Gender and Academic Resilience as predictors of Academic Stress among In-School Adolescents in Ibadan, Oyo state, Nigeria

Citation

Babalola, O. I., Alao, O. G., & Akintola, M. A. (2026). Gender and Academic Resilience as predictors of Academic Stress among In-School Adolescents in Ibadan, Oyo state, Nigeria. International Journal of Research, 13(3), 53–71. https://doi.org/10.26643/ijr/5

Olawale Idowu Babalola

Counselling and Human Development Studies

University of Ibadan, Nigeria

lawalebabalola@gmail.com

https://orcid.org/0009-0009-8967-8371

Olayinka Grace Alao

Counselling and Human Development Studies

University of Ibadan, Nigeria

gracefulfy@gmail.com

https://orcid.org/0009-0005-0213-8235

Motunrayo Adenike Akintola

Counselling and Human Development Studies

University of Ibadan, Nigeria

motunrayoadenike001@gmail.com

https://orcid.org/0009-0005-1597-6553

Abstract

The current study examined the extent to which gender and academic resilience are predictors of academic stress in adolescents pursuing secondary education in Ibadan, Oyo State, Nigeria. The objectives were to (i) determine the relationship between academic resilience and academic stress, (ii) determine the degree to which gender predicts academic stress, and (iii) determine gender-based differences in academic stress.

Academic stress is an over-riding problem of adolescents, and it is largely due to the pressure of examinations, academic workload, parental expectations and school demand. According to previous literature, academic resilience serves as a protective factor in stress response and that female students are more likely to report high levels of stress, although there is a wide range of empirical evidence across cultures and educational settings, especially in the Nigerian secondary school setting.

The survey design used was a correlational, descriptive survey. The sample consisted of 100 adolescents who were chosen through a simple random sampling method. Measurements were made using Academic Resilience Scale (ARS-30) and Academic Stress Inventory. Pearson product-moment correlations, multiple regression, and independent samples t-tests were used, with a significance level of 0.05.

The results of the analyses showed no statistically significant correlation between academic stress and academic resilience. Gender was also not a major predictor of academic stress. However, the independent samples t-test showed that the difference between the academic stress levels between genders was statistically significant, but only slightly with male students reporting slightly high academic stress levels compared to female students.

The results indicate that academic resilience may not have a pronounced effect on academic stress in the analysed group, and gender is not a very relevant predictor. These findings challenge existing assumptions about the universal buffer effect of resilience on stress and the reliability of gender-based differences in academic stress.

The following recommendations, in turn, are offered in the study: the delivery of individualised counselling services, adoption of balanced academic policies, the use of gender-neutral stress-management interventions, increased parental involvement, and additional research on contextual determinants of academic stress in adolescents.

Keywords

‎Quantitative Study, Academic stress, academic resilience, gender differences, In-School Students well-being, academic stress management, learning

1.1 Introduction

Stress is a psychological activity that destablise the reasoning, thinking and behaviour of an individual. It is not age bound as it is experienced at every age group. During adolescence, academic stress has been a critical problem for adolescents at the secondary level of education. Academic stress is the transient experience of pressure, anxiety, or distress related to achieving academic goals (Pascoe et al. 2020). It is the anxiety and pressure associated with schooling and education (Sudiksha et al., 2024). It usually arises as a result of the imbalance between academic duties and social performance. According to Galloway, et al. (2013) explained that students who do heavy homework at home do not have enough time to socialize with their peers and might not have some life skills necessary to accomplish some essentials of life. Adolescents can experience academic stress when they are concerned about their capacity to cope with the academic demands (Lazarus and Folkman, 1984). It is very important to note that academic stress among adolescents can relatively be influenced by their relationship with teachers, the personality of teachers, pressure to excel in exams, the need to complete schoolwork within a given period, and the overall atmosphere of the school. Notwithstanding, participation in co-curricular activities such as debates, quizzes, speeches, music, dance, and arts can help alleviate stress and improve student performance. Whilst continuous tests, grades, the demand for success, and external expectations are the primary sources of stress for senior In-School Adolescents. Addressing academic stress among In-School Adolescents is important given its potentially serious effects on educational attainment and wellbeing. High levels of academic stress are associated with poorer examination performance, mental wellbeing, affect, sleep, confidence, motivation, and even physical health (Shankar and Park, 2016). In their study A Study on Academic Stress among Senior In-School Adolescents, Sudiksha et al (2024) found out that some of the causes of academic stress among adolescents are examination, test, assignment, parental expectations, competition with peers among others. The expectations of teachers and parents seem a source of burden to students. Hosseinkhani et al. (2019) opined that many parents had very high expectations from their children, such as being the best students in school and involving in all school competitions. Also, teachers display unprofessional and disrespectful behaviour by mocking students in front of others and use inappropriate terms in class. Reddy et al. (2018) further stated that parents and schools relentlessly instill the fear of failure in students which consequently affects their self-esteem and confidence. Sudiksha et al. (2024) further suggested that in helping adolescents managing academic stress, counseling service is crucial. Well, not just mere counseling but a resilient and holistic approach to counseling adolescents will help in managing academic stress among the adolescents.‎ Some researches has revealed that female students are more prone to academic stress than their male counterparts (Calagus, 2011; Busari and Omoponle, 2018; Karaman et al., 2019). However, Dhakkal (2013) found that there is no relationship between gender and academic stress and could not pinpoint a significant gender difference in the level of academic stress. In some other studies, it was found that male students experience high level of academic stress and less coping mechanisms than the female students (Chen et al., 2009; Vijaya and Karunakaran, 2013; Rushmi, 2024).

Adolescents are not immune to stressful situations be it academic or non academic. There are many situations that may trigger stress among the adolescents which may include teasing, bullying, disagreements with peers or adults, competition with peers, assignments, tests and class presentations, transitioning from one school to another, etc. In any given stressful situations adolescents find themselves, it is very essential to build resilience.

The concept of Academic resilience is relative, as there has not been a firm or exact definition for its concept. The term Academic resilience has been well understood by various definitions from different perspectives. Academic resilience is not a simple task, as it involves a complex and broad concept which can usually be mixed up with other terms (Pina Lopez, 2015). It can be used to explain different terms, attitudes, and behaviors in the face of academic challenges (Fernandes de Araujo and Bermudez, 2015). It is even becoming harder for researchers to try to provide a standard and acceptable definition (Vinnacia et al., 2007). It emerges as a term within a lot of social sciences (Cichetti and Curtis, 2007) such as Psychology, Anthropology, Sociology and Education. In the 1980s, researchers often used the word “invulnerable” with the attention to describe those people who were able to maintain a positive aspect of view despite negative circumstances (Dimakos and Papakonstantinopoulou, 2012). Margalit (2004) points out that it is not a trait, but a process that involves internal and external factors. Masten (2011) defined it as the capability that students have in order to deal with important threats which can undermine their expected and normal progress and development in their academic journey. It is the capacity to adapt well when faced with adversity or stress in school related works. It helps students stave off the potential negative psychological effects of challenging experiences (Howley-Rouse, 2020). There are various essential abilities associated with academic resilience which are emotional regulation, impulse control, causal analysis, empathy, realistic optimism, self efficacy and opportunity seeking.

Resilient adolescents see academic or social stress in a positive way which enables them to increase their effort and develop new strategies towards achieving their goals. They tend to develop a growth mindset and show minimal problematic behaviours. This is because resilient people display the courage and motivation to face problems and difficulties accurately (rather than denying or exaggerating them) and maintain a positive mindset and the confidence to persevere (Howley-Rouse, 2020)

Academic resilience also contributes to productivity of adolescents as it fosters their beliefs that they have the ability to influence the external factors that contribute to their academic journey. Resilient students are high in autonomy and self-efficacy – they experience feelings of confidence and believe that things will work out. This sense of personal control gives adolescents an advantage in making changes when faced with difficulty and it can moderate the effect of adversity on wellbeing. (Howley-Rouse, 2020). Though fluctuates at different ages and developmental stages, and across different contexts, It is not a character trait that adolescents are born with, but is a developmental process mostly influenced by adolescents’ experiences and relationships. Importantly for Counselors, this means that academic resilience can be learned and developed among In-School studentss in Ibadan, Oyo state.

1.2 Statement of the Problem

The problem of academic stress has become an increasingly relevant concern among adolescents in secondary school, especially at a point where the academic demands and social expectations meet with developmental changes. Young people in Ibadan, Oyo State, are exposed to a lot of academic stressing pressure due to exams, constant tests, school work, parental pressure, teacher pressure, and peer pressure. These stressors are evidenced by a development phase characterised by emotional, cognitive and social changes making adolescents particularly vulnerable to stress-related problems that may interrupt school academic achievements, mental health, motivation, self-esteem and general adaptation to school life.

Although more and more attention is paid to academic stress and its negative outcomes, teenagers do not have a homogenic perception and response to stress. The evidence on gender differences in academic stress is not conclusive; other studies carried out in advance found contradicting evidence with some indicating that female students have a higher level of academic stress and male students have more academic stress and other studies found no significant difference in the academic stress between male and female students. This contradiction renders knowledge gap on the issue of how gender can be used as a predictor of academic stress particularly in the Nigerian context as well as among in-school adolescents in Ibadan.

At the same time, it has been found that academic resilience is one of the central protective factors that allow adolescents to overcome academic challenges and stressors. Adolescents who are resilient have better emotional control, are consistently optimistic, never give up in the face of adversity, and use adaptive coping strategies to fulfil their academic needs. However, even though the academic resilience has received a lot of literature coverage, there is still little empirical evidence on its predictive ability of academic stress in in-school adolescents in Ibadan, Oyo State, and its possible buffering role on academic pressure in this context.

The research gap lies in having an insufficient knowledge of the combined and separate predictive condition of gender and academic resilience with respect to academic stress among in-school adolescents in Ibadan. Without the presence of strong evidence that will outline these relationships, counsellors, educators, school administrators and policymakers will face challenges in formulating specific, effective and contextual relevant interventions to manage academic stress and promote the wellbeing of adolescents. This research gap needs to be considered in order to create comprehensive, resilience-oriented counselling and school-based interventions to help adolescents overcome academic pressures without compromising their psychological health and academic performance.

1.3 Purpose of the Study

The overall purpose of this study is to evaluate the extent to which gender and academic resilience predicts academic stress of married people living in the Abeokuta North Local Government, Ogun State, Nigeria. Specifically, the research attempts to:

Assess if there is any significant relationship between Academic Resilience and Academic Stress among In-school Adolescents in Ibadan, Oyo State.
Examine if gender significantly predict academic stress among In-School adolescents in Ibadan, Oyo State.
Evaluate any significant difference on Academic Stress among In-School Adolescents in Ibadan, Oyo State, based on Gender (Male and Female)?

1.4 Research Questions

Is there significant relationship between Academic Resilience and Academic Stress among In-School Adolescents in Ibadan, Oyo State?
Does gender significantly predict academic stress among In-School Adolescents in Ibadan, Oyo state?
Is there any significant difference on Academic Stress among In-School Adolescents in Ibadan, Oyo State, Nigeria based on Gender (Male and Female)?

2.1 Literature Review

Academic stress has been broadly noted to be one of the major psychological pressures facing students at all stages of learning. It refers to the psychological and emotional pressure, which accrue due to academic requirements such as exams, homework, time limits, workload, and the directions expected of them as per teachers and parents. When such demands surpass the ability of a student to manage them, stress will result and it can have a negative influence on academic performance, emotional health, and physical health. Academic stress has moved into the focus of growing academic interests especially in the face of greater competitiveness and performance orientation in modern education especially in adolescence and early adulthood when adaptive coping styles are still being developed.

The literature on gender disparity in academic stress is relatively large in number, and it is based on the assumption that male and female students perceive and react differently to stresses because of differences in socialisation processes, biological factors, and cultural demands. Several empirical studies document high levels of stress in the students (female). Graves and colleagues (2021) revealed that female students at college were more likely to report higher levels of moderate-to-high academic stress, and male students were more likely to report lower levels of academic stress, though. Simultaneously, Rubach et al. (2022) showed that academic stress had a more negative direct impact on mental-health outcomes in female students of universities, and stress was a predictor of emotional challenges among women more than among men. In the context of professional training, e.g. nursing and midwifery programmes, Alharbi et al. (2025) observed a greater acute and perceived stress among women; these findings suggest increased susceptibility to academic stress.

However, the data on the issue of gender differences in academic stress is not definitive. Other studies give insignificant or insignificant differences between male and female students. The study carried out by Souza-Lima et al. (2025) found that there were slight gender differences between pre-adolescent pupils, with girls feeling more stressed and bored at school than boys. More importantly, physical exercise reduced stress levels in both genders, implying that behavioural predictors might override gender effects. Similarly, Devchoudhury and Devasagayam (2022) did not find any statistically significant gender effect on general academic stress in the sample of undergraduate students, though female students had a slightly higher mean stress level. The inconsistencies mean that gender-related tendencies are not universal but depend on the context.

Gender differences in academic stress also vary as influenced by cultural context. Amoadu et al. (2024) studied high-school students in Ghana and indicated that they found no meaningful gender differences in academic resiliency or general wellbeing. Male and female students showed similar resilience and high wellbeing which highlights the moderating power of common cultural and educational milieu. The finding highlights the essential contribution of situational variables, such as educational systems, cultural norms, and social expectations, to the development of academic-stress experience.

Gender disparities also occur in the coping mechanisms adopted by students in order to manage academic stress. Emotion-oriented coping strategies are more popular among female students, who look to social support and emotions, compared to male students, who favour problem-oriented coping strategies. According to Graves et al. (2021), female students were more likely to use emotional expression and peer support. Additionally, Benitez-Agudelo et al. (2025) found that female students reported increased anxiety and their perception of stress more often but had more frequent better academic results, which indicates that adaptive coping can counteract stressful disadvantages.

Outside gender, academic resilience has become one of the most important constructs to explain how students react to academic stress. Academic resilience is the ability to adjust favourably and stay in academic activities in spite of difficulties like low grades or exam stress. Instead of an inborn characteristic, it is conceptualised as an active process that is influenced by interactions between personal and environmental factors and is not the same as academic buoyancy, which takes into account the daily struggles in academics (Martin and Marsh 2008).

The literature repeatedly emphasises the importance of protective factors in promoting academic resiliency. Resilience and academic success are predictable by individual factors such as self-efficacy, self-regulation, motivation, emotional intelligence and perseverance and additionally external reinforcements like parental encouragement and teacher emotional support. These associations are endorsed by meta-analytic and systematic reviews (Jowett et al., 2023; Kassis et al., 2024). Under-representation of gender in academic resilience seems to be minimal, and resilience indicates good wellbeing among both male and female students (Amoadu et al., 2024).

