Search Results (4,499)

Background: Identifying factors that predispose futsal athletes to anterior cruciate ligament (ACL) injuries is crucial for developing effective prevention strategies. This study aimed to determine whether specific dermatoglyphic markers are associated with an increased risk of ACL injury in this population. Methods: This retrospective case–control study analyzed 212 former male futsal athletes, divided into an injury group (n = 85 with a history of ACL injury) and a control group (n = 127 without injury). Fingerprint patterns (arches, loops, and whorls) and quantitative line counts were collected and analyzed using the dermatoglyphics method. Chi-square tests and log-linear regression were used for statistical analysis. Results: While no significant differences were found in the quantitative line counts between groups (p > 0.05), a significant association was identified for specific fingerprint patterns. The spiral whorl (WS) pattern on the left index finger (p = 0.043) and the right little finger (p = 0.007) was significantly more frequent in the ACL injury group. Overall, athletes presenting the WS pattern had approximately twice the odds of having a history of ACL injury (OR = 2.028, 95% CI 1.493–2.756). Conclusions: The findings suggest that specific dermatoglyphic patterns, particularly the spiral whorl, may serve as an indicator of a potential biological predisposition to ACL injuries in futsal athletes. This finding suggests dermatoglyphics could be a potential component for future multifactorial risk assessment models in futsal. Full article

The increasing recognition of interprofessional education in dentistry has further stimulated interest in digital dentistry-based convergence education as a means of fostering collaboration and enhancing clinical competence. Therefore, this study aimed to examine perceptions, experiences, perceived necessity, and educational needs regarding digital dentistry convergence education among undergraduate students majoring in dental hygiene and dental technology in South Korea. A total of 464 valid responses were collected through a structured questionnaire and analyzed for general characteristics, perceptions of convergence education, prior learning experience, perceived necessity, and preferred curriculum areas. Frequency analysis, chi-squared tests, and correlation analyses were applied. The participants’ direct experience with convergence education was limited, but more than 90% of the respondents recognized its necessity. Dental hygiene students most frequently preferred convergence with dental technology, while dental technology students preferred convergence with dental hygiene. Both groups prioritized clinical and basic courses as areas for convergence education and expected improvements in job-related knowledge as the primary educational outcome. Dental hygiene and dental technology students strongly acknowledged the importance of digital dentistry convergence education and interdisciplinary collaboration. These findings support the development of learner-centered convergence curricula and highlight the need to establish feasible educational models through curriculum innovation. Full article

Objectives: To evaluate the effects of digital health intervention (DHI) or/and personalized healthy breakfast guidance (PHBG) on the breakfast behavior and body composition of young adults in Tianjin, and to explore the underlying behavioral mechanisms using the Health Action Process Approach (HAPA) framework. Methods: In this single-blind, stratified RCT, 160 participants (n = 40/group) were randomly assigned to a control group, DHI group, PHBG group, or DHI + PHBG group. Breakfast behavior (primary outcome), HAPA constructs, and body composition were assessed at baseline and after 1 month. Group differences were analyzed using the Kruskal–Wallis test, chi-square test, and linear mixed-effects models. Mediation analysis assessed indirect effects via HAPA variables. Results: After a 1-month intervention, adherence to healthy breakfast guidelines was highest in the DHI + PHBG group (80%), followed by the PHBG (72.5%) and DHI (50%) groups, compared to 7.5% in the control group (χ² = 51.127, p < 0.001, DHI + PHBG group > DHI group: χ² = 7.912, p < 0.05). All interventions advanced participants along HAPA stages (H = 34.678, p < 0.001) and improved self-efficacy and planning. PHBG and DHI + PHBG further enhanced outcome expectations, intention, and, for the DHI + PHBG group, self-monitoring. Self-efficacy mediated 17.636% of the PHBG effect and 13.305% of the DHI + PHBG effect, and self-monitoring mediated 7.401% of the DHI + PHBG effect. Waist-to-hip ratios decreased modestly in all intervention groups (β = −0.015 to −0.013, p < 0.05), but no significant changes were observed in other body composition indices. Conclusions: DHI, PHBG, and especially their combination, improved breakfast habits in young adults, with self-efficacy as a key mediator. However, the effects of these interventions on body composition were limited due to the short duration of the trial. Full article

