Search Results (9,630)

Gestational weight gain (GWG) and birth weight (BW) have a multifactorial etiology, which makes identifying the most influential determinants difficult. The association between variants of the FTO and LEPR genes has been explored as contributing factors to obesity in various age groups; however, their role in GWG and BW in adolescent mothers and their offspring is uncertain. To determine whether the presence of polymorphisms rs9939609 (FTO) and rs1137101 (LEPR) is associated with gestational weight gain and newborn weight in a cohort of adolescent mothers. Methods: A prospective cohort study of 305 mother-child dyads was conducted between 2020 and 2024. Genotyping of the single nucleotide variants (SNVs) rs9939609 of the FTO gene and rs1137101 of the LEPR gene was performed using real-time PCR and high-resolution melting analysis (qPCR-HRM), using maternal peripheral blood and umbilical cord blood samples. GWG, BW, energy intake, and other perinatal data were recorded and classified. Genetic data from 305 mother–offspring dyads were analyzed. The median maternal age was 16 years, and 71.4% had a normal pre-pregnancy body mass index (BMI). The most frequent genotypes were TT for FTO rs9939609 and AG for LEPR rs1137101. In both groups, the genotypic distribution significantly deviated from Hardy–Weinberg equilibrium (p < 0.0001). The AA genotype of FTO was associated with a higher probability of excessive gestational weight gain (GWG) after adjustment for pre-pregnancy BMI and dietary and sociodemographic factors. High protein and lipid intake increased the risk of excessive GWG, whereas adequate intake of carbohydrates and legumes showed a protective effect. An initial significant association was identified between the LEPR rs1137101 variant (AA allele) and low birth weight (LBW); however, this association was lost after adjustment for confounding factors. The FTO rs9939609 variant was significantly associated with GWG. On the other hand, the LEPR rs1137101 variant in the offspring showed an association with BW categorized by percentiles (in crude analysis), while the FTO variant showed no relationship with birth weight. Full article

Gender-based and sexual violence are major public health concerns, and norms about consent are central to their prevention. This study examines how attitudes toward sexual consent relate to digital sexual consent and to the occasional feeling of distrust in public consent campaigns and institutions. We conducted a cross-sectional online survey embedded in the evaluation of a municipal consent campaign in Zaragoza (Spain). Adults (N = 404; 56.7% women) completed a 14-item short version of the Sexual Consent Scale–Revised, two items on digital sexual consent, and three items on institutional reluctance (perceived “sermonizing” tone, distrust in effectiveness, and lack of personal identification with the message). Correlation and multiple regression models with robust standard errors were estimated, controlling for gender, age, education, income, relationship status, and social media use. Attitudes toward sexual consent were strongly and positively associated with digital sexual consent. Gender was the most consistent sociodemographic correlate: men showed less egalitarian attitudes than women across all consent measurements. Institutional reluctance was systematically related to less supportive consent attitudes: perceiving institutional messages as exaggerated or personally irrelevant predicted lower support for sexual and digital consent norms, whereas trust in the campaign’s effectiveness was associated with more egalitarian attitudes. The findings support the continuity between sexual and digital consent and highlight gender and institutional trust as key determinants for the prevention of gender-based and sexual violence. Public health and social policies should integrate digital consent into consent education and co-design campaigns that minimize defensive reactions and rebuild trust in institutions. Full article

The article provides a comprehensive review of empirical studies on consumer attitudes, motivations, and behaviors in the functional food market. The main objective of this study is to identify groups of determinants and to update and systematize current knowledge on the influence of various factors on consumer purchasing decisions in this market. Based on an analysis of international research published between 2004 and 2025, four key groups of determinants were identified: (1) health- and trust-related factors, (2) cognitive and psychological factors, (3) perceptual and product-related factors, and (4) socio-demographic and segmentation factors. The analysis confirms that purchasing decisions in this product category are complex and multidimensional. They result from the interaction between rational factors (health-related and cognitive) and emotional-symbolic factors (psychological and sensory). The strongest predictors of functional food acceptance include perceived health benefits, trust in producers and information sources, sensory attractiveness, and product naturalness. Socio-demographic characteristics, such as age, education level, and income, further differentiate purchasing intentions and behaviors. Overall, the findings highlight the need for further comparative and cross-cultural research, as cultural and economic conditions may significantly shape consumer decisions across markets. The results obtained have both theoretical and practical implications. They contribute to a better understanding of consumer decision-making processes and emphasize the importance of promoting health awareness. Full article

