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(1) Background: Institutionalized older adults represent a vulnerable population. It is important to understand that higher levels of physical activity in older adults are associated with less risk of cardiovascular diseases, better cognition, and lower inflammaging and sarcopenia levels. The main objective was to evaluate the differences in health parameters in institutionalized older adults who perform different levels of weekly physical activity. The secondary objective was to analyze if weekly physical activity levels are a predictor of health parameters. (2) Methods: A cross-sectional observational study was conducted in nursing homes with adults over 75 years of age. A total of 76 participants was divided into three groups based on their weekly physical exercise frequency (1 day/week, 2 days/week, and 3 days/week). We measured demographic and anthropometric variables, along with cognitive level through the Mini Exam of Lobo. Handgrip strength, leg muscle strength, and power were also evaluated, and C-reactive protein levels were assessed through blood tests. Physical performance was measured using the Short Physical Performance Battery and walking speed. (3) Results: Significant differences were found in body mass index (p < 0.01; ES = 0.96), muscular strength (p < 0.01; ES = 0.70 ), and power (p < 0.01; ES = 1.09), Short Physical Performance Battery (p < 0.01; ES = 1.46) and walking speed (p < 0.01; ES = 0.87), cognitive function (p < 0.01; ES = 1.21), and C-reactive protein levels (p < 0.01; ES = 1.73), favoring the group who performed 3 days/week of physical activity. (4) Conclusions: Institutionalized older adults with three days per week of physical activity have greater physical and muscle function and less cognitive decline. Three days of weekly physical activity is associated with systemic inflammation and better cognitive status in institutionalized older adults. Full article

More than three decades ago, the Supreme Court of the United States (SCOTUS) ruled that individuals who are not competent (alternatively referred to by the Court as insane) at the time of their scheduled execution cannot be put to death. Despite the years that have passed since the Court’s decision and the literal life-or-death stakes involved, competency for execution (CFE) remains underexplored in the psychological, psychiatric, and legal literature. A number of important legal and ethical issues that arise when a person on death row maintains they are not competent to be executed are still unresolved even after the landmark Supreme Court cases such as Ford v. Wainwright (1986), Panetti v. Quarterman (2007), and Madison v. Alabama (2019). In this first-of-its-kind descriptive study, we analyzed the demographic and case characteristics of the 28 successful Ford claimants—individuals in the United States who have been found to be incompetent to be executed and compared them to the general death row population and homicide cases nationwide. Our findings reveal some similarities but also some differences between these claimants and the general death row population and homicide cases: the successful Ford claimants are exclusively male (in keeping with the general prison population on death row), relatively older, and underrepresented among White and Latinx inmates (i.e., Black claimants are more successful than their White and Latinx counterparts at evading execution). Nearly all (96%) suffer from schizophrenia, with 79% experiencing psychiatric comorbidity, yet only 54% received any significant treatment before or after the criminal offense. The claimants’ cases also involve a higher proportion of child victims, male family members, and female non-family member victims, as well as more multiple-victim cases (not indiscriminate) and fewer intraracial homicides. Fewer victims are male, and more are female. However, the cases do not align with typical male-on-male violent crimes or femicide patterns, such as those involving sexual or domestic violence. Additionally, systematic psycho-legal deficiencies are prevalent, including a low rate of mental health evidence (61%) presented at trials and some cases lacking psychiatric involvement in CFE evaluations. Temporal influence and drastic state variations on CFE evaluation are also noted. Although the small sample size limits generalizability, this small-scale descriptive study offers a number of important insights into the complexities of CFE decisions and lays the groundwork for future research and policy development. Full article