Overall, it has been shown that academic stress is common among students and that female students tend to report high instances of stress although this is diverse in terms of age and culture. However, academic resilience turns out to be a crucial adaptive process linked to reduced stress levels and beneficial educational achievement, which is why context-specific, resilience-driven interventions should be implemented to ensure the wellbeing of students.

2.2 Theoretical Frameworks

The theoretical frameworks present systematic statements of the way people go through and cope with stress in the academia and other taxing environments. One of the most conspicuous is the transactional model of stress and coping, the other one is the theory of conservation of resources that collectively provides complementary insights on a stress process, coping, and resilience. In this section, each framework is outlined in specific yet understandable terms that can be interpreted by a novice scholar, specifically touching on the key constructs and its application to academic stress.

2.2.1 Transactional Model of Stress and Coping

The conceptualisation of the transactional model highlights stress as a process in relation as it occurs or does between a person and the influence of the environment instead of an external force imposed or an intrinsic condition. Stress comes in when an individual evaluates a scenario as being burdensome or out of the resources they have thus putting their well-being at risk. The model revolves around two appraisal processes. Primary appraisal is an assessment of the nature of the significance of an event, that it is harm or loss, threat, challenge, or benign irrelevance. Secondary appraisal evaluates the options of coping and personal resources; on one hand, skills, support net or knowledge to depict manageability.

Coping is the process under consideration after the appraisal, referring to the behavioural and cognitive processes aimed at dealing with the stressor or controlling the attendant emotions. Problem-oriented coping is aimed at addressing the cause of the stress per se by engaging in such actions as planning, problem solving, or information seeking. The aim of emotion-oriented coping is to alter emotional reaction, e.g. through acceptance, positive reframing, social support, or evading. The model considers the stress process as dynamic and (iterative) and the feedback line through which reappraisal is pushed. Emotional conditions play a central role because positive emotions enable adaptive coping, and negative emotions may lead to the further development of the cycle of stress.

The framework takes the individual differences in responding to stress. As an example, a challenging test can be perceived as a threat by one student – it gives rise to anxiety and avoidance – whereas as a challenge by another, leading to practise and development. It sheds some light on the demand and resource availability perceptions and the impact they have on performance, mental health, and persistence in an academic setting. Lazarus and Folkman (1987) were the first to define the transactional model, the cognitive-relational character of stress and emotion. The fundamental role of the model has been supported by the literature that followed, with adaptations that add positive emotions towards coping (Biggs et al., 2017). There is empirical evidence both in the clinical and applied fields, including modified versions that are tested on psychosomatic patients (Oehrlein et al., 2021).

2.2.2 Conversation of Resources Theory

According to COR theory, people are compelled to obtain, maintain, defend, and develop resources to survive and ultimately achieve good health. The resources include material goods, commitment to relationships, or employment, personal factors, including self-efficacy and optimism, and such resources as time and physical strength. The main causes of stress are the loss of these resources (or a threat of the same) or a failed investment of resources in creating sufficient returns.

The most influential ones are the primacy of loss, in which loss of resources has a stronger psychological effect compared to the gain with the same magnitude. Individuals spend resources in order to avoid or reduce the losses that might trigger the gain or loss spirals by accumulating or rapidly depleting resource supplies. The resource-rich individuals show more resilience to threats and are placed in better positions to achieve beneficial results, and poor individuals suffer the increased vulnerability of resource-poor people. The resources have a tendency to form caravans, a network of resources and move through passageways, environmental facilitator or hindrances that mediate exchange of resources.

In the academic context, COR theory explains how stressors use up resources; including time and self-esteem due to repeated failures, and hence become spirals that lead to impaired performance or health. Resource development by assistance or skill training has the potential to cushion stress and promote strength. The theory is applicable to chronic and traumatic stress, and it has recognised that resources have to be managed as a form of adaptive functioning. Hobfoll proposed COR as a resource-based substitute of stress models based on demand (1989). Subsequent extensions used the model in the context of organisations and health, and integrated realistic dynamics of resources and outcomes (Hobfoll et al., 2018). Overall surveys emphasise its multilevel format to interpret reaction to adversity (Hobfoll et al., 2017).

To conclude, perceptual appraisals and adaptive coping strategies are predicted by the transactional model but conservation of resources theory revolves around the loss and protection of resources. The two taken together form a strong base of examining academic stress and resilience whereby perceptions of appraisals draw demand and resource management effects have long-term adaptation. The combination of these frameworks can guide interventions that would make more accurate appraisals, bolster coping, and lead to accrual of resources in learning settings.

3.1 Methodology

3.2 Research Design

‎This study used the descriptive survey design of correlation type. This research design was adopted because the researcher will not manipulate the variables of interest in the study.

3.3 Population

‎The target population for this study consists of all In-School Adolescents in Oyo State, Nigeria.

3.4 Sample and Sampling Technique

‎The sample of this study consists of one hundred (100) In-School Adolescents in Ibadan, Oyo State, Nigeria through simple random sampling technique. This technique was adopted because the target participants have homogeneous characteristics and they have equal chances of being selected for the study. The sample includes males and female In-School Adolescents in Oyo State, Nigeria state.

3.5 Research Instrument

Questionnaire was used as the instrument of collecting data.

3.5.1 Academic Resilience scale

‎The Academic Resilience of In-School Adolescents in Ibadan, Oyo state shall be assessed through the Academic Resilience Scale (ARS-30) developed by Simon Cassidy (2016). Respondents assess their level of Academic Resilience on 8 topics using a 4-point rating system, ranging from strongly agree (4) to strongly disagree (1). The internal consistency reliability coefficients, as measured by Cronbach’s alpha was 0.90.

3.5.2 Academic Stress scale

The Academic stress of In-School Adolescents in Ibadan, Oyo state was assessed using the Academic Stress Inventory by Lin and Chen (2009) because it covers study habits, test anxiety, peer comparison and parents expectations. The internal consistency reliability coefficients, as measured by Cronbach’s alpha was 0.90.

3.6 Method of Data Analysis

The data collected was analyzed through the use of descriptive statistics which include mean, standard deviation and frequency and using Pearson Product Moment Correlation (PPMC) and multiple regression analysis to give guide on the research questions at 0.05 level of significant.

4.1 Results

RQ1: Is there significant relationship between Academic Resilience and Academic Stress among In-School Adolescents in Ibadan, Oyo state?

Table 1: Summary of correlation matrix showing the relationship between the study variables

Variables	Mean	SD	1	2
Academic Stress	20.79	3.45	1.000	.048**
Academic Resilience	27.58	3.39	.048^**	1.000

Table 1 presents correlation analysis between academic resilience and academic stress in in-school adolescents in the Ibadan, Oyo State. The findings indicate a highly insignificant positive relationship (r = 0.048, p < 0.05). The coefficient is not very low, which means that the practical relationship between the two variables is insignificant; however, the coefficient is statistically significant, and the sample size probably led to that. In line with this, academic resilience appears to correlate with academic stress in this group of adolescents very weakly, indicating that increased academic resilience does not significantly lower or modify the perceived level of academic stress among such adolescents.

This finding is contrary to most of the literature that has been done, which often find a moderate negative relationship between resilience (or academic resilience) and stress (or academic stress). Indicatively, meta-analytic research involving college students reveals a moderate and negative correlation of significance (r = -0.29), which means that the stronger the resilience, the less stressful one is (Li et al., 2024). On the same note, a study conducted among students in universities indicates that perceived stress is a predictor of a lack of academic resilience, and resilience is a protective mechanism against stress-related outcomes (Alzoubi et al., 2025). Past studies demonstrated that resilience reduces the adverse impact of academic pressure on the psychological adaptation, mental well-being, and academic success among adolescents (Kim and Lee, 2023; Wang, 2024).

The almost negligible correlation here could be due to the contextual issues of in-school teens in Ibadan, including cultural bias, or differences in the measures, or the emphasis on the acute, and not the chronic stressors. It correlates with non-significant or weak correlations of links in some groups of students occasionally (Huwae, 2022). These discrepancies highlight the fact that additional studies on the topic are required to investigate moderators (age, cultural situation, or particular dimensions of resilience) in Nigerian adolescents.

RQ2: Does gender significantly predict academic stress among In-School Adolescents in Ibadan, Oyo state among In-School Adolescents in Ibadan, Oyo state?

Table 2: Multiple Regression Analysis on Academic Stress

R		R Square	Adjusted R Square		Std. Error of the Estimate
0.150		0.022	0.001		3.45222
SUMMARY REGRESSION ANOVA
Model		Sum of Squares	Df	Mean Square	F	Sig.
	Regression	25.477	2	12.738	1.069	.001^b
	Residual	1108.356	93	11.918
	Total	1133.833	95

Coefficients^a
Model		Unstandardized Coefficients		Standardized Coefficients	t	Sig.
Model		B	Std. Error	Beta	t	Sig.
	(Constant)	15.079	1.906		7.910	.000
	Gender	-1.014	.732	.142	-1.384	.170

The table 2 revealed the relative contribution of Gender to Academic Stress among In-School students in Ibadan, Oyo state; Gender (β = .142, t= -1.384, p>0.05) had no significant relative contribution to Academic Stress among In-School students in Ibadan, Oyo state. That is, Gender does not predict Academic Stress of In-School students in Ibadan, Oyo state.

The finding is in line with a number of studies that indicate that there are no significant gender differences in academic stress mainly in adolescent or secondary school environment. Indicatively, studies conducted on secondary school students have tended to have equal levels of stress in both genders with any differences being cultural, measurement, or contextual (Devchoudhury and Devasagayam, 2022). Similarly, gender has been reported as non-significant in some studies in Nigerian university and more general groups of adolescents when other predictors, like age or course of study, are incorporated, albeit having some mixed patterns (Fadipe et al., 2024).

However, in contrast, there is more evidence that indicates that gender is a valid factor; the female students tend to report greater academic stress. The meta-analyses and empirical studies have consistently shown that females have higher stress levels caused by societal expectations, differences in coping, or higher sensitivity to academic requirements (Graves et al., 2021; Li et al., 2024). Certain regression models have found that there is a notable gender impact (β = 0.177, p < 0.05) and females are more vulnerable (Fadipe et al., 2024).

This is because the absence of a strong gender influence in the study could be due to the nature of the sample. In Ibadan, adolescent in-school population can be subjected to acute stressors like exams that overshadow the chronic ones, or, the culture can even even the genders in terms of experiences. The above factors indicate the significance of context in the interpretation of the role of gender in academic stress.

RQ3: Is there difference on Academic stress among In-School students in Ibadan, Oyo State based on gender (Male and female)?

Table 3: Summary Table of t-test for independent measures showing comparison of Academic stress based on gender

	Gender	N	Mean	SD	Df	T	Sig
	Male	61	21.16	3.37
Academic stress					94	.352	.549
	Female	39	20.14	3.54

From Table 3, the result showed that there was significant difference in Academic stress based on gender (male and female) among In-School students in Ibadan, Oyo State (T₍₉₄₎= .352, p<.05). From the table above, a mean score of 21.16 for male participants while female participants had a mean score of 20.14 with a mean difference of 1.02 and statistically significant. This implies that the academic stress among In-School students students in Ibadan, Oyo State based on gender (Male and female) is difference. Male experience more of academic stress than the female.

The significance of this finding is that it contradicts the generally observed trend in previous studies, where the female students tend to report greater academic stress. The majority of studies on adolescents and secondary-school students indicate that girls can be more stressed, with a higher tendency to emotional sensitivity, an increased perception of workload, more social and performance expectations, and a different coping behaviour (Graves et al., 2021; Li et al., 2024). Most empirical studies, such as meta-analyses and extensive surveys, tend to show small to moderate differences, which are characterised by women having higher levels of stress (Souza-Lima et al., 2025). According to post-COVID-19 studies, female students experienced more stress and worse emotional adjustment when academic disruptions occurred (Sharma et al., 2022).

Nevertheless, an increasing body of literature confirms our observation and indicates that male adolescents and secondary-school students are also more likely to report higher levels of academic stress. In South Asian countries like India and Nepal, male students experience higher scales of academic stress, grade anxiety and self-expectations. It is postulated that these differences are due to cultural norms of male success, performance pressure imposed socially, and unique goal-setting and role socialisation (Adhikari et al., 2025; Frontiers in Public Health, 2025). On the other hand, the case in the Sub-Saharan Africa, especially in Nigeria is inconclusive. Some studies indicate no strong gender variations whereas others note tendencies that seem to be dictated by local culture, school types, or testing tools (Amoadu et al., 2024; other studies in Nigeria).

The small yet meaningful outcome of greater male stress in our sample puts into perspective this contextual image. The pattern may be attributed to factors such as high pressure during exams, high cultural expectation of male success in schools and measurement instruments that identify particular stressors in Ibadan. The difference is low (M = 1.02) and t-value is low, hence the effect-size is small and to be handled with care. These findings should be validated by conducting larger and more heterogeneous studies.

In total, these findings reveal that context and culture determine gender differences in academic stress. They further emphasise that gender-sensitive and context-specific interventions are required to support male adolescents in Nigerian schools and not to presuppose that all students are equally vulnerable as in the whole world.

4.1 Discussion

The findings of this study point to the fact that academic resilience is not considerably correlated with academic stress in in-school adolescents in Ibadan, Oyo State. This result is in contrast to the current literature assumed to suggest that academic resilience is a protective factor that enables successful coping with academic stress (Howley-, Rouse, 2020; Masten, 2011). The immediate conclusion is that the recovery skills in the event of academic misfortune do not necessarily go together with the reduced academic stress experiences as observed in the present setting. However, the finding agrees with Dhakkal (2013), who indicated that academic resilience showed a non statistically significant relationship with academic stress. The first reason could be that the presence of adaptive resources does not significantly reduce academic pressure and demands on resilient students when multiple stressors remain chronic and endemic or prevalent in a system, and as is the case with examination-based learning in school.

Besides, the evidence indicates that gender is not a statistically significant predictor of academic stress among respondents. This finding matches Dhakkal (2013), though it is opposite to a number of studies that indicate high stress levels among female students, which is often explained by high emotional sensitivity, parental demands and pressures in society (Busari and  Omoponle, 2018; Karaman et al., 2019). The lack of any visible gender effect of the current study suggests that academic stress might be presented in a widely similar way in both male and female adolescents in Ibadan, which could be because of common school setting, similar academic demands, and similar exposures to stress factors in school.

The independent t -test, however, demonstrated a slightly higher average level of academic stress in the males in comparison to their female counterparts. The difference is minimal, whereas it is contrasted to the overwhelming results of the literature which tend to document higher levels of stress in female students (Reddy et al., 2018). Such a trend can be related to contextual issues, including culture-based expectations on male students to perform on the academic level, the pressure to live to societal and or family expectations, or unequal perceptions and reporting of stress. However, due to the small scale of the difference, it should be considered with caution, and a new study is advised.