Background/Objectives: Emerging evidence suggests that ultra-processed food (UPF) consumption may be associated with depressive symptoms, yet data in the early postpartum period remain limited. This pilot study aimed to examine the association between UPF intake and postpartum depressive symptoms among women in the early postpartum. Methods: In this cross-sectional pilot study, 137 women within 6–8 weeks postpartum were recruited from hospitals, maternity clinics, and online support networks in Greece. Dietary intake was assessed using a validated food frequency questionnaire and classified according to the NOVA system. UPF consumption was categorized into quartiles. Postpartum depressive symptoms were evaluated using the Edinburgh Postnatal Depression Scale (EPDS), with clinically significant symptoms defined as EPDS ≥ 13. Multivariable logistic regression analyses were conducted, adjusting for sociodemographic and lifestyle factors. Results: The prevalence of clinically significant postpartum depressive symptoms was 29.9%. No statistically significant associations were observed in adjusted models. However, a higher prevalence of depressive symptoms was observed among women in the highest UPF intake quartile (40.0%) compared with lower quartiles (25.7–28.1%). Poor sleep quality was independently associated with higher odds of depressive symptoms, whereas breastfeeding was associated with lower odds. Confidence intervals were wide, indicating limited statistical precision due to the small sample size. Conclusions: While no statistically significant association was observed in multivariable analyses, a higher prevalence of depressive symptoms was noted among women in the highest UPF intake quartile. The wide confidence intervals indicate substantial uncertainty, and the findings should be interpreted with caution. Larger, adequately powered studies are required to confirm these findings. Full article

Background: Veterinarians are pivotal to wildlife health surveillance and game-meat safety, yet these topics receive limited emphasis in many veterinary curricula. Understanding students’ perceptions can inform targeted educational improvements. Methods: We conducted a cross-sectional, anonymous online survey among students enrolled in the Integrated Master’s in Veterinary Medicine at ICBAS-UP (Portugal). The questionnaire covered sociodemographic, meat and game-meat consumption, perceived appeal of working with game animals, and multi-select views on hunting, game-meat consumption and the veterinary role. We computed descriptive statistics and tested associations between categorical variables using Pearson’s Chi-square or Fisher’s exact tests (Monte Carlo correction when appropriate). Results: Of the 391 eligible students, 152 responded (39%). The majority (76%) associated hunting with veterinary inspection of game meat and research in epidemiology and emerging diseases, and many (72%) recognized as core roles monitoring the health of game animals and the contribution to public health and environmental sustainability. Significant associations included: prior game-meat consumption with finding game animals appealing/interest in learning more; year of enrolment with recognising hunting as an economic activity and acknowledging veterinary inspection and public health contributions; and perceiving game animals as appealing with associating hunting with population control (all p < 0.05; Cramer’s V indicating weak–moderate effects). Conclusions: Students show awareness of veterinary roles in game-animal health and meat inspection, but interest in working with game animals is low and knowledge gaps persist (e.g., inspection of game meat). Findings support curricular integration of wildlife health, game-meat inspection and One Health. Multicenter studies and evaluation of educational interventions are warranted. Full article

The oral cavity performs several functions that are essential for sustaining life and carrying out daily activities. Given the importance of maintaining functional abilities for healthy aging, exploration of the adverse health outcomes that may result from impaired oral function is needed. This cross-sectional study examined oral functional status in 176 community-dwelling older adults with preserved cognitive function and activities of daily living, and analyzed the association between oral hypofunction and physical frailty. Oral hypofunction was diagnosed using seven parameters. Frailty was assessed using the Korean version of the Fried Frailty Phenotype, which focuses on physical characteristics. Independent t-tests, one-way analysis of variance, the Kruskal–Wallis test, and multiple logistic regression analysis were conducted to examine the association between oral hypofunction and frailty. The prevalences of oral hypofunction and physical frailty were approximately 48% (n = 85) and 40% (n = 71), respectively. After adjusting for frailty-related factors, including sociodemographic and health-related characteristics, higher oral hypofunction scores were associated with an increased likelihood of physical frailty (odds ratio, 1.382; 95% confidence interval, 1.017–1.876). These findings suggest that maintaining the various functions of the oral cavity, including mastication, within normal ranges and restoring impaired oral abilities as early as possible may be relevant to healthy aging. Full article

