Healthcare最新文献

{"title":"Psychological Distress and Kidney Failure as Predictors of Chemoradiotherapy Toxicity and Quality of Life in Patients with Head and Neck Cancer.","authors":"Daniela Jicman Stan, Alin-Laurentiu Tatu, Alina-Maria Lescai, Corina Popazu, Adriana Liliana Vlad, Georgian Dobrea, Alexia Anastasia Ștefania Baltă","doi":"10.3390/healthcare13121476","DOIUrl":"10.3390/healthcare13121476","url":null,"abstract":"<p><p><b>Background</b>: Quality of life (QoL) in oncology patients is shaped by the interplay of biological, psychological and treatment-related factors. While prior studies have addressed the independent effects of treatment toxicity and psychological distress, little is known about the interaction between depressive-anxious disorders, kidney failure and haematological toxicity on QoL among patients with head and neck cancer undergoing chemoradiotherapy. <b>Objective</b>: This study aims to examine the combined effect of haematological toxicity, depressive-anxious disorders and chronic renal disease on the total QLQ-H&N43 score, a validated measure of QoL in patients with head and neck cancer. <b>Methods</b>: A total of 93 patients were included in an observational study. PROCESS macro for SPSS was used to test the three-way interaction between haematological toxicity (X), depressive-anxious disorders (W) and kidney failure (Z) on QoL (Y). <b>Results</b>: The three-way interaction was statistically significant (β = 31.04, <i>p</i> = 0.032), accounting for 18.9% of the variance in QLQ-H&N43 scores (R² = 0.1888). Patients presenting both depressive-anxious disorders and renal comorbidities reported higher QoL scores, indicating poorer quality of life in the presence of severe treatment toxicity. <b>Conclusions</b>: Psychological distress and kidney failure may synergistically exacerbate the negative effects of chemoradiotherapy toxicity on quality of life. These findings underscore the need for integrated care models addressing both psychological vulnerability and medical comorbidities in oncology.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12192723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144496066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Transphobia and Attitudes Toward Transgender Individuals Among Nurses in Türkiye: A Cross-Sectional Study.","authors":"Ezgi Şişman, Mehtap Güngör, Aila Gareayaghi, Hanife Yılmaz, Aslıhan Polat","doi":"10.3390/healthcare13121474","DOIUrl":"10.3390/healthcare13121474","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Transgender individuals face significant healthcare disparities, often exacerbated by provider prejudice and knowledge gaps. Nurses, as frontline providers, play a critical role in promoting inclusive care. This study aimed to evaluate the levels and predictors of transphobia and attitudes toward transgender individuals among nurses in Türkiye. <b>Methods</b>: A cross-sectional survey was conducted with 100 registered nurses. Participants completed the Transphobia Scale, the Attitudes Toward Transgender Individuals Scale, and the Hudson & Ricketts Homophobia Scale. Additional measures included perceived knowledge, prior education on transgender health, familial attitudes, and comfort levels when working with transgender patients. Multiple linear regression analyses identified predictors of transphobia and attitudes. <b>Results</b>: The mean Transphobia Scale score was 41.53 (SD = 12.67), and the mean Attitudes Toward Transgender Individuals Scale score was 57.45 (SD = 16.42). Greater homophobia, negative parental attitudes, and higher perceived knowledge significantly predicted higher transphobia scores (Adjusted R²= 0.327). Prior education on transgender health was also associated with lower transphobia. Lower comfort with transgender patients was marginally associated with higher transphobia. More positive attitudes toward transgender individuals were predicted by lower transphobia, lower homophobia, and prior education (Adjusted R² = 0.526). <b>Conclusions</b>: Findings underscore the urgent need for structured transgender health education and culturally sensitive interventions among nurses. Addressing sociocultural factors and training gaps could enhance equitable healthcare delivery for transgender populations, particularly in culturally conservative settings like Türkiye.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12192659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144496052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding High-Risk Behavior in Mexican University Youth: Links Between Sexual Attitudes, Substance Use, and Mental Health.","authors":"Gustavo A Hernández-Fuentes, Osiris G Delgado-Enciso, Jessica C Romero-Michel, Verónica M Guzmán-Sandoval, Mario Del Toro-Equihua, José Guzmán-Esquivel, Gabriel Ceja-Espíritu, Mario Ramírez-Flores, Margarita L Martinez-Fierro, Idalia Garza-Veloz, Fabian Rojas-Larios, Karla B Carrazco-Peña, Rosa Tapia-Vargas, Ana C Espíritu-Mojarro, Iván Delgado-Enciso","doi":"10.3390/healthcare13121473","DOIUrl":"10.3390/healthcare13121473","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Sexual