Overall, the discussion highlights that the popular beliefs about predictors of academic stress, including academic resilience and gender, might not be consistent across the context. The results also point out the relevance of considering environmental, cultural, and systemic factors in the studies of academic stress among adolescents.

4.2 Conclusion

This paper concludes that academic resilience is not a significant predictor of academic stress in in-school adolescents in Ibadan, Oyo state. Similarly, the gender does not have noticeable effects on the academic stress levels among this group of people. The findings, therefore, dispute existing hypotheses that academic resilience is an inherent buffer to academic stress and that there is gender difference in stress everywhere. Since the issue of academic stress continues to attract the attention of in-school adolescents, it is clear that additional factors, including parental expectations, the school climate, instructional practises, and personal strategies of coping, might have a stronger impact on the stress experiences of students.

4.3 Recommendations

Counselling and Support Services: Schools should support counselling services that help the in-school adolescents develop personalised, pragmatic stress management strategies, as opposed to using resilience-building interventions.

Whole Academic Policies: School administrators are expected to champion equitable academic policies that reduce overworking and integrate extra-curricular activities that enhance psychological health of the students.

Gender-Neutral Stress Management Interventions: Since there was no significant gender predicted academic stress, stress management programmes must be designed on an inclusive basis, which is able to help all students without favouring certain gender categories.

Parental Involvement: The parents must also be informed about the effects of academic stress and made to be supportive of the home environment where encouragement and understanding are promoted instead of the undue pressure.

Future research: Future research ought to examine other causes of academic stress, such as socioeconomic status, type of school, peer pressure and family life to provide a more complete picture of the factors that contribute to the occurrence of academic stress among adolescent students in Ibadan.

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Mindfulness in Stress Management: A Narrative Review from Buddhist and Modern Psychological Perspectives

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Hiếu, P. T. (2026). Mindfulness in Stress Management: A Narrative Review from Buddhist and Modern Psychological Perspectives. International Journal of Research, 13(3), 41–52. https://doi.org/10.26643/ijr/4

Phí Thị Hiếu

Associate Professor PhD, Thai Nguyen University of Education, Thai Nguyen, Vietnam

Abstract

Mindfulness has become an influential construct in contemporary stress management research and practice, particularly within psychological and clinical contexts. However, its conceptual roots in Buddhist traditions and the implications of this origin for modern applications are often insufficiently examined. This narrative review aims to synthesize and critically analyze the literature on mindfulness in stress management from the complementary perspectives of Buddhism and modern psychology. Relevant peer-reviewed articles and scholarly books were identified through searches of PsycINFO, PubMed, Scopus, and Google Scholar. The selected literature was analyzed using thematic and interpretive synthesis to identify key conceptual frameworks, theoretical models, and empirical findings. The results indicate that mindfulness contributes to stress reduction primarily through enhanced present-moment awareness, improved emotional regulation, and reduced cognitive reactivity. While modern psychological approaches emphasize measurable outcomes and intervention efficacy, Buddhist perspectives conceptualize mindfulness as part of a broader ethical and wisdom-based path addressing the root causes of suffering. Integrating these perspectives offers a more comprehensive understanding of mindfulness and supports the development of theoretically grounded and culturally sensitive stress management interventions. The review further highlights implications for theory, practice, and policy, suggesting that mindfulness-informed approaches may play a valuable role in mental health, education, and public health strategies when implemented with appropriate conceptual and ethical foundations.

Keywords: mindfulness; stress management; Buddhist psychology; modern psychology; narrative review

1. Introduction

Stress has become a defining feature of contemporary life and a central construct in psychological theories of health and adaptation. Beyond transient discomfort, chronic stress has been consistently linked to a wide range of adverse physical and mental health outcomes, including anxiety disorders, depression, cardiovascular disease, and diminished quality of life. Classical stress theory conceptualizes stress not merely as an external pressure but as a dynamic process involving cognitive appraisal and coping, through which individuals interpret and respond to environmental demands (Lazarus & Folkman, 1984). From this perspective, stress occupies a pivotal position in psychological theory because it represents a point of convergence between cognition, emotion, and behavior, making it a theoretically grounded focus for examining psychological functioning rather than a generic indicator of well-being.

Within this theoretical landscape, mindfulness has emerged as one of the most influential approaches to stress management in contemporary psychology. Commonly defined as a mode of nonjudgmental awareness of present-moment experience, mindfulness has been associated with improved emotional regulation, reduced stress reactivity, and enhanced psychological well-being (Bishop et al., 2004; Brown & Ryan, 2003). These conceptualizations have informed the development of mindfulness-based interventions, most notably Mindfulness-Based Stress Reduction (MBSR), which was explicitly designed to address stress-related suffering and has demonstrated effectiveness across clinical and non-clinical populations (Kabat-Zinn, 1990; Grossman et al., 2004). Importantly, the prominence of stress—rather than general well-being—as the primary target of these interventions reflects mindfulness’s theoretical alignment with models of appraisal, coping, and emotion regulation.

Despite its widespread adoption in psychological research and practice, mindfulness did not originate within modern psychological science. Its conceptual foundations can be traced to early Buddhist contemplative traditions, in which mindfulness (sati) occupies a central role in understanding and alleviating suffering (dukkha). Within the Buddhist framework, particularly as articulated in the Satipaṭṭhāna discourse, mindfulness is embedded within a broader path of ethical conduct, mental discipline, and insight, aimed not merely at reducing distress but at transforming habitual patterns of perception and reactivity that give rise to suffering (Anālayo, 2003). From this perspective, stress is not treated as an isolated symptom but as an expression of deeper cognitive and affective processes rooted in craving, aversion, and ignorance (Thich Nhat Hanh, 1998).

The growing integration of mindfulness into psychological stress management, however, has generated significant conceptual debate. Critics have argued that contemporary applications risk reducing mindfulness to a decontextualized technique, detached from its ethical and philosophical foundations—a phenomenon often described as “McMindfulness” (Purser & Loy, 2013). Others have raised concerns regarding secularization and cultural appropriation, suggesting that the translation of mindfulness into clinical and organizational settings may oversimplify or distort its original aims (Purser, 2019). These critiques are particularly salient in the context of stress management, where mindfulness is frequently framed as an individual coping tool, potentially obscuring broader social, relational, and ethical dimensions of stress.

Against this backdrop, there is a need for a critical synthesis that does not merely summarize empirical findings but interrogates how mindfulness is conceptualized, operationalized, and justified as a response to stress across disciplinary traditions. A narrative review is especially appropriate for this purpose, as it allows for theoretical comparison, conceptual clarification, and critical reflection on underlying assumptions that may not be captured through systematic or meta-analytic approaches alone.

Accordingly, this article aims to provide a narrative review of mindfulness in stress management from the complementary perspectives of Buddhist thought and modern psychology. By examining how each tradition conceptualizes stress, suffering, and the role of mindfulness, the review seeks to illuminate points of convergence and divergence, assess the implications of contemporary adaptations, and identify directions for more theoretically coherent and ethically informed applications of mindfulness in stress management research and practice.

2. Methods

This study employed a narrative review design to synthesize and critically examine existing literature on mindfulness in stress management from the perspectives of Buddhism and modern psychology. A narrative review approach was selected because the aim of this study was not to quantify intervention effects or to exhaustively aggregate empirical findings, but rather to provide a conceptual, theoretical, and integrative analysis of mindfulness across disciplinary and cultural contexts.

A comprehensive literature search was conducted to identify relevant scholarly publications related to mindfulness, stress, stress management, Buddhist psychology, and mindfulness-based interventions. The search was performed using major academic databases, including PsycINFO, PubMed, Scopus, and Google Scholar.

Key search terms included combinations of the following keywords: mindfulness, stress management, stress, coping, Mindfulness-Based Stress Reduction, Buddhist mindfulness, sati, Satipaṭṭhāna, and psychological well-being. Boolean operators (AND, OR) were used to refine the search. Reference lists of key articles and books were also manually screened to identify additional relevant sources.

The literature was selected based on the following inclusion criteria:
(1) peer-reviewed journal articles or scholarly books;

(2) publications addressing mindfulness conceptually, theoretically, or empirically in relation to stress or stress management;

(3) works grounded in either Buddhist traditions, modern psychological theories, or both;

(4) publications written in English.

Exclusion criteria included:

(1) non-scholarly sources such as blogs, opinion pieces, or unpublished manuscripts;
(2) studies focusing on mindfulness without conceptual relevance to stress or coping; and
(3) publications lacking sufficient theoretical or empirical grounding.

Given the narrative nature of the review, no restrictions were imposed on study design, and both empirical and theoretical works were considered.

Following the identification of relevant literature, sources were read and analyzed to extract key themes related to the conceptualization of mindfulness, theoretical models of stress and coping, and applications of mindfulness in stress management. Rather than statistical aggregation, the synthesis was conducted through thematic and interpretive analysis, allowing for comparison and integration of perspectives from Buddhist teachings and modern psychological frameworks.

Particular attention was given to foundational texts and influential empirical studies that have shaped contemporary understandings of mindfulness, such as early Buddhist analyses of mindfulness practice (Anālayo, 2003) and psychological models of mindfulness-based interventions (Kabat-Zinn, 1990; Bishop et al., 2004). The findings were organized thematically to highlight conceptual convergences, divergences, and complementary insights between the two traditions.

To enhance methodological rigor and transparency, the review process was documented systematically, including database selection, search terms, and inclusion criteria. Although this study does not follow a systematic review protocol, efforts were made to ensure a balanced and representative selection of influential and widely cited sources. The narrative synthesis emphasizes clarity of argumentation, explicit theoretical positioning, and critical reflection to minimize subjective bias.

3. Results

The narrative synthesis of the reviewed literature revealed a complex and multilayered understanding of mindfulness in relation to stress management, reflecting both convergence and divergence between Buddhist traditions and modern psychological frameworks. Across the selected sources, mindfulness consistently emerged as a central mechanism influencing how individuals perceive, experience, and respond to stress. However, the conceptual scope, underlying assumptions, and intended outcomes of mindfulness varied substantially depending on the theoretical context in which it was situated.

Within modern psychological literature, mindfulness is predominantly conceptualized as a psychological capacity or skill that facilitates present-moment awareness and emotional regulation. Foundational definitions describe mindfulness as purposeful attention to current experiences, characterized by openness, acceptance, and nonjudgment (Bishop et al., 2004). Empirical studies have demonstrated that individuals with higher levels of dispositional mindfulness tend to report lower perceived stress, reduced emotional reactivity, and greater psychological well-being (Brown & Ryan, 2003). These findings suggest that mindfulness functions as a moderating factor that alters the relationship between stressors and psychological outcomes by reducing automatic cognitive and emotional responses.

A major theme identified in the literature concerns the role of mindfulness in modifying stress appraisal and coping processes. Classical stress theories emphasize that stress responses are shaped not only by external demands but also by individuals’ cognitive appraisals and coping strategies (Lazarus & Folkman, 1984). Mindfulness appears to influence these processes by increasing awareness of automatic appraisals and by fostering a more flexible and less reactive stance toward stressors. Rather than attempting to eliminate stressors, mindfulness facilitates a shift in how stress is experienced, allowing individuals to observe stressful thoughts and sensations without becoming overwhelmed by them.

The effectiveness of mindfulness-based interventions constitutes another prominent theme in the reviewed literature. Mindfulness-Based Stress Reduction, one of the most extensively studied programs, was originally developed to support individuals coping with chronic stress, pain, and illness (Kabat-Zinn, 1990). Subsequent empirical research and meta-analytic findings indicate that mindfulness-based interventions are associated with significant reductions in stress-related symptoms, as well as improvements in psychological and physical health outcomes (Grossman et al., 2004). These effects have been observed across diverse populations, suggesting that mindfulness-based approaches have broad applicability as stress management strategies.

Beyond outcome-focused research, conceptual reviews highlight that mindfulness training influences fundamental cognitive and emotional processes. Baer (2003) emphasized that mindfulness contributes to increased acceptance, reduced experiential avoidance, and enhanced metacognitive awareness. These processes are particularly relevant in the context of stress, as they reduce tendencies toward rumination, suppression, and maladaptive coping. From this perspective, mindfulness supports stress management not by controlling or suppressing stress responses, but by transforming individuals’ relationships to their internal experiences.

In contrast to the functional and outcome-oriented emphasis of modern psychology, Buddhist perspectives present mindfulness as an integral element of a comprehensive framework for understanding and alleviating suffering. Early Buddhist teachings situate mindfulness (sati) within the path of mental cultivation, where it is systematically developed through practices such as the Four Foundations of Mindfulness (Anālayo, 2003). These practices involve sustained observation of bodily sensations, feelings, mental states, and mental phenomena, with the aim of cultivating insight into the impermanent and conditioned nature of experience.

From the Buddhist viewpoint, stress and psychological distress are not merely responses to external pressures but manifestations of deeper cognitive and emotional patterns rooted in craving, aversion, and ignorance. Mindfulness, therefore, serves a diagnostic and transformative function by bringing these patterns into awareness. Anālayo (2003) emphasized that mindfulness practice fosters clarity and discernment, enabling practitioners to recognize the arising and passing away of stressful experiences without identification or attachment. In this framework, stress management is not an isolated goal but a natural outcome of a broader process of insight and mental purification.

Another salient theme in Buddhist sources concerns the ethical and existential dimensions of mindfulness. Thich Nhat Hanh (1998) described mindfulness as inseparable from ethical awareness, compassion, and right understanding. Mindfulness practice is understood as a way of living attentively and responsibly, rather than merely a technique for symptom reduction. From this perspective, the alleviation of stress is closely linked to changes in lifestyle, values, and relational patterns, suggesting a more holistic approach to psychological well-being.

Comparative analysis across the reviewed literature revealed significant points of convergence between Buddhist and psychological approaches. Both traditions emphasize the cultivation of awareness and the reduction of habitual reactivity as central to managing stress. Both recognize that stress is amplified by unexamined cognitive and emotional patterns, and that mindfulness can interrupt these patterns by fostering a more reflective and accepting stance. These shared principles help explain why mindfulness-based practices, rooted in Buddhist traditions, have been successfully adapted into contemporary psychological interventions.

At the same time, notable divergences were identified in terms of goals, scope, and evaluative criteria. Modern psychological models typically frame mindfulness within a health and well-being paradigm, emphasizing measurable outcomes such as reduced stress, improved mood, and enhanced functioning. In contrast, Buddhist approaches situate mindfulness within a soteriological framework aimed at the cessation of suffering in a deeper and more existential sense (Anālayo, 2003; Thich Nhat Hanh, 1998). These differing orientations influence how mindfulness is taught, practiced, and assessed, and may account for variations in program structure and expected outcomes.