Background/Objectives: Persistent symptoms following SARS-CoV-2 infection pose a substantial burden in occupational settings. This study aimed to characterize symptoms following work-related SARS-CoV-2 infection and to assess their associations with sociodemographic and clinical factors. Methods: Data were obtained from a multicenter clinical registry of insured individuals referred for persistent symptoms 12 weeks after laboratory-confirmed work-related SARS-CoV-2 infection. Participants were assessed within a standardized post-COVID diagnostic program at six specialized clinics for occupational accident insurance in Germany. Persistent symptoms reported by ≥50% of participants were analyzed using generalized linear mixed models with random intercepts for center. Results: A total of 1511 participants (76.7% women; median age 54 years) were included, with a median interval of 16 months between infection and assessment. On average, participants reported ten persistent symptoms. The most frequent complaints were limited physical capacity (95.6%), concentration difficulties (78.8%), dyspnea (70.5%), exhaustion/tiredness (68.9%), and memory difficulties (67.5%). Individuals reporting more than ten acute symptoms had increased odds of persistent complaints (ORs between 2.1 and 4.66). Hospitalization was independently associated with persistent dyspnea (OR 1.62; 95%CI 1.17–2.25). Reinfections were linked to exhaustion and cognitive fatigue. Compared with Omicron, wild-type infection was associated with higher odds of concentration difficulties (OR 1.65; 95%CI 1.17–2.33). Comorbidities demonstrated symptom-specific associations. Conclusions: Among individuals with work-related SARS-CoV-2 infection, limited physical capacity and cognitive impairments were the most frequently reported symptoms, and higher acute symptom burden was strongly associated with the development of persistent symptoms. These findings support course-oriented evaluation and symptom-specific approaches in occupational disease assessment and management. Full article

Background and Objectives: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide and is frequently associated with multiple comorbidities. Bioelectrical impedance analysis (BIA) provides additional information on body composition and may contribute to the multidimensional assessment of patients with COPD. This study aimed to explore the relationship between BIA-derived parameters and clinical characteristics in hospitalized patients with COPD. Materials and Methods: A cross-sectional analysis of baseline data from a prospective cohort was conducted. A total of 72 hospitalized patients with COPD were included, according to predefined inclusion and exclusion criteria. All patients underwent multifrequency BIA using the InBody 380 device. Sociodemographic, clinical, and paraclinical data were collected and analyzed in relation to BIA-derived parameters. Results: Among the bioimpedance-derived parameters, phase angle (PhA) showed a significant correlation with clinical indices of disease severity, including the body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE) index and the modified Medical Research Council (mMRC) dyspnea scale. Hydration-related parameters reflecting extracellular fluid distribution were associated with the presence of heart failure as a comorbidity. In addition, the evaluation of body fat using bioimpedance identified a higher number of patients with excess body fat compared with obesity defined according to the classical body mass index–based criteria. Conclusions: BIA may provide clinically relevant information on body composition and fluid distribution in patients with COPD. These findings support the potential role of BIA as a complementary tool in the multidimensional evaluation of multimorbid patients with COPD, although further studies are needed to clarify its prognostic value and clinical applicability. Full article

Background: Drug-resistant tuberculosis (DR-TB) remains a major public health challenge in South Africa, particularly in rural settings with high HIV co-infection rates. Understanding predictors of treatment response among people living with HIV is essential for improving clinical management and programmatic outcomes. This study aimed to identify socio-demographic and clinical predictors of treatment outcomes among HIV-positive individuals diagnosed with multidrug-resistant (MDR) and extensively drug-resistant tuberculosis (XDR-TB) in rural Eastern Cape Province, South Africa. Methods: A retrospective cohort study was conducted using routinely collected clinical records of DR-TB patients initiated on treatment between January 2020 and December 2024 at two public healthcare facilities. A total of 239 patients with complete treatment outcome data were included. Treatment outcomes were classified as favourable (cured or treatment completed) or unfavourable (death, treatment failure, or loss to follow-up). Descriptive statistics were used to summarise patient characteristics, while univariate and multivariable logistic regression analyses were performed to identify factors associated with treatment outcomes. Results: Most participants were aged ≤ 39 years (58%), male (60%), unemployed (90%), and without income (80%). MDR-TB accounted for 40% of cases, rifampicin-resistant-TB (RR-TB) for 53%, and XDR-TB for 7.1%. Multivariable analysis showed that XDR-TB was the strongest independent predictor of unfavourable treatment outcome (AOR = 0.18; 95% CI: 0.06–0.58; p = 0.004). Income status was also significantly associated with outcome, with participants reporting some incomes having lower odds of favourable outcomes (AOR = 0.46; 95% CI: 0.23–0.92; p = 0.036). The model demonstrated modest predictive performance (AUC = 0.67). Conclusions: These findings highlight the dominant influence of resistance phenotype, particularly XDR-TB, on treatment prognosis among HIV-positive DR-TB patients in rural Eastern Cape. Integrating early resistance profiling, intensified clinical management of XDR-TB, and socioeconomic support mechanisms may improve treatment outcomes in high-burden rural settings. Full article