attitudes, particularly those on the erotophilia (positive openness) to erotophobia (negative fear) scales, play a critical role in shaping behaviors and health decisions. While associations between sexual behavior and substance use have been documented, limited research has explored how sexual attitudes relate to mental health and substance use among Latin American university populations. This study aimed to examine the associations among erotophilic attitudes, mental health symptoms (anxiety and depression), substance use risk, and sexual behaviors in Mexican university students. <b>Methods:</b> A cross-sectional observational study was conducted between 2019 and 2023 with 1475 undergraduate students aged 17-25 years. Participants completed the Revised Sexual Opinion Survey (R-SOS) to assess sexual attitudes, the Hospital Anxiety and Depression Scale (HADS) for mental health evaluation, and adapted items from the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) to measure substance use risk. Erotophilic attitudes were defined as R-SOS scores ≥ 70. Statistical tests included the Kolmogorov-Smirnov test for normality, <i>t</i>-tests or Mann-Whitney U tests for group comparisons, Fisher's exact test for categorical variables, and Spearman's correlations. Multivariate binary logistic regression was used to calculate adjusted odds ratios (AdORs) and 95% confidence intervals (CIs), with a significance level of <i>p</i> < 0.05. <b>Results:</b> Erotophilic students were more likely to be male, older, initiate sexual activity earlier, and report a greater number of sexual partners. Erotophilia was positively associated with anxiety and tobacco, alcohol and marijuana use, and negatively associated with depressive symptoms. Multivariate analysis indicated that erotophilia was independently associated with male sex, age ≥ 20, higher anxiety, lower depression, low socioeconomic status, and increased risk of tobacco and marijuana use. Lower rates of consistent condom use were also reported among erotophilic individuals. <b>Conclusions:</b> Erotophilia may serve as a behavioral risk marker linked to anxiety symptoms and increased substance use, but not to depression. These findings highlight the need for integrated interventions addressing sexual health, substance use, and mental well-being in university populations.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12192823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144496075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Perception to Action: Air Pollution Awareness and Behavioral Adjustments in Pregnant Women in Serbia.","authors":"Ana Susa, Milica Zekovic, Dragana Davidovic, Katarina Paunovic, Vera Kujundzic, Sladjana Mihajlovic, Ljiljana Bogdanovic","doi":"10.3390/healthcare13121475","DOIUrl":"10.3390/healthcare13121475","url":null,"abstract":"<p><p>In regions with sustained air pollution, the adoption of protective health behaviors is critical, particularly among pregnant women-a population marked by physiological vulnerability and heightened receptivity to preventive guidance. Understanding and supporting patient-driven behavioral change requires attention to individual perception and awareness, which are shaped by socio-economic and spatial factors, as well as access to credible information. <b>Objectives</b>: This study investigates how pregnant women in Serbia perceive air quality, identifies determinants that influence these perceptions, and evaluates the extent and nature of behavioral adaptations undertaken to mitigate exposure-related risks. <b>Methods</b>: A cross-sectional survey was conducted among 279 pregnant women using a structured, researcher-administered questionnaire. Collected data included demographic and psychosocial variables, air quality perceptions, self-reported health effects, and behavioral responses. Residential proximity to land-use attributes was assessed using GIS-based spatial analysis. <b>Results</b>: Most participants perceived air quality as poor (68.8%), primarily informed by unofficial sources such as mobile applications and social media. Living close to continuous urban fabric (OR = 0.180, 95% CI: 0.059-0.558, <i>p</i> = 0.003) and water (OR = 0.306, 95% CI: 0.127-0.738, <i>p</i> = 0.008) was associated with poorer perceptions, while proximity to forests (OR = 2.938, 95% CI: 1.323-6.525, <i>p</i> = 0.008) correlated with more favorable assessments. Despite prevalent concern, around half of respondents (50.2%) reported no behavioral modifications. Importantly, none had received guidance from healthcare professionals on the topic. <b>Conclusions</b>: These findings highlight critical gaps in environmental health literacy and provider engagement. Integrating tailored communication and behavioral support in existing prenatal counseling could advance health-related quality of life in this vulnerable population.