Objectives: This study explored the impact of a 12-week walking and barre exercise program on depression levels (CES-D), stress hormones (dopamine, epinephrine, norepinephrine, cortisol, serotonin), high-sensitivity C-reactive protein (hs-CRP), and immunoglobulins (IgA, IgG, IgM) in women aged 65 and above. Methods: Twenty-seven participants were divided into a walking exercise group (WG), barre exercise group (BG) and control group (CG), each comprising nine individuals. Sessions lasted 50 min, thrice weekly, with intensity progressing every 4 weeks. Two-way repeated measures of ANOVA assessed time–group interactions and main effects, and paired t-tests and one-way ANOVA were used post hoc with significance set at 0.05. Results: The CES-D scores demonstrated significant interaction (p < 0.001), decreasing significantly in the BG and WG (p < 0.01) while rising in the CG (p < 0.05). Post hoc analysis revealed significantly lower depression levels in the BG compared to the CG (p < 0.01). Stress hormones epinephrine and cortisol showed a main effect of time (p < 0.05), with epinephrine increasing significantly in the BG (p < 0.05) and cortisol decreasing in the BG and WG (p < 0.05). An interaction effect emerged in hs-CRP levels (p < 0.05), while IgA and IgM displayed interaction effects (p < 0.05 and p < 0.01, respectively), both significantly increasing in the BG (p < 0.05). Conclusions: In summary, regular exercise positively impacted depression, stress hormones, and immune functions in older women. Full article

Background/Objectives: The definitions of feeding disorders of infants and young children were historically based on a dichotomic organic/non-organic vision. Since 2019, a new definition of pediatric feeding disorders (PFDs) has reshaped the understanding of these disorders with a global vision. The aim of this study is to obtain a better understanding of the diagnostic criteria for general practice, both by exploring the evolution of classifications and by clearing the actual definition of PFDs and their possible treatments. Methods: We conducted a narrative review of the literature, including 36 articles about PFDs, excluding adolescents, anorexia nervosa, bulimia, pica, rumination, and specific neurodevelopmental or chronic pediatric disorders. We summarized these studies in three parts: the specific classifications for children before puberty, the current definition, and the clinical guidelines. Results: Concerning the history of the classifications, we summarized the studies of Chatoor and nzner and the older pediatric vision of failure to thrive. For the definition of pediatric feeding disorders, we presented this new category involving at least one out of four domains: medical, nutritional, feeding skills, or psychosocial. For the main clinical guidelines, we presented recommendations for both severe and common PFDs in each altered domain for use in daily practice. Conclusions: The new definition promotes a transdisciplinary vision of childhood feeding disorders, which considers each of the intricate domains of PFDs. Using common terminology for PFDs could help all healthcare providers, families, and researchers to better understand and address PFDs. Full article

Background and Objective: Age-related skin changes affect the skin’s structural and functional integrity and reduce the ability of the skin to perform its key barrier functions. Skin breakdown associated with dryness and itch becomes very common and older individuals are at an increasing risk. We aimed to evaluate a daily cleansing–moisturizing routine and conduct a skin assessment for the presence of five underlying skin integrity parameters among aged-care residents. Methods: This small, 6-week evaluation study included four participants over 80 years of age, all of whom were residents at OLC Care, Rocky Point Residence, Beverley Park, NSW, Australia. Skin assessment for the presence of five underlying clinical parameters including itchy skin, dry skin, bruising, skin tears and pressure injuries was conducted for all four participants at baseline and during the evaluation period. Clinical notes were also taken at baseline, during the evaluation and at the post-evaluation. Furthermore, clinical photographs were taken at baseline and after 2–3 weeks of the cleansing–moisturizing routine. Results: Of the four aged-care residents who participated in this evaluation study, all four showed overall improvement in the appearance of the skin with a reduction in severity of the five underlying skin integrity parameters, including itchy skin, dry skin, bruising, skin tears and pressure injuries, where present. Discussion and Conclusions: This case study has produced basic evidence to support a daily cleansing–moisturizing routine (comprising QV cleansers and moisturizers, and/or a protective barrier cream) as it provides moisturizing and protective benefits to the delicate and fragile skin of aged-care residents, where the aim is to reduce skin integrity associated issues. Full article

Existing virtual reality (VR) street view and 360-degree road view applications often rely on complex controllers or touch interfaces, which can hinder user immersion and accessibility. These challenges are particularly pronounced for under-represented populations, such as older adults and individuals with limited familiarity with digital devices. Such groups frequently face physical or environmental constraints that restrict their ability to engage in outdoor activities, highlighting the need for alternative methods of experiencing the world through virtual environments. To address this issue, we propose a VR street view application featuring an intuitive, gesture-based interface designed to simplify user interaction and enhance accessibility for socially disadvantaged individuals. Our approach seeks to optimize digital accessibility by reducing barriers to entry, increasing user immersion, and facilitating a more inclusive virtual exploration experience. Through usability testing and iterative design, this study evaluates the effectiveness of gesture-based interactions in improving accessibility and engagement. The findings emphasize the importance of user-centered design in fostering an inclusive VR environment that accommodates diverse needs and abilities. Full article

