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PubMed2026

Identifying and Prioritizing Core Components of Relationship Education Programs: a Case Study of an Artificial Intelligence (AI) Assisted Systematic Review.

The field of prevention science seeks to identify and implement effective strategies to address social, emotional, and health challenges. A critical aspect of this endeavor is determining the core components of prevention programs that drive positive outcomes. This article presents a case study utilizing artificial intelligence (AI)-assisted systematic review methods to identify key components of healthy marriage and relationship education programs. Given the growing body of research in this domain, AI tools offer a promising means to enhance the efficiency and accuracy of literature reviews. This study employed AI to screen, code, and validate research articles, demonstrating its effectiveness in expediting systematic reviews while maintaining high accuracy in inclusion screening. This case study involved a systematic review of 22,028 resources (identified from PsycINFO, Academic Search Ultimate, and Google) and a final data set of 268 relevant studies. AI screening was integral in effectively conducting multiple rounds of screening. However, findings also highlight challenges in AI-assisted qualitative data abstraction, underscoring the continued need for human expertise in complex coding tasks. The study contributes to the ongoing discourse on integrating AI into prevention science methodologies and offers insights for optimizing AI applications in systematic reviews.

Artificial Intelligence↗

PubMed2026

Experiences of stigma, bias, and communication challenges among pregnant healthcare workers: A systematic review of qualitative evidence.

BACKGROUND: Healthcare work environments are fraught with occupational hazards that can impact pregnant healthcare workers' health as well as patient care. Despite the feminization of healthcare globally, systematic discrimination against pregnant workers persists across diverse healthcare settings and cultural contexts. The intersection of stigma, bias, and communication challenges creates substantial barriers to career advancement and wellbeing. However, no systematic review has synthesized qualitative evidence on how these three constructs interact across healthcare professions and cultural contexts using an integrated theoretical framework. OBJECTIVE: To systematically review and synthesize qualitative evidence on experiences of stigma, bias, and communication challenges among pregnant healthcare workers across different healthcare settings and cultural contexts using an integrated theoretical framework. DESIGN: Systematic review of qualitative studies following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines with thematic synthesis. DATA SOURCES: Seven databases were searched from inception to January 2026. REVIEW METHODS: Included qualitative studies were appraised using the Critical Appraisal Skills Programme (CASP) checklist and synthesized through theory-guided thematic synthesis. Confidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual) approach. RESULTS: Fourteen studies encompassing 1223 participants across 17 countries revealed four major themes: (1) professional identity stigma and workplace discrimination through systematic labeling and stereotyping; (2) gender-based institutional bias rooted in masculine organizational logic; (3) multilevel communication failures creating fear-based climates; and (4) individual and collective resistance strategies developed despite constraints. Occupational hazards specific to pregnancy included exposure to infectious diseases, imaging, physical tasks, cleaning products, patient violence, and medication administration. Support from coworkers and supervisors was identified as the most critical facilitator for avoiding hazards and making necessary modifications, while the desire to be 'supernurses' and fear of consequences emerged as significant barriers. These patterns were consistent across healthcare professions, settings, and cultural contexts, with specialty culture and healthcare system type moderating discrimination intensity. Confidence in core findings was rated high using GRADE-CERQual. CONCLUSIONS: Pregnant healthcare workers globally experience interconnected stigma, bias, and communication challenges that are systematically embedded within healthcare organizational structures. These challenges operate synergistically, requiring comprehensive multilevel interventions beyond policy compliance. Healthcare organizations must implement evidence-based strategies addressing stigma reduction, bias interruption, and communication transformation simultaneously to retain skilled workers and ensure quality patient care.

Female↗

PubMed2026

Pathways of onward HIV disclosure in relationships among young people living with vertically acquired HIV receiving antiretroviral therapy: A qualitative analysis from the BREATHER Plus trial, South Africa.

