic and cultural barriers persist even in well-equipped facilities. Closing the screening gap requires a culturally sensitive, digitally enabled and policy aligned approach. Key priorities include engaging religious and community leaders, promoting men's engagement in women’s health and securing sustainable funding. With coordinated action across all sectors, MENA countries can build inclusive screening programmes that reach vulnerable women and reduce preventable cancer mortality.

Abstract: Background: The triglyceride–glucose (TyG) index, calculated from fasting triglyceride and glucose levels, has emerged as a simple and cost-effective surrogate marker of insulin resistance (IR). Given that IR is a pivotal mechanism underlying cardiovascular disease (CVD), the TyG index has gained increasing attention in recent years. Objective: This review summarizes the current evidence on the association between the TyG index and cardiovascular risk, exploring its biochemical basis, role in metabolism, epidemiological findings, and clinical implications. Methods: A narrative review of published studies was conducted, focusing on the predictive value of the TyG index for insulin resistance, diabetes, metabolic syndrome, and CVD outcomes. Findings from cohort, cross-sectional, and meta-analysis studies were integrated to provide a comprehensive overview. Results: Multiple epidemiological and clinical studies demonstrate that higher TyG index values are associated with an increased risk of cardiovascular events, independent of traditional risk factors. Compared to the homeostasis model assessment of insulin resistance (HOMA-IR), the TyG index shows greater accessibility and predictive capacity. However, heterogeneity in cut-off thresholds and limited prospective and interventional trial data remain major challenges. Conclusions: The TyG index represents a promising biomarker for cardiovascular risk assessment and may serve as a supplementary tool for early screening, particularly in young and asymptomatic adults. Future large-scale prospective and interventional studies are warranted to standardize cut-off values and establish its role in clinical practice.

Abstract: Wearable light loggers and optical radiation dosimeters are increasingly used to quantify personal light exposure in research and clinical contexts. However, the growing diversity of devices poses challenges for researchers selecting appropriate instruments. We present an open-access, web-based specification tool for wearable light loggers and optical radiation dosimeters that provides a structured framework for defining, comparing, and communicating device requirements. The tool integrates expert-informed parameters spanning usability, fidelity, and data requirements and generates exportable Word or PDF specifications suitable for procurement or documentation. By supporting transparent and consistent specification, the tool contributes to harmonisation in light exposure research and facilitates reproducibility and interoperability.

Abstract: National Tuberculosis Reference Laboratories (NTRLs) are central to tuberculosis (TB) control programs. Between 2018 and 2025, the Republic of Congo, a country of 6 million inhabitants, achieved a transformative strengthening of its TB diagnostic system, coordinated by the NTRL. Strategic investments, supported mainly by international partners, enabled a substantial decentralization of services, expanding the diagnostic network from 40 to 113 facilities and increasing GeneXpert sites from 3 to 31. This was bolstered by a national sample transport system that slashed diagnostic inequities and a robust External Quality Assessment framework to ensure reliability. Critically, the establishment of a BSL-3 facility and the deployment of advanced assays like Xpert MTB/XDR ended the reliance on overseas testing by introducing in-country capacity for multidrug-resistant and extensively drug-resistant TB detection. These systemic improvements directly translated into significant outcomes including an annual molecular testing surging from 11,609 to over 27,000, bacteriological confirmation rates rose from 34 to 73%. This comprehensive laboratory systems strengthening, which also facilitated cross-programmatic initiatives like HIV, Mpox testing integration, underscores how sustained investment in infrastructure, logistics, and quality management is fundamental to improving case detection, surveillance, and progress toward the WHO End TB Strategy milestones.

Abstract: Tuberculosis (TB) remains a major public health challenge, particularly in sub-Saharan Africa, where the emergence and spread of drug-resistant Mycobacterium tuberculosis (MTB) strains threaten current control efforts. This study aimed to characterize the frequency and distribution of genetic mutations associated with resistance to rifampicin, isoniazid, ethambutol, fluoroquinolones, and second-line injectable agents in MTB isolates from culture-positive pulmonary TB patients in the Republic of Congo. A total of 45 MTB culture-positive samples collected between 2018 and 2019 were analyzed using targeted next-generation sequencing (MinION). Key resistance associated genes, including rpoB, katG, embB, gyrA, and rrs, were examined. Overall, 48% (22/45) of isolates harbored at least one mutation conferring drug resistance. Drug resistance associated mutations were detected in 48% (15/22) of sequences for rifampicin, mainly driven by Ser531Leu, Asp516Val, and His526Tyr. For Ethambutol, the prevalence was 50% (11/22), mainly associated with Met306Val mutation. Isoniazid represented 40.9% (9/22), primarily linked with Ser315Thr mutation. The floroquinolone represented 9% (2/22) mainly driven by Ala90Val and Asp94Gly. Lastly aminoglycosides resistance counted for 4% (1/22) mainly A1401G mutation. The results underscore the critical need to enhance molecular surveillance and strengthen treatment protocols for drug-resistant TB in the Republic of Congo to effectively combat this evolving health crisis.