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12193646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144496008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Episiotomy Skills Through Interactive Online Simulation.","authors":"Hülya Tosun, Hava Özkan","doi":"10.3390/healthcare13121472","DOIUrl":"10.3390/healthcare13121472","url":null,"abstract":"<p><p><b>Background/Objectives:</b> The COVID-19 pandemic has significantly restricted clinical training for midwifery students, highlighting the need for alternative teaching methods. With the disruption of traditional face-to-face education, online simulation-based training has emerged as an effective alternative for developing essential clinical skills. The acquisition of hands-on skills has a direct impact on students' self-confidence and clinical performance. Interactive online simulations support the learning process by enhancing both theoretical knowledge and practical competencies. This study aims to evaluate the impact of online simple simulation-based episiotomy repair training on students whose clinical practice was limited due to the COVID-19 pandemic. <b>Methods:</b> A mixed-method approach was used, considering the outcomes from 61 midwifery students. Data were collected via observational questionnaires, which provide an online learning readiness scale and scales for student satisfaction and self-confidence. The analysis included descriptive statistics, McNemar's, binary logistic regression, and the Mann-Whitney U test. <b>Results:</b> Students who trusted themselves in both opening and repairing an episiotomy after training had more readiness for online learning (t(43) = 2.73, <i>p</i> = 0.009; t(43) = 2.40, <i>p</i> = 0.02). Students with better training performance are more likely to obtain higher scores on the final exam of the Clinical Practice module (rho = 0.33, <i>p</i> = 0.01). Additionally, their performance was a positive and significant predictor of achieving a full mark (b = 0.11, s.e. = 0.05, <i>p</i> = 0.01). <b>Conclusions:</b> Interactive online simulation training improved midwifery students' hand skills and self-confidence in clinical practice. Such methods should be promoted in circumstances like COVID-19.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12193111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144496001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Healthcare Integrity Using Simple Statistical Methods: Detecting Irregularities in Historical Dermatology Services Payments.","authors":"Andrej F Plesničar, Nena Bagari Bizjak, Pika Jazbinšek","doi":"10.3390/healthcare13121464","DOIUrl":"10.3390/healthcare13121464","url":null,"abstract":"<p><p><b>Background and Objectives:</b> Healthcare payment systems face challenges such as fraud and overbilling, which often require costly and resource-intensive detection tools. In response, the utility of simple statistical tests was explored in this study as a practical alternative for identifying irregularities in dermatology service payments within the Health Insurance Institute of Slovenia (HIIS). <b>Materials and Methods:</b> Ten-year-old anonymized billing data from 30 dermatology providers in Slovenia (with a population of 2 million) were analyzed to evaluate the effectiveness of the proposed methodology while aiming to avoid reputational harm to current providers. The dataset from 2014 included variables such as the \"number of services charged\", \"total number of points charged\" (under Slovenia's point-based tariff system at the time), \"number of points per examination\", \"average examination values (EUR)\", \"number of first examinations\", and \"total number of first/follow-up examinations\". Data credibility was assessed using Benford's Law (for calculating χ² values and testing null hypothesis rejection at the 95% level), and Grubbs' test, Hampel's test, and T-test were used to identify outliers. <b>Results:</b> An analysis using Benford's Law revealed significant deviations for the \"number of services charged\" (<i>p</i> < 0.005), \"total number of points charged\" (<i>p</i> < 0.01), \"number of points per examination\" (<i>p</i> < 0.0005), and \"average examination values (EUR)\" (<i>p</i> < 0.005), suggesting anomalies. Conversely, data on the numbers of \"first\" (<i>p</i> < 0.7) and \"total first/follow-up examinations\" (<i>p</i> < 0.3) were found to align with Benford's Law, indicating authenticity. Outlier detection consistently identified two institutions with unusually high values for points per examination and average examination monetary value. <b>Conclusions:</b> Simple statistical tests can effectively identify potential irregularities in healthcare payment data, providing a cost-effective screening method for further investigation. Identifying outlier providers highlights areas needing detailed scrutiny to understand anomaly causes.