For young people living with HIV (YPLHIV) navigating their status since birth, managing onward disclosure of a potentially stigmatising condition in relationships is challenging, and may or may not lead to social support, with implications for wellbeing. In a clinical trial setting in KwaZulu-Natal, South Africa, we investigate how young people living with vertically acquired HIV navigate onward disclosure. Data were from the qualitative component of the BREATHER Plus randomised controlled trial evaluating the efficacy, safety and acceptability of short-cycle dolutegravir/tenofovir-based triple antiretroviral therapy (ART) in young people aged 12-19 years. We analyse data on 35 participants receiving ART engaged in clinical trials at the research site: 29 in longitudinal in-depth interviews (IDIs) and 12 across three focus group discussions (FGDs), including 6 in IDIs and FGDs. The Disclosure Processes Model was applied in the thematic analysis. Pre-disclosure was characterised by social assessments of potential confidants. During disclosure, reciprocal vulnerability and partial information-sharing were employed. Post-disclosure processes entailed linear and non-linear feedback trajectories, impacting future disclosures. The findings show that the study cohort of young people receiving ART navigated many bidirectional disclosure pathways to maintain social connections in relationships, and counselling guidelines need to be responsive to this.

Humans↗

PubMed2026

Determinants of private health insurance uptake and its association with healthcare utilization in Gulf Cooperation Council countries: a systematic review.

All Gulf Cooperation Council (GCC) countries have a multi-payer healthcare system that comprises governmental health coverage (GHC), funded by the government, and private health insurance (PHI), mainly sponsored by employers and purchased by individuals. Both are expected to influence healthcare utilization and contribute to system efficiency and patient well-being. This systematic review explored the determinants of PHI uptake and its association with healthcare service utilization in the presence of GHC in GCC countries. We systematically searched CINAHL, PubMed, Scopus, Web of Science, and Cochrane Library for peer-reviewed studies published between January 2012 and October 2022. Study quality was assessed using the Critical Appraisal Skills Programme (CASP) checklists for both quantitative and qualitative studies, following PRISMA guidelines. Twenty-six studies met the inclusion criteria. Determinants of PHI uptake were mapped to Andersen's Behavioral Model of Health Services Use (BMHSU) and categorized into (1) predisposing factors (sex, age, marital status, and education), (2) enabling factors (employment/income and health system-related factors such as access and perceived service quality), and (3) need factors (health status, including chronic noncommunicable diseases). PHI uptake was positively associated with being male, married, highly educated, employed with a high income, and having chronic diseases. PHI was positively associated with healthcare utilization, particularly routine check-ups, preventive services, and the use of prescribed medicines. In GCC countries, PHI uptake is influenced by sociodemographic and socioeconomic characteristics, health status, and perceived service quality. PHI is also associated with higher healthcare utilization, underlining the need for evidence-informed policies that enhance equity and expand coverage.

Humans↗

PubMed2026

The effects of fitspiration TikTok content on body image and mood among young adult women in the U.S.

Fitspiration is an appearance-based form of media that promotes physical fitness and dieting. While not true of all fitspiration media, some forms promote these ideals through visuals of toned, athletic bodies that have become increasingly prevalent on the short-form video platform, TikTok. Although often framed as health-promoting, fitspiration exposure has been associated with upward appearance comparison (i.e., comparison with people perceived as more attractive) and negative effects on body image and mood. The present study investigated the effects of short-form video-based fitspiration on social comparison, appearance importance, appearance anxiety, body dissatisfaction, and negative affect. Using an experimental design, 150 undergraduate women (Mage = 19.28) in the United States were randomly assigned to view a five-minute TikTok compilation of either animal (n = 75) or fitspiration videos (n = 75). Participants completed baseline measures prior to viewing and state-level measures after completing their video set. Results indicated that, relative to control, viewing fitspiration content led to greater social comparison, appearance concerns, feelings of being fat, and sadness. Baseline appearance concerns and depressive symptoms significantly moderated group differences in responses, such that negative fitspiration effects on state-level appearance concerns were found among individuals high but not low in baseline appearance concerns and among individuals low but not high in baseline depressive symptoms. These findings contribute to the growing literature on fitspiration by demonstrating the immediate psychological effects of this content in short-form videos and highlighting the importance of considering individual differences in vulnerability.

Humans↗

PubMed2025

Exploring determinants of vaccine hesitancy among healthcare professionals: a systematic literature review.

