Search Results (21,812)

Background/Objectives: Routine depression screening is recommended in primary care, yet depression may remain underdetected among Filipino American patients. Provider-level factors, including culturally responsive preparation, communication challenges, workflow constraints, and attitudes toward mental health screening, may influence opportunities for early identification and referral. This exploratory cross-sectional study examined provider perspectives on barriers to depression screening and mental health discussions with Filipino American patients using the Capability, Opportunity, Motivation, and Behavior (COM-B) framework as an implementation-informed organizing lens. Methods: A cross-sectional survey was conducted among healthcare providers (N = 81) with experience caring for Filipino American patients in the United States. Survey items assessed provider confidence, perceived adequacy of mental health training, cultural and communication barriers, perceived stigma-related concerns, comfort discussing mental health, and interest in additional culturally responsive resources. Items from the adapted Attitudes Toward Assisting Filipino American Patients with Mental Health Symptoms (ATFA) scale and one item from the Mental Illness Clinicians’ Attitudes scale were conceptually mapped to the COM-B domains. Descriptive statistics, internal consistency estimates, and nonparametric tests were used to summarize findings and explore differences by provider characteristics. Results: Most providers recognized that Filipino cultural beliefs and customs may influence mental health help-seeking and symptom expression. Although many providers reported confidence identifying mental health symptoms, fewer reported adequate training to assess mental health concerns among Filipino American patients. Communication barriers, stigma-related concerns, and interest in additional culturally tailored resources were commonly reported. COM-B domain scores were not significantly associated with provider role or years of clinical experience. Providers who identified as Filipino reported greater perceived capability and opportunity related to initiating mental health discussions compared with non-Filipino providers. Conclusions: Findings suggest that provider motivation to address mental health concerns may be present, while capability- and opportunity-related barriers, including culturally responsive training, communication support, workflow integration, and referral resources, may remain important targets for future implementation efforts. Because this exploratory study used a modest convenience sample and an adapted measure that requires further psychometric validation, the findings should be interpreted with caution. Larger studies using validated instruments are needed to examine further provider-level determinants of culturally responsive depression screening among Filipino American patients. Full article

Education is a well-established determinant of health and well-being, yet its benefits may not be equally distributed across populations. This study examines whether educational attainment predicts psychological well-being, financial difficulty, and social support among deaf adults and whether these associations differ from those observed among hearing adults. Using nationally representative data from the U.S. Household Pulse Survey, we analyzed a weighted sample of adults aged 25–54 (N = 36,810), employing multivariate linear regression models that included education, hearing status, their interaction, and demographic covariates. Higher education was generally associated with more favorable outcomes among deaf adults, particularly in psychological well-being and social and emotional support, though effects were modest and less consistent for financial difficulty. Hearing adults reported significantly better outcomes across all domains, and interaction effects indicated that the benefits of education were significantly larger for hearing adults than for deaf adults. These findings suggest that while education remains beneficial for deaf people, its protective effects are limited, likely due to persistent structural and communication barriers. Given the importance of education, improving access alone will not eliminate disparities in well-being without concurrent efforts to address structural and social inequities. Full article

The study aims to investigate the Health-Related Quality of Life (HRQOL) in lung cancer survivors, comparing it with the HRQOL of survivors of other types of cancer, analyzing its association with clinically significant distress, and exploring the modulating role of sociodemographic, clinical, and psychosocial variables. A total of 141 lung cancer survivors who had completed treatment with curative intent and were disease-free completed the Quality of Life in Adult Cancer Survivors questionnaire (QLACS), the Brief Symptom Inventory-18 (BSI-18), the Medical Outcomes Study–Social Support Survey (MOS-SSS), and the Utrecht Proactive Coping Competence scale (UPCC). Several multivariate analyses of variance (MANOVA) were performed to address the study objectives. Statistical analysis was performed using IBM SPSS Statistics 22.0. The overall HRQOL of lung cancer survivors did not differ from the HRQOL of hematologic, breast, and gynaecologic cancer survivors and was lower than that of colorectal, head/neck, prostate, and melanoma cancer survivors. HRQOL was associated with clinically significant distress. Younger age, female sex, lower levels of proactive coping, and less positive social interaction were independently associated with worse HRQOL in lung cancer survivors. The overall HRQOL of lung cancer survivors is among those with the poorest HRQOL compared with other cancer survivors’ groups. The modifiable nature of the psychosocial variables that characterize the risk profile (with the exception of sociodemographic ones) allows for the establishment of more ambitious goals than the simple establishment of subgroups on which to prioritize care. The team of professionals involved in the care of lung cancer survivors should also provide intervention strategies that improve their well-being. Full article