Background and Objectives: Clinical ethical judgments are often elicited through scenario-based (vignette-based) dilemmas that guide interpretation, reasoning, and moral judgment. Despite its importance, little is known about how healthcare professionals and students respond to such scenario-based dilemmas in Eastern European settings. This study explored differences in ethical decision-making between senior medical/dental students and practicing clinicians in Romania, focusing on how scenarios-based dilemmas influence conditional versus categorical responses. Materials and Methods: A cross-sectional survey was conducted with 244 participants (51 senior students; 193 practitioners). Respondents completed a validated 35-item questionnaire presenting hypothetical ethical scenarios across seven domains: informed consent, confidentiality, medical errors, public health duties, end-of-life decisions, professional boundaries, and crisis ethics. Each scenario used a Yes/No/It depends response structure. Group comparisons were analyzed using chi-square and non-parametric tests (α = 0.05). Results: Scenario-based dilemmas elicited frequent conditional reasoning, with “It depends” emerging as the most common response (47.8%). Strong consensus appeared in rejecting concealment of harmful errors and in treating unvaccinated families, reflecting robust professional norms. Divergences arose in areas where scenario-based dilemmas emphasized system-level duties: students more often supported annual influenza vaccination (52.9% vs. 32.6%, p = 0.028) and organ purchase authorization (76.47% vs. 62. 18%, p = 0.043), while practitioners more frequently endorsed higher insurance contributions for unhealthy lifestyles (48.7% vs. 23.5%, p = 0.003). Conclusions: Scenario-based dilemmas strongly shape moral decision-making in healthcare. While students tended toward principle-driven transparency, practitioners showed pragmatic orientations linked to experience and system stewardship. To promote high-quality clinical work and align decision-making with best practice and health policy, our findings support institutional protocols for transparent error disclosure, continuing professional development in ethical communication, the possible adoption of annual influenza vaccination policies for healthcare personnel as policy options rather than categorical imperatives, and structured triage frameworks during crisis situations. These proposals highlight how scenario-based ethics training can strengthen both individual reasoning and systemic resilience. Full article

The quality of teacher education represents a fundamental pillar for effective educational systems. European and Czech educational policies emphasise alignment with labour market demands and continuous professional development of teachers. This study examines the motivations of and barriers faced by secondary school teachers enrolled in a pedagogical study programme at the Czech University of Life Sciences Prague, contextualised within broader European and national strategic frameworks. Employing a mixed-methods approach, the research combined document analysis of international and national educational policy reports with a longitudinal questionnaire survey of 404 bachelor’s level teacher education students. Chi-square tests and sign residual analyses investigated relationships between labour market position, study motivation, and perceived obstacles. Findings reveal that employer requirements primarily drive educational professionals to pursue further qualifications, whilst other occupational groups cite personal interest as their main motivator. Time constraints emerge as the predominant barrier across all groups, followed by inadequate employer support. No significant association was identified between motivation and perceived barriers. Comparative analysis demonstrates Czech teachers’ lower remuneration satisfaction relative to other countries examined in this research. The study concludes that enhanced employer support and targeted policy measures addressing time constraints are essential for effective teacher professional development. Full article

Background and Objectives: Urban–rural health disparities reflect differences in health outcomes, healthcare access, and socio-economic conditions between populations. In Serbia, limited research has quantified how socio-demographic and socio-economic characteristics influence settlement type and healthcare utilization. The aim of this study was to examine the relationship between settlement type and socio-demographic/socio-economic factors, and to assess whether these differences are reflected in patterns of healthcare utilization. Materials and Methods: Data were drawn from the 2019 Serbian National Health Survey, a nationally representative, stratified, two-stage random sample including 12,439 adults aged ≥20 years. Settlement type (urban vs. rural) was the primary dependent variable. Descriptive statistics, Chi-square and t-tests, and bivariate and multivariate logistic regression models were used to assess associations. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated, with significance set at p < 0.05. Results: Urban residence was more likely among unmarried individuals, those living in Šumadija/Central Serbia, and those with higher education. Primary or lower education reduced the odds of urban residence, and middle-income groups were less likely to live in urban areas compared to the richest. Settlement type was not significantly associated with hospital or day hospital use. However, rural residents had lower use of prescribed medicines, higher use of non-prescribed medicines, and more frequent physiotherapy visits. Private practice use was over twice as likely in urban settlements. Conclusions: To address urban–rural healthcare disparities in Serbia, targeted strategies could include enhancing health literacy in rural areas, incentivizing physicians to work in underserved regions, expanding telemedicine and mobile health services, improving access to prescribed medications, and strengthening public–private healthcare integration to ensure equitable access across all settlement types. Full article