INTRODUCTION: This systematic review aims to assess determinants of vaccine hesitancy (VH) among healthcare professionals, to identify knowledge gaps and inform targeted training programs. RESEARCH DESIGN AND METHODS: A systematic search of PubMed and Scopus was conducted in February 2024. PRISMA criteria were applied, and methodological quality was assessed using a cross-sectional study evaluation tool. Studies addressing HCWs' VH determinants, including knowledge, attitudes, communication, and organizational factors, were included. RESULTS: Out of 1394 records, 221 articles were included. Reported prevalence of VH among HCWs varied across studies, reflecting differences in professional roles, settings, and vaccines studied. Key determinants included gaps in knowledge, personal beliefs, organizational barriers, and communication skills. The review highlights the importance of evidence-based information, continuing education, and effective communication in addressing VH among HCWs. CONCLUSIONS: Educational and organizational interventions are essential to improve HCWs' knowledge, attitudes, and practices regarding vaccination. Strengthening vaccine education, fostering effective communication, and addressing organizational challenges can reduce hesitancy and support HCWs in promoting vaccination among patients. Future initiatives should consider the diversity of educational settings, professional roles, and training requirements across healthcare systems.

Humans↗

PubMed2026

Predictors of transition readiness in adolescents with neurogenic lower urinary tract dysfunction.

PURPOSE: Adolescents with Neurogenic Lower Urinary Tract Dysfunction (NLUTD) face significant challenges in their quality of life and readiness to transition to adult healthcare services. This study examines the impact of various demographic and clinical factors on transition readiness. METHODS: We performed a retrospective review of prospectively collected data from 75 adolescents with NLUTD managed at a specialized tertiary referral pediatric facility. We employed multivariate linear regression analysis to explore the relationship between transition readiness scores collected from the Good2Go questionnaire, including the total transition readiness score and its sub-domains (self-advocacy, knowledge, self-care, and social support), and predictors such as age, sex, reconstructive surgery status, and clean intermittent catheter (CIC) usage. RESULTS: The mean age of participants was 16.74 years (SD 2.44). Reconstructive surgery had been performed in 32 % of patients, and 77.3 % were on CIC. Multivariate regression analysis indicated that age significantly predicted transition readiness across several domains. Each additional year of age was associated with a 4.40-point increase in the total transition readiness score, a 3.66-point increase in knowledge, a 4.26-point increase in self-advocacy and a 5.41-point increase in self-care. Conversely, CIC significantly negatively impacted the social support domain, with scores decreasing by 9.69 points. Reconstructive surgery was significantly associated with lower self-care scores, with an average decrease of 12.12 points among those who had undergone surgery. CONCLUSION: Age significantly improves transition readiness in adolescents with NLUTD, reflecting cognitive and developmental growth. However, the negative effects of CIC on social support and reconstructive surgery on self-care underscore the need for personalized interventions to optimize health outcomes during the transition to adult care.

Humans↗

PubMed2026

Life-course stress exposure and cognitive decline in middle-aged and older Chinese adults: The role of sex differences and educational protection.

BACKGROUND: Stressful life events (SLEs) across the life course have been associated with cognitive decline, but evidence on their cumulative impact and potential modifiers remains limited. We aimed to examine the associations between SLE exposure in childhood, adulthood, or both life stages and cognitive trajectories, and to investigate whether these associations vary by sex and education. METHODS: We used data from the China Health and Retirement Longitudinal Study, a nationally representative cohort of adults aged ≥45 years. Participants with complete data on SLEs, cognition, and covariates were included (n = 5922). SLEs were retrospectively assessed for childhood and adulthood. Cognitive function was measured using a composite score (range 0-21) across three waves (2011-2015). Linear mixed-effects models examined longitudinal associations, adjusting for sociodemographic factors, health behaviors, and chronic conditions, with interaction analyses for sex and education. RESULTS: Compared with participants reporting no SLEs, cumulative exposure showed the strongest association with cognitive decline (β = -0.52, 95% CI -0.69 to -0.35), followed by childhood-only (β = -0.34, -0.48 to -0.20) and adulthood-only exposure (β = -0.22, -0.37 to -0.07). Sex significantly moderated the associations for childhood and cumulative exposure, with women exhibiting greater cognitive vulnerability. Higher educational attainment attenuated the associations between single-period stress and cognitive decline, with only partial protection observed against cumulative adversity. CONCLUSION: Cumulative life-course stress is associated with accelerated cognitive decline in Chinese middle-aged and older adults. Women appear more vulnerable to stress-related cognitive effects, whereas higher education confers partial resilience, highlighting the need for sex-sensitive and education-informed prevention strategies.

Humans↗

PubMed2026

Acceptability of alcohol-based hand rub during neonatal care in rural Ugandan households: a qualitative study nested within the BabyGel trial.