Introduction: Increasing rates of youth suicide are a growing concern worldwide. The single highest risk factor for suicide is a prior suicide attempt; however, knowledge around the broader factors that may increase the likelihood of the initial suicide attempt is limited. Understanding these risk factors is critical for clinicians to inform the development of early intervention strategies. This study examines the characteristics of a specific cohort of young people attending a tertiary mental health service in Melbourne, Victoria, following a suicide attempt or with persistent suicidal ideation. Method: A file audit of all young people attending the service was conducted from the commencement of the new service in 2022 through to the end of 2024. One hundred and seventy-one files were examined for specific data, including items such as age, gender, gender diversity, socio-economic factors and neurodivergence. Results: One-sample z proportion tests showed significantly higher proportions of young people who were LGBTIQIA+, transgender, gender diverse or non-binary (TGDNB), neurodivergent, not engaged in employment, education or training (NEET), and international students in the clinical cohort compared with the Australian population. Almost one-fifth of the cohort reported a history of trauma. Discussion: The study provides insight into characteristics observed among a cohort of suicidal young people. Findings highlight that young people from several marginalised groups were more frequently observed in this clinical cohort. The findings have implications for youth mental health services, supporting earlier identification of potential factors associated with suicidality so that prevention strategies can be implemented in a timely manner. Full article

Background/Objectives: Substance use disorder (SUD) in pregnancy is an increasingly complex public health challenge that is known to worsen maternal and neonatal outcomes. Rates of polysubstance use are steadily rising. The objective of this study was to assess the impact of co-occurring opioid and stimulant use disorder on adverse pregnancy outcomes (APOs) among inpatient pregnancy hospitalizations. Methods: We conducted a cross-sectional analysis of inpatient pregnancy hospitalizations for delivery admissions from the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS) from 2016 to 2020. ICD-10 codes were used to identify patients with opioid and stimulant use disorder and with APOs. APO was defined as a composite to include hypertensive disorders of pregnancy, antepartum hemorrhage, postpartum hemorrhage, preterm birth, and fetal growth restriction. Multivariable logistic regression analyses were undertaken to predict the likelihood of APOs among pregnancy hospitalizations with opioid use, stimulant use, or co-occurring (opioid and stimulant) use disorders. Sociodemographic covariates, including age, race and/or ethnicity, insurance payor type, and income level, were accounted for. Results: From 2016 to 2020, 32,602 delivery hospitalizations complicated by stimulant or opioid use disorder were identified. Of these admissions, 21,049 (64.6%) had opioid use disorder, 9472 (29.1%) had stimulant use disorder, and 2081 (6.4%) had co-occurring opioid and stimulant use disorder. In the entire cohort, the prevalence of APOs was significantly highest among pregnancy delivery hospitalizations with co-occurring opioid use and stimulant use disorder (1136/2081—54.6%, p < 0.001), as compared with opioid use disorder (8923/21,049—42.4%) or stimulant use disorder alone (4654/9472—49.1%). Rates of APOs increased in subsequent years for all cohort groups. Adjusting for relevant sociodemographic covariates, co-occurring opioid and stimulant use disorder was an independent predictor of APO (aOR 3.65; CI 95%, 3.34–3.99). In comparison, opioid use disorder and stimulant use disorder were independent predictors of APOs with a less strong correlation, aOR 2.22 (CI 95%, 2.16–2.29) and aOR 2.89 (CI 95%, 2.77–3.02), respectively. Conclusions: Patients with co-occurring opioid and stimulant use disorder have the highest exposure risk for APOs, acting as an independent predictor for APOs when adjusting for sociodemographic covariates. Full article

Background and Objectives: Rates of obesity have been consistently increasing in recent years across all age groups, with a notable rise among young people. Obesity represents a persistent inflammatory condition and a key contributor to various chronic health problems, such as cardiovascular disorders, metabolic abnormalities, cancer, and psychological conditions. The move from high school to university is a transitional phase accompanied by specific pressures that can affect both body weight control and mental health in students. This cross-sectional investigation aimed to investigate potential associations between excess weight and the presence of depressive and anxiety symptoms in university populations. Methods: This cross-sectional analysis included 5298 students enrolled at universities across ten geographic areas of Greece. Participants filled out questionnaires concerning demographic information and lifestyle behaviors. Levels of depression and anxiety were measured using the Beck Depression Inventory (BDI-II) and the short form of the State Anxiety Inventory (STAI-6), respectively. Measurements of height and body weight were obtained to compute Body Mass Index (BMI). Results: The presence of overweight or obesity among students was significantly and independently related to female sex, urban residence, living independently, tobacco use, and lower academic performance (p = 0.0103, p = 0.0102, p = 0.0203, p = 0.0075, and p = 0.0168, respectively). Individuals reporting insufficient physical activity had 85% higher odds of being overweight or obese (p = 0.0068). Similarly, participants experiencing depressive or anxious symptomatology had more than double odds of excess body weight compared with those without such symptoms (p = 0.0015 and p = 0.0012, respectively). Furthermore, poor Mediterranean diet adherence was linked to more than a twofold increase in the odds of overweight or obesity (p = 0.0005). Conclusions: These findings offer considerable evidence that symptoms of depression and anxiety may serve as significant contributors to the development of overweight and obesity among university students. Additional longitudinal studies are strongly encouraged to substantiate these observations. Full article

