The research team, led by Mary Aku Ogum and including Thomas Hormenu and Edward Wilson Ansah, set out to quantify both the prevalence of risky sexual behaviours and the social and demographic factors that predict them among unmarried, regular undergraduate students. Their motivation was straightforward: university students in Ghana, as in many countries, represent a large, mobile, and socially transitional population. They are typically living away from parental oversight for the first time, navigating new peer environments, and encountering the freedoms and pressures of early adulthood. Studies from universities in multiple countries have shown that this group is more likely to be sexually active and to engage in behaviours with negative consequences for health and academic achievement, making them a priority population for prevention efforts.

Methodologically, the study was ambitious in scale. The researchers conducted a quantitative cross-sectional survey using a multistage sampling procedure to recruit 10,896 undergraduate students, split evenly between 5,448 males and 5,448 females. Data were collected with an adapted questionnaire drawn from the Core Expanded Questions of the Global School-based Student Health Survey, a standardized instrument designed to allow comparison across settings and countries. The team then analyzed responses using frequencies, percentages, and binary logistic regression, a statistical technique that estimates how strongly each candidate factor predicts a binary outcome, in this case whether a student engaged in risky sexual behaviour. The study received ethical approval from the Institutional Review Board of the University of Cape Coast, and every participating student signed an informed consent form before taking part.

The headline numbers are sobering. Of the 10,896 students surveyed, 38.3 percent, or 4,176 individuals, reported being sexually active. Within that sexually active group, the researchers documented a cluster of behaviours that epidemiologists consider high-risk. The most common was condom non-use: 63.7 percent of sexually active students, amounting to 2,661 individuals, reported not using condoms. Nearly half, 45.7 percent or 1,654 students, reported having multiple sexual partners, a pattern that multiplies the number of potential transmission pathways for HIV and other sexually transmitted infections. A substantial 37.2 percent, or 1,552 students, reported using alcohol or drugs in connection with sex, a behaviour known to impair judgment, reduce condom negotiation, and increase the likelihood of unprotected encounters.

Two further findings rounded out the risk profile. Some 16.3 percent of sexually active students, or 682 individuals, reported engaging in anal sex, a practice associated with a heightened biological risk of HIV transmission compared with vaginal intercourse because of the fragility of rectal mucosal tissue. Meanwhile, 12.4 percent, or 520 students, reported an early onset of sexual activity, defined in the study context as first intercourse at a young age. Taken together, these behaviours produced an overall magnitude of risky sexual behaviour of 78.8 percent among sexually active students, meaning 3,291 of the 4,176 sexually experienced respondents reported at least one behaviour placing them at elevated risk. The authors frame this figure as a clear signal that the burden of sexual risk in this population is not confined to a small minority but is a mainstream campus health issue.

Beyond the raw prevalence figures, the study’s regression analysis identified which characteristics predicted risky behaviour. Chronological age emerged as a significant factor, with risk profiles shifting as students moved through their undergraduate years. Religious affiliation also played a measurable role, consistent with a body of literature suggesting that religious identity can shape sexual norms, expectations, and disclosure behaviour among young adults in Ghana. Perhaps most tellingly, the age at first sexual intercourse and the circumstances influencing that first experience predicted later risk-taking, suggesting that early sexual trajectories cast a long shadow over subsequent behaviour during university years.

Living arrangements and family communication completed the predictive picture. The researchers found that who students lived with during their studies influenced their likelihood of engaging in risky behaviour, an intuitive but important result given that residence type shapes supervision, privacy, and peer exposure. Equally significant was the difficulty students reported in discussing sexual issues with their parents. Where parent-child communication about sexuality was strained or absent, students were more likely to engage in risky practices. This finding resonates with a broader public health consensus that open, accurate family communication about sexuality acts as a protective factor, delaying sexual debut and increasing protective behaviours such as condom use when sexual activity does begin.

The implications for intervention are spelled out clearly in the study’s conclusion. The authors argue that public health programmes should incorporate campus-based counselling and peer education, with a particular focus on students who are already sexually experienced. Peer education, in which trained students deliver health information and norm-change messages within their own social networks, has a long track record in HIV prevention because it leverages trust and shared language in ways that top-down messaging often cannot. Counselling services, meanwhile, can address the individual-level drivers of risk, including alcohol use, relationship pressures, and gaps in knowledge about transmission and contraception. The finding that parental communication difficulties predict risk suggests that interventions may also need to reach beyond the campus gates, supporting families in sustaining conversations about sexual health into late adolescence and early adulthood.

The study also situates itself within global health frameworks. The rising prevalence of HIV/AIDS and unintended pregnancies is widely attributed to exactly the behaviours this survey measured: non-use of condoms, alcohol intake before sex, multiple sexual partnerships, early sexual debut, and survival sex. Because university students represent an educated cohort whose health behaviours today shape the health of families and communities tomorrow, the authors argue that securing their well-being is crucial for the overall health and development of society, in line with the United Nations Sustainable Development Goals. In Ghana, where young people constitute a large share of the population, the stakes of translating these findings into policy are considerable.

Caveats are worth noting, as with any cross-sectional survey. The design captures behaviour at a single point in time and cannot establish cause and effect; it shows that age, religious affiliation, early sexual debut, living situation, and parental communication are associated with risky behaviour, not that one directly produces the other. Self-reported data on sexual behaviour are also vulnerable to social desirability bias, particularly on sensitive topics, although the large sample size and use of a validated international instrument strengthen confidence in the overall patterns. The study was conducted at a single public university, so generalization to other institutions or countries should be made cautiously. The authors received no specific funding for the research and declare no competing interests. Even with these limitations, the sheer scale of the survey, nearly eleven thousand respondents balanced by sex, makes it one of the most detailed portraits to date of sexual risk among Ghanaian undergraduates, and its central message is hard to ignore: condom use, partner reduction, and substance-related risk remain stubbornly high on campus, and the levers of change run through families, faith communities, and student peer networks as much as through clinics and lecture halls.

Subject of Research: Prevalence and predictors of risky sexual behaviours among undergraduate university students in Ghana

Article Title: Prevalence and factors influencing risky sexual behaviours among university students in Ghana

Article References: Ogum, M. A., Mintah, J. K., Ogum, P. N., Hormenu, T., & Ansah, E. W. (2026). Prevalence and factors influencing risky sexual behaviours among university students in Ghana. BMC Public Health. https://doi.org/10.1186/s12889-026-29715-w

Image Credits: AI Generated

DOI: 10.1186/s12889-026-29715-w

Keywords: risky sexual behaviour, university students, Ghana, HIV/AIDS, condom non-use, multiple sexual partners, sexually transmitted infections, unintended pregnancy, cross-sectional survey, peer education, parental communication, public health

The scale of the omission is striking. More than half of the surveyed educators reported that traditional health content is not taught at any level of their undergraduate programme, and only a small minority indicated that their institutions offer dedicated curriculum components on the subject. Foundational concepts, the values and belief systems underpinning traditional practice, the regulatory framework governing traditional health practitioners, and the professional roles nurses may play in relation to these systems were all reported as largely absent from teaching. In a country where traditional healing remains a first point of contact for many communities, the finding points to a deep structural disconnect between what nursing students learn and what their future patients believe and practise.

The research team approached the question with a quantitative, cross-sectional descriptive survey, representing the second phase of an exploratory sequential mixed-methods design. In the first phase, qualitative work informed the development of the questionnaire, ensuring that the survey instrument reflected the lived realities of educators rather than imposing externally derived categories. For the national phase, the researchers stratified public nursing education institutions by type, covering universities, universities of technology, and public nursing colleges, and collected responses from 408 nurse educators across the country. The questionnaire probed curriculum structure, the presence and depth of ATHKP-related content, teaching and assessment methods, and educators’ own perceptions of how important such teaching is.

The methodological rigour of the survey was supported by standard psychometric checks, including an assessment of sampling adequacy using the Kaiser-Meyer-Olkin measure, and the data were analysed with descriptive statistics. This design choice matters: rather than relying on anecdote or single-institution case studies, the study offers the first national-level evidence base on how, or whether, Indigenous health knowledge is woven into South African nursing education. Ethics approval was granted by the Faculty of Health Sciences Research Ethics Committee at the University of Pretoria, and participation was voluntary with informed consent obtained from all respondents.