Background/Objectives: Healthcare-associated infections (HAI) affect an estimated 4.3 million patients annually in EU/EEA hospitals; yet, reported prevalence rates vary nearly fivefold across member states, a degree of variation inconsistent with clinical or epidemiological differences alone. Romania exemplifies this paradox: it records one of the lowest reported HAI prevalence rates in Europe while sustaining one of the highest antimicrobial consumption levels on the continent. This study examines whether antimicrobial consumption data can serve as a cross-check on reported HAI prevalence across EU/EEA countries and discusses implications for European funding mechanisms. Methods: A cross-sectional ecological analysis was conducted using data from 26 EU/EEA countries. HAI prevalence was extracted from the ECDC Point Prevalence Survey 2022–2023; antimicrobial consumption indicators from the ESAC-Net Annual Epidemiological Report 2023. Pearson and Spearman correlations, multiple linear regression with Cook’s distance diagnostics, bootstrap resampling, and k-means cluster analysis were performed. Variance inflation factors were computed to assess multicollinearity; community sector AMC was excluded from the final regression model due to near-perfect collinearity with total AMC. Results: No antimicrobial consumption indicator was significantly associated with reported HAI prevalence (total AMC: r = 0.274, p = 0.175; broad-spectrum hospital proportion: r = 0.082, p = 0.692); bootstrap confidence intervals confirmed the instability of all estimates. Romania and Bulgaria were identified as influential outliers whose consumption profiles are substantially inconsistent with their reported infection rates, with model-based estimates of 7.3% and 7.0% respectively against reported values of 3.1% and 3.7%. Cluster analysis placed both countries in an isolated group with the highest antimicrobial consumption and broad-spectrum hospital antibiotic use in the sample alongside the lowest reported HAI prevalence, a configuration not replicated elsewhere in the EU/EEA. Conclusions: The absence of a significant aggregate association between antimicrobial consumption and reported HAI prevalence, combined with the systematic identification of Romania and Bulgaria as influential observations whose consumption profiles are inconsistent with their reported infection rates, raises the hypothesis of surveillance underreporting as a plausible explanation, though the ecological design does not permit causal inference and alternative explanations, including differences in antimicrobial stewardship maturity and prescribing culture, cannot be excluded. Antimicrobial consumption indicators, particularly the proportion of broad-spectrum antibiotics in hospital use, may serve as a proxy for HAI burden where direct surveillance is incomplete, and their integration into European surveillance frameworks is warranted. These findings have direct policy relevance for the allocation of resources under EU4Health, EU-JAMRAI 2, and national recovery and resilience programmes, and support investment in surveillance reform as a precondition for effective infection prevention programmes. Full article

