Carina Fernandes

Background: Population aging is associated with an increased prevalence of cognitive decline, functional impairment, and other vulnerabilities that compromise autonomy and quality of life among older adults. Multidomain interventions have emerged as promising strategies to promote healthy aging by targeting multiple modifiable risk factors simultaneously. However, existing multidomain programs have rarely addressed financial and digital literacy, despite growing evidence that these competencies may contribute to independence, resilience, and quality of life in later life. This study aims to evaluate the effectiveness of EMBRACE, a multicomponent, non-pharmacological randomized controlled trial designed to preserve cognitive functioning and quality of life while enhancing financial and digital literacy among older adults. Methods: We will conduct a randomized controlled trial with 120 community-dwelling adults aged 60 to 80 years. Participants will be randomly allocated to either the EMBRACE intervention or a control group receiving standard health advice. Standard health advice was selected as the comparator to reflect usual preventive health information available to community-dwelling older adults while avoiding exposure of the control group to the structured multidomain components of the EMBRACE intervention. This approach will allow the effects of the structured multicomponent program to be evaluated against a minimal-intervention condition. The intervention integrates cognitive training, language stimulation, physical activity, nutritional counseling, oral health support, and a financial and digital literacy program. Assessments will be conducted at baseline, at the end of the 9-month intervention period, and at 6-month follow-up. The co-primary outcomes are quality of life, assessed using the WHO Quality of Life Assessment, and global cognitive performance, assessed using a composite score derived from validated neuropsychological measures of memory, attention, executive functioning, and language. Secondary outcomes include functional status, physical health indicators, adherence to the Mediterranean Diet, financial literacy, digital inclusion, and biomarkers associated with healthy aging. Discussion: EMBRACE expands upon current multidomain prevention models by integrating financial and digital literacy into a comprehensive intervention targeting both traditional and emerging determinants of healthy aging. By combining cognitive, linguistic, physical, nutritional, oral health, and educational components, the program aims to address multiple modifiable factors associated with cognitive decline, functional capacity, and overall well-being in later life. The findings will contribute to understanding the effectiveness of multidomain interventions in preserving quality of life and cognitive functioning among older adults. Trial registration: ClinicalTrials.gov, NCT07628686. Registered on June 5, 2026.

In the healthcare sector, burnout has become a critical concern due to the combination of high job demands and sustained emotional strain. Burnout is closely linked to systemic and organizational pressures, and psychosocial risks are widely recognized as central determinants of burnout. Within this multidimensional framework, Work Values are understood as an integral component of psychosocial risks, shaping how professionals interpret and respond to these pressures. The present study aims to analyze whether emotional intelligence moderates the relationship between psychosocial risk factors, namely work values conflict and burnout, among healthcare professionals. A cross-sectional online survey, based on a snowball sample with 205 healthcare professionals, was performed. Measurement instruments included the Burnout Assessment Tool (BAT-23), used to assess burnout dimensions; the Health and Work Survey (ERPS_INSAT), used to evaluate psychosocial risk factors; and the Wong and Law Emotional Intelligence Scale (WLEIS-P), used to assess emotional intelligence. A moderation analysis using the PROCESS macro (model 1) was conducted to examine whether emotional intelligence moderates the relationship between psychosocial risk, work values factor, and burnout among healthcare professionals. The results show that the psychosocial risk–work values dimension was a significant positive associated factor of burnout (total scale: B = 0.27, p < 0.001; Exhaustion: B = 0.33, p < 0.001; Mental distance: B = 0.32, p < 0.001; Cognitive Impairment: B = 0.14, p < 0.001; Emotional Impairment: B = 0.30, p < 0.001), indicating that higher perceived risk was associated with higher burnout symptoms. Emotional intelligence did not significantly predict burnout on its own (total scale: B = 0.07, p > 0.05; Exhaustion: B = 0.09, p > 0.05; Mental Distance: B = 0.11, p > 0.05; Cognitive Impairment: B = 0.11, p > 0.05; Emotional Impairment: B = −0.04, p > 0.05). The interaction term (psychosocial risk = work values × emotional intelligence) was not significant, suggesting that no significant moderating effect was detected in this sample for emotional intelligence in the relationship between work values and burnout. These findings highlight the central role of psychosocial risk factors in the development of burnout among healthcare professionals, and emotional intelligence does not seem to have a significant moderating effect against burnout in this study. Such findings highlight the crucial role that organizational-level interventions at the workplace play in resolving conflicts between work values and lower burnout and improved worker wellbeing.