The synthesis also revealed limitations and gaps within the existing body of research. While empirical studies provide robust evidence for the effectiveness of mindfulness-based interventions in reducing stress, relatively few works explicitly engage with Buddhist conceptual frameworks beyond superficial references. Ethical considerations and philosophical foundations emphasized in Buddhist teachings are often underrepresented in psychological models, potentially narrowing the conceptualization of mindfulness. This gap suggests opportunities for further interdisciplinary dialogue and theoretical integration.

Overall, the reviewed literature indicates that mindfulness plays a significant role in stress management across both Buddhist and modern psychological contexts, albeit with differing emphases and underlying assumptions. The findings highlight the value of examining mindfulness through an integrative lens that acknowledges both its empirical effectiveness in stress reduction and its deeper conceptual foundations rooted in Buddhist traditions.

4. Discussion

The findings of this narrative review indicate that mindfulness occupies a complex and contested position in contemporary stress management, functioning simultaneously as an empirically supported psychological mechanism and as a concept rooted in a broader ethical–philosophical tradition. While the convergence between Buddhist and psychological perspectives around attentional awareness and reduced reactivity helps explain the effectiveness of mindfulness-based interventions, this convergence should not obscure important theoretical divergences that carry significant implications for both research and practice.

From the standpoint of stress theory, mindfulness aligns well with transactional models that emphasize appraisal and coping processes. Psychological conceptualizations typically frame mindfulness as a self-regulatory capacity that modifies how stressors are perceived and responded to, thereby attenuating maladaptive emotional and physiological reactions (Lazarus & Folkman, 1984; Bishop et al., 2004). This functional interpretation has enabled mindfulness to be operationalized, measured, and integrated into evidence-based interventions. However, such instrumental framing also narrows the construct, privileging outcomes related to stress reduction while bracketing broader questions concerning meaning, values, and ethical orientation.

In contrast, Buddhist perspectives conceptualize mindfulness not as a neutral attentional skill but as a component of a comprehensive path of mental cultivation aimed at understanding the causes of suffering. Within this framework, stress is not merely a response to external demands but an expression of deeply ingrained cognitive and affective patterns, including attachment and aversion (Anālayo, 2003). Mindfulness, therefore, is inseparable from ethical discipline and insight, and its stress-reducing effects are understood as secondary consequences of more fundamental transformations in perception and conduct. This divergence challenges contemporary psychological models to consider whether prevailing definitions of mindfulness adequately reflect its theoretical origins or whether they represent a selective appropriation shaped by pragmatic and methodological constraints.

The tendency to abstract mindfulness from its ethical foundations has been increasingly criticized in the literature. When mindfulness is presented as a value-neutral technique for managing stress, it risks being reduced to a form of psychological palliative care that facilitates individual adaptation without questioning the broader conditions that generate stress. Such simplification may inadvertently support what critics describe as the commodification or instrumentalization of mindfulness, where practices are deployed to enhance productivity or resilience while leaving systemic sources of stress unexamined. From a Buddhist-informed perspective, this represents a substantive misalignment, as mindfulness divorced from ethical intention may sharpen awareness without necessarily reducing suffering.

These concerns are particularly relevant for mindfulness-based interventions such as MBSR, which have been widely disseminated across clinical, educational, and organizational contexts. Although these programs demonstrate robust short-term benefits, their long-term impact may be constrained if mindfulness practice is not accompanied by reflection on intention, values, and relational responsibility. The review suggests that interventions emphasizing technique over ethical orientation may produce uneven outcomes, especially when participants engage mindfulness primarily as a tool for performance optimization rather than self-understanding. This raises critical questions about the assumptions underpinning intervention design and the criteria by which effectiveness is evaluated.

Conceptual ambiguity further complicates the field. Variability in how mindfulness is defined and measured contributes to inconsistencies across studies and obscures theoretically meaningful distinctions between different forms of practice. Buddhist analyses of mindfulness emphasize the quality of attention, the presence of ethical discernment, and the cultivation of insight across bodily, emotional, and cognitive domains (Anālayo, 2003). Incorporating these dimensions into psychological models may enhance construct validity and clarify why superficially similar interventions yield divergent outcomes in stress-related research.

Taken together, these findings suggest that integration between Buddhist and psychological perspectives should not aim for conceptual homogenization but for critical dialogue. Rather than selectively adopting elements of mindfulness that are easiest to operationalize, future research should engage more explicitly with the ethical and philosophical assumptions embedded in different models of stress management. Such engagement may help prevent conceptual dilution and support the development of interventions that address not only the immediate experience of stress but also its deeper psychological and existential foundations.

5. Conclusion and Policy Implications

This narrative review synthesized Buddhist and modern psychological perspectives on mindfulness in stress management, highlighting both their conceptual convergence and distinctive emphases. The reviewed literature demonstrates that mindfulness consistently contributes to stress reduction by enhancing present-moment awareness, improving emotional regulation, and reducing maladaptive cognitive patterns such as rumination and experiential avoidance. While modern psychological research has largely operationalized mindfulness as a secular, skills-based intervention with measurable outcomes, Buddhist traditions conceptualize mindfulness as an integral component of a broader ethical and wisdom-based path aimed at alleviating the root causes of suffering. The integration of these perspectives offers a more comprehensive understanding of mindfulness, positioning it not only as a stress management technique but also as a transformative process influencing cognition, emotion, and behavior over time.

From a theoretical standpoint, the findings suggest that contemporary models of stress and coping may benefit from incorporating insights from Buddhist psychology, particularly regarding impermanence, non-attachment, and ethical intentionality. Such integration can deepen conceptual clarity and address ongoing debates concerning the definition, scope, and mechanisms of mindfulness. At the applied level, mindfulness-based interventions may achieve greater sustainability and cultural sensitivity when they acknowledge both their empirical foundations and their contemplative roots.

The findings of this review carry several policy implications. In the fields of mental health and public health, policymakers may consider supporting the inclusion of evidence-based mindfulness programs as complementary approaches within stress prevention and mental well-being strategies, particularly in educational, workplace, and healthcare settings. In education policy, mindfulness-informed curricula may be integrated not merely as relaxation techniques but as tools for cultivating emotional regulation, attention, and ethical awareness among students. In healthcare policy, training standards for mindfulness-based interventions could emphasize practitioner competence, ethical grounding, and contextual adaptation to avoid superficial or inappropriate applications. Finally, research policy may encourage interdisciplinary collaboration between psychology, neuroscience, religious studies, and contemplative traditions to foster theoretically grounded and culturally responsible mindfulness research.

Overall, positioning mindfulness at the intersection of Buddhist wisdom and modern psychological science provides a robust framework for advancing both theory and practice in stress management. Such an integrative approach holds promise for informing future research, guiding responsible application, and shaping policies that promote sustainable psychological well-being.

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A combination of Zingiber officinale and Allium sativum ethanol extracts prevented liver and kidney toxicities caused by doxorubicin in Wistar rats

Oraekei Daniel Ikechukwu1*, Okoye Odinachi Anthony2, Mba Ogbonnaya2, Abone Harrison Odera3, Obidiegwu Onyeka Chinwuba4

1Department of Pharmacology and Toxicology, Faculty of Pharmaceutical Sciences, Olivia University, Bujumbura, Burundi.
2Department of Pharmacology and Toxicology, Faculty of Pharmaceutical Sciences, Nnamdi Azikiwe University, PMB 5025 Awka, Anambra State, Nigeria.
3Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharmaceutical Sciences, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria.
4Department of Pharmaceutical and Medicinal Chemistry, Faculty of Pharmaceutical Sciences, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria.
Daniel Ikechukwu Oraekei email: oraekeidanielikechukwu@gmail.com
Odinachi Anthony Okoye email: nachi.t.okoye@gmail.com
Ogbonnaya Mba email: mbabte@gmail.com
Harrison Odera Abone email: harrisonabone@gmail.com
Onyeka Chinwuba Obidiegwu email: oc.obidiegwu@unizik.edu.ng

*Corresponding author
Daniel Ikechukwu Oraekei,
1Department of Pharmacology and Toxicology, Faculty of Pharmaceutical Sciences, Olivia University, Bujumbura, Burundi.
Email: oraekeidanielikechukwu@gmail.com
Phone: +25771629919
ABSTRACT
Background: It is the function of the liver and kidneys to deal with processes concerning detoxification, metabolism, and the excretion of waste products. Aim: This study tested the liver and kidney protective effects of a combination of Z. officinale and A. sativum in Wister rats treated with doxorubicin. Methods: The qualitative phytochemical analysis and acute toxicity studies were carried out using standard methods. Bacterial lipopolysaccharide from Escherichia coli was used to induce systemic inflammatory and oxidative stress. The animals were pretreated for 14 days with the combined extracts of Z. officinale and A.sativum alone, the extracts with doxorubicin, and doxorubicin alone. LPS at 1 mg/kg intraperitoneally dissolved in normal saline was given daily to the animals along with the treatments for an additional 14 days. On the last day, the animals were anesthetized with ketamine and xylazine, and blood samples were withdrawn from the retro-orbital plexus of the animals into plain tubes. Serum alanine transaminase, Alkaline phosphatase, Serum creatinine, and blood urea nitrogen were estimated using standard methods. Results: among all tested phytochemicals, Z. officinale lacks tannins, steroids, Steroids and terpenoids, while A. sativum lacks saponins and glycosides. No mortality was observed after the acute toxicity study. Group 4 rats, which were treated with Z. officinae, A. sativun, and doxorubicin, showed lower serum levels of alanine aminotransferase, alkaline phosphatase, creatinine, and blood urea nitrogen than the control group. Conclusion: Z. officinale-A. sativum combination showed a favorable safety profile and also exhibited significant protective effects against chemotherapeutic liver and kidney toxicities.
Key words: Allium sativum, doxorubicin, kidney toxicity, liver toxicity, Zingiber officinale
INTRODUCTION
Background of the study
The liver and kidneys of the human body actively deal with processes concerning detoxification, metabolism, and the excretion of waste products. The protective role of natural products derived from plants against drug-induced damage to the organs has received significant attention. Zingiber officinale and Allium sativum are two widely used herbs in culinary and medicinal fields. They are well studied for their chemoprotective, anti-inflammatory, and antioxidant properties. (Oraekei et al., 2024). Z. officinale contains gingerol and shogaol, and A. sativum contains allicin and ajoene, and these are some of the active constituents that have properties to avert oxidative damage and enhance the functions of organs (Mao et al., 2019). Doxorubicin’s molecular composition leads to the production of free radicals and triggers oxidative stress, which is associated with cellular damage (Tacar et al., 2013). Doxorubicin is a chemotherapeutic agent that is effective in treating various cancers; it is known to induce oxidative stress, leading to hepatotoxicity and nephrotoxicity (Kciuk et al., 2023). Doxorubicin, also known as Adriamycin, is a widely used anthracycline antibiotic that’s actually derived from the bacterium Streptomyces peucetius. (Arcamone et al., 1969). Doxorubicin has been noted to have harmful effects on the liver (Abdulrhaman et al., 2025). It also decreases other protective components like cytochrome P-450 and glutathione in the rat’s liver (Timm etal., 2022). Notably, high glutathione levels have been shown to protect liver cells from Doxorubicin’s toxic effects (Deng et al., 2015). Doxorubicin’s long-term use is limited by severe side effects, including a potentially fatal heart condition that worsens with higher doses. (Belger et al., 2023). The combined use of Z. officinale and A. sativum may offer synergistic effects, potentially mitigating the toxic impact of chemotherapeutic agents like doxorubicin. This study aims to test the liver and kidney protective functions of a combination of Z. officinale and A. sativum in rats treated with doxorubicin. Through biochemical assays, the research seeks to determine whether this herbal blend can mitigate doxorubicin-induced toxicity and support liver and kidney health.
Aim of Study
The aim of the study is to test the liver and kidney protective effects of a combination of Z. officinale and A. sativum in Wister rats treated with doxorubicin.
Scope of Study
This study was narrowed to evaluate the biochemical changes in liver and kidney functions due to doxorubicin toxicity, assess key biomarkers like alanine aminotransferase (ALT), alkaline phosphatase (ALP), creatinine and blood urea nitrogen (BUN).
Literature review
Studies have shown doxorubicin to be a highly chemotherapeutic agent used in treating various cancers. Its use is limited due to the toxic effect it causes on various organs, including the liver and kidneys (Alshabanah et al., 2010). Renal and Hepatic functions are assessed by testing biomarkers such as Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), Alkaline phosphatase (ALP), Creatinine levels, and Blood urea nitrogen (BUN) (Lala et al., 2023). Treatment with Z. officinale showed significant improvement in AST, ALT, and superoxide dismutase (SOD) activities (Abdel-Azeem et al., 2013). Z. officinale administered alone at 530 mg/kg body weight had a greater hepato-protective effect than when given in combination with A. sativum (Oraekei et al., 2024); and this study showed that Z. officinale significantly reduced liver and kidney damage, and the combination containing a higher proportion of Z. officinale was most protective than the other tested combinationse. High levels of ALP or BUN may indicate liver disease or a certain bone disorder or kidneys not functioning well (Lowe et al., 2023).
Herbal medicine combination in pharmacotherapy
When herbs are combined, a lot of interactions can occur, but the desirable interactions are those that can result in enhanced therapeutic benefit. The effects of herbal medicine combinations are usually variable. A herb can be used to potentiate the effect of another herb. An example is the combination of ginseng root and aconite daughter root in an anti-shock remedy (Che et al, 2013). In this combination, the aconite daughter root potentiated the effects of ginseng. Herbal drug combinations can also be antagonistic in their actions. An example is the interaction between turnip root and ginseng root, where ginseng is used as a tonic drug, but when used in the presence of turnip root, its effect will be reduced (Che et al, 2013).
Herb-Drug combination
The use of herb-drug combinations can lead to various clinical presentations, such as potentiation, as seen in the potentiation of the effect of oral corticosteroids by liquorice (Kahraman et al., 2021). The impact of herb-drug combinations can also provide effects that may be additive or antagonistic. Herb-drug combinations can lead to alterations in the gastrointestinal functions, which can affect drug absorption (Brantley et al., 2014). It can also cause induction and inhibition of metabolic enzymes and transport proteins (Fasinu et al., 2012). It can also lead to alteration of renal excretion of drugs and their metabolites (Dresser et al., 2002). Long-term use of St. John’s wort can lead to reduced clinical effectiveness of cytochrome P450 subtype CPY3A4 substrate drugs by CPY3A4 induction, which can cause rapid metabolism and a decrease in the dosage of the drugs (Markowitz et al., 2003).
Possible Herb-Drug Interactions
Herb-drug interactions can occur when herbal supplements are taken with prescription drugs and affect how the medications work in the body. There are so many herb-drug interactions like garlic increasing bleeding when taken with an anticoagulant (Hu et al., 2005). Ginseng interacts with anticoagulants and calcium channel blockers reducing their effects (Jiang et al., 2004). St John’s Wort poses high risks with drugs like cyclosporine, oral contraceptives, and indinavir (Roby et al., 2000).
Brief description of Zingiber officinale
Z. officinale is a rhizome that is widely used as a spice and a medicinal herb. It can be used fresh, dried, or in powdered form in the making of teas and cooking. It contains bioactive compounds like gingerol, which have anti-inflammatory or antioxidant properties. It is used in the treatment of nausea and for relief of cold (Mao et al., 2019).