What the numbers revealed was a curriculum gap with several distinct layers. Content was not merely thin; it was unevenly distributed and largely theoretical. Where traditional health topics did appear, educators described predominantly lecture-based, classroom-bound delivery, with little use of experiential learning approaches such as community engagement, clinical exposure, or dialogue with traditional practitioners. Formal assessment of ATHKP content was uncommon, meaning that even where material was taught, students faced little incentive to master it. In curriculum design terms, unassessed content is functionally optional, and the survey suggests that traditional health knowledge has been relegated to precisely that status.

The paradox at the heart of the findings is that nurse educators themselves do not dismiss the subject. Most respondents perceived the teaching of African traditional health knowledge as important and explicitly identified the need for educator development, clearer regulatory guidance, and structured curriculum support. In other words, the barrier appears to be institutional and systemic rather than attitudinal. Educators lack the training, the policy clarity, and the curricular scaffolding to translate their own recognition of the subject’s importance into classroom practice. This distinction is crucial for policymakers, because it reframes the problem from one of persuading sceptical faculty to one of equipping willing ones.

The clinical stakes of this gap are considerable. Nurses routinely care for patients whose health beliefs and practices are informed by Indigenous knowledge systems, including the use of herbal remedies, consultation with traditional health practitioners, and explanatory models of illness that differ from biomedical frameworks. Without formal preparation, graduates may respond to these practices with ignorance at best and cultural insensitivity or outright dismissal at worst. That carries risks in both directions: patients may conceal traditional treatments that interact pharmacologically with prescribed drugs, or may disengage from care entirely when their beliefs are met with hostility. Culturally responsive care, long championed by the World Health Organization’s emphasis on integrating traditional medicine into national health systems, requires practitioners who can navigate pluralistic health landscapes safely and ethically.

South Africa’s regulatory environment adds another layer of urgency. Traditional health practitioners in the country operate within a formal regulatory framework, and the survey found that content relating to this regulation, and to the professional roles nurses might occupy in relation to traditional practitioners, was largely missing from teaching. This means newly qualified nurses may enter the workforce without understanding the legal status of the healers their patients consult, the boundaries of their own professional responsibilities, or the referral pathways that could link the two systems. The educators surveyed flagged the absence of clearer regulatory guidance as a specific obstacle, suggesting that curriculum reform cannot proceed without parallel policy development from bodies such as the South African Nursing Council.

The study’s authors argue that strengthening curriculum content, pedagogical approaches, educator preparedness, and assessment practices related to ATHKPs could enhance culturally responsive nursing education and better prepare graduates to provide care within pluralistic healthcare systems. The recommendations are deliberately structural: educator development programmes to build faculty confidence and competence, clearer regulatory guidance to define what should be taught, and structured curriculum support to embed the material at multiple levels of the programme rather than leaving it to individual initiative. The finding that assessment practices lag behind even limited teaching suggests that any reform must address evaluation as well as delivery, since what is examined shapes what students take seriously.

For a country whose constitution recognises cultural diversity and whose health system serves a population that frequently combines biomedical and traditional care, the study reads as a wake-up call delivered with statistical precision. The gap it documents is not between nurses and their patients’ beliefs in the abstract, but between what 408 educators across the nation’s accredited public nursing institutions say matters and what their curricula actually contain. Closing that gap, the evidence suggests, will require more than goodwill; it will demand deliberate investment in teaching capacity, regulatory clarity, and curriculum design that treats African traditional health knowledge not as folklore at the margins of medicine, but as an essential competency for safe, ethical, and effective nursing practice in one of the world’s most pluralistic healthcare environments.

Subject of Research: Integration of African traditional health knowledge and practices into undergraduate nursing education in South Africa

Article Title: Teaching African traditional health knowledge and practices in undergraduate nursing education: a national survey of South African nurse educators

Article References: Teaching African traditional health knowledge and practices in undergraduate nursing education: a national survey of South African nurse educators. (n.d.). https://doi.org/10.1186/s12912-026-05431-z

Image Credits: AI Generated

DOI: 10.1186/s12912-026-05431-z

Keywords: African traditional health knowledge, nursing education, South Africa, nurse educators, curriculum integration, Indigenous knowledge systems, traditional health practitioners, culturally responsive care, cross-sectional survey, BMC Nursing, health policy, undergraduate nursing

The study, led by Anna Zimny-Zając of the Jagiellonian University Medical College in Kraków together with colleagues from the Maria Skłodowska-Curie National Research Institute of Oncology, found that 61.8 percent of respondents with a self-reported cancer history had used a dietary supplement or an over-the-counter preparation in the previous twelve months. Daily use was reported by 26.9 percent of the entire group, meaning that more than one in four cancer survivors in the sample was taking at least one non-prescription product every single day. The remaining 38.2 percent reported no use at all during the preceding year. Because the survey assessed dietary supplements and non-prescription medicines jointly in a single question, the researchers could not separate the two categories in their analysis, a limitation they acknowledge explicitly.

What exactly are people taking? Among users, multivitamin preparations dominated the list, selected by 52.5 percent of those reporting any use. Digestive products, hair and skin preparations and sleep products rounded out the most frequently chosen categories. The survey asked respondents to indicate both the type of preparation and its intended purpose, and the authors are careful to describe these as reported product categories or purposes of use rather than motivations, since underlying motivations were not directly measured. Even so, the pattern echoes what has been documented internationally: cancer survivors gravitate toward multivitamins, single-nutrient products such as vitamin D, and preparations marketed for fatigue, immune support or general wellbeing.

The demographic fingerprint of supplement use was equally revealing. In a multivariable logistic regression model, higher educational attainment showed the strongest positive association with use, with university-educated respondents having the greatest odds of reporting supplementation. Women were more likely to use these products than men, and older age was associated with lower odds. More frequent stressful situations also predicted higher odds of use, hinting at a possible link between psychological burden and the search for self-care tools, although the authors stress that such mechanisms were not directly assessed and should be treated as hypotheses. Associations with self-rated mental health were statistically significant but did not increase consistently across progressively poorer health categories, complicating any simple interpretation.

Perhaps the most clinically consequential finding concerned comorbidities. Respondents with coexisting non-cancer conditions had greater odds of using supplements and over-the-counter products, and 85.3 percent of the cohort reported at least one such condition. This matters because interaction risk grows with the number of concomitant agents, and many supplements are taken chronically without ever being reviewed by a clinician. The authors argue that this makes a strong practical case for including non-prescription products in routine medication histories taken in oncology clinics, where incomplete disclosure remains a well-documented problem.

That disclosure gap is real and quantified. Previous research cited in the paper found that only 42.2 percent of users of complementary and alternative medicine had discussed their use with an oncologist, while a Polish study reported that 46.6 percent of such users had never informed their physician. Clinical practice guidelines, including an integrative review by Balneaves and colleagues, recommend that oncology professionals routinely ask about complementary products, document what patients are taking and assess potential interactions as part of ongoing care. The new Polish data suggest that without proactive questioning, a majority of patients may be carrying a substantial pharmacological load that never appears in their medical record.

The pharmacological concern is not theoretical. Herbs, foods and dietary supplements can alter the metabolism of anticancer drugs through the cytochrome P450 enzyme system, particularly the CYP3A4, CYP2D6, CYP1A2 and CYP2C8 isoforms that handle many targeted and cytotoxic therapies. Interactions involving drug transport proteins have also been documented. On the outcomes side, the evidence base is uncertain but troubling: in the MARIE cohort, concurrent antioxidant supplementation during chemotherapy or radiotherapy was associated with higher all-cause mortality and poorer recurrence-free survival, and an ancillary study within the randomized SWOG S0221 trial found point estimates suggesting higher hazards of recurrence and death among antioxidant users, though the confidence intervals there included unity. These observational findings raise a potential safety concern without establishing causation, but they are enough to warrant caution.