In the healthcare sector, burnout has become a critical concern due to the combination of high job demands and sustained emotional strain. The present study aims to analyze whether emotional intelligence moderates the relationship between psychosocial risk factors, namely working values conflict and burnout among healthcare professionals. A cross-sectional online survey was conducted among 205 healthcare professionals. Measurement instruments included the Burnout Assessment Tool (BAT-23) to assess burnout dimensions; the Health and Work Survey (ERPS_INSAT) to evaluate psychosocial risk factors; and the Wong and Law Emotional Intelligence Scale (WLEIS-P) to assess emotional intelligence. A moderation analysis using the PROCESS macro (model 1) was conducted to examine whether emotional intelligence moderates the relationship between psychosocial risk, working values factor, and burnout among healthcare professionals. The results show that the psychosocial risk-work values dimension was a significant positive predictor of burnout (total scale: B = 0.27, p < 0.001; Exhaustion: B = 0.33, p < 0.001; Mental distance: B = 0.32, p < 0.001; cognitive Impairment: B = 0.14, p < 0.001; emotional Impairment: B = 0.30, p < 0.001), indicating that higher perceived risk was associated with higher burnout symptoms. Emotional intelligence did not significantly predict burnout on its own (total scale: B = 0.07, p > 0.05; Exhaustion: B = 0.09, p > 0.05; Mental Distance: B = 0.11, p > 0.05; Cognitive Impairment: B = 0.11, p > 0.05; Emotional Impairment: B = -0.04, p > 0.05). The interaction term (psychosocial risk: work values × emotional intelligence) was not significant, suggesting that emotional intelligence does not moderate the relationship between working values and burnout. These findings highlight the central role of psychosocial risk factors in the development of burnout among healthcare professionals, but emotional intelligence does not seem to have a protective effect against burnout. Such findings point to the need for organizational interventions that reduce workplace risks and demand a more in-depth analysis of organizational context determinants, with particular attention to the impact of working values conflict as a critical driver of burnout.

This is the protocol for a Campbell evidence and gap map. The objectives are as follows: to identify and describe the available evidence on interventions designed to improve financial literacy, digital financial skills, financial decision-making, and resilience to fraud and abuse among older adults; map the scope and focus of existing research, including the type of interventions implemented, target populations, delivery modalities, and contextual factors; assess the quality of the types of evidence available, including randomised and non-randomised controlled trials, as well as qualitative studies exploring the effectiveness and acceptability of financial literacy interventions; identify evidence clusters where sufficient studies exist to support further synthesis (e.g., systematic reviews or meta-analyses) and highlight evidence gaps where additional primary research is most needed, and; provide a structured and accessible resource for policymakers, practitioners, researchers, and advocacy groups to inform the design, adaptation, and implementation of financial literacy programmes for older adults.

This is the protocol for a Campbell evidence and gap map. The objectives are as follows: to identify and describe the available evidence on interventions designed to improve financial literacy, digital financial skills, financial decision-making, and resilience to fraud and abuse among older adults; map the scope and focus of existing research, including the type of interventions implemented, target populations, delivery modalities, and contextual factors; assess the quality of the types of evidence available, including randomised and non-randomised controlled trials, as well as qualitative studies exploring the effectiveness and acceptability of financial literacy interventions; identify evidence clusters where sufficient studies exist to support further synthesis (e.g., systematic reviews or meta-analyses) and highlight evidence gaps where additional primary research is most needed, and; provide a structured and accessible resource for policymakers, practitioners, researchers, and advocacy groups to inform the design, adaptation, and implementation of financial literacy programmes for older adults.

Cognitive Training (CT) is proposed to improve cancer-related cognitive impairment (CRCI), but its effect on objective cognition remains unclear. This systematic review and meta-analysis (PROSPERO ID: CRD42023426761) aimed to examine the efficacy of CT on objective CRCI using neuropsychological tests categorised into cognitive domains following international classifications. Secondary objectives were to assess CT effects on self-reported variables. A systematic search was conducted in PubMed, PsycINFO and Cochrane Library (last search in May 2024). Controlled trials performing CT and reporting neuropsychological outcomes were included. Risk of bias was assessed with RoB-2 and certainty of evidence with the GRADE approach. Hedges’ g at post-intervention was the primary outcome of the multivariate meta-analysis, calculated as the standardized mean difference between groups at post-intervention. Hedges´ g at pre-intervention was included as a fixed covariate. Fifteen studies were included in the systematic review and 12 in the meta-analysis (control group n = 507; intervention group n = 578). The meta-analysis showed a small, significant effect of CT on executive functioning (Hedges’ g = 0.15, 95% CI [0.00, 0.29], p = .047). This result warrants cautious interpretation due to low-quality evidence. No significant effects were found in other cognitive domains or self-reported indices. Although these results contrast with previous meta-analyses, this study includes a larger dataset, enhancing the robustness of the results, and introduces a novel analysis strategy by grouping neuropsychological tests according to international classifications. In conclusion, CT shows a small benefit for executive functioning in CRCI, but high-quality studies are needed to confirm its efficacy.