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12193562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144496002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"It Takes a Village: Unpacking Contextual Factors Influencing Caregiving in Urban Poor Neighbourhoods of Bangalore, South India.","authors":"Eunice Lobo, Giridhara Rathnaiah Babu, Debarati Mukherjee, Onno C P van Schayck, Prashanth Nuggehalli Srinivas","doi":"10.3390/healthcare13121459","DOIUrl":"10.3390/healthcare13121459","url":null,"abstract":"<p><p><b>Background</b>: Caregivers in urban settings often face unique challenges in providing nurturing care. This qualitative study explores the complex realities of caregiving among mothers and grandmothers in urban poor neighbourhoods of Bangalore, South India. Grounded in Bronfenbrenner's ecological systems theory, this is the first study in urban India that examines how caregivers' perceptions, along with individual and systemic factors, shape caregiving practices in this setting. <b>Methods</b>: In-depth interviews (IDIs) were conducted with 22 mothers and grandmothers of 4-6-year-old children from the urban MAASTHI cohort in Bangalore, South India. Topic guides were developed, pre-tested, and piloted. IDIs were conducted in local languages (<i>Kannada</i> and <i>Hindi</i>). Transcripts were coded using NVivo 12 plus and analyzed via a thematic analysis approach using Bronfenbrenner's ecological systems framework to organize themes. <b>Findings</b>: At the microsystem level, caregivers engaged with children through storytelling and play, though competing demands like household chores often constrained these interactions. Disciplining techniques varied, and the absence of fathers placed additional burdens on mothers. The mesosystem revealed the critical role of extended family in providing support. At the exosystem level, unsafe neighbourhoods limited children's opportunities for outdoor play. The macrosystem highlighted how religious values provided moral frameworks for parenting and the presence of stigma against single mothers. The chronosystem explored declining social support over time and challenges. <b>Conclusions</b>: These findings emphasize that caregiving inequities are not isolated but structurally embedded, demanding interventions that address sociocultural, economic, and spatial barriers to equitable support for caregivers, particularly those in disadvantaged settings. It calls for context-sensitive interventions, including community-based parenting programmes including maternal well-being, strengthening community and public support systems, improving safe play spaces, and longitudinal research. By amplifying marginalized caregivers' voices, this research highlights the need for policies that support nurturing care in low-resource settings to break intergenerational cycles of disadvantage.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12192858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144496043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of Body Mass Index and Lifestyle Factors with Suicidal Ideation, Planning, and Attempts Among Korean Adolescents: A Cross-Sectional Study.","authors":"Haitao Wang, Kyung-O Kim","doi":"10.3390/healthcare13121470","DOIUrl":"10.3390/healthcare13121470","url":null,"abstract":"<p><strong>Background: </strong>Unhealthy lifestyles constitute significant risk factors for adolescent suicide, and their detrimental effects may persist from adolescence into adulthood. This research study sought to examine how Body Mass Index (BMI), alongside various lifestyle behaviors among teenagers in Korea, correlates with suicidal thoughts, the formulation of suicide plans, and actual suicide attempts.</p><p><strong>Methods: </strong>The research examined unprocessed information collected during the 2022 Korean Youth Risk Behavior Web-based Survey (KYRBS), which was administered by the Korea Disease Control and Prevention Agency (KDCA). Lifestyle factors associated with suicidal behavior were selected as independent variables. The sample was stratified according to BMI for further analysis. Logistic regression models were applied to assess the association between lifestyle factors and the risk of adolescent suicide.</p><p><strong>Results: </strong>The analysis identified significant correlations between unhealthy dietary patterns, hazardous drinking behavior, smoking, and a sleep duration of less than 5 h, all of which were associated with a heightened suicide risk among adolescents. Notably, underweight adolescents who had a sleep duration of less than 5 h demonstrated a markedly elevated risk of suicidal ideation (OR = 2.391, 95% CI [1.035-5.525]). Among overweight adolescents, frequent coffee consumption was significantly associated with both suicidal planning (OR = 1.850, 95% CI [1.133-3.020]) and suicide attempts (OR = 1.958, 95% CI [1.024-3.742]). Importantly, hazardous drinking behavior was strongly associated with suicide attempts (OR = 2.277, 95% CI [1.132-4.580]). Non-smoking behavior exhibited a significant relationship with a decreased likelihood of suicidal ideation (OR = 0.706, 95% CI [0.507-0.983]) and suicidal planning (OR = 0.528, 95% CI [0.299-0.930]). Furthermore, among obese adolescents, non-smoking behavior significantly decreased the risk of suicidal ideation compared to smoking (OR = 0.514, 95% CI [0.297-0.887]).