Abstract: This study explores the association between early-life vaccine scheduling intensity and autism prevalence across 12 high-income countries, aiming to inform evidence-based public health policy. We examined whether the number and timing of vaccine doses administered to infants under one year correlate with standardized autism incidence rates. Using cross-national data from countries with comparable healthcare systems and diagnostic standards, we applied descriptive statistics, partial correlations (controlling for overall vaccination coverage), and multivariate regression models. Nations with higher autism prevalence (USA, Canada, Australia, Japan, South Korea, Singapore) averaged 15 vaccine types and 20 doses for infants ≤1 year, whereas lower-prevalence countries (Norway, Denmark, Finland, Italy, Sweden, UK) averaged 8 vaccines and 9 doses. Partial correlations revealed strong positive associations between autism prevalence and both vaccine types (r = 0.87, p < 0.001) and doses (r = 0.79, p < 0.01). Regression analysis indicated that a 1% increase in vaccine types corresponded to a 0.47% increase in autism prevalence (p = 0.001), explaining 81% of variance. While these findings do not establish causality, they identify patterns warranting further investigation. For practitioners and policymakers, these results underscore the importance of evaluating vaccine scheduling strategies alongside developmental outcomes. More gradual schedules, as observed in countries with lower autism prevalence, may merit consideration in future research and policy discussions to optimize neurodevelopment while maintaining high immunization coverage. This study provides actionable insights for disease prevention and health promotion professionals seeking to balance immunization goals with long-term child health outcomes.

Abstract: Background/Objectives: Assisted suicide and suicide prevention remain subjects of intense societal, political, and professional-ethical debate in Germany. Nurses working in residential and home-based long-term care (LTC) play a pivotal role in responding to requests for assisted suicide and in supporting suicide prevention. While international research has explored diverse ethical perspectives and challenges related to these issues, little is known about how LTC nurses in Germany experience and navigate them. This study examines German LTC nurses’ ethical perspectives on assisted suicide and suicide prevention and explores the associated ethical challenges. Methods: A qualitative design employing both in-person and online focus groups was used. Data were analyzed following Mayring’s qualitative content analysis. Results: Twelve focus groups with a total of 96 nurses working in residential and home-based LTC were conducted between February and September 2025. Findings show that nurses perceive assisted suicide and suicide prevention as ethically complex and emotionally demanding. Three overarching themes emerged: (1) Intuitive and Emotional Reactions, (2) Ethical Perception and Ethical Reflection, and (3) Ethical Challenges. Conclusions: LTC nurses expressed varying ethical perspectives on and attitudes towards assisted suicide and suicide prevention. The ethical challenges identified may contribute to the development of moral distress. To help nurses navigate these ethically demanding situations, strategies at multiple levels are required. These include continuous ethics education, an open ethical culture, role definitions and clear professional guidance, alongside societal support for equitable access to general healthcare and suicide prevention services.

Abstract:

Stress- and inflammation-related disorders remain the dominant global health burdens, yet few preventive tools operate across molecular, psychological, and social scales. We hypothesize that OM-induced vibrational coherence functions as a mathematical–cum-biophysical regulator capable of harmonizing energy from cellular metabolism to genomic expression through the vagal–microbiome–brain axis. Following the physical law that energy transforms but is conserved, the OM-to-Genome continuum extends this principle to living systems, where metabolic, immune, reproductive, and neural energies represent biological analogues of potential, chemical, and kinetic forms. Mathematics provides the syntax of these transformations—frequency, proportion, and rhythm—governing energy construction and deconstruction from birth to death. Within the author’s Evolution-to-Solution framework, OM vibration mediates these conversions, translating conscious intent into physiological order. Evidence from neuroimaging, electrophysiology, and molecular biology supports this pathway as a low-cost, culturally neutral mechanism for stress regulation and immune balance. Integrating mathematics, physics, chemistry, and physiology thus yields a unified One Health model linking awareness and biology through a single law of energy coherence.