BACKGROUND: Poor access to water, sanitation and hygiene exacerbates the spread of infections among newborns. The BabyGel cluster randomised trial assessed the effectiveness of a community-level alcohol-based hand rub with a training component in reducing infection or death rates among newborns in Uganda. OBJECTIVE: Nested in the BabyGel trial, this study investigated the acceptability of the BabyGel intervention among mothers and household members in Eastern Uganda, using the Theoretical Framework of Acceptability. METHODS: In 2022, we conducted individual semistructured interviews with mothers, and group interviews with mothers and other household members, all recruited from intervention-arm clusters. Thematic analysis combined inductive and deductive coding, structured by the framework's seven constructs: affective attitude, burden, ethicality, intervention coherence, opportunity costs, perceived effectiveness and self-efficacy. RESULTS: Twenty mothers and 14 household members participated in 10 individual and 10 small group interviews. Participants found the intervention generally acceptable, appreciating its convenience and perceived protection against infection. Many described hand hygiene changes that persisted beyond the intervention period. However, concerns related to its harmful effects, spiritual beliefs and social tensions with visitors occasionally influenced its use. CONCLUSION: Alcohol-based hand rub combined with a training component was generally well accepted, driven by perceived health and practical benefits, although concerns related to safety, belief systems and social dynamics remained. Because data collection coincided with the COVID-19 pandemic, a period of heightened hygiene awareness, the acceptability observed could differ in nonpandemic periods. Culturally adapted education, community engagement and reinforcement of correct use may enhance acceptability and sustainability in similar settings.

Humans↗

PubMed2026

Smartphone apps for obesity management: A systematic review using self-determination theory.

BACKGROUND: While bariatric surgery and pharmacotherapy are effective treatments for obesity, ongoing supportive care remains a challenge. Smartphone applications (apps) may assist with symptom management, but their effectiveness and practical use in obesity treatment is unclear. This review evaluated the effectiveness, acceptability, and feasibility of these apps in supporting individuals following obesity treatment. To better understand how these apps may promote sustained engagement and behaviour change, their design was analysed using Self-Determination Theory (SDT). METHODS: A systematic search was conducted across MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, SCOPUS, and CENTRAL databases. Eligible studies included randomised and non-randomised interventions involving adults (≥18 years) with obesity (BMI ≥ 30 kg/m2) who had undergone bariatric surgery or pharmacotherapy. Interventions had to include an app designed to support post-treatment symptom management. Findings were synthesised narratively, and app features were mapped to SDT constructs of autonomy, competence, and relatedness. RESULTS: Five studies (three RCTs, two cohort studies) involving 1,133 participants were included (female: 78 %; median age: 47.63 years). Most apps targeted post-bariatric surgery care; only one focused on pharmacotherapy. Common features included tracking, reminders, and education, supporting autonomy and competence. Relatedness features such as communication and peer support were least represented. Two studies reported improvements in weight-related outcomes and one in medication adherence. Effects on quality of life, self-efficacy, and healthcare utilisation were not significant. Patient satisfaction was reported in one study, with 95 % expressing positive feedback, though formal assessments of feasibility and acceptability were limited. CONCLUSION: Smartphone apps show potential to support obesity management, particularly after bariatric surgery. While some evidence suggests benefits for weight loss and adherence outcomes, the limited studies and variability of reporting prevent conclusive observations in other outcomes. Future app development should integrate behavioural theory to address psychological needs, nutritional risks and promote holistic self-management beyond weight control.

Female↗

PubMed2026

Childhood Economic Mobility and Systemic Inflammation Among Men Who Experienced Low Income in Toddlerhood: The Moderating Role of Trait Hostility.

OBJECTIVE: Childhood economic upward mobility (ie, increases in family income across childhood) may attenuate links between childhood poverty and systemic inflammation in adulthood, the extent of which may vary depending on inter-individual differences in personality characteristics, including hostility. METHODS: Men who experienced low income in toddlerhood (N=171) were followed prospectively into adulthood. Annual family income was collected 12 times when men were 1.5 to 17 years old. Men completed the Cook-Medley Hostility Scale and had their fasting blood drawn to measure circulating levels of C-reactive protein (CRP) at age 32. Multiple linear regression analyses examined main and moderation effects of childhood economic upward mobility and adult hostility on CRP levels adjusting for income at 1.5 years, race, parent educational attainment, and adult income, education, waist circumference, and smoking status. RESULTS: Main effects were nonsignificant, but an interaction effect emerged. Counter to expectations, childhood economic upward mobility related to greater adult CRP as trait hostility decreased ( β =-0.203, P =.018). Simple slope analyses further revealed that childhood economic upward mobility was positively associated with CRP among men lower in hostility ( β =0.23, SE=0.09, P =.020) but was unrelated to CRP among men higher in hostility. Results of post hoc sensitivity analyses are also discussed. CONCLUSIONS: Counterintuitive findings suggest that for men who experience poverty in toddlerhood, the association between childhood economic upward mobility and adult CRP may be nuanced and even in the positive direction for men low in hostility, which aligns with work on unintended health consequences of upward mobility.