</p><p><strong>Conclusions: </strong>The study revealed that the combined impact of unhealthy behaviors-smoking, eating an unhealthy breakfast, sleeping for less than 5 h, and hazardous drinking behavior-significantly affect suicide-related behaviors in adolescents. The interaction between BMI and lifestyle factors is a critical determinant of these behaviors. Specifically, sleep health exerts a substantial influence on suicide-related behaviors in underweight adolescents, while smoking strongly correlates with suicidal behaviors in overweight and obese adolescents. Targeted attention to the interplay of smoking, diet, sleep, and alcohol consumption with BMI is crucial for the early detection and prevention of adolescent suicide.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12192561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144495951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Review of Lead Exposure and Its Effects on Caries and Aesthetics in Children and Adolescents.","authors":"Gianina Tapalaga, Livia Stanga, Ioan Sîrbu","doi":"10.3390/healthcare13121460","DOIUrl":"10.3390/healthcare13121460","url":null,"abstract":"<p><p><b>Background</b>: Early childhood dental decay remains a pervasive chronic condition, and environmental toxicants-particularly lead-may exacerbate its development. This systematic review was designed to synthesize evidence on how lead exposure correlates with both the occurrence of carious lesions and aesthetic alterations in children's primary teeth. <b>Methods</b>: A comprehensive search was conducted in PubMed, Scopus, and Web of Science through April 2025, selecting observational investigations that assessed the link between lead levels and primary-tooth decay in pediatric cohorts. Thirteen eligible studies, encompassing 44,846 participants aged 2-19 years, were included for qualitative synthesis. Aesthetics were screened using author-defined enamel-defect or discoloration endpoints; however, only three studies reported compatible metrics, precluding quantitative pooling. Heterogeneity in exposure matrices likewise ruled out meta-analysis. <b>Results</b>: Most studies reported a statistically significant association between higher lead burden and greater prevalence or severity of caries in primary teeth. Blood lead concentrations across studies ranged from means of 1.53 μg/dL to geometric means of 7.2 μg/dL. Notably, elevated lead was linked to increased decayed, missing, or filled surfaces-with an adjusted risk ratio of 1.14 (95% CI: 1.02-1.27) at levels below 5 μg/dL-and adjusted mean ratios of up to 2.14 for decayed or filled teeth when blood lead reached 5-10 μg/dL. <b>Conclusions</b>: Current evidence suggests that children's exposure to lead may heighten the risk of caries and detract from the aesthetic quality of primary teeth. However, variability in study design, lead quantification methods, and confounder adjustment limit the consistency of findings. Mitigating lead exposure in early life could represent a valuable preventive strategy against dental decay in susceptible pediatric populations.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12193460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144496074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a Multidimensional Community-Based Intervention on the Feeling of Unwanted Loneliness and Its Consequences: A Quasi-Experimental Study.","authors":"Alba Francisco-Sánchez, Sofía Martínez-León, Alejandro García-Pérez, Juan Andrés Báez-Hernández, Martín Rodríguez-Álvaro, Alfonso Miguel García-Hernández","doi":"10.3390/healthcare13121465","DOIUrl":"10.3390/healthcare13121465","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Unwanted loneliness is the gap between the social relations a person has and those they want. The main objective of this research is to assess the impact of a multidimensional community-based intervention on the feeling of unwanted loneliness in the population over the age of 65 years old who live alone, are under social risk, or are socially isolated living on La Palma island. <b>Methods</b>: A quasi-experimental study was designed with pre- and post-intervention (at three months) measurements, with no control group or randomization. A sample comprising 90 subjects was estimated for a small-moderate (0.3) or large (0.8) effect size, with a significance level (α) of 0.05 and a power (1 - β) of 0.8. <b>Results</b>: The intervention was initiated with 90 participants in 8 of the 9 Basic Health Districts from the La Palma Health Area. A moderate effect size (d = -0.77; 95%CI [-1.02, -0.52]) was evidenced in self-perceived loneliness. Three months after the proposed community-based intervention, significant differences were evidenced in adequate eating habits, physical activity, support network, anxiety, depression, and perceived social support. <b>Conclusions</b>: Compartiendo Salud (Sharing Health) presents promising results, as it exerts positive effects on health management among older adults that live alone. The results of this intervention could serve as a model to design replicable strategies in other communities, improving the quality of life and levels of perceived social support in older adults.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12193032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144496019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}