Current survivorship guidance, including the American Cancer Society nutrition and physical activity guideline and the NCCN survivorship guidelines, emphasizes healthy dietary patterns and regular physical activity and does not recommend routine supplement use for most cancer survivors. Supplementation may be appropriate in selected circumstances based on individual nutritional or clinical needs, such as correcting a confirmed deficiency. The authors of the new study outline a pragmatic counselling approach for clinicians: elicit a complete list of supplements and over-the-counter products, including dose and brand where possible; clarify the intended purpose and expected benefit; screen for potential interactions and duplication with prescribed therapy; and advise particular caution with high-dose antioxidant preparations during chemotherapy or radiotherapy unless a clear medical indication exists.

The temporal picture added another layer of interest. Use varied significantly across the six survey waves, peaking in 2021 and reaching its lowest point in 2025, with daily use ranging from 23.6 percent in 2020 to 30.2 percent in 2021 before settling at 26.2 percent in 2025. The study period spanned the COVID-19 pandemic and its aftermath, and the authors suggest that changes in health-related behaviours, healthcare circumstances and the composition of respondents to the voluntary online survey may all have contributed to the between-wave variation. Notably, there was no consistent year-to-year decline, indicating that supplement use among this population is a stable and persistent phenomenon rather than a passing trend.

The study’s limitations deserve honest weight. The survey used quota-based, non-probability sampling of adult internet users, so people with limited digital access, very advanced disease or severe functional impairment are likely underrepresented, and the observed proportions cannot be read as true population prevalence. Cancer history was captured by a single self-report checklist item, with no data on tumour type, stage, time since diagnosis or ongoing treatment. All measures were self-reported, the 12-month recall window was broad, and no information was collected on product composition, dose, duration or who recommended the product. Residual confounding is likely, and the repeated cross-sectional design without individual linkage rules out conclusions about causality or within-person trajectories over time.

Even with those caveats, the message for oncology practice is clear and actionable. Non-prescription products are not a marginal habit among people with a history of cancer; they are a mainstream behaviour, patterned by education, sex, age, stress exposure and comorbidity, and largely invisible to treating physicians. The authors conclude that routinely asking about dietary supplements and over-the-counter products as part of medication review, documenting what patients take, assessing intended purposes and potential interactions, and providing evidence-based counselling where appropriate could close a significant safety gap in cancer follow-up care. For a growing population of survivors, the pills taken at home may matter as much as the drugs prescribed in hospital, and the first step is simply asking about them.

Subject of Research: Dietary supplement and over-the-counter product use among adults with a self-reported history of cancer in Poland

Article Title: Use of dietary supplements and over-the-counter products among adults with a self-reported history of cancer in Poland

Article References: Zimny-Zając, A., Kowalska-Bobko, I., Pacholczak-Madej, R., & Püsküllüoğlu, M. (2026). Use of dietary supplements and over-the-counter products among adults with a self-reported history of cancer in Poland. Supportive Care in Cancer, 34(10), Article 1033. https://doi.org/10.1007/s00520-026-11263-z

Image Credits: AI Generated

DOI: 10.1007/s00520-026-11263-z

Keywords: dietary supplements, over-the-counter products, cancer survivors, cancer survivorship, Poland, medication history, drug interactions, cytochrome P450, multivitamins, complementary and alternative medicine, supportive care, cross-sectional survey

The study, published in BMC Nursing by Asako Futami, Maiko Noguchi-Watanabe, and Noriko Yamamoto-Mitani of the University of Tokyo, set out to answer a deceptively simple question: does the environment in which nurses work influence how faithfully they carry out guideline recommendations, and does that, in turn, leave a fingerprint on patient health? The researchers surveyed staff nurses in five acute care hospitals in Japan, collecting data on their awareness and implementation of guideline recommendations related to two of the most stubborn problems in hospital care — pressure ulcers and infection control — alongside their perceptions of the organizational context using a validated instrument called the Alberta Context Tool.

Clinical practice guidelines, or CPGs, are systematically developed statements that translate the best available research evidence into recommendations for care. They exist for nearly every major clinical scenario, from wound prevention to hand hygiene. Yet the gap between what guidelines recommend and what actually happens at the bedside is a persistent puzzle in health services research. Implementation science, the field devoted to closing that gap, has increasingly focused on organizational context — the shared norms, leadership behaviors, resources, and feedback loops that surround clinical work. The Promoting Action on Research Implementation in Health Services framework, from which the Alberta Context Tool derives, holds that successful implementation is a function of evidence, context, and facilitation working together.

The Alberta Context Tool, or ACT, breaks this context down into measurable concepts: leadership culture, workplace culture, evaluation practices — meaning how data on team performance are used — structural and electronic resources, social capital, informal interactions, formal interactions, staffing levels and skill mix, and organizational slack, which refers to the spare time, space, and staffing a unit has available to absorb new practices. Nurses rate their units on each of these dimensions, producing a profile of how receptive the environment is to evidence-based change. The tool has been used widely in Canada and Europe, but the Japanese researchers noted that the relationship between context and guideline implementation may be culture-bound, and that its specific contours within Japanese health care settings remained unclear.

What they found was sobering on one front and illuminating on another. Of the 508 staff nurses whose data were analyzed, approximately 40 percent reported that they were simply unaware of the clinical practice guidelines relevant to their work. This is a striking figure: four in ten nurses in acute care settings could not confirm they knew the very documents designed to standardize and improve their practice. Awareness, of course, is only the first rung of the implementation ladder. Even among nurses who knew the recommendations, consistent execution was far from universal. The percentage of respondents who said they always implemented a given recommendation ranged from 15.0 percent to 48.2 percent, depending on which recommendation was being measured. In other words, for some guideline elements, fewer than one in six nurses could claim consistent adherence.

The analysis then turned to the question of what distinguishes units where guidelines are followed from those where they are not. Using hierarchical linear modeling — a statistical approach appropriate for data in which individual nurses are nested within units, which are in turn nested within hospitals — the researchers identified several ACT concepts that were positively associated with the implementation of guideline recommendations. Workplace culture, structural and electronic resources, evaluation practices, and staffing emerged as significant factors. Units where the culture was supportive, where nurses had access to adequate material and digital resources, where performance data were actively used to assess and improve team practice, and where staffing was sufficient, saw higher rates of guideline implementation.

Perhaps the most consequential finding concerned patient outcomes. The researchers examined two hard, clinical endpoints: the incidence rate of pressure ulcers and the incidence of MRSA infection. Four concepts from the Alberta Context Tool — evaluation, leadership, staffing, and time — were significantly associated with these outcomes. This is a critical link in the causal chain that implementation scientists have long hypothesized but rarely documented so directly in the Japanese context. It suggests that the organizational environment does not merely shape nurse behavior in the abstract; it appears to ripple through to whether patients develop avoidable wounds or acquire dangerous antibiotic-resistant infections during their hospital stay.

The specificity of the associations carries practical implications. Each guideline recommendation was associated with a somewhat different configuration of organizational context, which the authors interpret as evidence that a one-size-fits-all implementation strategy is unlikely to succeed. A recommendation that depends heavily on electronic documentation may rise or fall with structural and electronic resources, while one that requires coordinated team behavior may hinge on culture and informal interactions. Hospital administrators seeking to improve adherence would therefore do well to diagnose which contextual dimensions matter most for each specific practice they hope to embed, rather than launching generic awareness campaigns.

The cultural dimension of the findings deserves particular attention. The researchers explicitly framed their study as an effort to understand whether the well-documented relationships between context and implementation hold within Japanese culture, where hierarchical communication patterns, group-oriented norms, and different staffing structures may shape how evidence-based practice takes root. Their results suggest that the fundamental associations do hold — supportive culture, data-driven evaluation, and adequate resources matter in Japan just as they do elsewhere — but the study also underscores that implementation strategies must be culturally calibrated. Importantly, the study found no funding source and was conducted with ethical approval from the research ethics committee of the Graduate School of Medicine at the University of Tokyo, with informed consent obtained from all respondents in accordance with the Declaration of Helsinki.