Objectives: Understanding how aging shapes neural mechanisms of decision-making across diverse contexts is critical to promote adaptive choices throughout the lifespan. To this purpose, we examined how age and decision context influence neural processes preceding and following decisions. Methods: Seventy-five healthy adults (20–80 years) performed three versions of the Monetary Incentive Delay task while EEG was recorded: a standard risk-based task, a social variant (outcomes benefiting another person), and an uncertainty variant (cue–outcome contingencies learned through feedback). We analyzed event-related potentials (ERPs) indexing anticipatory processing (Cue-P3), motor preparation (CNV), motivated action (Target-P3), earlier feedback appraisal (FRN), and later evaluative outcome processing (Feedback-P3). Results: Older adults exhibited attenuated Cue-P3 and Target-P3 amplitudes relative to younger adults across decision contexts. In the remaining ERP components, the overall ERP amplitudes were preserved, but the differentiation between incentivized and neutral conditions was reduced in older adults. Decision context modulated neural responses across all groups: social and uncertainty contexts elicited enhanced Cue-P3, Target-P3, and Feedback-P3 amplitudes compared to the risk context, indicating greater attention and motivational engagement. Notably, context effects were consistent across age groups, with no significant interactions between age and context, highlighting preserved sensitivity to social and learning demands in older adults. Discussion: These findings suggest that while aging selectively reduces affective processing of incentives, neural responsiveness to contextual factors may remain robust across adulthood, underscoring the potential of socially meaningful and learning-rich environments to sustain decision engagement in later life.

Objective: Examine the correlation between depressive and anxiety symptoms and cognitive performance across adulthood, with particular attention to differences observed across age groups. Methods: 154 participants (45 young adults, 61 middle-aged adults, and 48 older adults) underwent neuropsychological assessment to evaluate cognitive performance and psychopathological symptomatology. Multivariate analyses were conducted with age group as the between-subject factor and sex and years of education as covariates. Partial correlations, controlling for sex and education, were used to examine the associations between emotional symptoms and cognitive performance in the total sample and by age group. Results: Young and middle-aged adults outperformed older adults across multiple domains, confirming the pattern of age-related cognitive decline. No significant differences were found in verbal fluency. Depressive and anxiety symptoms did not differ significantly between groups. Correlational analyses revealed no significant associations between depressive symptoms and cognitive performance in any group. Anxiety symptoms were negatively associated with executive functions and global cognition in the total sample, and these associations were stronger among older adults, extending to marginal associations with visuospatial working memory and cognitive flexibility. Conclusion: These findings suggest that anxiety symptoms, even below diagnostic thresholds, can negatively impact cognitive functioning, highlighting a modifiable vulnerability factor. Subclinical depressive symptoms showed no measurable impact. The results underscore the importance of investigating anxiety symptoms as a potential risk factor for cognitive performance across the lifespan and of developing strategies to promote cognitive health and preserve autonomy.

Background/Objectives: In the healthcare sector, burnout has become a critical concern due to high job demands and emotional strain. The main objective of the study is to examine the predictive role of psychosocial work-related risks in the development of burnout. Methods: A cross-sectional study was conducted, using a snowball recruitment method, from May to September 2025, among 154 healthcare workers. Data were collected using the psychosocial risk factors scale (INSAT_ERPS) and the Burnout Assessment Tool (BAT) and analyzed with descriptive and inferential statistics to analyze the predictive role of the psychosocial risk on burnout dimensions. Results: Psychosocial risk factors are consistently linked to the development of burnout symptoms. For exhaustion, the predictors included Working Hours (β = 0.312, p < 0.001), Social Work Relations (β = 0.196, p = 0.026), and Emotional Demands (β = 0.295, p = 0.002). For mental distance, the predictors included Work Intensity (β = −0.193, p = 0.049), Emotional Demands (β = 0.294, p = 0.004), and Work Values (β = 0.348, p = 0.003). For cognitive impairment, Work Values (β = 0.240, p = 0.042) and for emotional impairment, Employment Relations (β = 0.182, p = 0.038) emerged only one significant positive predictor. Conclusions: Findings underscore a crucial understanding: the development of burnout is not solely determined by the workload intensity, or the number of hours worked, the quality of working life and the dynamics within the workplace play pivotal roles in predicting burnout. A multidomain evaluation aligns with a holistic well-being approach to well-being by emphasizing that enhancing healthcare workers’ health demands systemic interventions addressing psychosocial work environment.

Background/Objectives: In the healthcare sector, burnout has become a critical concern due to high job demands and emotional strain. The main objective of the study is to examine the predictive role of psychosocial work-related risks in the development of burnout. Methods: A cross-sectional study was conducted, using a snowball recruitment method, from May to September 2025, among 154 healthcare workers. Data were collected using a validated two questionnaires and analyzed with descriptive and inferential statistics. Results: The main results shows that psychosocial risk factors are consistently linked to the development of burnout symptoms. For exhaustion, the predictors included, Working Hours (β = .312, p < .001), Work Relations (β = .196, p = .026), and Emotional Demands (β = .295, p = .002). For mental distance, the predictors included Work Intensity (β = −.193, p = .049), Emotional Demands (β = .294, p = .004), and Work Values (β = .348, p = .003). For cognitive impairment, Work Values (β = .240, p = .042) and for emotional impairment, Employment Relations (β = .182, p = .038) emerged only one significant positive predictor. Conclusions: Findings underscore a crucial understanding: the development of burnout is not solely determined by the workload intensity, or the number of hours worked, the quality of working life and the dynamics within the workplace play pivotal roles in predicting burnout. A multidomain evaluation aligns with a holistic well-being approach to well-being by emphasizing that enhancing healthcare workers’ health demands systemic interventions addressing psychosocial work environment.