Heavy episodic drinking (HED) is prevalent in young adulthood, yet its relationship with psychosocial well-being remains complex. This study examines the association between HED and perceived social isolation among young adults and tests whether this relationship varies by sexual orientation. Using pooled, nationally representative data from the 2022 and 2024 Health Information National Trends Survey (HINTS), this study analyzed adults aged 18–29 (N = 723). Perceived social isolation was measured using the PROMIS Social Isolation Short Form. Weighted multivariable linear regression models assessed interactions between sexual orientation and HED occasions (0 vs. 1+), adjusting for sociodemographic variables and psychological distress. 45.5% reported HED. Lesbian/gay (B = 5.62, SE = 0.58, p < 0.001) and bisexual (B = 1.66, SE = 0.34, p < 0.001) young adults reported higher isolation than straight peers; HED was inversely associated with isolation (B = −1.71, SE = 0.20, p < 0.001). A significant interaction indicated that among lesbian/gay young adults, heavy drinking was associated with lower perceived isolation (B = −5.77, SE = 0.98, p < 0.001). Interventions should account for the social meanings of alcohol use to avoid unintentionally increasing isolation among sexual minoritized populations. Full article

The evolving digital landscape, including artificial intelligence (AI) and its generative forms, is changing how younger generations learn. As students utilize generative AI systems, they cultivate trust in such technology to support their current and long-term learning. The objective of this study was to investigate the relationship between generative AI use among students in health professions and their trust in this technology to support their lifelong learning as future health professionals. This study employed a survey methodology using a cross-sectional study design. The survey included sociodemographic variables and questions regarding students’ generative AI use and their trust in this technology to support their lifelong learning. Descriptive and inferential statistical procedures were used to analyze the data. A total of 558 students representing various health professions responded to the survey. In the regression analysis, after controlling for student’s sex and location variables, greater generative AI use was associated with students’ increased trust in this technology to support their lifelong learning (beta = 0.58, p < 0.001), explaining close to 40% of the total variance. Given the rapidly evolving digital landscape, this finding warrants further study, with implications for training of the future health workforce. Full article

Background/Objectives: Cancer places emotional and psychosocial demands on healthcare professionals; therefore, this study aimed to examine sociodemographic and psychosocial determinants, including emotional competence, empathy, and stigma, and to assess their interrelationships with mental health, attitudes towards cancer, and cancer-related stigma among healthcare professionals involved in cancer care. Methods: This cross-sectional study was conducted from July 2025 to January 2026 via a self-administered questionnaire among 264 hospital and primary care healthcare professionals in Osijek, Croatia (69 men and 195 women; median age 37 years, IQR 31–47, age range 20–64 years), all directly involved in providing healthcare to cancer patients in Croatia. Results: Significant differences were observed by gender, age, occupation, and workplace. Men were more frequently physicians and had higher education levels and socioeconomic status, whereas women achieved higher scores in emotional competence and empathy. Physicians more often had shorter overall work experience and reported greater perceived controllability of cancer. Age-related differences were found in perceived discrimination, stigma, and controllability of cancer. Primary healthcare professionals showed a higher level of empathy and proactivity and a lower perception of cancer as an incurable disease. Higher empathy was associated with lower stigma, while negative emotions and greater proactivity were associated with higher stigma, and emotional competence was a strong predictor of empathy. Conclusions: The study identified notable sociodemographic and psychosocial differences among healthcare professionals. Emotional competence strongly predicted empathy, which was inversely associated with cancer-related stigma, suggesting potential targets for interventions to improve attitudes towards cancer care. Furthermore, women exhibited significantly higher emotional competence and empathy than men, highlighting the importance of incorporating gender-specific perspectives into developing educational and support strategies for cancer healthcare professionals. Full article