For a field often dominated by discussions of new drugs and devices, this study is a reminder that some of the most powerful levers for improving patient care are organizational rather than pharmacological. A hospital that cultivates a supportive work culture, applies performance data to assess its teams, invests in resources, and protects staff time may see fewer pressure ulcers and fewer MRSA infections — not because it purchased new technology, but because it built an environment in which nurses can actually practice the evidence they already possess. With roughly 40 percent of nurses unaware of relevant guidelines and consistent implementation rates sometimes dipping below one in five, the headroom for improvement in Japanese acute care appears substantial. The message for hospital leaders worldwide is equally clear: the fastest route to better guideline adherence may run not through the guidelines themselves, but through the daily conditions of the nurses expected to follow them.

Subject of Research: The relationship between organizational context, nurses' implementation of clinical practice guidelines, and patient outcomes in Japanese acute care hospitals

Article Title: The relationship between organizational context and nurses’ implementation of clinical practice guidelines and patient outcomes in Japanese acute care settings: a cross-sectional survey

Article References: Futami, A., Noguchi-Watanabe, M., & Yamamoto-Mitani, N. (2026). The relationship between organizational context and nurses’ implementation of clinical practice guidelines and patient outcomes in Japanese acute care settings: a cross-sectional survey. BMC Nursing. https://doi.org/10.1186/s12912-026-05457-3

Image Credits: AI Generated

DOI: 10.1186/s12912-026-05457-3

Keywords: clinical practice guidelines, organizational context, nursing, Alberta Context Tool, evidence-based practice, Japan, pressure ulcers, MRSA, infection control, acute care hospitals, implementation science, cross-sectional survey

The research team, led by Ahmed A. Ahmed of the Department of Social Sciences at the University of Ha’il, together with colleagues from the university’s psychology department and researchers at Capital University in Egypt, set out to test three hypotheses about café culture. The first proposed that higher frequency of café attendance would be positively associated with increased social interaction and a stronger sense of belonging. The second predicted that attractive environmental factors—ambience, design, comfort—would significantly predict positive psychological outcomes. The third, and arguably most intriguing, suggested that the specific activities practiced within cafés would mediate the relationship between how often young people visit and how they feel as a result.

To test these ideas, the researchers gathered responses through an online questionnaire administered via Google Forms to university students in the Ha’il region. The data were then subjected to a battery of statistical techniques, including descriptive statistics to characterize the sample, multiple regression to isolate the predictors of psychological outcomes, and mediation analysis to examine whether activities inside cafés explain the link between visit frequency and wellbeing. The study received ethical approval from the Research Ethics Committee of the University of Ha’il under approval number H-2025-801, dated 12 May 2025, and all procedures followed the Declaration of Helsinki. Electronic informed consent was obtained from every participant, and no minors or vulnerable groups were included.

The findings on the first hypothesis were largely affirmative. Young people who visited cafés more frequently reported more social interaction and a greater sense of belonging, confirming the intuition—long embedded in sociological theory—that cafés act as connective tissue in urban life. In a region where formal entertainment infrastructure has historically been limited, and where social life has traditionally revolved around family gatherings, the proliferation of coffee shops appears to have opened a new channel for peer contact. The café, in this reading, is a low-threshold social arena: accessible, informal, and open to repeated, unstructured encounters that build familiarity and trust over time.

But the study’s most striking result concerns what frequency alone cannot deliver. Although being at a café helps socializing, the authors report, it alone does not ensure more favorable psychological outcomes. The mediation analysis showed that the relationship between visit frequency and psychological wellbeing runs through the activities young people engage in while they are there. A young person who spends hours in a café passively scrolling a phone, or sitting at the edge of a group without genuine participation, may accumulate visit after visit without any measurable psychological benefit. By contrast, those whose café time involves meaningful engagement—conversation, shared activities, active participation in the social life of the space—show the positive outcomes the researchers were looking for.

This distinction carries real theoretical weight. It suggests that the psychological value of a third place is not a property of the place itself but of the quality of interaction it hosts. Environmental attractiveness, the second hypothesis, did emerge as a significant predictor of positive psychological outcomes, indicating that design, comfort, and ambience matter—but apparently as enablers rather than as sufficient conditions. A beautifully designed café can draw young people in and make them want to stay, yet the ambience only pays off psychologically when it facilitates the kinds of engagement that translate presence into connection.

The implications extend beyond academic theory. The authors point out that their findings suggest clear, data-grounded steps that decision makers can take to strengthen these spaces. If meaningful engagement is the active ingredient, then policies and business practices that encourage interaction—seating arrangements that foster conversation, events and programming that bring patrons together, environments designed for groups rather than isolated individuals—could amplify the social and psychological returns of café culture. Conversely, a café landscape optimized purely for turnover and takeaway consumption might be quietly eroding the very benefits that make these venues socially valuable.

The Saudi context makes the study particularly timely. The Kingdom has undergone rapid social transformation in recent years, with expanding entertainment options and a young population eager for new forms of public life. Coffee shops have proliferated across Saudi cities, and in regions such as Ha’il they often serve as the primary venue where young adults gather outside institutional settings. Understanding whether these venues nourish or merely occupy their patrons is therefore a question with consequences for public health, urban planning, and youth policy alike. The study was funded by the Scientific Research Deanship at the University of Ha’il through project number RCP-25 023, reflecting institutional interest in this emerging social phenomenon.

Methodologically, the study has the limitations inherent to its design. A cross-sectional survey captures a single moment in time, so it can establish associations but not definitively prove causal direction: it remains possible, for example, that young people who already feel socially connected simply visit cafés more often. The sample of 177 participants, drawn through an online questionnaire among university students, is meaningful but modest, and generalizing to all young people in the region—or to other regions of Saudi Arabia—will require further work. The authors themselves frame the findings as highlighting the importance of both social interaction and psychological outcomes in understanding café attendance, rather than as a final word on the subject.

Even with those caveats, the research offers a memorable takeaway for anyone who has ever wondered whether the hours spent in a coffee shop are time well spent. The café, the study suggests, is not a wellness intervention in a cup. It is a stage, and the psychological benefits depend on whether young people step onto it—talking, sharing, and genuinely engaging with the people around them. For a generation navigating the tensions between tradition and rapid modernization, that stage may matter more than anyone realized, and the new evidence gives policymakers a concrete lever: design and support café spaces that invite participation, because presence alone is only half the story.

Subject of Research: The social and psychological effects of café attendance on youth in the Ha'il region of Saudi Arabia

Article Title: The social and psychological effects of cafes and coffee shops on youth in the Ha’il region of Saudi Arabia

Article References: Ahmed, A. A., Alshammari, S. A., Moussa, S. E., Helal, I. A., Alaghdaf, A. A., & El-Moazen, B. Y. M. (2026). The social and psychological effects of cafes and coffee shops on youth in the Ha’il region of Saudi Arabia. Discover Psychology. https://doi.org/10.1007/s44202-026-00910-5

Image Credits: AI Generated

DOI: 10.1007/s44202-026-00910-5

Keywords: cafés, third places, youth, social interaction, psychological wellbeing, Saudi Arabia, Ha'il, social psychology, mediation analysis, cross-sectional survey, community hubs, belonging

The study was conducted by researchers at the National Research Center in Complementary and Alternative Medicine at UiT The Arctic University of Norway, together with a colleague from VID Specialized University in Oslo. Between February and August 2024, the team administered an online cross-sectional survey built on an adapted version of the International Complementary and Alternative Medicine Questionnaire, known as the I-CAM-Q, an instrument designed to allow comparisons of complementary medicine use across countries and populations. Participants were 488 first-generation immigrants, meaning people born in Pakistan who migrated to Norway, and 445 second-generation immigrants born in Norway to Pakistani parents, all aged 18 or older. To avoid the skewed samples that plague many online surveys, the researchers used proportional stratified random sampling, drawing participants from the National Register of Citizens so that gender, generation, and age groups were represented in proportion to the underlying population.