Background: Urinary tract infections (UTIs) are among the most common bacterial infections in children, and the antibiotic susceptibility in the youngest patients remains poorly understood. This study aimed to describe the distribution of uropathogens and their antibiotic susceptibility, focusing on oral formulations. Methods: Data from the first microbiological isolation, between January 2007 and December 2023, at Istituto Gaslini, in young infants (aged <6 months), were analyzed. Results: We isolated 2473 infants’ first pathogen, with a median age in the sample of 2.8 months and 62.6% male. A total of 2498 bacterial isolates were identified, of which 88.8% were Gram-negative and 11.2% were Gram-positive. Escherichia coli (53%) was the most frequent isolate, followed by Klebsiella pneumoniae (12.3%) and Enterococcus spp. (9.6%). No significant differences were observed between males and females, but infants younger than 3 months exhibited a significantly different pathogen distribution compared to older infants. The pathogen distribution showed significant changes before and after 2015, with a marked increase in Klebsiella pneumoniae isolates post-2015. Escherichia coli showed increases in resistance to amoxicillin-clavulanate and ciprofloxacin after 2015. Conclusions: Escherichia coli remains the most common uropathogen; however, Klebsiella pneumoniae has not only shown a high prevalence but also significant resistance, particularly in recent years. Full article

Sexist ideologies and attitudes perpetuate gender inequalities in both private and public contexts. Traditional views of sexism emphasize hostility, but the phenomenon is more complex, involving interdependent power relations between men and women. The Ambivalent Sexism Theory identifies two forms: hostile sexism (HS) and benevolent sexism (BS). This study aimed to measure the levels of HS and BS among men in a northern Italian town, examining sociodemographic factors associated with elevated sexism scores. A paper questionnaire was administered by a volunteer organization and the Local Health Authority to male individuals over 18 in Cesena from February to April 2023. The convenience sample was recruited from diverse settings, including universities, companies, cafes, and hospitals. The Ambivalent Sexism Inventory (Glick & Fiske) was translated into Italian and used for data collection. A total of 275 participants were included. The mean age was 44.4 years, with a diverse educational background. Regression analyses revealed that higher education levels were associated with lower HS scores with a high school education and a bachelor’s degree or higher showing statistically significant coefficients of −5.33 (SE = 2.26, p = 0.019, and 95% CI: −9.78–−0.88) and −8.64 (SE = 2.51, p = 0.001, and 95% CI: −13.58–−3.69), respectively, if compared to individuals with middle school education or less. Age was a significant predictor of BS, with older individuals showing higher BS scores (Coeff. = 0.20, SE = 0.05, p < 0.001, and 95% CI: 0.10–0.31). Healthcare professionals had higher HS scores, while unionists had both lower HS and BS scores. This study highlighted the levels of both HS and BS in various professional and social contexts. Education appears to be a critical factor in reducing HS, while age influences BS. Full article

Background and Aim: Current evidence suggests that both arthritis and hypertension (HTN) can contribute to an increase in pain severity, potentially owing to shared pathophysiological pathways. However, the extent to which these conditions jointly affect pain severity has not been well studied. The aim of this study was to explore the association between the coexistence of HTN and arthritis and their impact on pain severity among community-dwelling older adults. Methods: A cross-sectional design was used. Data from the Wave 2 (2010–2011) of the National Social Life, Health, and Aging Project (NSHAP) were used. Participants were community-dwelling older adults and categorized based on self-reported diagnoses into four groups: combined HTN and arthritis, HTN only, arthritis only, and neither. Pain severity was measured using the Verbal Descriptor Scale (VDS). Multiple generalized linear regression analyses were conducted with adjustments for age, sex, race, body mass index, educational level, and the use of pain and hypertension medications. Results: Data for 1754 participants were analyzed. The prevalence of combined HTN and arthritis was 28.4%. The prevalence of HTN only and arthritis only was 35.2% and 14.2%, respectively. Participants with both HTN and arthritis had higher pain severity compared to those with neither or only one of these conditions. After covariate adjustment, the combined HTN and arthritis group showed a significant association with higher pain severity (B = 0.39, p < 0.001). Similarly, the arthritis-only group also demonstrated a significant association with increased pain severity (B = 0.26, p = 0.002). However, the HTN alone showed no significant associations with pain severity (B = 0.014, p = 0.83). Compared to the arthritis-only group, combined HTN and arthritis showed a significant association with pain severity (B = 0.16, p = 0.049) in an unadjusted model only, and this association disappeared after adjusting for covariates (B = 0.15, p = 0.08). Conclusions: This study found no significant association between coexisting HTN and arthritis compared to arthritis alone after adjusting for covariates among community-dwelling older adults. The influence of covariates highlights the multifaceted nature of pain determinants, which emphasize the need for a multidisciplinary approach to pain management to enhance their functional capacity and overall quality of life. Full article