Background: Serious bacterial infections (SBIs) in neonates present a significant diagnostic challenge due to nonspecific symptoms and immature immune responses. Early identification is essential to ensure timely treatment and prevent adverse outcomes. This study investigates clinical, laboratory, and epidemiological parameters associated with SBI in febrile neonates. Methods: A retrospective analysis was conducted on neonates hospitalized for suspected SBI at University Hospital Split from 1 January 2023 until 31 December 2024). The data was analyzed using descriptive statistics, Mann–Whitney U test and Chi-square test. Results: The study included 71 neonates hospitalized with suspected SBI, of whom 38 (53.5%) had a confirmed SBI. Neonates with SBI had a significantly longer hospital stay (p < 0.001). C-reactive protein (CRP) levels at admission were significantly higher in the SBI group (p = 0.020), while other laboratory parameters showed no significant differences. The most common diagnosis in the SBI group was urinary tract infection (50%). In urine analysis, abundant bacterial presence, strongly positive leukocyte esterase (3+), and positive nitrite findings were significantly associated with the presence of urinary tract infection (UTI). Conclusions: In neonates with suspected SBI, elevated CRP levels and prolonged hospital stay were significantly associated with confirmed SBI. Among specific diagnoses, UTI were most frequent, with urinalysis parameters (bacteria, leukocyte esterase, and nitrites) proving useful in identifying affected cases. However, individual clinical signs showed limited diagnostic value, highlighting the importance of combining clinical and laboratory data in early recognition of SBI. Full article

Background: Although research has been conducted on older adults and social media, the relationship between social media use and social isolation remains unclear. This study aimed to explore the relationship between social isolation and the frequency of use of social media and group chats. Methods: We measured social isolation using the Japanese version of the Lubben Social Network Scale (LSNS-6) in 411 older adults people living in urban areas. We used a questionnaire to survey their use of social networking services (SNS) such as LINE, Facebook, X (formerly Twitter), and Instagram, and their use of group chats. A separate questionnaire surveyed frequency of and participation in group chats. We analyzed associations between variables with logistic regression and a chi-squared test. Results: The most used service was LINE, with 51.3% of users participating in group chat. The analysis did not show an association between frequency of social media use and social isolation. However, group chat use, especially in groups of friends and acquaintances, was significantly negatively associated with social isolation (OR = 0.30, p < 0.001). Conclusions: This study revealed that LINE group chats may ameliorate social isolation among older adults. It also suggests that research focusing on its content and usage is needed. Full article

Objective: This study explores the prevalence of violence and forced displacement as indicators of inequity among Bogotá’s elderly population, with a particular focus on how these factors affect their health and access to healthcare services. Methods: This is a subsidiary analysis of the SABE-Bogotá survey. The design was a probabilistic cluster sample of 2000 people aged 60 and over. The study was carried out by the Pontificia Universidad Javeriana’s Institute on Aging and cosponsored by Colciencias. The variables of interest were displacement and experiences of violence, assessed through self-reporting. A descriptive analysis of all variables was performed, calculating simple frequency distributions. Subsequently, dependency and association analyses were performed using Chi-square, T-tests, and multivariate logistic regressions, depending on each case. Results: 43.32% of the subjects were victims of some type of violence in the last year, among which offensive language was one of the most frequent. Individuals with severe depression (OR 2.10 [1.21–3.65]) and those who had been victims of displacement (OR 2.55, CI 95% [1.65–3.95]) had the highest risk of violence. The results reveal a direct correlation between these experiences and pre-existing health conditions. For instance, severe depression and a history of displacement were associated with a higher risk of experiencing violence, while the risk of displacement was higher among individuals with diabetes, severe depression, and, crucially, those who lacked access to health insurance. Conclusion: A high percentage of the elderly population in the city of Bogotá has been victims of different types of violence, including ones related to armed conflict and forced displacement, which is a particular and exclusive form of violence suffered by this group of people. These findings suggest that violence and displacement are social determinants of health that exacerbate inequities, underscoring the need for more inclusive health policies and improved access to medical care for this vulnerable population. Full article