Figure 1: Image of Z. officinale

Brief description of Allium Sativum
A. sativum is a bulbous plant in the onion family. It is widely used as a culinary spice and in traditional medicine. It has a pungent flavor, which comes from sulfur compounds like allicin. It enhances the cardiovascular system, supports the immune system, and has antimicrobial properties. (Ansary et al., 2020).
Figure 2: Image of A. Sativum.
Materials
Animals
Female Wister rats (230 – 240 g) were used for this study. All the animals were obtained from the animal house of the Department of Pharmacology and Toxicology, Enugu State University of Science and Technology, Enugu State, Nigeria. The animals were housed in standard laboratory conditions of 12 hours’ light, room temperature, 40-60% relative humidity, and fed with rodent feed (Guinea Feeds Nigeria Ltd). They were allowed free access to food and water. All animal experiments were conducted in compliance with the NIH guide for care and use of laboratory animals (National Institute of Health (NIH), 2011) Pub No: 85-23), and animal protocol was approved by Animal care and ethics committee of Enugu State University of Science and Technology with approval number ESUT/2025/AEC/0962/AP 845.
Plant materials
Fresh Z. officinale rhizome and A. sativum bulb were purchased from Ogbete main market in Enugu state, Nigeria.
Drug
Doxorubicin was used for this research.
Equipment
Glass column, flasks, beakers, test tubes, surgical blade, measuring cylinder, forceps, scissors, white transparent paper, Analytical Weighing balance(Metler H30, Switzerland), Electric oven, Water bath (Gallenkamp, England) Water bath, disposable pipette tips (Labcompare USA), intubation tubes, stop watch (Avi Scientific India), BUN and creatinine test kits (Teco Diagnostics, USA), precision pipettes (25, 50, 100, and 300 μl, 1,000 µL) (Labcompare USA), AST test kit (Span Diagnostics Ltd., India), UV-VIS spectrophotometer (Model 752, China), distilled or deionized water (SnowPure Water Technologies USA), micropipette (Finnipipette® Labsystems, Finland), disposable hand gloves (Supermax Malaysia), National Blender (Japan), ALP test kit (Span Diagnostics Ltd., India), ALT test kit (Span Diagnostics Ltd., India), plethysmometer (Biodevices, New Delhi, India).
Methods
Phytochemical analysis
The qualitative phytochemical analysis of the extracts was carried out using standard methods described by Odoh et al. (2019).
Test for alkaloids: The plant extracts (0.2 g) were heated in 20 mL of 2% acid solution (HCL) individually in a water bath for about 2 minutes. The resulting solutions were allowed to cool and then filtered, and then 5 mL of the filtrate was used for Hager’s test. The samples (5 mL) were placed in labeled test tubes, and a few drops of Hager’s reagent (saturated picric acid solution) were added. Formation of a yellow precipitate indicated the presence of alkaloids.
Test for glycosides
The samples were extracted with 1% H2SO4 solution in a hot water bath for about 2 minutes. The resulting solution was filtered and made distinctly alkaline by adding 4 drops of 20% KOH (confirmed with litmus paper). One milliliter of Fehling’s solution (equal volume of A and B) was added to the filtrates and heated on a hot water bath for 2 minutes. Brick red precipitate indicated the presence of glycosides.
Test for saponins
The plant extracts (0.2 g) were dissolved in methanol individually, and the resulting solutions were used for Frothing test. The samples (5 mL) were placed in labeled test tubes, and 5 mL of distilled water was added and the mixtures were shaken vigorously. The test tubes were observed for the presence of persistent froth.
Test for tannins
The plant extracts (0.2 g) were dissolved in methanol individually, and the resulting solutions were used for the test. To 3 mL of each of the samples, a few drops of 1% Ferric chloride were added and observed for brownish green or a blue-black coloration.
Test for flavonoids
Using methanol, 0.2 g of the plant extracts and fractions were dissolved individually, and the resulting solutions were used for Ammonium hydroxide test. A quantity of 2 mL of 10% ammonia solution was added to a portion of each of the samples and allowed to stand for 2 minutes. Yellow coloration at the lower ammoniacal layer indicated the presence of a flavonoid.
Test for steroids and terpenoids
Salkowski test: The plant extracts were dissolved in methanol individually, and the resulting solutions were used for the test. A 5 mL of each of the samples was mixed with 2 mL of chloroform, and concentrated H2SO4 was carefully added to form a layer. A reddish-brown coloration at the interface indicated a positive test.
Acute toxicity studies
Acute oral toxicity of the combination of Z. officinale, A. sativum (6:4) and doxorubicin (318, 212, and 5 mg/kg respectively) was performed according to the Organization of Economic Cooperation and Development (OECD, 2021) guideline 425 for testing of chemicals (Up and down method). The single combination dose was administered to the animal based on their body weight. The animals were closely observed for the first 30 minutes, then for 4 hours. Food was provided after 2 hours of dosing. After the survival of the first treated animal, 4 more animals were treated with the same dose at an interval of 48 hours each. The control group of rats (n = 5) was administered with distilled water (vehicle used in preparing the herbal mixture) in the same volume as that of the treated group. All the groups were closely observed for 6 hours and then at regular intervals for 14 days. The animals were weighed and observed for mortality, salivation, diarrhea, asthenia, hypo-activity, hyperactivity, piloerection, hyperventilation, aggressiveness, yellowing or loss of hair fur, drowsiness, convulsion, tremor, dizziness, and other obvious signs of toxicity.
Experimental design
Bacterial lipopolysaccharide (LPS) from Escherichia coli, purchased from Sigma-Aldrich, was used to induce systemic inflammatory and oxidative stress states. The animals were pretreated for 14 days with the combined extracts of Z. officinale and A. sativum alone; the extracts with doxorubicin; and doxorubicin alone. LPS at 1 mg/kg intraperitoneal (I.P) dissolved in normal saline was given daily to the animals along with the treatments for an additional 14 days. Treatment was done 30 minutes before the LPS injection. On the last day, 2 hours after injection of LPS, the animals were anesthetized with ketamine and xylazine, and blood samples were withdrawn from the retro-orbital plexus of the animals into plain tubes.
Animal grouping (5 animals per group)
A total of 25 rats were allocated into five groups of five rats each. Group 1 were uninduced control (Naïve) and were treated with normal saline + 5 ml/kg distilled water via the oral route (p.o.). Group 2 were the negative control and was treated with LPS 1mg/kg i.p + 5 ml/kg distilled water p.o. Group 3 were treated with Z. officinale and A. sativum combination 6:4 (318:212 mg/kg p.o.) + LPS 1mg/kg i.p. Group 4 were treated with Z. officinale: A. sativum: doxorubicin combination (318:212: 5 mg/kg) + LPS 1 mg/kg i.p. While group 5 were treated with doxorubicin 5 mg/kg i. p.
Serum preparation
At the end of the study, blood samples were collected through retro-orbital plexus into a plain covered test tube. The blood samples were allowed to clot by leaving them undisturbed at room temperature for 30 minutes. The clots were removed by centrifuging at 2,000 x g for 10 minutes in a refrigerated centrifuge. The resulting supernatant (serum) was immediately transferred into a clean polypropylene tube using a Pasteur pipette. The samples were maintained at 2–8 °C while handling and apportioned into 0.5 ml aliquots.
Hepatic function tests.
Quantitative determination of alanine aminotransferase (ALT)
Serum alanine transaminase was estimated by the method described by Oraekei et al., (2024) using the ALT test kit (Span Diagnostics Ltd., India). A 0.25 ml of mixture of L-alanine (200 mmol/l), α-oxoglutarate (2.0 mmol/l), and phosphate buffer (100 mmol/l) was added to 0.5 ml of each sample and blank (containing distilled water). They were mixed and incubated at 37 °C for exactly 30 minutes in a water bath. A 0.25 ml of 2,4- dinitrophenylhydrazine was added to the sample and blank test tubes and incubated again at room temperature for 20 minutes. A 2.5 ml of sodium hydroxide (0.4 mol) was then added to all the test tubes, and the absorbance of the sample was read against the blank at 546 nm using a UV-VIS spectrophotometer (Model 752, China). The ALT concentration was extrapolated from a graph of concentration against wavelength absorbance of known ALT concentrations.
Quantitative determination of alkaline phosphatase (ALP)
Alkaline phosphatase was estimated by the method described by Colville (2002) using the ALP test kit (Span Diagnostics Ltd., India). A 0.5 ml of Alkaline Phosphatase substrate was placed in the sample and blank labeled test tubes and equilibrated to 37 °C for 3 minutes. At a timed interval, 0.05 ml each of standard, control (deionized water), and sample was added to its respective test tubes. The mixture was incubated for 10 minutes at 37 °C. A 2.5 ml of alkaline phosphatase color developer (0.1 M Sodium Hydroxide and 0.1 M sodium Carbonate) was added and properly mixed. The absorbance of the samples was read at 590 nm using a UV-VIS spectrophotometer (Model 752, China) and recorded. ALP concentration was calculated using the equation below;
Calculation of ALP concentration
ALP= (Abs of samples x value of standard (IU/L¬))/(Abs of standard)
Where Standard Value = 50 IU/L
Renal function tests
Serum creatinine and blood urea nitrogen (BUN) were estimated by the method described by Tietz (1976) and Heinegard and Tiderstrom (1973), respectively, using creatinine and BUN test kits (Teco Diagnostics, USA).
Quantitative determination of creatinine
Creatinine working reagent was prepared by combining equal volumes of 10 mM picric acid and Creatinine buffer reagent (10 mM sodium borate, 240 nM sodium hydroxide). Then 3.0 ml of this reagent was added to labelled tubes (test, blank, and standard) to which 100 µl of serum (test), 5 mg/dl of Creatinine (Standard), and distilled water (blank) were added and mixed in their designated test tubes. The tubes were incubated at 37 °C for 15 minutes, and the absorbance was measured spectrophotometrically at 520 nm against a test blank. The concentration of Creatinine (mg/dl) was calculated thus:
Creatinine= (Abs of Test)/(Abs of Std) ×Conc.of Std
Where Abs = Absorbance, Std = Standard
Quantitative determination of blood urea nitrogen
A 1.5 ml of BUN Enzyme reagent (containing 10,000 µ/l Urease, 6.0 mmol/l sodium salicylate, 3.2 mmol/l sodium nitroprusside) was added to 10 µl of Test (serum), Standard (20 mg/dl), and Blank (distilled water) followed by incubation for 5 minutes at 37 °C. At a timed interval, 1.5 ml of BUN color developer (6 mmol/L of sodium Hypochlorite and 130 mmol/l sodium hydroxide) was added to each of the labelled tubes and were incubated for another 5 minutes at 37 °C. The absorbance of the tests and standards was measured spectrophotometrically at 630 nm against a blank. Urea nitrogen concentration (mg/dl) was calculated thus:
BUN= (Abs of Test)/(Abs of Std) ×Conc.of Std
Where Abs = Absorbance, Std = Standard
Results
Table 1: Phytochemical analysis of Z. officinale and A.sativum
Phytocompounds Zingiber officinale Allium sativum
Alkaloids + +
Saponins + –
Tannins – +
Flavonoids + +
Steroids and terpenoids – +
Glycosides + –
Yield 44.8 g (11.2%) 62.4 g (15.6%)
Key: + = Present; – = Absent
Acute toxicity study
No mortality was observed throughout the observational period. Reduced physical activities were observed after drug administration, but normalcy was restored 30 minutes later. Other observations were similar to those of the control group that received the vehicle. Delayed signs of toxicity were not recorded within the 14-day observational periods.
Liver and kidney function tests
Figure 1: Serum level of alanine aminotransferase (ALT)
Figure 2: Serum level of alkaline phosphatase (ALP)

Figure 3: Serum level of creatinine
Figure 4: Serum level of blood urea nitrogen (BUN)
Discussion
In the present study, the phytochemical composition and protective effects of a combined extract of Z. officinale and A. sativum against doxorubicin-induced toxicity were investigated, with a particular focus on liver and kidney function biomarkers. The phytochemical analysis revealed that both Z. officinale and A. sativum contain bioactive compounds such as alkaloids and flavonoids, known for their antioxidant, anti-inflammatory, and hepatoprotective properties. Z. officinale showed the presence of saponins and glycosides, which were absent in A. sativum, while A. Sativum uniquely contained tannins and a combination of steroids and terpenoids, which were absent in Z. officinale. These differences suggest that the combination of both plants could offer a wider spectrum of protective phytochemicals than each of the herbs alone. A study conducted by Mao et al., (2019) confirmed the presence of bioactive compounds like flavonoids and gingerols in Z. officinale, which exhibited antioxidant and anti-inflammatory properties.
The acute toxicity assessment showed no mortality or significant adverse effects in the treated animals over a 14-day observation period. Although a temporary reduction in physical activity was observed shortly after extract administration, the animals recovered within 30 minutes. This rapid return to normal behavior, coupled with the absence of delayed toxicity signs, suggests that the herbal combination is safe at the administered dosage. Z. officicinale was shown to be safe when administered in rats at doses up to 2000 mg/kg. (Rong et al., 2009)
Biochemical analyses further supported the extract’s protective effects. Doxorubicin, known for its potent chemotherapeutic activity as well as its hepatotoxic and nephrotoxic side effects, significantly elevated serum markers of liver and kidney injury. Alanine aminotransferase (ALT), a key indicator of liver cell damage, increased significantly following doxorubicin administration. However, animals pre-treated with the Z. officinale-A. sativum combination exhibited a significant reduction of ALT levels compared to the doxorubicin-only group, indicating a strong hepatoprotective effect of the extracts. Similarly, levels of alkaline phosphatase (ALP), another marker of hepatic function, were elevated by doxorubicin treatment but attenuated in animals co-treated with the extracts. The extract alone maintained ALP and ALT levels close to those of the healthy control group, suggesting it has no intrinsic hepatotoxicity and may even support liver health under normal conditions.
Renal functions, assessed via serum creatinine and blood urea nitrogen (BUN), also deteriorated significantly in response to doxorubicin. However, treatment with the Z. officinale-A. sativum combination weakened these effects. Although creatinine and BUN levels remained higher than those of untreated controls, they were significantly lower than in the doxorubicin-only group, indicating nephroprotection. The extract alone maintained creatinine and BUN levels within normal ranges, again reinforcing its safety and potential therapeutic value.
Overall, the results demonstrated that the combined extract of Z. officinale and A. sativum can effectively reduce biochemical signs of liver and kidney toxicity induced by doxorubicin. This protective effect is likely due to the synergistic action of the various phytochemicals present in both plants. Alkaloids, flavonoids, saponins, glycosides, tannins, and terpenoids are all known to contribute to antioxidant defense mechanisms and membrane stabilization, which may account for the observed mitigation of organ damage.
Conclusion
From this study, the Z. officinale-A. sativum combination not only showed a favorable safety profile but also exhibited significant protective effects against chemotherapeutic toxicity. These findings suggest that such a combination could serve as a promising adjunct therapy to reduce organ damage in patients undergoing doxorubicin treatment.

