Medication adherence in older adults with chronic diseases is a public health challenge, given the growing and irreversible aging of the population, with direct repercussions on clinical outcomes and collective wellbeing. This scope review seeks to identify the main barriers and facilitators of pharmacological adherence and effective evidence-based interventions to optimize it.

A scope review was conducted for the period 2015-2025. Forty-one observational and interventional scientific studies (clinical trials) were selected from PubMed, Scopus, Web of Science, and ScienceDirect. Initially, a search was performed in six databases covering public health, medicine, life sciences, and biomedicine (PubMed and ScienceDirect), evidence-based healthcare (Cochrane Library), social sciences, arts, and humanities (Scopus and Web of Science), and research output, with an emphasis on Latin America, Spain, and Portugal. The four databases with the largest number of publications on the older adult population were selected, including topics such as medication adherence (compliance with pharmacological treatment and prescribing recommendations), medication persistence (uninterrupted continuity in medication recovery and administration), and patient prioritization interventions using automated mechanisms. The final selection of articles was carried out by three experts, who performed a critical appraisal of the evidence. The discrepancies were resolved by two other researchers, following the identification, screening, selection and inclusion phases of the PRISMA-2020 guidelines. The analysis of the information was carried out through synthesis and narrative integration.

Individual barriers were identified, including demographic (age, sex, educational level, and income), psychological (anxiety, depression, and self-efficacy), cultural (beliefs, fatalism, and stigmas), physical and mental health status (multimorbidity and cognitive impairment), and pharmacological (number of medications and adverse effects) factors. Facilitators identified are related to the health system (continuity of care, fragmentation of care, assertive communication, access, and provision of medicines). The interventions include personalized health education.

Medication adherence in older adults should be addressed with comprehensive and sustainable interventions. These interventions combine pharmacist education, technological support, continuous monitoring, and patient participation in therapeutic decision-making. Strategies should be designed with a collaborative approach involving patients, families, and healthcare professionals, ensuring measurable clinical outcomes and improving their quality of life.

Child welfare involved youth have high rates of behavioral health needs; however, many never receive needed mental health services. The specific barriers children and their caregivers face are not well described. The objective of this study was to describe the process and experience of initiating mental health care for youth entering out-of-home care.

Youth-caregiver dyads were enrolled in a 12-month longitudinal study, after entering protective custody for the first time, during which dyads completed surveys every 3 months. Electronic health records data linked with administrative child welfare data were extracted. Subgroups of dyads were identified based on reported mental health needs and whether needs were met over time. Descriptive analyses of these subgroups were completed to compare sociodemographic and child welfare characteristics and mental health screening scores. Youth or caregivers of youth with reported unmet mental health needs were recruited to participate in semi-structured interviews regarding experiences seeking mental health services. Timeline recall was used to support enhanced reporting. Timelines created during interviews were analyzed to uncover additional patterns in the events described. Thematic content analysis was applied to all interviews using Dedoose.

N = 201 youth-caregiver dyads were enrolled in the longitudinal study. The survey data showed that most youth entering out-of-home care have mental health needs, and these needs were inconsistently met over time. Descriptive analysis of subgroups showed that most characteristics were comparable across groups; however, some differences were noted. Nineteen dyads completed the interview. Timeline analysis revealed that adolescents rarely access mental health services prior to child welfare involvement, and caregivers who recognized service need and acted early accessed resources quicker than those who did not. Thematic analysis revealed both barriers and facilitators to mental health care which manifested in three primary categories: Caregiver, youth, and family-of-origin attributes, the mental health system, and other social service systems.

Most youth access mental health services while in out-of-home placement; however, mental health needs are often not consistently met over time. Caregivers play an important role in both reporting mental health concerns and accessing mental health services. Integrated mental health services are an important resource for child welfare involved youth seeking mental health treatment.

Despite evidence for safe and effective treatment of Opioid Use Disorder (OUD) with medications (MOUD), few patients engage in treatment. Among other barriers, patients report challenges related to generic ED discharge materials that fail to meet individual patients' MOUD-related needs and preferences. Our study aimed to design and develop an intervention to address this gap.

This study adopted a community-engaged, user-centered design approach. A community advisory board (CAB), comprising individuals with lived experience of OUD, ED physicians, addiction experts, and community program staff, informed intervention design. An initial prototype was designed to address CAB-identified challenges The prototype was iteratively refined with end-user feedback to develop the final product.

The CAB-identified challenges to MOUD engagement included lengthy, generic MOUD discharge materials that fail to meet the urgent needs of patients in opioid withdrawal. The initial prototype was refined with feedback from 20 individuals with OUD and ED clinicians to develop the final product. The final product included a novel, multi-component intervention consisting of: (1) A clinician-facing intake form to identify patients' MOUD preferences and socio-economic needs, (2) a paper-based, customized ED discharge summary, containing essential information tailored to individual needs, (3) a QR code accessible, digital component, containing supplemental information, and (4) a patient-facing poster for the ED care area to encourage patients to discuss MOUD treatment with their clinicians.