Background: With accelerated population aging, depressive symptoms in later life have become a major public health issue. The Chinese version of the MIND (cMIND) diet is a neuroprotective dietary pattern adapted to Chinese dietary habits. Previous studies have found that adherence to the cMIND diet is associated with lower levels of depressive symptoms, but the underlying statistical association patterns remain unclear. This study adopted a statistical moderated mediation framework to characterize cross-sectional associations, to examine the direct association between cMIND diet adherence and depressive symptoms, the statistical associational mediating pattern of social participation, and the exploratory moderating effect of exercise on the first segment of the statistical mediation chain. Methods: Data were drawn from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), including 8578 adults aged 65 years and older. Cross-sectional mediation and moderated mediation analyses were conducted using Model 4 and Model 7 of the PROCESS macro, with 5000 bootstrap resamples to test the significance of cross-sectional statistical indirect effects. Results: cMIND diet adherence was negatively associated with depressive symptoms (B = −0.414, p < 0.01). Social participation showed a statistical partial mediation pattern in this association, with the statistical indirect effect accounting for 14.02% of the total effect. Exploratory moderated mediation analysis showed that exercise moderated the first segment of the statistical mediation chain (B = 0.283, p < 0.01). The positive association between cMIND diet adherence and social participation was stronger among exercisers (simple slope = 0.635, p < 0.01) than among non-exercisers (simple slope = 0.352, p < 0.01). Correspondingly, the indirect association between cMIND diet adherence and depressive symptoms through social participation was stronger in the exercise group (indirect effect = −0.064, 95% CI [−0.079, −0.050]) than in the non-exercise group (indirect effect = −0.036, 95% CI [−0.045, −0.026]). Conclusions: Among Chinese older adults, higher adherence to the cMIND diet is significantly associated with lower levels of depressive symptoms, and this association shows a partial statistical mediation pattern linked to higher social participation. The positive association between cMIND diet adherence and social participation is more pronounced among adults who engage in regular exercise, which corresponds to a more pronounced statistical indirect association with depressive symptoms through social participation. As these findings are based on cross-sectional data and reflect only associational patterns, and given the limited effect magnitude, they provide only preliminary theoretical reference for the development of intervention strategies integrating dietary improvement and social participation promotion for late-life depressive symptoms. Full article

Q fever, caused by Coxiella burnetii, remains an important zoonotic disease with significant implications for animal health, livestock production, and public health. Epidemiological data regarding the circulation of C. burnetii in Romania remain limited, particularly in the western region of the country. This study aimed to assess the observed seropositivity and geographic distribution of anti-C. burnetii antibodies among sampled small ruminants from Western Romania. A cross-sectional sero-epidemiological survey was conducted using 546 serum samples collected from sheep (n = 451) and goats (n = 95) originating from five counties (Timiș, Arad, Bihor, Caraș-Severin, and Hunedoara). Sera were tested for IgG antibodies against C. burnetii using a commercial indirect enzyme-linked immunosorbent assay (ELISA). Overall, 87 animals were seropositive, corresponding to an observed seropositivity of 15.9% (87/546). Species-specific seropositivity was significantly higher in goats (25.3%) than in sheep (14.0%) (p = 0.006). Seropositive animals were detected in all surveyed counties, with prevalence ranging from 5.1% in Arad County to 21.3% in Timiș County. Significant geographic variation in seroprevalence was also observed among the investigated counties (p = 0.040). These findings indicate widespread serological evidence of exposure to Coxiella burnetii among the sampled small-ruminant population in Western Romania and reveal heterogeneous exposure patterns associated with both host species and geographic location. Continued surveillance integrating serological and molecular approaches is warranted to better characterize the epidemiology and transmission dynamics of C. burnetii within a One Health framework. Full article