Acknowledgement
I am thankful to God for his unwavering support throughout this study. My appreciation also goes to Dr. Ajaghaku Lotenna Daniel and the laboratory technologists of the Pharmacology and Toxicology department, Enugu State University of Science and Technology, for their expertise that enabled the smooth completion of this study.
Disclosure of conflict of interest
Daniel Ikechukwu Oraekei declared no conflict of interest
Odinachi Anthony Okoye declared no conflict of interest
Ogbonnaya Mba declared no conflict of interest
Harrison Odera Abone declared no conflict of interest
Onyeka Chinwuba Obidiegwu declared no conflict of interest
Statement of ethical approval
Maintenance and care of all animals were carried out in accordance with EU Directive 2010/63/EU for animal experiments. Guide for the care and use of Laboratory Animals, DHHS Publ. # (NIH 86-123) were strictly adhered to. Animal protocol was approved by the Animal Care and Ethics Committee of Enugu State University of Science and Technology with approval number ESUT/2025/AEC/0962/AP 845. There was additional approval by the Nnamdi Azikiwe University’s Ethical Committee for the use of Laboratory Animals for Research Purposes (Approval number is NAU/AREC/2025/0077).

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Efficacy of Personal Emergency Response Systems (PERS) in Geriatric Care: A Multi-Dimensional Analysis of Mortality Reduction, Psychosocial Outcomes, and Economic Impact

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By Faiz Muhammad

Abstract The global demographic shift towards an aging population presents a critical challenge to healthcare infrastructure: the rising incidence of falls and unmonitored medical emergencies among independent-living seniors. Falls remain the leading cause of fatal and nonfatal injuries in adults aged 65 and older. This article provides a comprehensive review of the efficacy of medical alert monitoring systems, evaluating their role in reducing the “long lie” post-fall, alleviating caregiver burden, and mitigating healthcare costs. By synthesizing data from recent longitudinal studies and technological assessments—including the integration of medical alert monitoring with SOS system protocols and advanced automatic fall detection devices—we argue that these interventions are no longer merely reactive safety nets but essential components of proactive geriatric health management. The review further explores the psychological benefits of “aging in place” facilitated by these technologies, concluding that modern monitoring solutions significantly improve quality-adjusted life years (QALYs) for the elderly.

1. Introduction

The concept of “aging in place”—the ability to live in one’s own home and community safely, independently, and comfortably—has become a central tenet of modern gerontology. However, the biological reality of aging introduces significant risks, primarily related to mobility and acute medical events. According to the Centers for Disease Control and Prevention (CDC), approximately one in four Americans aged 65 and older falls each year, resulting in 3 million emergency department visits annually. The mortality rate from these accidental falls has risen by 30% over the last decade.

The critical determinant in fall-related mortality is often not the trauma of the impact itself, but the duration of the subsequent immobilization, clinically referred to as the “long lie.” Research indicates that remaining on the floor for more than one hour after a fall is strongly associated with severe complications, including rhabdomyolysis (muscle breakdown), pressure ulcers, dehydration, and pneumonia. Consequently, the latency period between an incident and the arrival of medical assistance is a definitive variable in survival rates. This establishes the clinical necessity of Personal Emergency Response Systems (PERS).

2. The Physiology of Delayed Intervention and the “Long Lie”

The primary medical justification for continuous monitoring lies in the mitigation of delayed intervention. A retrospective cohort study involving 295 individuals demonstrated that PERS users were significantly less likely to experience a “long lie” of 60 minutes or more compared to non-users. The mechanism of protection is straightforward yet profound: by reducing the time to discovery, the physiological cascade of stress responses is interrupted.

For seniors living with chronic conditions such as congestive heart failure or COPD, the risks extend beyond falls. Acute exacerbations of these conditions often render the patient unable to reach a telephone. In these scenarios, the integration of medical alert monitoring with SOS system integration becomes a lifeline. Unlike standard telecommunications, these dedicated systems bypass the cognitive load required to dial emergency numbers, connecting the user immediately to a specialized response center. This rapid connection capability is correlated with a higher probability of returning to independent living post-hospitalization, as faster treatment onset typically limits the severity of the initial medical insult.

3. Technological Evolution: Accelerometry and Algorithmic Detection

Early iterations of PERS relied entirely on user activation—the classic “push-button” model. While effective in conscious, mobile patients, these systems failed in cases of syncope (fainting) or incapacitating trauma. This gap has been bridged by the advent of automatic fall detection devices.

Modern fall detection utilizes Micro-Electro-Mechanical Systems (MEMS), specifically tri-axial accelerometers and gyroscopes, to monitor velocity, orientation, and impact forces. Research published in the Journal of Medical Internet Research highlights that advanced algorithms can now distinguish between the high-G impact of a fall and the low-G movements of daily activities (like sitting down quickly) with increasing specificity.

Recent deep learning frameworks have further refined these capabilities. By training neural networks on vast datasets of human movement, false positive rates—historically a barrier to adoption—have been significantly reduced. For instance, sensors can now detect the “pre-fall” phase (loss of balance) and the “post-fall” phase (lack of movement), triggering an alert even if the user is unconscious. This passive layer of protection ensures that cognitive impairment or loss of consciousness does not preclude the arrival of emergency services.

4. Psychosocial Impact on the Dyad: User and Caregiver

The efficacy of medical alert systems extends into the psychological domain, impacting both the user and their informal caregivers (often family members). Fear of falling (FOF) is a well-documented psychological syndrome in the elderly, leading to self-imposed restrictions on activity, social isolation, and physical deconditioning—which, paradoxically, increases the risk of falls.

A study analyzing user perception found that 75.6% of participants reported an enhanced feeling of security after adopting a monitoring system. This “peace of mind” effectively acts as a buffer against FOF, encouraging seniors to maintain mobility and engage in social activities, which are critical for cognitive health.

For caregivers, the burden of “vigilance anxiety” can be debilitating. The constant worry that a loved one has fallen while alone contributes to caregiver burnout. The implementation of a reliable monitoring system serves as a surrogate proxy for presence. Data suggests that caregivers of PERS users report significantly lower stress levels and higher subjective well-being. This reduction in caregiver strain is a vital, often overlooked, outcome that supports the sustainability of home-based care arrangements.

5. Economic Implications for Healthcare Systems

From a health economics perspective, the cost-benefit analysis of medical alert monitoring is compelling. The alternative to aging in place—institutional care—imposes a massive financial burden on families and state healthcare systems. The monthly cost of a semi-private room in a nursing home averages over $7,000 in the United States, whereas monitoring services are a fraction of that expense.

Furthermore, by preventing the complications associated with long lies (e.g., intensive care for rhabdomyolysis or sepsis), monitoring systems reduce the average length of hospital stays (LOS). A study on healthcare utilization found that while PERS users have high rates of chronic conditions, the system facilitates earlier discharge to home settings rather than skilled nursing facilities, as the home is deemed a “safe environment” due to the presence of the monitor.

6. Discussion: The Convergence of Monitoring and Telehealth

The future of geriatric safety lies in the convergence of emergency response with broader health monitoring. We are observing a shift from “alarm-based” systems to “predictive” platforms. Emerging providers are moving beyond simple SOS functions to integrate biometric monitoring (heart rate, oxygen saturation) that can alert response centers to medical crises before a fall occurs.

Institutions and forward-thinking platforms, such as Vitalis, are increasingly recognized for adopting these rigorous standards, bridging the gap between consumer electronics and medical-grade reliability. This adherence to high-fidelity monitoring protocols ensures that the technology remains a robust clinical tool rather than a mere convenience.

7. Conclusion

The literature surrounding medical alert monitoring for seniors presents a unified conclusion: these systems are a cornerstone of modern geriatric safety. By drastically reducing response times, they directly mitigate mortality and morbidity risks associated with falls and acute medical events. Beyond the physiological benefits, they offer a profound psychological dividend, restoring confidence to the elderly and relieving the anxiety of caregivers.

As technology continues to miniaturize and algorithms become more sophisticated through AI, the distinction between “lifestyle wearables” and “medical devices” will blur, likely leading to higher adoption rates. For healthcare providers and families alike, the data supports a clear directive: the integration of automatic fall detection and 24/7 professional monitoring is not merely a precaution, but a critical intervention for preserving the longevity, dignity, and independence of the aging population.

References

Herne, D. E. C., Foster, C. A. C., & D’Arcy, P. A. (2008). Personal Emergency Alarms: What Impact Do They Have on Older People’s Lives? Investigating the lived experience of PERS users and the reduction of fear of falling.
Centers for Disease Control and Prevention (CDC). Older Adult Fall Data. Statistics on fall-related mortality and injury rates in the United States (2023-2024 data).
Journal of Medical Internet Research (JMIR). An Effective Deep Learning Framework for Fall Detection: Model Development and Study Design (2024). Analysis of accelerometer accuracy and algorithmic improvements in distinguishing falls from daily activities.
Stokke, R. (2016). The Personal Emergency Response System as a Technology Innovation in Primary Health Care Services. An examination of the economic impacts of PERS on municipal healthcare costs.

Fleming, J., & Brayne, C. (2008).Inability to get up after falling, subsequent time on floor, and summoning help: prospective cohort study in people over 90. The definitive study on the risks of the “long lie.”

A Review Conventional and Herbal medicine treating Brain-Eating Amoeba (Naegleria fowleri)

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How to Cite it

Surose, R. G., Tawade, R. V., Tejare, P., Patil, M., & Godi, S. (2026). A Review Conventional and Herbal medicine treating Brain-Eating Amoeba (Naegleria fowleri). International Journal of Research, 13(1), 219–224. https://doi.org/10.26643/rb.v118i12.13073

Miss Rutika Gopal Surose; Miss Rani Vinod Tawade; P. Tejare, Mr. Makarand Patil; *Dr Sandhya Godi

Abstract

The brain-eating amoeba, Naegleria fowleri, is a free-living, thermophilic protozoan responsible for Primary Amoebic Meningoencephalitis (PAM), a rare but rapidly fatal infection of the central nervous system. The organism is commonly found in warm freshwater environments and infects humans when contaminated water enters the nasal cavity. Following nasal entry, the amoeba migrates along the olfactory nerve to the brain, where it causes extensive inflammation, tissue necrosis, and cerebral edema. Clinical symptoms typically begin within one week of exposure and progress quickly from headache and fever to seizures, coma, and death. Diagnosis is challenging due to symptom overlap with bacterial meningitis and the rapid progression of the disease. Current treatment involves aggressive combination therapy using antifungal and ant parasitic drugs such as amphotericin B and miltefosine, along with intensive supportive care; however, the mortality rate remains above 95%. Preventive strategies, including proper water treatment and public awareness, are crucial in reducing infection risk. Continued research into early diagnostic methods and novel therapeutic approaches, including plant-based compounds, is essential to improve survival outcomes.

Keywords: Naegleria fowleri, amoeba , conventional medicine and herbal medicine

Introduction

The brain-eating amoeba, scientifically known as Naegleria fowleri, is a free-living, thermophilic protozoan that inhabits warm freshwater environments such as lakes, rivers, hot springs, and poorly maintained swimming pools. Although human infection is extremely rare, N. fowleri causes a devastating disease known as Primary Amoebic Meningoencephalitis (PAM). This infection affects the central nervous system and progresses rapidly, often resulting in death within days. Due to its high mortality rate and rapid disease progression, Naegleria fowleri remains a significant concern in medical microbiology and public health.

History

Naegleria fowleri was first identified in 1965 in Australia by Fowler and Carter while investigating cases of fatal meningoencephalitis. Initially, the disease was mistaken for bacterial meningitis due to similar clinical manifestations. Subsequent laboratory studies confirmed the causative agent as a free-living amoeba. Over the years, sporadic cases have been reported worldwide, particularly in tropical and subtropical regions. Advances in diagnostic techniques have improved detection, but effective treatment options remain limited.

Pathogenesis

Infection occurs when water contaminated with N. fowleri enters the nasal cavity, usually during swimming or diving. The amoeba attaches to the olfactory epithelium and migrates along the olfactory nerve, passing through the cribriform plate to reach the brain. Once inside the central nervous system, the organism multiplies rapidly, causing severe inflammation, hemorrhage, and necrosis of brain tissue. The amoeba destroys neural cells by phagocytosis and releases cytolytic enzymes, leading to cerebral edema and increased intracranial pressure, which are the main causes of death.

Causes

Exposure to warm freshwater contaminated with Naegleria fowleri
Water forcefully entering the nose during swimming, diving, or water sports
Use of untreated or contaminated water for nasal irrigation (e.g., neti pots)
Poorly chlorinated swimming pools

Importantly, infection does not occur from drinking contaminated water.

Keywords: Naegleria fowleri, amoeba , conventional medicine and herbal medicine

Symptoms

Symptoms typically appear 1–9 days after exposure and worsen rapidly.

Early symptoms:

Severe headache
Fever
Nausea and vomiting
Loss of smell or taste

Advanced symptoms:

Neck stiffness
Confusion and disorientation
Seizures
Hallucinations
Coma

Death often occurs within 5–7 days after symptom onset.

Treatment

Conventional Medicine

Treatment of PAM is challenging due to late diagnosis and rapid disease progression. Current conventional therapy includes a combination of antimicrobial drugs and supportive care:

Amphotericin B – the primary drug used to kill the amoeba
Miltefosine – an antiparasitic drug shown to improve survival in some cases
Rifampicin, Fluconazole, and Azithromycin – used as adjunct therapies
Corticosteroids – to reduce brain inflammation
Management of intracranial pressure – including therapeutic hypothermia

Despite aggressive treatment, survival remains rare.

Treatment Using Medicinal Plants

herbal medicinal plants cure for Naegleria fowleri infection; however, several medicinal plants have demonstrated anti-amoebic, antimicrobial, and neuroprotective properties in laboratory studies and traditional medicine. These plants are considered supportive or preventive, not curative.