Social distancing, hand hygiene, mask wearing, surface decontamination, travel restrictions, and school closures have been implemented worldwide to control coronavirus disease 2019 (COVID-19). It was reported that the number of EBV infections as well as the age characteristics of infected persons before and after the COVID-19 pandemic significantly decreased in children from China. Since no studies have explored the changes in EBV-associated lymphomas so far, our aim was to explore EBV infection and viral-associated Hodgkin lymphoma (HL) in a pediatric cohort from a single center. A decrease in EBV+ children by serology was proved, in particular, in those undergoing primary infection, along with a significant increase in the mean age of healthy carriers. Furthermore, a decrease in EBV-associated pediatric cHL was observed post-pandemic, particularly in the NS subtype, with a marked decrease in cases diagnosed from 2022 onward. Even though the underlying reasons for the change in incidence rates seen in this study still remain speculative, it could be hypothesized that, after the pandemic, older children have a better ability to control the EBV-mediated lymphomagenesis, based on the fact that the age of infected patients increased. Full article

Municipal solid waste management (MSWM) is an advantageous subject for implementing circular economy (CE) strategies. In this context, the waste generation and waste collection steps of MSWM in the third largest Greek city (Patras), in western Greece, were evaluated according to the proposed CE indicators. Public opinion and knowledge on CE in MSWM were also evaluated in a small sample of citizens from the Municipality of Patras (207 individuals) through a questionnaire survey. Results showed that (a) the CE performance indicators objectively assessed circularity in MSWM; (b) Patras fared better than Greece and EU in some indicators [waste generation (kg per capita × year), food waste generation (kg per capita × year)] and worse in others [food waste composting (% w/w), WEEE recycling (kg per capita × year)]; (c) citizens have not adopted CE practices in their waste management; and (d) there is a clear reluctance to change practices in older individuals. Based on these results, some recommendations for improvement were made. These results may aid in delineating existing conditions in MSWM in large eastern Mediterranean cities and contribute to the transition toward a reduction in waste disposal and an increase in material reuse. Full article

Under the dual constraints of limited resources and cold climate, the built environment of small cities in cold areas has a particularly prominent impact on the outdoor activities of the elderly and the need for aging optimization. Based on a questionnaire survey and field measurement data, combined with multiple linear regression, Spearman correlation analysis, and difference analysis, this paper systematically discusses the effects of different built environment characteristics on outdoor activity behaviors (frequency, intensity, and stay time) of the elderly in Bei’an City, Heilongjiang Province, China. The difference in environmental satisfaction of the elderly with different genders, ages, and education levels was analyzed. The results show that green coverage, air quality, leisure facilities, and barrier-free facilities are the core environmental factors that significantly improve the activity behavior of the elderly. In contrast, noise level, road damage, and inadequate facility maintenance significantly inhibit the activity willingness of the elderly. It was found that older adults are more dependent on barrier-free facilities and site safety, while younger people pay more attention to sports facilities and social space. Older women pay more attention to environmental details and cultural elements, while men tend to evaluate environmental functionality and so on. Further analysis shows that green environments and leisure facilities in cold climates provide visual beauty and play an important role in improving air quality and enhancing mental health. These elements are particularly critical in winter activities for older people, demonstrating the potential of the built environment to promote health and social participation. Starting from the unique background of small cities in cold regions, this study verified the applicability of the WHO age-friendly city framework in small cities in cold climates through empirical data, and revealed the necessity of climate-adaptive design (such as winter anti-slip facilities and cold-resistant greening) to improve the activity behavior of the elderly, providing a regional supplement to the existing theories. Full article