Background/Objectives: In Romania, diabetes mellitus remains a significant public health challenge, characterized by high prevalence and significant undiagnosed cases. This study assessed the prevalence of elevated glycated hemoglobin (HbA1c) levels within the adult population participating in the European Health Examination Survey (EHES) and examined their associations with major cardiometabolic risk factors, subjective health perception, and patient awareness of previously diagnosed chronic conditions. Methods: This cross-sectional study analyzed data from the EHES in Romania, including systematic, population-weighted sample of adults aged 25–64 years. Data were analyzed using the Complex Samples module in SPSS, version 29.0 (IBM Corp., Armonk, NY, USA). HbA1c levels were measured through standardized clinical examination, with values of 5.7–6.4% classified as at risk for diabetes mellitus, and values ≥6.5% as diabetes mellitus. Results: Among 5380 representative adults, the prevalence of elevated HbA1c (≥6.5%) was 7.1%, while prediabetes (HbA1c 5.7–6.4%) affected 35.4% of participants; both conditions were significantly more prevalent in men than in women. Elevated HbA1c and prediabetes were substantially more frequent among individuals with hypertension and hypercholesterolemia, and glycemic control among participants with previously diagnosed diabetes was generally poor (all p ≤ 0.05). Individuals who are aware of having a chronic health condition appear to engage more actively in self-care practices, including increased physical activity and more frequent monitoring of key biological parameters. Conclusions: Elevated HbA1c and prediabetes were more prevalent than estimates reported in other studies using HbA1c-based diagnostic criteria. These observations highlight the importance of early detection and timely diagnosis, as awareness of one’s health status may facilitate healthier behaviors that mitigate metabolic complications. Full article

Teacher discipline serves as a vital instructional and managerial tool for facilitating adolescent development and exerts profound influences on students’ physical and mental well-being. Grounded in expectancy violation theory, deservingness justice theory, and life history theory, the present study adopts data from the China Education Panel Survey (China Education Panel Survey, CEPS, 2013–2014) to explore the association between teacher disciplinary intensity and adolescents’ mental health problems and rigorously tests violation severity as the first-stage moderator and family migration status as the second-stage moderator within a moderated moderation framework. This study employs cross-sectional data from a nationally representative sample of 17,788 adolescents, and statistical analyses, including descriptive statistics, bivariate correlations, and moderation effect analyses, were conducted using SPSS 24.0 and the PROCESS macro. The empirical results demonstrate significant positive associations between teacher disciplinary intensity, student violation severity, and adolescent mental health difficulties. Family migration status is negatively correlated with perceptions of disciplinary appropriateness and the degree of student violation. Furthermore, violation severity negatively moderates the predictive relationship between discipline intensity and mental health problems. Although intensified teacher discipline significantly predicts higher levels of adolescent mental health problems across both high- and low-violation contexts, such adverse effects are substantially weakened when student violations are severe. Critically, the interactive pattern between discipline intensity and violation severity is more salient for migrant adolescents than for their non-migrant peers. These findings offer a clear theoretical explanation for why reasonable and equitable school discipline can protect and promote adolescents’ mental health. Full article

This study investigated the perceptions and practices of disinfectant use among students at the City University of New York (CUNY) before, during, and after the peak of the COVID-19 pandemic, with a focus on behaviors observed following a controversial statement made by President Donald Trump in April 2020 suggesting the potential use of disinfectants as a treatment for a SARS-CoV-2 infection. Utilizing an online survey of 441 CUNY students, data was collected on cleaning and disinfection behaviors during four distinct periods: pre-pandemic (January–February 2020), during the pandemic’s height (March–April 2020), after the pandemic’s height (June–August 2020), and following the aforementioned presidential statement. Data patterns illustrate an increase in cleaning frequency and disinfectant use during the peak of the pandemic, followed by a notable decrease after the presidential statement. The data also illustrated potentially dangerous practices, such as misting the body with cleaning sprays and using household cleaners on bare skin, though these behaviors generally decreased after the peak of the pandemic. The study highlights the impact of public health communication and the role of misinformation in shaping hygiene practices during a crisis. It underscores the need for clear, evidence-based messaging to promote safe and effective disinfectant use and to counter misinformation that may lead to harmful behaviors. This novel research contributes to the understanding of how a specific student population responded to the pandemic and provides insights for future public health interventions. Full article