Introduction: Colonization by Staphylococcus aureus—including methicillin-resistant strains (MRSA)—represents a growing public health concern, particularly in community and rural settings. In Portugal, limited data are available regarding its prevalence in populations with agricultural or animal-related exposures. Objectives: To determine the prevalence of S. aureus and MRSA nasal colonization among adults residing in the municipality of Sertã, Portugal, and to explore potential sociodemographic and behavioral factors associated with colonization. Methods: A cross-sectional study was conducted with 292 adult participants from multiple parishes of Sertã. Nasal swabs were collected for microbiological identification of S. aureus and MRSA. Data on sociodemographic characteristics, occupational exposure, animal contact, and recent antibiotic use were collected via structured questionnaires. Descriptive statistics and inferential analyses (chi-square and Fisher’s exact tests) were performed, and odds ratios were estimated. Results: The overall prevalence of S. aureus colonization was 19.9% (58/292), with MRSA detected in 4.8% (14/292) of participants, representing 24.1% of all S. aureus carriers. Colonization by S. aureus was slightly more frequent among females (51.7%) and predominantly observed in individuals aged 35–59 years. MRSA was more frequent in participants aged ≥ 60 years and was equally distributed between sexes. 57% of MRSA cases reported recent antibiotic use and all MRSA cases reported daily contact with animals—primarily domestic species. No statistically significant associations were identified between colonization and the analyzed variables, although trends suggested increased risk among individuals with animal contact and moderate to high-risk occupations. Conclusions: This study revealed a notable prevalence of S. aureus and MRSA colonization in a rural Portuguese population. Although no statistically significant associations were found, with animal contact, occupational exposure, and recent antibiotic use emerged as relevant epidemiological factors. These findings highlight the need for strengthened surveillance and further investigation into zoonotic transmission and occupational risk in rural environments. Full article

Background: The rising prevalence of neurodegenerative conditions such as dementia underscores the impact of population aging. Consequently, long-term care needs have increased and are often met by family members through informal caregiving, thereby supporting formal care systems by reducing associated costs. These caregivers face physical and mental health challenges, raising concerns about their psychological well-being and prompting interest in both clinical and psychosocial research. Ryff’s eudaimonic model offers a robust framework for the assessment of psychological well-being; yet, in Romania, data on this population segment remain limited. Objective: This study aimed to compare the psychological well-being of Romanian dementia family caregivers with a reference population from the Romanian adaptation of the 54-item Ryff Psychological Well-Being Scale, and to explore how sociodemographic characteristics relate to relevant differences across well-being dimensions. Methods: A cross-sectional study was conducted among 70 Romanian family caregivers recruited from a single clinical hospital in Bucharest, Romania. Caregivers completed the 54-item Ryff Scale (Romanian adaptation), and scores were compared to reference values using one-sample t-tests with bootstrap confidence intervals. The most relevant dimension (purpose in life) was dichotomized and further examined in relation to sociodemographic and caregiving variables using Chi-squared and Fisher’s exact tests. Results: Caregivers reported significantly lower scores compared to the reference population in purpose in life (p < 0.001, d = −1.01), personal growth (p < 0.001, d = −0.91), and positive relations (p = 0.01, d = −0.30). The most pronounced deficit was observed in purpose in life, with 85.7% of caregivers scoring below the reference mean. This dimension was further examined in relation to caregiver characteristics. Retirement status showed a statistically significant association with Purpose in Life, with retired caregivers more likely to report lower scores (χ² (1) = 4.04, p = 0.04), supported by the likelihood ratio test (p = 0.01) and a linear trend (p = 0.05). Additional marginal associations were found for household income (p = 0.14) and whether the patient slept in a separate room (p = 0.15), suggesting possible links between caregiver well-being and economic or environmental conditions. Conclusions: The study findings highlight notable psychological vulnerabilities among Romanian dementia caregivers, particularly in purpose in life and personal growth. Associations with structural and contextual factors such as retirement status, income, and caregiving environment suggest that caregiver well-being is shaped by broader socioeconomic conditions. While the magnitude of these deficits may be underestimated due to elevated stress levels in the reference group, the findings underscore the need for targeted clinical, social, and policy-level interventions aimed at strengthening existential meaning and personal development in culturally specific settings. Full article

Background and Objectives: Diabetic foot gangrene remains a major cause of lower limb amputation, driven by vascular, neuropathic, and infectious mechanisms. Identifying predictors for amputation type is essential to optimizing outcomes and reducing disability. We aimed to analyze the burden of diabetic foot gangrene and the patients’ characteristics according to the type of surgery, minor or major amputations. Methods: We conducted a retrospective observational study including 295 diabetic patients who underwent surgery for foot lesions at a Romanian tertiary center (January 2023–December 2024). Patients were classified according to surgical outcome as minor (toe/foot-level) or major (below/above-knee) amputations. Clinical, demographic, and pathological variables were compared between groups. Statistical analysis was performed with IBM SPSS Statistics 20.0. Categorical variables were expressed as frequencies and percentages, and continuous variables as mean ± SD or median (min–max). Group comparisons used Student’s t-test, Mann–Whitney U, Chi-square, or Fisher’s exact test, and binary logistic regression was applied to calculate odds ratios (OR) with 95% confidence intervals (CI). Results: Among the patients included (mean age 64.8 ± 10.8 years; 69.2% male), 191 (64.7%) underwent minor amputations/debridement and 104 (35.3%) required major amputations. Patients with major amputations were older (66.8 ± 11.3 vs. 63.7 ± 10.4 years, p = 0.012) and less frequently male (56.7% vs. 75.9%, p = 0.001). Lesion extension to the foot or beyond strongly predicted major amputation (p < 0.001). Peripheral arterial disease was more prevalent in the major group (85.6% vs. 65.4%, OR = 3.13, 95% CI = 1.68–5.84), while neuropathy was associated with minor procedures (12.6% vs. 3.8%, p = 0.015). Anemia (70.2% vs. 56.5%, p = 0.021) and leukocytosis (68.3% vs. 49.2%, p = 0.002) were also independent predictors of major amputation. Conclusions: The study highlights the need for early detection, coordinated multidisciplinary care, and personalized assessment of diabetes burden and its complications to minimize the risk of major limb amputation. Full article