The headline numbers are striking. Natural products, which in this context include herbal remedies, spices, oils, and other ingestible preparations rooted in South Asian tradition, were used by 99.3 percent of respondents in the previous year. Religious self-care practices, encompassing prayer and other spiritually grounded health activities, were reported by 75.7 percent. Self-care activities such as yoga and meditation were practiced by 35.1 percent, and 27.8 percent had visited a traditional and complementary medicine provider, whether a herbalist, a practitioner of Unani medicine, or another kind of traditional healer. Taken together, these figures suggest that for this community, complementary medicine is not an occasional experiment or a fringe preference but a continuous, everyday framework of health maintenance.

The intensity of use varied considerably across subgroups, and the patterns are statistically revealing. First-generation women emerged as the heaviest users of all, reporting a median of 16 different traditional and complementary medicine modalities, with an interquartile range of 23, meaning the middle half of these women reported anywhere from a handful to dozens of distinct practices. After adjusting for other variables in logistic regression models, women were significantly more likely than men to engage in self-care practices. Meanwhile, visiting traditional and complementary medicine providers was significantly associated with older age, higher income, and the presence of chronic disease. That last association makes intuitive sense: people living with long-term conditions often seek additional sources of relief when conventional care does not fully resolve their symptoms, and those with more disposable income can afford to pursue options outside the public health system.

One of the most consequential findings concerns geography. Several participants reported visiting traditional and complementary medicine providers abroad, typically during trips to Pakistan or other countries where such practitioners are embedded in the mainstream health landscape. This detail matters for patient safety in ways that a simple prevalence figure cannot capture. Practitioners operating outside Norway are beyond the reach of Norwegian regulation, and the products they dispense may not have been assessed under European standards. When patients later return to Norwegian general practitioners, they may not mention these consultations or the remedies they brought home, creating a hidden layer of pharmacological exposure that clinicians cannot see. The researchers argue that this pattern underscores the need for open, non-judgmental communication about traditional medicine use during clinical encounters.

Why do people turn to these practices? The survey found that traditional and complementary medicine was used mainly for well-being and illness prevention, framing it as part of a proactive, holistic approach to health rather than a desperate fallback. At the same time, 42.7 percent of participants reported using natural products for acute conditions, such as infections, digestive complaints, or minor injuries. This dual role, both preventive and curative, mirrors patterns documented in Pakistan itself, where traditional and complementary medicine is widely used for both health maintenance and illness management, and it confirms that migration does not sever these habits. The researchers interpret the persistence as evidence of a culturally rooted, holistic model of health that continues to make sense to people regardless of which country they live in.

The perceived benefits were overwhelmingly positive, but the survey did not shy away from risks. Although most participants found traditional and complementary medicine helpful, some reported adverse effects, and these were attributed mainly to natural products, with 23.8 percent of users of such products reporting harm. This is a critical nuance. The word natural carries a halo of safety in popular discourse, yet herbal preparations are pharmacologically active substances. They can interact with prescription drugs, vary unpredictably in potency and purity, and in some cases contain contaminants. For a community in which essentially everyone uses natural products, even a modest adverse effect rate translates into a substantial number of people. The authors highlight this as a central argument for integrating questions about traditional medicine into routine healthcare conversations rather than leaving patients to volunteer the information.

The generational comparison embedded in the study design adds another layer of interest. Because the sample deliberately included both migrants and their Norwegian-born children, it offers a window into how health practices transmit, or fade, across generations. The persistence of high overall use suggests that the family remains a powerful conduit for health culture, but the differences between generations in specific modalities hint at selective adaptation. Second-generation immigrants navigate two healthcare worlds simultaneously, and understanding which practices they retain, which they abandon, and which they reinterpret is essential for designing health services that actually meet them where they are. The study’s stratified sampling and statistical adjustments, using Pearson’s chi-square and Fisher’s exact tests for categorical associations alongside non-parametric tests for differences in natural product use and overall use, give these comparisons a methodological solidity that convenience-sample surveys often lack.

Methodologically, the study took care with ethics and privacy. Approval was obtained from the Norwegian Agency for Shared Services in Education and Research, and the Regional Committees for Medical and Health Research Ethics determined that the project did not constitute health research requiring their approval. Participants received information letters in both Norwegian and Urdu and gave explicit informed consent before proceeding. No identifying information such as names, birth dates, or addresses was collected by the researchers, although the survey company linked responses to basic demographic data from the national register to enable the stratified sampling. The work was funded by the National Research Centre for Complementary and Alternative Medicine at UiT, with publication charges covered by the university’s publication fund.

The broader significance of this research extends well beyond the Pakistani-Norwegian community. European health systems are increasingly serving multicultural populations, and studies like this one demonstrate that complementary and traditional medicine is not a marginal phenomenon confined to alternative-lifestyle subcultures. It is a mainstream reality for entire communities, woven into religious practice, family tradition, and everyday self-care. The Norwegian findings argue for a pragmatic response: healthcare providers should routinely and respectfully ask about traditional medicine use, pharmacists should be prepared to advise on interactions involving herbal products, and health services should develop culturally sensitive approaches that acknowledge, rather than dismiss, the healing frameworks patients bring with them. With 99.8 percent of a community engaged in some form of traditional health practice, the choice facing clinicians is not whether these practices exist in their patients’ lives, but whether they will be visible in the medical record.

Subject of Research: Traditional and complementary medicine use among first- and second-generation Pakistani immigrants in Norway

Article Title: Use of traditional and complementary medicines among first- and second-generation Norwegian Pakistanis: a cross-sectional survey

Article References: Use of traditional and complementary medicines among first- and second-generation Norwegian Pakistanis: a cross-sectional survey. (n.d.). https://doi.org/10.1186/s12906-026-05521-0

Image Credits: AI Generated

DOI: 10.1186/s12906-026-05521-0

Keywords: traditional medicine, complementary medicine, Pakistani immigrants, Norway, natural products, herbal medicine, self-care, cross-sectional survey, migrant health, cultural health practices, patient safety, I-CAM-Q

SGM youth, a term encompassing young people who identify as lesbian, gay, bisexual, transgender, queer, or otherwise outside cisgender heterosexual norms, experience markedly elevated rates of depression, anxiety, and suicidality compared with their peers. Researchers attribute these disparities less to identity itself than to minority stress: stigma, rejection, and discrimination accumulate and wear down mental health. Access to affirming healthcare, in which providers understand and validate minority identities rather than pathologize them, is one of the strongest protective factors available. Yet many young people report that the clinicians they encounter lack the vocabulary, the conceptual grounding, and the practical skills to deliver such care, even when those clinicians sincerely intend to help.

The Israeli research team set out to map precisely where that translation from intention to action breaks down. Rather than treating attitudes, beliefs, knowledge, and behaviors as separate variables in a conventional regression, the investigators used network analysis, a statistical framework borrowed in part from psychology and complexity science. In a network model, each measured construct is represented as a node, and the statistical associations between nodes are drawn as edges, producing a map of how the components of a professional’s orientation toward SGM youth reinforce or fail to reinforce one another. The approach allows researchers to identify which nodes occupy bridging positions, meaning they connect otherwise weakly linked parts of the system and can therefore act as levers for change.

The study recruited 318 Israeli healthcare professionals drawn from medical, mental health, and allied health disciplines. The sample was almost evenly divided between those who had received training specific to SGM populations, 48.7 percent, and those who had not, 51.3 percent, allowing a direct comparison of the two networks. Most participants identified as women, 74.5 percent, followed by men at 19.2 percent, nonbinary or genderqueer individuals at 3.5 percent, and other identities at 2.8 percent. Each participant completed validated measures covering four domains: attitudes toward SGM youth, affirmative practice beliefs, SGM-specific knowledge, and affirmative practice behaviors, the concrete actions clinicians take to make their practice welcoming and competent for minority youth.

The first finding was straightforward and encouraging. Professionals who had received SGM-specific training reported significantly more positive attitudes toward SGM youth, greater SGM-specific knowledge, stronger affirmative practice beliefs, and more frequent affirmative practice behaviors than their untrained colleagues. Training, in other words, was associated with improvement across the entire profile of professional orientation, not merely with an accumulation of facts. This pattern is consistent with the idea that structured education does more than transmit information; it also normalizes engagement with minority health topics and builds confidence to act on one’s values.