This innovative intervention can deliver customized MOUD-related patient education materials at ED discharge. A future trial will evaluate the intervention's effectiveness in improving patient MOUD engagement.

Electroconvulsive therapy (ECT) is a well-established and effective treatment for several psychiatric disorders, however, stigma and misinformation surrounding ECT remain widespread. Social media has become a major source of health information for patients and may influence treatment perceptions and decision-making, yet the quality and reliability of ECT-related content vary substantially across platforms. This study aimed to evaluate the quality, reliability, and dissemination characteristics of ECT-related videos on TikTok, BiliBili, and YouTube, and to identify factors associated with higher informational quality.

On December 8, 2025, the top 100 videos retrieved using the Chinese keyword "" on TikTok and BiliBili, and the English term "ECT" on YouTube were screened. Videos were independently assessed for attitude toward ECT, content completeness, and overall quality using the Global Quality Scale (GQS), modified DISCERN (mDISCERN), and the Medical Video Evaluation Tool (MQ-VET). Inter-rater reliability was calculated, and non-parametric statistical tests and Spearman correlation analyses were performed.

A total of 71 TikTok videos, 75 BiliBili videos, and 86 YouTube videos were included. YouTube videos demonstrated significantly greater content completeness than those on BiliBili. Overall quality scores were higher on YouTube than on BiliBili, and YouTube also outperformed TikTok in both mDISCERN and total MQ-VET scores. Video uploader identity, presentation format, and content category were differentially associated with video quality across platforms. Engagement metrics were not correlated with video quality on TikTok or BiliBili, whereas positive correlations were observed on YouTube.

Substantial platform-specific differences exist in the dissemination and quality of ECT-related health information. TikTok demonstrates strong user engagement, whereas YouTube provides more comprehensive and reliable content. These findings underscore the importance of platform-tailored, evidence-based strategies to improve the quality and public communication of ECT-related information.

Appropriate support is essential for the recovery of individuals with complex needs. In the United Kingdom, individuals with multiple complex needs such as those experiencing homelessness or recovering from substance use reside in supported housing. This type of housing is provided by a range of housing associations, local authorities, and charities. Often, a proportion of these individuals require tailored support to address their overlapping needs relating to health and daily living. However, there is a paucity of United Kingdom research on this topic. The aim of this present study is to explore the experiences of residents' living in recovery and homelessness supported housing provision. Semi-structured interviews were conducted with 11 residents from a coastal town in the North-West of England. Data collection occurred between February and March 2024. To analyze the interviews, thematic analysis was used. Two overarching themes were identified. The first was "going beyond" which unpacked into four subthemes "compassionate care," "availability of support," "comfort and safety," and "personalized approach." The second theme was "community and relationships" which unpacked into three subthemes "other residents," "activities" and "stigma." Findings showed that tenants valued staff who provided support beyond their formal roles, especially those with lived experience. The findings also highlight the importance of housing conditions, personal autonomy, and community engagement in fostering a sense of home and identity. The implications of this study highlight the need for service models that extend beyond basic care.

The well-being of university students is increasingly recognized as a critical public health issue, influenced by complex interactions among psychological, behavioral, and contextual factors. Despite growing research, measurement tools often lack standardization and contextual specificity, limiting the understanding of students' health. This review aimed to map and critically analyze instruments assessing well-being, ill-being, and health-related lifestyle behaviors among Italian university students, as well as the associated variables, including risk and protective factors.

The systematic review followed PRISMA guidelines and included peer-reviewed studies published from 2010 onward, identified across five databases: Scopus, APA PsycInfo, PubMed, ERIC, and Web of Science. A structured data extraction process was applied to collect information on sample characteristics, health-related outcomes, and associated variables (protective and risk factors). Descriptive statistics were used to synthesize frequencies, proportions, and distributions of measurement instruments and constructs across the included studies.

A total of 223 studies were included. Samples were largely non-probabilistic and female-biased. Ill-being measures appeared exclusively in 66.3% of the studies, while 7.9% focused on well-being, and 25.8% included both. A total of 159 instruments assessing well-being and ill-being were identified. Of these, the majority measured ill-being (118 instruments), followed by instruments assessing well-being (28), and a smaller number addressing both constructs (13). In addition, 154 instruments measuring lifestyle were identified. Lifestyle behaviors were measured in a fragmented, health-risk-oriented manner, often lacking contextual influences. Individual predictors (130) were prioritized over relational and environmental factors (53). Few instruments were tailored specifically to university students, and many studies used non-validated or ad hoc tools, especially those developed during the COVID-19 pandemic.

Findings highlight the need for standardized, validated, and context-sensitive instruments to assess student health holistically.

Functional movement and physical fitness are critical indicators of health and performance in young adults, yet their determinants among university students remain underexplored.

This study examined the predictive roles of gender, age, physical activity level, sleep duration, injury history, and academic performance on functional movement screening (FMS) scores and physical fitness outcomes.

A cross-sectional design was employed among university students. Functional movement was assessed using the FMS, while physical fitness was measured through standardized strength, endurance, and flexibility tests. Multiple regression analyses were conducted to identify significant predictors.