Background/Objectives: Solitary plasmacytoma of bone (SPB) results from abnormal proliferation of plasma cells and accounts for 2–5% of all plasmacytic malignancies. Radiation therapy is the standard of care in treating SPB due to its efficacy in controlling disease progression and optimizing patient survival. However, prior studies have highlighted disparities in radiation therapy receipt among various cancer types. In this study, we aim to investigate whether similar sociodemographic and clinical disparities exist in the treatment of SPB through use of the Surveillance, Epidemiology, and End Results (SEER) database. Methods: The SEER database was queried for biopsy-confirmed cases of SPB between 2000 and 2021 using the ICD-O-3 histology code 9731/3 and primary site codes C40.0–41.9. Chi-square tests, Fisher’s exact tests, and multivariable logistic regression were completed using SPSS v29.0.2, with significance set to p < 0.05. Results: A total of 4139 patients were identified, of which 75.3% received treatment with radiation therapy. Multivariable analysis revealed that low-income patients making less than $74,999 annually (aOR 0.80, 95% CI 0.67–0.97), as well as those from non-Hispanic Asian/Pacific Islander (aOR 0.49, 95% CI 0.33–0.73) and Hispanic (aOR 0.77, 95% CI 0.60–0.98) racial and ethnic groups, were significantly less likely to receive radiation therapy. Conclusions: These findings reveal notable disparities in radiation therapy utilization for SPB patients based on income and race and ethnicity, emphasizing the need for interventions to address systemic inequities, improve access to care, and ensure that all patients receive high-quality cancer care to optimize long-term outcomes. Full article

Physical activity (PA) has been identified as a protective factor for adolescent mental health. This study analysed the association between PA and levels of anxiety, depression, and stress among adolescents, considering gender, educational stage, and type of sport. A cross-sectional design was conducted with 106 Spanish secondary school students aged 12–16 years. Data were collected through a self-reported questionnaire on PA participation and the validated DASS-21 scale. Descriptive statistics, chi-square (χ²) tests, and adjusted residual analyses were performed. The results showed a significant negative association between PA and anxiety (χ² = 303.34, p < 0.01), stress (χ² = 310.64, p < 0.01), and depression (χ² = 324.32, p < 0.01). Non-athletes presented higher levels of psychological problems compared with active peers, while girls and older students showed greater vulnerability. Adolescents involved in team sports exhibited lower anxiety and stress than those participating in individual sports. In conclusion, higher participation in physical activity, particularly team-based disciplines, is associated with better mental health in adolescents. These findings reinforce the importance of integrating regular physical activity into school contexts to support psychological well-being during adolescence. Full article

This study intends to identify and quantify the individual, perceptual, and contextual factors associated with odor-related perception and to assess the perception of odor sources according to meteorological conditions. Two face-to-face seasonal community surveys were conducted using stratified random sampling with proportional allocation, yielding representative samples of residents in a southern Brazilian city, where mild constant temperatures throughout the year and shifting prevailing wind directions expose residents to different odor sources. Chi-Square tests were applied to assess associations between odor perception and qualitative variables, while logistic regression was used to identify predictors of higher annoyance. Results showed that prevailing wind direction influenced source attribution, with steel industry and sewage-related sites most frequently cited. Proximity to the steel plant increased both source recognition and annoyance levels. Reported impacts included closing windows and reducing outdoor activities. Self-reported respiratory problems consistently predicted higher annoyance levels in both surveys. The statistical methods were effective in analyzing the likelihood of odor-related perception and its relationship with explanatory variables. These findings highlight the value of a data-driven approach—specifically, integrating wind direction, source proximity, and community-based perception—to support urban environmental management and guide odor mitigation strategies. Full article