The network results, however, revealed a more subtle and arguably more important story. In the network estimated for trained professionals, knowledge, and specifically clinical and conceptual knowledge about SGM populations, occupied a prominent bridging position between attitudes and beliefs on one side and affirmative practice behaviors on the other. In plain terms, for clinicians who had been trained, knowing things was the connective tissue that turned positive feelings and supportive convictions into actual practice. Attitudes alone, however warm, did not flow directly into behavior; they traveled through knowledge. This makes mechanistic sense. A physician may wholeheartedly support transgender youth yet hesitate in the examination room when unsure about terminology, developmental considerations, or evidence-based protocols. Knowledge dissolves that hesitation and gives goodwill a concrete channel.

The network for untrained professionals looked structurally different, and the difference is diagnostic. Among clinicians who had never received SGM-specific training, knowledge was comparatively disconnected from affirmative practice behavior. Instead, affirmative practice beliefs carried greater bridge connectivity, serving as the main pathway linking attitudes to action. The authors interpret this as a system running on conviction without competence. Untrained professionals may believe firmly in affirming care, and those beliefs may nudge them toward supportive behaviors, but without a substrate of clinical and conceptual knowledge, the pathway from belief to skilled practice remains thin. Goodwill can carry a clinician only so far when the clinical questions, the correct language, and the relevant evidence base are unfamiliar.

Why does this structural distinction matter so much? Because it identifies a target for intervention. If knowledge sits at the bridge between intention and action in trained professionals, then knowledge is the node most worth strengthening. The authors argue that SGM-specific knowledge represents a potentially important target for professional training and for future longitudinal and experimental evaluation. Longitudinal studies could track whether increases in knowledge precede and predict increases in affirmative behavior over time, while experimental designs could test whether targeted knowledge interventions, such as case-based modules on SGM health, produce measurable shifts in clinical practice. The cross-sectional design of the present study cannot establish causality, and the authors are careful on this point, but the network architecture provides a principled hypothesis about where causal leverage likely lies.

The policy implications follow directly. The authors conclude that, considered alongside prior evidence, their results support investing in structured, evidence-based SGM training within professional education, accreditation standards, and continuing education. This is a notable reframing of the usual diversity-training debate. Much criticism of such programs targets interventions that raise awareness without building skill. The present findings suggest the criticism is partly warranted but points in the wrong direction as a reason to abandon training. The problem is not that training adds knowledge; it is that knowledge without integration into clinical routines is insufficient, and conversely, that attitudes without knowledge are inert. Structured curricula that pair conceptual grounding, such as minority stress theory and SGM developmental contexts, with clinical application, such as affirming intake practices and competent communication, are precisely the kind that build the bridge the network analysis identified.

For SGM youth, the stakes of this line of research are concrete. Every gap between a clinician’s good intentions and their actual practice is a moment in which a vulnerable young person may feel unseen, misgendered, or subtly judged, and may disengage from care altogether. The Haifa team’s work offers a technically grounded map of where that gap lives and how it might be closed. The message to medical schools, licensing bodies, and continuing education providers is unusually clear: empathy is the starting point, but knowledge is the bridge, and bridges are things we can deliberately build. The study was funded by the Israel National Institute for Health Policy Research and approved by the University of Haifa ethics committee, and it appears in an open-access journal, making the full network models available to educators and policymakers worldwide who are weighing how best to prepare the next generation of clinicians to serve minority youth.

Subject of Research: How SGM-specific knowledge links healthcare professionals' attitudes and beliefs to affirming clinical practice for sexual and gender minority youth

Article Title: A network analysis of healthcare professionals’ attitudes, affirming beliefs, and behaviors toward SGM youth: professional knowledge as a bridge

Article References: Berkowitz, R., Gewirtz-Meydan, A., & Maoz, S. (2026). A network analysis of healthcare professionals’ attitudes, affirming beliefs, and behaviors toward SGM youth: professional knowledge as a bridge. BMC Medical Education. https://doi.org/10.1186/s12909-026-10492-4

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10492-4

Keywords: network analysis, SGM youth, healthcare professionals, affirmative practice, medical education, SGM training, professional knowledge, health disparities, minority stress, cross-sectional survey, clinical behavior, BMC Medical Education

The research team, led by Tido von Schoen-Angerer of the Charité Competence Center for Traditional and Integrative Medicine in Berlin together with colleagues from the University of Bremen, the Charité, the University Hospital Tübingen, the Robert Bosch Center for Integrative Medicine and Health, the Otto-Friedrich-University Bamberg and other institutions, set out to answer a question that earlier cross-sectional studies had left only partially resolved: not simply how many people use TCIM, but which illnesses they use it for, and whether they feel it helps. To do this, the questionnaire asked participants about fifteen distinct illness categories and assessed health-related quality of life using the EQ-5D-5L instrument, a widely used standardized measure that captures mobility, self-care, usual activities, pain or discomfort, and anxiety or depression on five severity levels each.

The disease-specific results reveal a clear pattern. The highest lifetime rates of TCIM use were reported for acute respiratory illnesses, at 55.9 percent, followed by chronic gastrointestinal illnesses at 51.4 percent and acute gastrointestinal illnesses at 49.2 percent. In other words, the conditions most commonly treated with complementary approaches are everyday ailments—colds, coughs, digestive complaints—that most people experience repeatedly over a lifetime. This finding complicates a common assumption that complementary medicine is primarily sought by patients with severe chronic disease for whom conventional treatment has failed. While chronic conditions certainly feature prominently in the data, the leading edge of TCIM use in Germany appears to be the self-management of common, non-life-threatening illness.

Perhaps the most consequential number in the study is the self-reported benefit. Across the fifteen illness categories, the proportion of users who reported that TCIM had helped them ranged from 61.4 percent to 86.2 percent, with a mean of 70.8 percent. That is a remarkably narrow and consistently high band given how different these conditions are, from acute infections to chronic pain and gastrointestinal disease. The authors also examined whether this perceived benefit declined among people in worse overall health, and found that it did not: individuals with poorer health-related quality of life on the EQ-5D-5L still reported substantial benefit from the therapies they used. This suggests that perceived benefit is not simply an artifact of generally healthy people rating mild interventions for mild problems.

The study also tested a hypothesis that has circulated in the complementary medicine research community for years: that the popularity of a therapy in the population might track the volume of scientific research devoted to it. When the researchers plotted TCIM use across disease categories against global research activity in those same categories, no apparent relation emerged. Usage patterns in the German population, in other words, do not mirror the distribution of published studies. People are not choosing complementary therapies for the conditions where the evidence base is strongest, at least not as measured by aggregate research output. This disconnect between research allocation and real-world utilization is one of the study’s more provocative implications, because it suggests that public demand and scientific prioritization are currently operating on separate tracks.

Methodologically, the survey is a cross-sectional design, meaning it captures a snapshot at a single point in time rather than following individuals forward. The sample of 4,065 respondents was recruited to be representative of the German online population within the 18-to-75 age range, and the analysis combined descriptive statistics with inferential testing. The researchers reclassified their fifteen illness categories into the WHO’s ICD-11 framework, the eleventh revision of the International Classification of Diseases, to allow comparison with international data. The study was approved by the Charité Ethics Committee and funded by the Karl and Veronica Carstens Foundation, which had no role in study design, data collection, analysis or publication. The authors note that the article was shared early as a citable, peer-reviewed accepted version subject to final editorial edits.

Context matters for interpreting these figures. Germany has an unusually deep institutional entanglement with natural and complementary medicine compared with many other countries. Naturopathy, or Naturheilkunde, has historical roots in German medical culture, and certain complementary treatments can be prescribed and reimbursed under the statutory health insurance system in specific circumstances. Previous large German health surveys, such as the German Health Update studies referenced by the authors, have already suggested frequent TCIM use, but the new survey adds the disease-specific granularity and the quality-of-life dimension that earlier work lacked. The 70 percent lifetime figure places Germany among the countries with the highest reported use of complementary medicine in Europe, and the 52 percent positive-attitude figure indicates that this is a mainstream phenomenon rather than a fringe practice.