Humans↗

PubMed2026

Advancing nursing education through social and emotional learning: A systematic review guided by the Collaborative for Academic, Social, and Emotional Learning framework.

BACKGROUND: With Generation Z entering the nursing workforce in growing numbers, strengthening social and emotional learning is critical for academic success, professional adaptation, and safe practice. However, the existing evidence remains fragmented because of varied interventions and inconsistent approaches. OBJECTIVES: This systematic review examined (1) the social and emotional learning essential for nursing students and nurses within the Collaborative for Academic, Social, and Emotional Learning framework, (2) their impact on educational and clinical outcomes, and (3) implications for advancing nursing education and practice. METHODS: Following Joanna Briggs Institute methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, five international (PubMed, EMBASE, CINAHL, PsycINFO, Cochrane) and three Korean (RISS, KoreaMed, KMBASE) databases were searched up to June 2025. Eighteen studies involving 2,952 participants met the inclusion criteria, including quasi-experimental quantitative studies, descriptive quantitative studies, qualitative studies, and mixed-methods studies. The methodological quality of the included studies was appraised using the Mixed Methods Appraisal Tool. RESULTS: Within the Collaborative for Academic, Social, and Emotional Learning framework, relationship skills and self-management were the most frequently studied competencies, emphasizing teamwork, communication, and stress regulation. Self-awareness and social awareness were underexplored, despite their importance in empathy, resilience, and reflective practice. Responsible decision-making was the least studied competency, despite its importance in ethical reasoning. Social and emotional learning was consistently associated with enhanced adaptation, communication, leadership, relationships, and clinical performance. Effective strategies included blended learning, simulation, reflective activities, and mentorship, which are aligned with Generation Z's learning preferences. CONCLUSION: Although social and emotional learning integration is associated with improvements in educational and clinical outcomes in nursing, current research has largely centered on relational and stress-related competencies while underrepresenting responsible decision-making. To cultivate reflective, empathetic, and ethically grounded nurses, curricula should integrate social and emotional learning through a balanced and structured approach. REGISTRATION: This study was registered on PROSPERO (ID: CRD420251005683).

Humans↗

PubMed2026

Gender-specific pathways linking body dissatisfaction, self-disgust, and social anxiety in Chinese adolescents: A three-wave longitudinal study.

Adolescence is a critical period for physical and psychological development. Body dissatisfaction is a significant concern during this stage, contributing to psychological issues such as social anxiety. However, the longitudinal relationships among body dissatisfaction, self-disgust, and social anxiety, as well as the potential role of gender differences in these dynamics, remain unclear. A total of 1109 junior high school students in China completed the baseline survey, with data collected at three time points (Mage = 12.67 years, SD = 0.68; 51.9% girls). Data were collected using the Body Areas Satisfaction Scale (BASS), the Self-Disgust Scale (SDS), and the Social Anxiety Scale for Children (SASC). Structural equation modeling (SEM) was employed to examine the longitudinal mediating effects among body dissatisfaction, self-disgust, and social anxiety, as well as to explore gender differences in these relationships. After controlling for autoregressive effects of self-disgust and social anxiety across waves, body dissatisfaction at T1 was found to indirectly predict social anxiety at T3 through self-disgust at T2, while indirectly predicting self-disgust at T3 through social anxiety at T2. Multi-group analyses revealed significant gender differences: for females, only the mediating pathway with self-disgust as the mediator was significant; for males, only the pathway with social anxiety as the mediator was significant. These findings contribute to a more nuanced understanding of the emotional mechanisms linking body dissatisfaction to social anxiety and highlight the importance of considering gender-specific pathways in prevention and intervention efforts.