Gender emerged as the strongest predictor across both domains: females achieved higher FMS scores, whereas males demonstrated superior physical fitness, particularly in strength and endurance. Physical activity level significantly predicted functional movement but not overall physical fitness, highlighting qualitative versus quantitative dimensions of performance. Age was positively associated with muscular strength, while low GPA was unexpectedly linked to higher physical fitness. Recent injury history (<6 months) negatively influenced movement efficiency, whereas sleep duration and smoking status were not significant predictors when controlling for other variables.

Findings underscore the multidimensional nature of student health, with gender, activity level, and injury history serving as primary determinants. These results highlight the need for integrated, gender-sensitive, and injury-prevention strategies to optimize movement quality and physical fitness in university populations.

In mainland China, approximately 250 million people are unable to afford healthy meals. Food insecurity has been linked to poorer health outcomes in western countries, yet its impact remains understudied in China, especially among working-age adults. We analyzed cross-sectional data from an online survey conducted in 2024 with 4,795 individuals aged 30-60 from three Chinese provinces. Respondents self-reported chronic conditions, mental disorders, disabilities, and doctor visits. Household food insecurity was assessed by the FAO's Food Insecurity Experience Scale (FIES). The results showed that food insecurity was positively associated with chronic conditions, mental disorders, disabilities, and doctor visits in a dose-response fashion after confounders adjustment. Health insurance participation mitigated the association of food insecurity with chronic conditions and doctor visits. Healthcare accessibility, dietary quality, social support, and psychological chronic stress partially mediated the food insecurity-health relationship. Efforts to broaden and upgrade health insurance coverage and promote healthcare accessibility may help reduce health inequity across food security levels.

Grounded in environmental restorativeness theory, this study investigates the association between perceived restorative environments and meaning in life among active older adults. It further examines the mediating roles of psychological resilience, perceived stress, and place attachment, with particular attention to urban-rural differences in the context of population aging.

A questionnaire survey collected 511 valid responses of "Active Older Adults" (aged 60-80) from some urban and rural areas of China. We employed Amos 26.0 to construct structural equation models for path analysis and mediation effect testing, and utilized SPSS 26.0 combined with the Bootstrap method to assess indirect effects. Multi-group analyses were performed to compare the structural relationships between urban and rural subsamples.

Perceived restorative environments were found to exert a significant direct positive effect on meaning in life (effect = 0.193, p < 0.001). Additionally, three indirect pathways were identified: an independent mediating effect of psychological resilience, accounting for 35.37% of the total effect; an independent mediating effect of place attachment, accounting for 25.73%; and a chained mediating effect through psychological resilience and perceived stress, accounting for 8.46%. Multi-group analyses revealed notable urban-rural differences: among urban older adults, psychological resilience played a more prominent mediating role, whereas among rural older adults, place attachment emerged as the primary pathway linking restorative environments to meaning in life.

These findings underscore the critical role of restorative environments in enhancing meaning in life and psychological wellbeing during later adulthood. Optimizing community environments represents an effective public health strategy for promoting active aging. Age-friendly development should prioritize restorative environmental design and integrate mental health promotion, employing context-sensitive approaches tailored to the distinct needs of urban and rural older populations.

Dementia diagnosis in sub-Saharan Africa is constrained by limited access to specialist neuroimaging interpretation and reduced specificity of brief cognitive tools in low-literacy populations. We evaluated the agreement, incremental value, and comparative performance of Mini Mental State Exam (MMSE), visual MRI medial temporal atrophy (MTA), and automated brain morphometry in older Ugandan adults with suspected dementia.

In this cross-sectional study, adults aged ≥50 years with suspected dementia were recruited from neurology and psychiatry clinics at two hospitals and from a community cohort. Participants underwent MMSE and standardized 1.5T brain MRI. Visual MRI ratings were performed by radiologists blinded to clinical data, and automated morphometry was generated using NeuroQuant^® normative percentiles. Hippocampal occupancy (HOC <5th percentile) was used as a reference MRI biomarker for comparative classification. Agreement between visual and automated measures was assessed using Spearman correlation and intraclass correlation. Incremental value was assessed using regression models, and comparative performance using area under the curve (AUC).

Sixty-three participants were included (mean age 75.6 ± 8.7 years; 49 female). Agreement between visual ratings and automated morphometry was poor. MMSE correlated inversely with MTA (ρ = -0.47; p = 0.049) and correlated positively with hippocampal volume percentile (ρ = 0.46; p = 0.056). Adding hippocampal volume to MTA did not improve model fit for MMSE (ΔR² = 0.028; p = 0.18). For comparative classification, MMSE alone was sensitive but poorly specific, while the combined MMSE-MTA model improved specificity and discrimination (AUC 0.70 vs 0.62 for either measure alone).

Visual and automated MRI measures were not interchangeable in this heterogeneous cohort. Automated hippocampal volumetry added limited value beyond visual MTA for global cognition, while combining MMSE with visual MTA showed modest improvement in comparative classification and warrants further validation.