The self-perceived benefit data deserve particular scrutiny, and the authors are careful about what they can and cannot claim. Perceived benefit is a subjective endpoint. It reflects patient experience, expectation effects, the natural course of self-limiting illness, and any genuine pharmacological or physiological activity of the treatments, all mixed together. For acute respiratory and gastrointestinal complaints, which often resolve on their own, high satisfaction rates do not by themselves establish efficacy. At the same time, patient-reported benefit is not medically meaningless: it is associated with adherence, satisfaction with care, and health-related quality of life, and it is precisely the kind of outcome that integrative medicine advocates argue conventional research designs underweight. The study documents what the population experiences and believes; it does not, and does not claim to, adjudicate clinical effectiveness for any specific therapy or condition.

The authors draw pointed conclusions for health policy. They argue that stakeholders in the German healthcare system should critically examine the high level of TCIM use, promote rigorous scientific evaluation of the most widely used therapies, integrate evidence-informed complementary medicine with conventional care, and ensure appropriate reimbursement through statutory health insurance. This is a notably balanced position. It neither dismisses the enormous public uptake as misguided nor accepts perceived benefit as a substitute for evidence. Instead it treats the prevalence data as a mandate for research investment: if seven in ten citizens use these approaches and most report benefit, the argument runs, then the evidence base should be built up to match the scale of real-world use, particularly given the observed mismatch between research activity and utilization patterns.

For the international readership watching the integrative medicine field, the German data offer a template for the kind of study that is increasingly needed elsewhere. By combining a representative sample, a standardized quality-of-life instrument, a broad set of illness categories mapped onto ICD-11, and explicit questions about perceived benefit, the survey moves the conversation beyond the crude question of whether people use complementary medicine toward the more useful questions of who uses it, for what, with what perceived result, and how that maps onto research priorities and insurance coverage. With 18 percent of German adults currently using TCIM and a majority viewing it favorably, the study makes clear that these therapies are already embedded in everyday healthcare behavior. The open question, which the authors explicitly place on the agenda of clinicians, researchers and insurers alike, is whether the scientific and regulatory infrastructure will be developed to match that reality.

Subject of Research: Population-level use and perceived benefits of traditional, complementary and integrative medicine across disease categories in Germany

Article Title: Treatment choices: insights into disease-specific use and self-perceived benefits of traditional, complementary and integrative medicine in Germany

Article References: von Schoen-Angerer, T., Wischnewsky, M., Jeitler, M., Brinkhaus, B., Ortiz, M., Hoffmann, R., & Kessler, C. S. (2026). Treatment choices: insights into disease-specific use and self-perceived benefits of traditional, complementary and integrative medicine in Germany. BMC Complementary Medicine and Therapies. https://doi.org/10.1186/s12906-026-05496-y

Image Credits: AI Generated

DOI: 10.1186/s12906-026-05496-y

Keywords: complementary medicine, integrative medicine, traditional medicine, Germany, cross-sectional survey, health-related quality of life, EQ-5D-5L, health care utilization, naturopathy, acupuncture, ICD-11, public health

The research took the form of a cross-sectional survey, a design in which data are gathered from participants at a single point in time. Zemedkun recruited 105 trainees with visual impairment through comprehensive sampling, meaning that every eligible trainee in the six purposively selected teacher education colleges was invited to take part rather than a random subset being drawn. This approach maximizes statistical power in settings where the population of interest is small and scattered, a common challenge in disability research across sub-Saharan Africa. Structured questionnaires were used to measure three things: resilience, perceived social support, and life satisfaction, the last of which is widely treated in psychology as a cognitive component of subjective well-being, reflecting how people evaluate their lives as a whole rather than how they feel moment to moment.

The statistical analysis proceeded in two stages, and both stages told a consistent story. First, Pearson’s correlation coefficients were computed to assess the strength and direction of the relationships between the variables. Resilience showed a strong positive correlation with life satisfaction, with a coefficient of r = .574, statistically significant at p < .001. Perceived social support also correlated positively with life satisfaction, though more modestly, at r = .349, likewise significant at p < .001. In plain terms, trainees who reported greater resilience and stronger perceived support tended to report markedly higher life satisfaction, and neither relationship could plausibly be attributed to chance given the sample size.

Correlation alone, however, cannot disentangle the contributions of two variables that are themselves likely to be related, and this is where multiple regression analysis came in. This technique allows researchers to estimate the unique effect of each predictor while holding the other constant. The results were decisive. Resilience emerged as a powerful predictor of life satisfaction, with an unstandardized coefficient of B = 0.899, significant at p < .001. Perceived social support also remained a significant predictor, with B = 0.142, but its contribution was considerably smaller. Together, the two variables explained 37.3 percent of the variance in life satisfaction, a substantial share for research on subjective well-being, where single studies often account for far less.

The decomposition of that shared variance is perhaps the most striking technical detail in the study. Of the 37.3 percent explained, resilience alone accounted for 33 percent, while perceived social support contributed just 4.3 percent. That asymmetry suggests that for these trainees, an internal psychological resource does far more work than an external one in shaping how satisfied they feel with their lives. It does not mean social support is irrelevant; the regression confirmed it retains a significant independent effect even after resilience is taken into account. But it does mean that the dominant driver of well-being in this population appears to be what trainees carry within them rather than what surrounds them.

Why would resilience loom so large? The psychology literature offers several converging explanations. Resilience is generally understood as a dynamic process encompassing the ability to bounce back from setbacks, to regulate emotion under stress, and to find meaning in difficulty. For students with visual impairment pursuing professional training in a resource-constrained educational system, daily life involves navigating inaccessible materials, transportation challenges, and social attitudes that can range from supportive to dismissive. A trainee with a well-developed capacity for adaptation may experience these obstacles as surmountable challenges, whereas the same obstacles may erode the life satisfaction of someone with fewer internal coping resources. Perceived social support, by contrast, depends partly on circumstances outside the individual’s control, such as family proximity, peer attitudes, and institutional culture, which may explain why its measured contribution is smaller even though it matters.

The study’s setting gives the findings particular weight. The Amhara Region is one of Ethiopia’s major educational hubs, and its teacher education colleges train the instructors who will staff classrooms across the region. Trainees with visual impairment who complete these programs enter a profession where their success has ripple effects on hundreds of future students. Yet research on the psychosocial well-being of people with disabilities in Ethiopia has historically been sparse, and interventions are often designed on the basis of assumptions imported from high-income countries. By grounding the analysis in the lived context of Amhara colleges, the study provides locally relevant evidence that can inform policy in a way that generic international findings cannot.

The methodological choices deserve attention as well. Comprehensive sampling eliminates the sampling error that can arise when a small subgroup is randomly sampled, ensuring that the 105 participants represent the full population of visually impaired trainees in the selected colleges. The use of structured questionnaires allows standardized measurement, though it also means the data reflect self-reports, which can be shaped by social desirability and by how participants interpret questionnaire items. The cross-sectional design, meanwhile, establishes association but not causation: it is possible that higher life satisfaction itself fosters resilience, or that a third factor, such as financial security or health status, influences both. Longitudinal follow-up would be needed to confirm the direction of the relationships, and the author’s recommendation for intervention programs is framed as an association-based inference rather than a proven causal effect.

Ethical safeguards were notably thorough. The study received approval from the Institutional Ethics Committee of Dessie College of Teachers Education under reference number IECDCTE/1-1042/2025, and procedures followed the principles of the Declaration of Helsinki. Permission was obtained from the deans and registrar offices of all six colleges, and informed consent was secured in writing from every participant. Because many participants could not read standard print consent forms, the forms were read aloud and explained thoroughly before signing, a practical accommodation that reflects both ethical rigor and sensitivity to the population being studied. Participation was voluntary, and trainees were told they could withdraw at any time without penalty.