Some notable medicinal plants include:

Azadirachta indica (Neem): Exhibits antimicrobial and antiparasitic activity
Allium sativum (Garlic): Contains allicin, known for broad antimicrobial effects
Curcuma longa (Turmeric): Has anti-inflammatory and neuroprotective properties
Ocimum sanctum (Holy basil): Enhances immune response and has antimicrobial action
Nigella sativa (Black seed): Known for anti-inflammatory and antioxidant effects

While these plants may support immune function or reduce inflammation, they cannot replace conventional medical treatment for PAM.

Discussion

Primary Amoebic Meningoencephalitis remains one of the most lethal infectious diseases known, largely due to delayed diagnosis and limited treatment options. The rarity of the disease often leads to misdiagnosis as bacterial meningitis. Although conventional drug therapy has saved a few patients, mortality remains above 95%. Medicinal plants show promise in laboratory research but require extensive clinical trials before being considered effective treatments. Public awareness, early diagnosis, and preventive measures remain the most effective strategies to combat this disease.

Conclusion

Naegleria fowleri infection is a rare but deadly condition that poses a serious challenge to modern medicine. Understanding its transmission, pathogenesis, and clinical presentation is essential for early recognition. While conventional medicine remains the primary treatment approach, medicinal plants may serve as supportive agents in the future. Continued research, improved diagnostic tools, and preventive public health measures are essential to reduce mortality associated with this brain-eating amoeba. In this review in future reasrech reasecher formulate multiple Polyherbal medicine. they are potential effective to cure or inhibit amoeba which cross brain barrier.

References

Fowler, M., & Carter, R. F. (1965). Acute pyogenic meningitis probably due to Naegleria fowleri. British Medical Journal, 2(5464), 740–742.
Centers for Disease Control and Prevention (CDC). (2023). Naegleria fowleri – Primary Amebic Meningoencephalitis (PAM).
Visvesvara, G. S., Moura, H., & Schuster, F. L. (2007). Pathogenic free-living amoebae. FEMS Immunology & Medical Microbiology, 50(1), 1–26.
Marciano-Cabral, F., & Cabral, G. (2007). Pathogenesis of Naegleria fowleri infection. Clinical Microbiology Reviews, 20(3), 557–572.
Cope, J. R., et al. (2016). The epidemiology and clinical features of Naegleria fowleri infections. Clinical Infectious Diseases, 63(9), 1159–1164.
Cowan, M. M. (1999). Plant products as antimicrobial agents. Clinical Microbiology Reviews, 12(4), 564–582.

When Rybelsus Fits Into Type 2 Diabetes Care: A Practical Guide

Oral options for type 2 diabetes are changing how people manage blood sugar. Rybelsus is one such option that works through a hormone pathway and supports day-to-day glucose control. This guide explains what to expect, how to use it well, and ways to reduce common challenges.

For context about formulation and dosing strengths, reviewRybelsus Semaglutide Pills to understand how the tablet is designed and taken on an empty stomach. The information below focuses on practical steps, symptom patterns, and safety considerations in everyday life.

How this oral GLP-1 option works in the body

This medicine acts like GLP-1, a gut hormone that helps regulate glucose. It signals the pancreas to release insulin when blood sugar rises and reduces excess sugar made by the liver. It also slows stomach emptying slightly, which may help with appetite and post-meal spikes.

Why this mechanism matters

People often notice steadier fasting levels and fewer late-day highs. Some experience reduced hunger, which can support gradual weight changes. Results vary, and benefits build over weeks as the body adjusts.

Who may consider it

Adults with type 2 diabetes who need better A1C control despite diet and exercise may be candidates. It is not for type 1 diabetes or diabetic ketoacidosis. A clinician will factor in kidney function, gastrointestinal history, and personal goals before prescribing.

Symptoms, goals, and everyday challenges

High blood sugar can cause thirst, frequent urination, fatigue, and blurry vision. Over time, chronic highs raise risks for heart, kidney, eye, and nerve complications. The aim is consistent, safe targets while maintaining energy and preventing lows.

Setting realistic targets

Tracking fasting and post-meal readings helps spot patterns. Many people start with small, achievable goals such as trimming a 20–30 mg/dL rise after meals. Discuss personal targets and A1C goals with your clinician, especially if you have other conditions.

Recognizing early signals of change

During the first weeks, you may see smoother mornings or fewer sugar spikes after larger meals. Appetite may shift, making smaller portions feel sufficient. Keep a simple log of meals, doses, and symptoms to guide adjustments.

Getting started safely: timing, dosing, and interactions

Oral GLP-1 therapy is sensitive to timing and stomach conditions. The tablet is typically taken on an empty stomach with a small amount of water, followed by a wait period before eating, drinking, or taking other medications. Consistency at the same time each day helps absorption and outcomes.

Baseline checks and medical history

Before starting, clinicians often review kidney function, gastrointestinal history, and risk factors such as pancreatitis. Share all medications and supplements, including over-the-counter products. Mention any prior gallbladder issues, thyroid concerns, or severe reflux.

Other medicines and low-sugar risk

On its own, a GLP-1 usually has a low risk of hypoglycemia (low blood sugar). However, when used with insulin or sulfonylureas, lows can occur. Know symptoms like shakiness, sweating, or confusion, and carry fast-acting carbs if your regimen includes a low-risk medicine paired with a higher-risk one.

Class context and options

These therapies are part of a broader group that target the GLP-1 pathway. For a general overview of the class, seeGLP-1 Agonists and discuss with your clinician how the oral form compares with injections for your needs.

Managing common side effects and staying consistent

Most side effects are gastrointestinal and tend to be mild to moderate. Nausea, fullness, burping, or softer stools are common during dose changes. They often improve within two to eight weeks as your body adapts.

Ways to reduce nausea and reflux

Eat smaller, more frequent meals instead of large portions.
Favor bland foods early on; limit very spicy or greasy meals.
Sip water slowly; avoid chugging liquids around meals.
Wait the recommended time after dosing before eating or drinking.
Reduce carbonated beverages if bloating is bothersome.

If symptoms persist

Track what triggers discomfort and share specifics with your clinician. Slowing the dose increase or pausing escalation can help. Seek urgent care for severe abdominal pain, persistent vomiting, signs of dehydration, or yellowing of the skin or eyes.

Protecting hydration and digestion

Because this class can slow stomach emptying, hydration matters. Aim for consistent fluids across the day, especially in hot weather or during exercise. Include fiber from vegetables, legumes, and whole grains to support regularity.

Nutrition, activity, and daily routines that reinforce progress

Medication works best when paired with simple habits. Consistent meals, movement, and sleep can sharpen your response and reduce swings. Small, repeatable steps often outperform drastic short-term changes.

Meal planning and portion balance

Build plates around non-starchy vegetables, lean proteins, and healthy fats.
Choose high-fiber carbohydrates like beans, oats, and berries.
Watch added sugars in drinks, sauces, and snacks.
Use a consistent breakfast, especially important with a morning tablet routine.

Movement that fits your life

Even short walks after meals can reduce post-meal spikes. Aim for regular aerobic activity and two sessions of resistance training weekly, as tolerated. If activity raises low-sugar concerns with other medicines, plan a small carb snack and test more often.

Sleep, stress, and alcohol

Short sleep and high stress can raise glucose. Create a bedtime routine and practice brief stress breaks during the day. If you drink alcohol, monitor sugars more closely and avoid drinking on an empty stomach. Using a non invasive blood glucose monitor can make tracking your glucose levels easier and more comfortable, allowing you to check trends without frequent finger pricks and adjust your lifestyle choices in real time.

Monitoring progress and knowing when to adjust

Regular reviews help you and your clinician decide on dose changes. Many people see early shifts within four to eight weeks, with larger A1C changes over several months. Labs and home readings together give the clearest picture.

What to track weekly

Fasting glucose at least a few mornings per week.
One or two post-meal checks at varying meals.
Side effects, appetite changes, and hydration.
Body weight trends, if weight is a goal.

When readings are off target

Consider meal timing, missed doses, illness, or new medicines. Review tablet timing and the wait period to protect absorption. Bring your log to appointments so your clinician can tailor next steps.

Safety signals to discuss promptly

Contact a clinician for ongoing severe GI symptoms, signs of dehydration, or unexplained abdominal pain. Sudden worsening of glucose with illness warrants closer monitoring. If you become pregnant or plan to conceive, review your treatment plan.

Some people explore cross-border options for cost or access and consider Canadian pharmacies that ship to the United States. If comparing sources, confirm licensure and dispensing standards, and discuss any changes with your clinician beforehand.

Medical disclaimer: This content is for informational purposes only and is not a substitute for professional medical advice.

For site-wide education and resources on diabetes care, visitCanadianInsulin for general information and articles focused on condition management.

7 Surprising Benefits of Macadamia for Heart, Brain, and Metabolic Health

Most people meet macadamias in a cookie or a gift tin and mentally place them in the “treats” category. They feel rich, indulgent, and special-occasion. Look a little closer, though, and these creamy nuts behave much more like a smart wellness tool than a guilty pleasure.

When you zoom in on the nutritional benefits of macadamia nuts, they start to look like a quiet powerhouse for heart, brain, and metabolic health. Instead of chasing the latest superfood trend, you can get a lot of long-term value by making simple, sustainable upgrades to what you already eat, and macadamias are a very easy one to plug into daily life.

1. A Creamy Nut Loaded With Good Fats

First, it helps to understand the basic macadamia nut nutritional facts. A small handful of macadamias, around 10 to 12 nuts or roughly 28 grams, comes in at about 200 calories. In that serving you get around 21 grams of fat, a couple of grams of protein, and only a few grams of carbohydrates, including a modest amount of fiber. On paper that sounds like a high-fat food, but the nuance sits in the type of fat.

Most of the fat in macadamias is monounsaturated. This is the same overall category of fat often associated with better heart and metabolic markers when it is part of a balanced diet. Instead of flooding your system with quick-burning sugars, macadamias give you slower, steadier energy. That makes them especially useful for people who feel better on lower-carb patterns or anyone who wants snacks that genuinely carry them between meals.

2. Supporting Better Cholesterol and Blood Vessels

From a heart health perspective, macadamias earn their place in the pantry. The monounsaturated fats they provide can support healthier cholesterol patterns when they replace more processed or saturated-fat-heavy snack options. Swapping a bag of refined crackers or sweets for a measured handful of macadamias seems like a small decision, but those small decisions are exactly what shape long-term cardiovascular health.

Beyond cholesterol, macadamias bring antioxidants and plant compounds that support blood vessel function. Over time, regularly including foods like this can encourage more flexible arteries, healthier blood lipids, and a calmer level of background inflammation. None of that is dramatic or overnight, but it is the kind of slow, steady improvement that matters when you think in years instead of days.

3. Low-Carb, Blood-Sugar-Friendly Energy

If you care about stable energy and metabolic health, macadamias are easy to work with. They are naturally low in carbohydrates and very low in sugar, and they have a bit of fiber to slow digestion. Instead of sending your blood sugar on a quick spike and crash cycle, they offer a slower burn that keeps you feeling more steady and focused.

This is where a strategy mindset pays off. Imagine a typical day where your snacks are biscuits, sweets, or highly processed bars. Replacing even one of those with a portion of macadamias removes a spike and gives your system something gentler to work with. You do not need a perfect diet to feel better. You just need a few key swaps that tilt your averages in the right direction.

4. Brain and Nerve Support From Fats, Vitamins, and Antioxidants

Your brain runs on a lot of energy and prefers stability over drama. It is built largely from fats, and it performs best when those fats are high quality and your antioxidant defenses are supported. Macadamias help on both fronts. Their monounsaturated fats and natural antioxidants contribute to protection from everyday oxidative stress, which is tied to how we age and how our brains function over time.

They also provide useful micronutrients, including thiamin, manganese, magnesium, and copper. These nutrients play roles in nerve signaling, energy production, and the body’s own antioxidant systems. Macadamias are not a memory supplement, but consistently including foods like this helps create a better environment for brain and nerve health, especially when combined with sleep, movement, and stress management.

5. Surprisingly Satisfying for Weight Management

At first glance, the calorie density of macadamias can feel intimidating if you are watching your weight. In practice, nuts are often linked with better appetite control and healthier body weight outcomes when used wisely. The mix of healthy fats, a little protein, and some fiber helps you feel properly satisfied instead of just temporarily distracted from hunger.

The difference shows up in your behavior. A small, intentional serving of macadamias can take the edge off hunger and keep you out of that desperate state where any snack will do. When you are not constantly fighting strong cravings, it becomes much easier to make calm, rational food choices. Over time, those more relaxed decisions often matter more than any strict short-term diet rules.

6. Tiny Source of Fiber and Protective Compounds

Macadamias will not replace high-fiber foods like beans or oats, but they still contribute meaningfully to your total intake. A serving offers a couple of grams of fiber, which supports regular digestion and acts as fuel for beneficial gut bacteria. A better-nourished gut is linked with smoother digestion, more stable mood, and a stronger immune system.

They also contain plant compounds such as phytosterols and flavonoids. These work alongside healthy fats to support a less inflammatory internal environment. Chronic, low-grade inflammation is connected with many modern health issues, from metabolic problems to joint discomfort. Building a diet around whole foods that nudge inflammation down, even slightly, can add up when you repeat those choices day after day.

7. A Nutrient-Dense Upgrade for Everyday Meals

One of the most underrated benefits of macadamia is how easy they are to plug into meals you already enjoy. A spoonful of chopped macadamias on a salad adds crunch, richness, and staying power. Mixed into roasted vegetables, they turn a simple side into something that feels restaurant-level. Sprinkled over yogurt, oats, or smoothie bowls, they add both texture and healthy fats without a complicated recipe.

Their flavor is naturally rich, so a little goes a long way. You might add only a tablespoon or two, but it can completely change how satisfying a meal feels. That is the real advantage of a nutrient-dense food. You are not just eating for numbers on a label. You are upgrading fullness, enjoyment, and nourishment at the same time.

In Conclusion

When you pull all of these pieces together, macadamias look less like a luxury and more like a smart, flexible tool in your health strategy. They support heart health with good fats, contribute to stable energy and metabolism, bring valuable nutrients to your brain and nervous system, and play a small but meaningful role in gut and inflammation balance. All of that comes wrapped in a food that is genuinely enjoyable to eat.

You do not need to overhaul your entire diet to make use of them. Start by swapping one processed snack for a measured handful of macadamias or add a spoonful to one meal a day. Track how your energy, cravings, and satisfaction feel over a few weeks. That kind of practical, sustainable shift tends to beat extreme rules every time, and macadamias are a simple, delicious way to move your everyday habits in a healthier direction.

Photography and Neuropsychology: How Emotional Images Activate Memory and Imagination

by Tatiana Belova (Tanya Beloved)
Professional photographer, two-time winner of the “Best Photographs of Russia” competition, author of over 2000 family and individual sessions across the USA, Europe, and CIS countries. Featured in Forbes, USA Today, and other major publications.