Background: Burn injuries have complex physical and psychological consequences, making holistic rehabilitation essential. This mixed methods service evaluation explored the acceptability and perceived benefits of a peer-supported breakfast group delivered as part of routine occupational therapy practice for adult inpatient burn survivors. Methods: A tailored survey integrating PROMIS items with open-ended questions was completed by nine participants. All English-speaking inpatients aged >18 years who attended were invited to participate. In total 36 patients attended and 9 completed the survey (n = 36; n = 9). A convergent design integrated open-ended survey responses with PROMIS patient-reported outcome items, analysed thematically and interpreted using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) and MMR-RHS (Mixed Methods Reporting—Rehabilitation and Health Sciences) frameworks. Results: Quantitative findings suggested high perceived physical function and strong emotional support, with low anxiety and depression, and low social isolation. Reflexive thematic analysis generated four themes: fostering human connection and emotional wellbeing; restoring autonomy and confidence; preparing physically and psychologically for discharge; and the influence of the rehabilitation environment. Conclusion: While descriptive only, findings provide early insight into the value of peer-supported group activity in inpatient burn care. Larger controlled studies with baseline measurement are needed to evaluate effectiveness and implementation feasibility. Full article

Employment is a key social determinant of health, yet autistic individuals face high levels of unemployment, with consequences for well-being and social inclusion. This exploratory study examined stakeholder perceptions regarding the inclusion of autistic individuals in public administration employment within the Italian context, considering its potential role in advancing health equity through stable and regulated work environments. A cross-sectional online survey was conducted to explore perceptions of current inclusion measures, the importance of specific inclusion domains, and the usefulness of potential support tools. Participants (n = 62) included autistic adults, family members, and professionals with expertise in autism. Quantitative data were analyzed using non-parametric tests, while qualitative responses were examined through reflexive thematic analysis. Quantitative findings showed that educators express more positive views on existing measures and greater support for new interventions compared to family members; autistic participants report intermediate perspectives. Qualitative analysis identified five areas: recognition of autistic perspectives, need for interventions, support figures, work personalization, and staff training. Although the study does not evaluate intervention effectiveness, the findings highlight stakeholder priorities and perceived needs related to employment inclusion. While exploratory and based on a limited sample, the results may inform future research and the development of more inclusive public employment practices. Full article

Aim: This study aims to explore how competitive psychology mediates the relationship between involution and depression–anxiety–stress among college students from three universities in Anhui Province, China. Background: Against the global involution trend, college students excessively pursue academic achievements, leading to heightened self-involution and psychological issues like anxiety and depression, while competitive psychology’s mediating role here remains under-explored. Methods: A multi-cross-sectional survey in three Anhui universities used convenience sampling to collect 592 samples. Results: Three validated scales assessed involution, competitive psychology, and depression–anxiety–stress, with mediation analysis via SPSS Process 3.3. The results showed strong positive correlations between the three variables (r = 0.827, 0.638, p < 0.001), and competitive psychology significantly mediated the involution–depression–anxiety–stress relationship (r = 0.110). Conclusions: The observed data are consistent with a correlational mediation model among college students from three universities in Anhui Province. The findings provide theoretical references for local university educational practice and mental health guidance, without causal inference or nationwide policy generalization; future research should explore related mechanisms and interventions. Clinical Relevance: This study provides empirical evidence for nursing and mental health professionals to design targeted psychological interventions for college students, helping mitigate the negative impacts of involution and competitive pressure on mental health in clinical practice. Full article