The practical implications are straightforward and potentially transformative. The study concludes that resilience and perceived social support are important psychosocial resources associated with higher life satisfaction among trainees with visual impairment, and it recommends that teacher education colleges implement programs to foster resilience and strengthen social support networks. In practice, that could mean embedding coping-skills training and peer mentoring into teacher preparation, training staff to recognize and respond to psychological distress, and building campus cultures in which students with disabilities receive consistent academic and social backing. Given that resilience explains roughly eight times more of the variance in life satisfaction than social support in this sample, investments in students’ internal coping capacities may yield the greatest returns, while support networks remain a meaningful complementary lever. For a group of future teachers whose own well-being will shape the classrooms of the next generation, the message from this Ethiopian study is clear: helping students build resilience may be the single most effective thing their colleges can do.

Subject of Research: The influence of resilience and perceived social support on life satisfaction among teacher trainees with visual impairment in Ethiopia

Article Title: The influence of resilience and perceived social support on life satisfaction among teacher trainees with visual impairment in selected teacher education colleges of the Amhara Region, Ethiopia

Article References: Zemedkun, M. A. (2026). The influence of resilience and perceived social support on life satisfaction among teacher trainees with visual impairment in selected teacher education colleges of the Amhara Region, Ethiopia. Discover Psychology, 6(1), Article 264. https://doi.org/10.1007/s44202-026-00904-3

Image Credits: AI Generated

DOI: 10.1007/s44202-026-00904-3

Keywords: resilience, perceived social support, life satisfaction, visual impairment, teacher education, Ethiopia, Amhara Region, subjective well-being, positive psychology, disability and education, cross-sectional survey, multiple regression

The study, led by Nevin Cambaz Kurt of the Department of Pediatrics at Başakşehir Çam and Sakura City Hospital in Istanbul, together with colleagues from hospitals and universities across Türkiye, set out to fill a well-defined gap. Although interest in herbal products and complementary medicine for pediatric patients has grown steadily, the authors note that pediatricians’ attitudes toward phytotherapy and the factors driving those attitudes remained insufficiently characterized. To address this, the team recruited 206 physicians practicing in pediatric care through professional communication networks and online platforms, using convenience sampling, and measured their views with a structured psychometric instrument rather than ad hoc questions.

That instrument was a modified 22-item version of the Attitude Scale for Phytotherapy Practices, a questionnaire designed to quantify where a clinician falls on a spectrum from skepticism to enthusiasm about plant-based treatment. The researchers subjected the scale to rigorous statistical scrutiny. Internal consistency, the degree to which items measuring the same underlying construct produce similar responses, was assessed with Cronbach’s alpha, and the modified scale returned an exceptionally high value of 0.966, well above the conventional 0.70 threshold for reliability. Exploratory factor analysis, a technique that examines whether groups of items cluster around shared latent dimensions, supported a dominant general factor structure, meaning the scale behaves as a coherent measure of a single overall attitude rather than a loose collection of unrelated opinions.

The demographic profile of the sample reflects the modern pediatric workforce in Türkiye. Of the 206 participants, 144 were women, representing 69.9 percent of respondents, and the largest age group was 30 to 40 years old, accounting for 42.7 percent. Against this backdrop, the headline numbers on training are stark. Only 5.3 percent of the pediatricians surveyed held any formal phytotherapy certificate, meaning roughly one in twenty had structured credentials in the field. Yet when asked whether they wanted such education, 66.0 percent said yes. That gap, between barely any formal training and a two-thirds majority hungry for it, is arguably the single most consequential finding of the study, because it suggests demand for evidence-based herbal medicine instruction that current pediatric curricula are not meeting.

The mean total phytotherapy attitude score across the sample was 75.99, with a standard deviation of 16.79, indicating a moderately positive average attitude with substantial spread between individuals. The more interesting question is what predicts where a given pediatrician falls within that spread. To answer it, the researchers turned to multivariable linear regression, a statistical method that estimates the independent contribution of each predictor while holding the others constant. The model adjusted for demographic and professional characteristics and produced a result that is unusually strong for survey research of this kind: the adjusted model explained 55.4 percent of the variance in attitude scores, a proportion of explained variation that few psychosocial models achieve.

Three factors emerged as independent predictors of more favorable attitudes toward phytotherapy. The first was possession of a phytotherapy certificate, which was associated with an increase of 7.99 points on the attitude scale, with a 95 percent confidence interval of 1.76 to 14.23 and a p-value of 0.012. The second, and by far the largest, was a stated desire to receive phytotherapy education, which added 14.60 points on average, with a confidence interval of 10.58 to 18.62 and a p-value below 0.001. The third was the frequency with which a physician used phytotherapy for themselves or close relatives, contributing 5.05 points per unit increase in frequency, with a confidence interval of 2.94 to 7.17 and a p-value below 0.001. Notably absent from the list of significant predictors were the demographic and professional variables that often dominate such analyses.

This pattern carries a clear interpretive message: what pediatricians know, want to know, and have personally experienced with herbal medicine matters far more than who they are. Attitudes toward phytotherapy were associated mainly with educational interest, certification status, and experiential familiarity rather than demographic or professional characteristics alone, the authors conclude. The finding that a desire for education is such a powerful predictor is statistically interesting in itself, since it raises the possibility of a feedback loop: physicians who already view herbal medicine favorably are the ones most likely to seek training, which in turn reinforces favorable attitudes. The researchers addressed this concern with a sensitivity analysis, reported in supplementary material, that re-ran the regression model excluding the desire for phytotherapy education, a standard robustness check for a predictor that may be conceptually entangled with the outcome.

The methodological apparatus of the study deserves attention because it signals a level of statistical care that is not always present in survey-based complementary medicine research. The authors report using a heteroscedasticity-consistent covariance estimator, specifically the HC3 variant, which makes regression standard errors robust to uneven variance in the residuals, a common problem in Likert-scale survey data. They also report variance inflation factors, used to detect multicollinearity among predictors, and interquartile ranges alongside standard deviations for descriptive statistics. The study was reported in accordance with the STROBE guidelines, the widely used checklist for strengthening the reporting of observational studies, and was approved by the Van Training and Research Hospital Clinical Research Ethics Committee with electronic informed consent obtained from all participants in line with the Declaration of Helsinki.

As with any cross-sectional survey, there are limits to how far the findings can be generalized. The sample of 206 physicians was recruited through convenience sampling, which means participants may be more engaged with the topic of complementary medicine than the average pediatrician, potentially inflating both attitude scores and expressed demand for education. The survey captures attitudes at a single point in time, so the causal direction between experience, education, and attitude cannot be definitively established. The study was also conducted entirely within Türkiye, and attitudes toward herbal medicine are known to vary across cultures and health systems, shaped by national traditions, regulatory frameworks, and the availability of herbal products. The authors themselves frame their conclusions carefully, emphasizing associations rather than causal claims.

Even with those caveats, the practical implications are hard to ignore. If two-thirds of pediatricians want structured phytotherapy education while fewer than six percent have any formal certification, then children’s doctors are being asked questions about herbal teas, plant extracts, and supplements that most have never been trained to answer, in an environment where families are already using these products regardless of physician guidance. The authors argue that their findings support the integration of evidence-based, safety-oriented, and clinically oriented phytotherapy content into pediatric education. That framing matters: the goal they describe is not to promote herbal medicine but to ensure that the physicians on the front lines of child health can evaluate it with the same rigor they apply to any other therapy, distinguishing preparations with genuine evidence from those with only marketing behind them. In a medical landscape where patient demand for complementary therapies shows no sign of slowing, that may be the most sensible prescription of all.

Subject of Research: Pediatricians' attitudes toward phytotherapy and the factors associated with them

Article Title: Pediatricians’ views and attitudes toward phytotherapy: a cross-sectional survey study

Article References: Kurt, N. C., Güven, D., Erol, C., Güzel, M., & Kurt, B. (2026). Pediatricians’ views and attitudes toward phytotherapy: a cross-sectional survey study. BMC Complementary Medicine and Therapies. https://doi.org/10.1186/s12906-026-05551-8

Image Credits: AI Generated

DOI: 10.1186/s12906-026-05551-8

Keywords: phytotherapy, pediatrics, complementary medicine, physician attitudes, cross-sectional survey, medical education, herbal medicine, Türkiye, attitude scale, linear regression, pediatricians, survey research