California, USA

Website: https://tanyabeloved.com

A Glimpse That Lingers

When we look at a photograph that moves us — a child laughing in a puddle, a parent’s tearful smile, a portrait where someone meets our gaze so truthfully — something in our brain lights up. Not just metaphorically. In fMRI scans, the hippocampus (our memory hub), the amygdala (our emotion processor), and the visual cortex all flash into activity.

Photography doesn’t just show. It reactivates. It replays old memories, triggers new narratives, and even projects forward into imagined futures.

I have worked with over 2000 families and individuals across the U.S. and Europe, capturing more than portraits — I capture neural echoes. When people view their own images afterward, they often say, “I remember exactly what I felt.” And their bodies remember, too.

The Brain Behind the Lens

Neuropsychology tells us that emotionally charged images activate multiple systems:

Amygdala – for emotional tagging
Hippocampus – to link feelings with past experiences
Prefrontal Cortex – to interpret and assign meaning
Default Mode Network (DMN) – engaged in self-referential thinking and imagination

A photo, especially a personal photo, serves as a stimulus that ignites the entire memory-imagination-emotion triad. This is why family albums, personal portraits, and emotionally resonant visual stories feel so powerful — they are not passive. They are interactive stimuli for our inner world.

Visual Therapy, in Practice

In my sessions, I’ve often observed how clients begin narrating their life stories through a single image. A mother sees a photograph with her child and says, “This reminds me of how my mom used to hold me.” An elderly man holds a black-and-white photo I took and begins to cry — “I haven’t seen me like this in decades.”

This is not coincidence. This is cognitive-emotional activation.

I began incorporating soft guided reflection into my post-shoot viewing sessions. I ask: “What does this moment remind you of?”, “Do you see yourself differently here?”, “Where does this feeling live in your body?” Often, the answer opens not just memory — but healing.

Brain Zones Activated by Emotional Portraiture

Brain Region — Function

Visual Cortex — decoding visual detail
Amygdala — tagging emotional salience
Hippocampus — associating memory traces
Default Mode Network (DMN) — projecting identity, imagining self
Prefrontal Cortex — assigning narrative and value

Why Photographers Must Understand the Mind

In an era dominated by AI-generated images, authentic photography becomes a neurological anchor. AI can replicate a smile — but not the emotional resonance behind it. True photography speaks the language of the nervous system. It can soothe, evoke, reflect, or even disrupt — consciously and unconsciously.

Understanding this helps photographers move from technical creators to emotional translators. And it helps clients understand their images not just as “pictures,” but as emotional tools for self-knowledge.

Final Insight

Photographs are not just memories — they are maps of identity. They light up our minds like constellations. And in this light, we see not only who we were — but who we are becoming.

References

Kandel, E. (2012). The Age of Insight: The Quest to Understand the Unconscious in Art, Mind, and Brain.
LeDoux, J. (2015). Anxious: Using the Brain to Understand and Treat Fear and Anxiety.
Immordino-Yang, M. H. (2016). Emotions, Learning, and the Brain: Exploring the Educational Implications of Affective Neuroscience.
Schacter, D. L. (2021). The Seven Sins of Memory: How the Mind Forgets and Remembers.

Date: November 17, 2025

Advancing Understanding of Cognitive Decline Through Research

Cognitive decline remains one of the most pressing challenges in modern healthcare. Scientists continue to search for answers that explain how memory loss begins and progresses. Their investigations aim to improve treatments and guide better patient support systems. This ongoing exploration draws from both advanced technology and the personal experiences of those affected. As findings evolve, they reshape how society views brain health and aging. Each step forward signals new opportunities for knowledge and care.

Whelan, R., Barbey, F.M., Cominetti, M.R. et al. Developments in scalable strategies for detecting early markers of cognitive decline. Transl Psychiatry 12, 473 (2022). https://doi.org/10.1038/s41398-022-02237-w

Researchers emphasize that memory decline is not only a medical condition but also a societal issue. Families, caregivers, and healthcare providers all feel the impact of this growing concern. Studies now focus on identifying early indicators that may slow or delay progression. These efforts require collaboration across institutions and disciplines worldwide. The pursuit of solutions highlights the urgency of preparing for an aging global population. By examining new research, society gains hope for improved futures.

Progress in Memory Health Studies

Recent years have produced a steady stream of studies exploring the causes of memory decline. These investigations examine biological factors, lifestyle influences, and patterns of disease progression. By analyzing large sets of patient data, researchers uncover insights that can transform treatment approaches. This process of discovery builds a foundation for more effective therapies in the future. One widely referenced example is the Lilly memory loss study, which underscores the value of long-term observation in shaping outcomes. The emphasis is on identifying key stages where intervention may be most effective. Each discovery informs both clinical practice and patient support strategies. The result is a deeper understanding of memory health across populations.

The consistency of findings across multiple studies adds credibility to the results. Scientists rely on patterns that emerge across different demographics and conditions. These patterns reveal how memory loss interacts with various risk factors over time. With every confirmed result, the medical community gains stronger guidance for care. Moreover, the use of advanced imaging and biomarkers enhances the accuracy of these studies. As a result, clinicians can design approaches that are tailored to individual needs. By combining technology with patient data, research continues to refine its direction. The outlook for memory health treatment grows more promising with every advance.

The Value of Clinical Research in Cognitive Disorders

Clinical research remains a cornerstone in the effort to address memory decline. These studies provide the evidence necessary to confirm or challenge existing theories. Without them, progress in developing new interventions would slow dramatically. Clinical trials also provide opportunities for patients to participate directly in advancing knowledge. A notable example is the memory loss clinical research study Lilly, which contributed valuable findings to the field. Its results illustrate how carefully designed studies inform not only treatments but also preventive strategies. By including diverse populations, researchers ensure that conclusions apply broadly. This diversity strengthens the relevance of research in real-world settings.

The practical impact of clinical studies extends beyond academic research. Data collected through these trials often guides regulatory decisions and healthcare policies. This influence shapes how treatments become available to patients on a larger scale. Furthermore, trials allow for comparisons between existing and experimental therapies. Such comparisons highlight strengths and weaknesses in current approaches. Patients benefit directly when new findings inform clinical guidelines. Over time, research translates into more accurate diagnoses and better management of symptoms. The path from study to treatment remains essential for progress in brain health.

Understanding the Role of Alzheimer’s Trials

Alzheimer’s disease continues to receive significant attention in research due to its widespread impact. Studies in this area aim to clarify the mechanisms that drive progression. By targeting these mechanisms, researchers hope to develop more effective therapies. The importance of Alzheimer’s disease clinical trials lies in their ability to validate new treatment strategies. These trials explore experimental drugs, behavioral interventions, and monitoring technologies. Each contributes to building a clearer picture of how the disease can be slowed or managed. The outcomes also inform broader approaches to cognitive decline. What begins in the lab eventually influences global health practices.

The scope of Alzheimer’s research reflects the seriousness of the condition. Millions of people worldwide face its effects, making solutions urgently needed. Clinical trials not only test drugs but also examine the role of care methods. This includes caregiver education, lifestyle adjustments, and community support initiatives. Such holistic approaches ensure that research findings reach beyond laboratory settings. Policymakers often look to these trials when designing public health strategies. In this way, the results of Alzheimer’s research resonate across healthcare systems. They provide both immediate guidance and long-term direction for society’s response.

The Impact of Technology on Memory Research

Technology has transformed the way cognitive decline is studied and managed. Imaging tools allow researchers to observe subtle brain changes over time. Digital platforms enable real-time data collection from patients in various settings. These innovations shorten the gap between symptom onset and early detection. As a result, treatments can be introduced at more effective stages. Wearable devices also play a role in monitoring cognitive performance daily. Their data adds valuable detail to long-term clinical studies. Technology continues to expand the possibilities for understanding memory health.

The integration of artificial intelligence further accelerates discovery. Algorithms analyze massive datasets for patterns invisible to the human eye. This capability strengthens predictions about disease progression and treatment outcomes. With more precise information, clinicians can craft strategies tailored to individual needs. Furthermore, technology helps researchers collaborate globally by sharing data securely. Such cooperation enhances the speed and scale of discovery. Patients also benefit from more personalized monitoring tools. These developments represent a significant step toward proactive brain health care.

The Broader Public Health Perspective

Cognitive decline extends beyond individual patients into the realm of public health. As populations age, societies must adapt healthcare systems to manage growing demand. Research findings guide decisions on resource allocation and program development. Communities depend on accurate data to implement preventive measures. Without research, policies would lack the foundation needed for effectiveness. The challenge of memory decline becomes a shared responsibility across governments, institutions, and families. By investing in research, societies prepare for long-term challenges. Knowledge gained benefits not only patients but also entire communities.

Public awareness also plays a critical role in shaping outcomes. Campaigns that educate citizens about memory health encourage early screenings. These actions increase the chances of detecting issues before they become severe. Awareness also reduces stigma, making it easier for patients to seek support. Healthcare providers can use public outreach to strengthen relationships with communities. Informed citizens place greater value on preventive care and early diagnosis. This creates a cycle where research and public health reinforce each other. A stronger focus on prevention reduces the overall burden on healthcare systems. Together, research and awareness provide a roadmap for addressing memory decline.

Wrap Up

Memory research remains a central component in addressing the challenges of cognitive decline. Each study builds on the work of those before it, contributing to a growing body of evidence. Researchers rely on both advanced technology and patient data to gain insights. Clinical trials continue to serve as the testing ground for new therapies. The inclusion of diverse participants strengthens the impact of findings. Collaboration across institutions ensures that results are relevant worldwide. Every advancement increases the hope for more effective care. The journey is ongoing, but the progress is undeniable.

The broader impact of research is felt in policies, healthcare systems, and everyday life. Families benefit when treatments improve quality of care. Communities gain resilience when public health strategies address memory decline effectively. Healthcare providers use research to refine diagnoses and interventions. Policymakers rely on findings to allocate resources wisely. Patients, in turn, experience better outcomes through informed care. While challenges remain, the direction of progress is clear. By continuing to invest in research, society moves closer to a future with stronger solutions.

How Exercise and Movement Improve Quality of Life for Older Persons

Staying active is a vital part of maintaining health and independence in later life. As we get older, our bodies naturally change, but regular physical activity can help manage these shifts, supporting both physical and mental well-being. Incorporating gentle movement into daily routines can have a significant positive impact, helping to preserve strength and vitality for years to come.

Strengthening the Body and Preventing Falls

One of the most important benefits of regular movement is its effect on muscle strength, bone health, and balance. Activities that build strength can help counteract the natural decline in muscle mass and bone density that occurs with age. This is important because stronger muscles and bones reduce the risk of falls and related injuries, such as fractures.

Exercises that focus on balance and coordination are particularly effective in preventing falls. Simple movements can improve stability and confidence on your feet. Activities like brisk walking, swimming, or cycling also support cardiovascular health by strengthening the heart and improving circulation.

Boosting Mental and Emotional Health

The connection between physical activity and mental well-being is well-established. Exercise releases endorphins, which can improve mood and act as a natural stress reliever. Regular movement has been shown to reduce feelings of anxiety and depression while promoting a sense of satisfaction. It can also lead to better sleep, which is often a challenge for older persons.

Beyond mood, physical activity supports cognitive function. Engaging in activities that require focus and coordination can help keep the mind sharp. Some studies suggest that regular exercise may help maintain memory and thinking skills as we age. Group activities can also provide valuable social engagement, reducing feelings of loneliness.

Gentle Exercises to Get Started

You do not need to engage in strenuous workouts to see benefits. Even light activity is better than none at all. Simple, low-impact movements can be easily incorporated into your day. Always speak with a healthcare provider before beginning a new exercise programme, especially if you have existing health conditions.

Here are some gentle exercises that can be done at home:

Chair-based movements: Seated leg lifts and upper body twists can help improve flexibility and strength without putting pressure on joints. Simply standing up from a chair without using your hands is a great way to build leg strength.
Walking: A daily walk is an excellent low-impact activity that supports heart health and mobility. Walking heel-to-toe can also help improve your balance.
Stretching: Gentle stretches help maintain flexibility and can relieve muscle stiffness. Simple ankle rotations and shoulder stretches can be done while seated or standing.
Balance exercises: Standing on one foot while holding onto a stable surface can build stability over time. As you gain confidence, you can try holding the position for longer periods.

Putting It Into Practice

Consider the case of a man who became hesitant to leave his home after a minor stumble. The fear of falling caused him to limit his activities, leading to increased stiffness and a decline in his confidence. A family member suggested he start with simple chair exercises for a few minutes each day. Over several weeks, he noticed his leg strength improving. He then began taking short, supervised walks around his garden. This gradual approach helped him rebuild his physical strength and, just as importantly, his confidence. His improved mobility meant he could continue living independently with less worry.

Embracing regular movement, no matter how small it starts, is a powerful way to enhance your quality of life. It supports physical health, sharpens the mind, and lifts the spirits. For those who may need assistance with movement and daily activities, exploring options for safe mobility support at home can provide the confidence and help needed to stay active. Building a routine of gentle exercise helps maintain independence and allows for a more fulfilling and active life.

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1. Introduction

2. The Physiology of Delayed Intervention and the “Long Lie”

3. Technological Evolution: Accelerometry and Algorithmic Detection

4. Psychosocial Impact on the Dyad: User and Caregiver

5. Economic Implications for Healthcare Systems

6. Discussion: The Convergence of Monitoring and Telehealth

7. Conclusion

References

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Abstract

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How this oral GLP-1 option works in the body

Why this mechanism matters

Who may consider it

Symptoms, goals, and everyday challenges

Setting realistic targets

Recognizing early signals of change

Getting started safely: timing, dosing, and interactions

Baseline checks and medical history

Other medicines and low-sugar risk

Class context and options

Managing common side effects and staying consistent

Ways to reduce nausea and reflux

If symptoms persist

Protecting hydration and digestion

Nutrition, activity, and daily routines that reinforce progress

Meal planning and portion balance

Movement that fits your life

Sleep, stress, and alcohol

Monitoring progress and knowing when to adjust

What to track weekly

When readings are off target

Safety signals to discuss promptly

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1. A Creamy Nut Loaded With Good Fats

2. Supporting Better Cholesterol and Blood Vessels

3. Low-Carb, Blood-Sugar-Friendly Energy

4. Brain and Nerve Support From Fats, Vitamins, and Antioxidants

5. Surprisingly Satisfying for Weight Management

6. Tiny Source of Fiber and Protective Compounds

7. A Nutrient-Dense Upgrade for Everyday Meals

In Conclusion

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Progress in Memory Health Studies

The Value of Clinical Research in Cognitive Disorders

Understanding the Role of Alzheimer’s Trials

The Impact of Technology on Memory Research

The Broader Public Health Perspective

Wrap Up

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Strengthening the Body and Preventing Falls

Boosting Mental and Emotional Health

Gentle Exercises to Get Started

Putting It Into Practice

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