Adolescent↗

PubMed2026

Effects of acute inflammatory challenge on anhedonia and social reward processing: A randomized controlled trial of endotoxin.

Anhedonia is a core feature of depression that reflects reward system dysfunction. Acute inflammatory challenge has been shown to induce transient anhedonia and reward processing deficits, but its effects on distinct components of social reward processes remain poorly understood. This randomized, double-blind, placebo-controlled study evaluated anhedonia and social reward responsivity following acute inflammatory challenge. Low-dose endotoxin (0.8 ng/kg body weight; n = 18) or placebo (same volume of 0.9% saline; n = 22) was administered to female adults (ages 25-44). Anhedonia (Snaith-Hamilton Pleasure Questionnaire) and blood samples for cytokine assessment were collected pre-infusion and 2 and 4 h post-infusion. Social reward motivation (wanting to engage in a social task) was assessed at a baseline eligibility visit and 2 h post-infusion. Sensitivity to positive social cues (attentional bias toward and recognition of happy faces) was assessed pre-infusion and 2 h post-infusion. Results showed that endotoxin increased anhedonic symptoms (p = .005) and decreased social motivation by 2 h post-infusion (p = .001); within the endotoxin condition, changes in both outcomes were associated with increases in TNF-α (p's < .04). A significant condition-by-time interaction for happy-face recognition (p = .011) was driven by increased accuracy in the placebo (p = .04) but not endotoxin (p = .43) condition. Endotoxin administration did not affect attentional bias toward happy faces. Findings suggest that acute inflammatory challenge induces anhedonia and reduces social motivation, with more limited effects on sensitivity to positive social cues, highlighting specific reward-related pathways through which immune activation may contribute to inflammation-associated depression. Future work could examine whether immune-related changes in social motivation contribute to motivational deficits in depression.

Humans↗

PubMed2026

How the Social Context and Peer Helping Contribute to Better Alcohol Outcomes Among Sober Living House Residents: Mediation Analyses.

BACKGROUND: Sober Living Houses (SLHs) adopt a social model approach, which emphasizes peer helping. Although SLHs appear to be effective, little is known regarding why. This longitudinal study examined whether higher SLH social model adherence produces better resident outcomes by increasing resident helping. METHODS: Baselines were conducted with 205 residents entering 28 SLHs, with follow-ups through 6 months. Measures included 1-month perceived SLH social model adherence; 2-month help given to and received from SLH residents; and 6-month alcohol use and severity. Analyses were lagged, multivariate mediation models accounting for clustering within SLH. Separate models examined help given and received for each outcome, yielding four model tests. RESULTS: The hypothesized model was unsupported, with all four tests showing nonsignificant indirect effects. However, exploratory post-hoc tests showed significant indirect effects between higher 1-month resident helping and better 6-month alcohol outcomes via higher 1-month SLH social model adherence. Effects held across three of four model tests. CONCLUSIONS: Results suggest that residences adhering to social model principles do not achieve better outcomes by stimulating helping, but rather that more resident helping may foster a supportive SLH social environment, which itself drives better outcomes. Thus, residences might emphasize both resident helping and social model principles.

Sober living↗

PubMed2026

Indigenous body image amid rapid social and economic change: A reflexive thematic analysis of Wayuu narratives.

The Wayuu, Colombia's largest Indigenous group, are experiencing rapid social, economic, and technological change, including expanding internet access, educational opportunities, and increasing exposure to globalised media. Though the harmful effects of appearance-idealised media imagery on body image are well documented, indigenous body image research remains unevenly distributed across global contexts, with Latin American Indigenous communities particularly underrepresented. This study explored how Wayuu people understand and experience appearance ideals and body image in the context of expanding digital media exposure and rapid sociocultural and economic change. Five focus groups of up to 9 participants were conducted with 29 Wayuu participants (18-68 years; 23 women, 6 men). Using reflexive thematic analysis, three overarching themes were identified: (1) Intersecting sources of appearance pressure: encompassing influences from social media, Wayuu family expectations, and discrimination from non-Indigenous peers; (2) Negotiating and resisting appearance ideals: from body dissatisfaction and restrictive eating to affirmation of cultural identity as protection; and (3) The changing role of appearance in today's Wayuu culture: participants linked globalised appearance ideals to expanding educational opportunities, migration, digital connectivity, and broader socioeconomic transformations occurring within Wayuu territories. While exposure to global ideals fostered comparison and dissatisfaction, cultural pride and collective belonging appeared to buffer against internalised colonial values. Culturally grounded media literacy and education initiatives co-developed with Wayuu communities could foster critical reflection while strengthening heritage. These results highlight the need for decolonial, community-based approaches to body image research and intervention in Indigenous contexts.