In the context of rapid urbanization and increasing awareness of environmental justice, ensuring equitable access to high-quality park services is crucial for promoting healthy lifestyles and sustainable urban development. This study investigates park equity in Wuhan, China, by developing a comprehensive evaluation index system that incorporates park quality and considers the heterogeneity of park demand among different population groups, particularly older adults. Using multi-source big data and spatial analysis, this study examines the patterns of park supply and demand and explores the causes of mismatch between them. The results find that the further away from the city center one is, the lower the park supply and demand value. The difference is that the decrease in demand is more moderate relative to supply, and the demand is less affected by the natural environment and urban construction. The findings reveal that park accessibility is closely related to urban infrastructure development and natural resources, with central urban communities enjoying better park supply and quality than peripheral communities. Additionally, the study uncovers that the elderly comprise a vulnerable group that needs more park services in urban China. There are still 28.25% of communities with an unmet demand for parks. The overall goal of the paper is to come up with policy recommendations for optimizing city park equity. It is found that the relieving strategies of park equity are different and should be based on local context, such as enhancing existing park service capacity in urban centers and prioritizing new park development in underserved suburban areas. Full article

As the global population ages, so too does the prevalence of older people with chronic kidney disease (CKD). Helping people age well with CKD and supporting older people with end-stage kidney disease (ESKD) to make personalized decisions regarding kidney replacement therapy (KRT) or conservative care (CC) are an essential component of care. However, these factors are relatively underreported in both the fields of nephrology and geriatric medicine, and prospective, randomized evidence is lacking. This narrative review article, authored by both nephrologists and geriatricians, discusses specific geriatric issues that arise in older people with CKD and why they matter. The available evidence for KRT or CC in older people with frailty is outlined. The importance of performing a comprehensive geriatric assessment, or a modified nephrogeriatric assessment, to ensure a systematic evaluation of the person’s medical problems and life needs, goals, and values is described. We consider different models of nephrogeriatric care and how they may be implemented. Kidney supportive care—addressing an individual’s symptoms and overall well-being alongside the more traditional nephrological principles of preventing disease progression and optimizing risk—is highlighted throughout the article. We outline ways of identifying the later stages of a person’s disease journey, when transition to palliative care is indicated, and elaborate methods of preparing patients for this through multidisciplinary advance care planning. Finally, we discuss practice and systems for nephrogeriatric care in five different European countries and consider future directions, challenges, and highlights in this rapidly evolving, increasingly relevant field. Full article

Background: Patients with rectal cancer may be exposed to a loss of muscle strength and quality. This study aimed to assess the role of preoperative CT-based sarcopenia on postoperative clinical, pathological, and oncological outcomes after rectal cancer surgery. Methods: This retrospective monocentric study included patients who underwent elective oncologic resection for rectal adenocarcinoma between 01/2014 and 03/2022. The skeletal muscle index (SMI) was measured using CT at the third lumbar vertebral level, and sarcopenia was defined based on pre-established sex-specific cut-offs. Patients with sarcopenia were compared to those without sarcopenia in terms of outcomes. A Cox proportional hazard regression analysis was used to determine the independent prognostic factors of disease-free survival (DFS) and overall survival (OS). Results: A total of 208 patients were included, and 123 (59%) had preoperative sarcopenia. Patients with sarcopenia were significantly older (66 vs. 61 years, p = 0.003), had lower BMI (24 vs. 28 kg/m², p < 0.001), and were mainly men (76 vs. 48%, p < 0.001). There was no difference in overall and major complication rates between the sarcopenia and non-sarcopenia group (43 vs. 37%, p = 0.389, and 17 vs. 17%, p = 1.000, respectively). Preoperative and postoperative features related to rectal surgery were comparable. The only predictive factor impacting OS was R1/R2 resection (HR 4.915, 95% CI, 1.141–11.282, p < 0.001), while sarcopenia (HR 2.013, 95% CI 0.972–4.173, p = 0.050) and T3/T4 status (HR 2.108, 95% CI 1.058–4.203, p = 0.034) were independently associated with DFS. Conclusions: A majority of patients undergoing rectal cancer surgery had preoperative CT-based sarcopenia. In this cohort, sarcopenia had no impact on postoperative morbidity and OS but was independently associated with DFS. Full article