Background: Myopia has become a major public health issue for the ocular health of children and adolescents worldwide and has been found to be associated with dietary factors, including the consumption of beverages. However, current research lacks detailed classification and longitudinal analysis of the relationship between different types of commercial non-alcoholic beverages and children’s visual function and related measurements. Methods: From 2021 to 2024, we conducted a four-year cohort study in Shanghai, China, aiming to explore the association between consumption of various commercial non-alcoholic beverages, including sugar-sweetened beverages (SSBs), non-sugar-sweetened beverages (NSSBs), and fruit and vegetable beverages, and the vision of children and adolescents. Participants were surveyed once a year, including the collection of beverage consumption frequency using a semi-quantitative food frequency questionnaire (FFQ), as well as ophthalmological examinations covering binocular uncorrected visual acuity, refraction, and axial length (AL). A total of 5199 participants with complete data were included in the study. Generalized Estimating Equations (GEE) were used to analyze the longitudinal associations between the frequency of consumption of various beverages and myopia as well as vision-related measurements. Results: Among the 5199 participants included in the study, 37.9% were defined as myopic at baseline, with this proportion rising to 65.6% by the end of the study in 2024. Participants with myopia typically had lower consumption frequencies of 100% and non-100% fruit and vegetable juices and higher consumption frequencies of carbonated beverages and milk tea beverages. Increased consumption of 100% and non-100% fruit and vegetable juices was associated with reduced odds of myopia, increased spherical equivalent (SE), and decreased AL in children. In contrast, increased consumption of carbonated beverages, milk tea beverages, and NSSBs was associated with higher odds of myopia, reduced SE, and increased AL in children. Conclusions: Different types of commercial non-alcoholic beverages have varying effects on the vision of children and adolescents. Consumption of carbonated beverages, milk tea beverages, and NSSBs is associated with myopia and AL growth in children, whereas drinking fruit and vegetable juice has been found to be associated with slower myopia progression. Full article

Avian metapneumovirus (aMPV) is an economically significant respiratory virus of poultry that causes major losses due to reduced egg production and increased susceptibility to secondary infections. It has global significance in poultry production systems and mainly affects turkeys, chickens, and ducks. It was first detected in South Africa in 1978 and is classified into four distinct subtypes (A–D) based upon sequence divergence of the glycoprotein (G) gene. Subtype C has historically been the dominant subtype in the US, first detected in the late 1990s, causing approximately $15 million economic loss per year in Minnesota alone. However, after a decade, aMPV re-emerged in the fall of 2023. Subtype A in California and B in North Carolina was detected for the very first time in the US, impacting multiple states, with an estimated $112 million loss in Minnesota alone. The most recent US Animal Health Association (USAHA) annual survey has now ranked aMPV as the most frequently reported issue in turkey production. Even after four decades of virus identification, areas such as transmission routes, host–virus interactions and tissue tropism within the host are not studied in detail. Addressing these gaps via current modernized research tools is crucial in minimizing the impact of aMPV on the poultry industry. Therefore, this review article summarizes current knowledge on aMPV while identifying critical research gaps and emphasizing future research directions for combating aMPV and supporting long-term sustainability of the turkey industry. Full article

Background: Workplace wellbeing has become a key focus of occupational and public health, with increasing attention to mental health, psychosocial risks, fatigue, and work–life balance. However, limited evidence compares employee and employer perspectives, distinguishes support availability from support use, or examines whether wellbeing is more closely associated with isolated interventions or the broader support environment. Method: Cross-sectional survey data were collected from public-sector employees (N = 1307) and employers (N = 321) in Ontario, Canada. Analyses compared employee and employer ratings of workplace wellbeing dimensions and supports, examined support availability and use, and assessed associations between support use and perceived workplace impact on personal wellbeing using linear regression models. Results: Employees consistently rated workplace wellbeing dimensions and supports as more important and more effective than employers. Several supports were widely available, but availability varied across sectors and did not consistently translate into use, particularly for mental health, psychological health and safety, and fatigue-related supports. Among employees using at least one support, the cumulative number of supports used was positively associated with wellbeing (B = 0.196, p < 0.01), whereas few individual supports demonstrated independent associations. Fatigue management programs showed a consistent positive association across model specifications. Conclusions: Findings suggest that workplace wellbeing is associated with the broader support environment, not only with individual programs. Employee-informed, integrated approaches that improve both access and uptake may strengthen workplace wellbeing; however, causal interpretation is limited by the cross-sectional design. Full article