Adolescent↗

PubMed2026

Individual differences in brain dynamics across a social cognition network induced by cortico-cerebellar tDCS in adults with autism spectrum disorder (ASD).

Autism spectrum disorder (ASD) is a neurodevelopmental condition with core diagnostic domains of social communication impairments, restricted interests and repetitive behaviors. Idiosyncratic brain organization is a potential hallmark of ASD. Previous transcranial direct current stimulation (tDCS) studies often targeted dorsolateral prefrontal cortex, with changes oin brain dynamics averaged across the cohort. We utilized a magnetoencephalographic (MEG) array to characterize individual differences in brain dynamics induced by cortico-cerebellar tDCS across nodes of a social cognition network. A randomized, sham-controlled, double-blind, within-subject clinical trial was conducted in a cohort of 24 young adults with ASD or high autistic traits. Two separate sessions of computerized social learning activities were combined with verum/sham tDCS, with anodal electrode over right temporoparietal junction (TPJ) and cathode on right deltoid. Following stimulation, theta- and alpha-band activity were evaluated within nodes of a social cognition network: bilateral TPJ, fusiform, medial prefrontal cortex and Crus I/II of cerebellum. Idiosyncratic participant-specific up- and down-regulation of theta- and alpha-band activity occurred across the network. Activity in right Crus I/II, a region inundated by the stimulation current, strongly correlated with the change of activity summed across all cerebral cortical nodes in theta- but not alpha-band. Intrinsic theta-band activity is believed to mediate input/output relationships in cerebellar cortex and to drive synaptic plasticity. These results suggest that theta-band stimulation of cerebellar cortex might be an effective therapy for individuals on the autism spectrum who present with cerebellar hyperactivity.

Humans↗

PubMed2026

Associations of Illness Perception, Resignation Coping, and Social Support With Self-Regulatory Fatigue in Patients With Type 2 Diabetes: A Cross-Sectional Study.

AIMS: To examine the associations among illness perception, resignation coping, social support, and self-regulatory fatigue (SRF) in patients with Type 2 diabetes mellitus. The study specifically explores whether resignation coping and social support exhibit indirect associations with SRF in the context of illness perception. DESIGN: A cross-sectional study. METHODS: From November 2024 to October 2025, a convenience sample of 302 adult patients with T2DM was recruited from a tertiary general hospital in China. Participants completed validated instruments with established psychometric properties, namely the Brief Illness Perception Questionnaire, the Medical Coping Modes Questionnaire, the Perceived Social Support Scale, and the Self-Regulatory Fatigue Scale. Statistical analyses included Spearman correlation and serial mediation analysis using the PROCESS Macro (Model 6) with bias-corrected bootstrapping. RESULTS: SRF was positively correlated with negative illness perception (r = 0.579, p < 0.01) and resignation coping (r = 0.612, p < 0.01), and negatively correlated with social support (r = -0.598, p < 0.01). Serial mediation analysis revealed that illness perception was associated with SRF through indirect pathways involving resignation coping and social support. Resignation coping and social support mediated the association between illness perception and self-regulatory fatigue, both individually and sequentially. CONCLUSIONS: Negative illness perception correlates with higher SRF. This observed correlation is additionally linked to indirect pathways involving resignation coping and lower social support. Collectively, these findings highlight a pattern of interrelated cognitive (illness perception), behavioural (resignation coping), and resource (social support) factors that are associated with self-regulatory fatigue in this cross-sectional study. IMPLICATIONS FOR THE PROFESSION: The findings offer a clear, evidence-based framework for nursing practice. They highlight the potential value of integrated assessment and intervention that simultaneously addresses patients' illness beliefs, maladaptive coping strategies, and social support systems, which are associated with lower SRF and better diabetes self-management. REPORTING METHOD: This study adheres to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for cross-sectional studies. PATIENT OR PUBLIC CONTRIBUTION: Patients participated solely as research participants by providing survey data. They were not involved in the study design, implementation, data analysis, interpretation, or manuscript preparation. All patients provided written informed consent prior to questionnaire completion.

Humans↗