Healthcare最新文献

{"title":"A Systematic Review of 3D-Printing in Spine Surgery: Applications, Accuracy, and Outcomes.","authors":"Majdi Hashem","doi":"10.3390/healthcare14193344","DOIUrl":"10.3390/healthcare14193344","url":null,"abstract":"<p><p><b>Background</b>: Three-dimensional (3D)-printing has increasingly been applied in spine surgery for patient-specific planning, instrumentation, and implants. This systematic review and meta-analysis aimed to evaluate the applications, technical accuracy, and outcomes of 3D-printing in spine surgery. <b>Methods</b>: This systematic review study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A comprehensive literature search was conducted for the available literature that was published before 7 November 2024, using three medical databases (PubMed, Scopus, and Cochrane). <b>Results</b>: A total of 40 studies were included in this systematic review, of which 28 (70.0%) were retrospective design studies. Seven studies were included in the meta-analysis of screw placement accuracy, which showed a significantly higher probability of achieving the defined accuracy outcome with 3D-printing-assisted techniques (RR = 1.12, 95% CI: 1.06-1.19; <i>p</i> = 0.003). Meta-analysis of eight studies showed significantly shorter surgical time (MD = -28.97 min, 95% CI: -43.41 to -14.53; <i>p</i> < 0.001) and lower blood loss (MD = -80.70 mL, 95% CI: -149.92 to -11.48; <i>p</i> = 0.022) with 3D-printing-assisted approaches. However, substantial heterogeneity was observed for surgical time and blood loss. <b>Conclusions</b>: The available evidence suggests that 3D-printing-assisted approaches may improve technical accuracy and reduce surgical time and blood loss in spine surgery. However, the findings should be interpreted cautiously because of substantial clinical and methodological heterogeneity and limitations in the quality of the available evidence. Further well-designed prospective studies and randomized controlled trials are needed to confirm these findings.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 19","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192883","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":"Beyond Screening Populations: Context-Dependent Performance of Lung Cancer Risk Assessment Strategies in a Diagnostically Enriched Cohort.","authors":"Aysegul Erinc, Ali Kirac, Damla Azakli, Guliz Kizir, Gulsum Kirhan Karabulut, Hilal Rumeysa Ozkan Eksert, Cetin Yakisik, Celal Satici","doi":"10.3390/healthcare14193350","DOIUrl":"10.3390/healthcare14193350","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Lung cancer screening with low-dose computed tomography has been shown to reduce disease-specific mortality, but optimal strategies for identifying high-risk individuals remain debated. This retrospective, single-center cohort study examined the context-dependent behavior of two individualized lung cancer risk prediction models, PLCOm2012 and the Bach model, and National Comprehensive Cancer Network (NCCN) screening criteria when retrospectively applied to hospitalized patients undergoing diagnostic evaluation. The study was not designed as an external validation of these approaches for their intended screening purpose, but rather to assess their ability to discriminate between patients with and without prevalent lung cancer in a diagnostically enriched clinical population. <b>Methods:</b> Among 254 patients in the overall cohort, 86 had histopathologically confirmed primary lung cancer. For the primary head-to-head comparison, a common analytic cohort of 133 current or former smokers for whom all three approaches could be evaluated was used; 56 of these patients had lung cancer. <b>Results:</b> PLCOm2012 demonstrated high sensitivity (87.5%) but low specificity (15.6%), whereas the Bach model, at the cohort-derived exploratory threshold of ≥0.49%, showed lower sensitivity (42.9%) and higher specificity (57.1%). NCCN criteria yielded the highest sensitivity (96.4%) but very low specificity (3.9%). Likelihood ratios were close to unity for all three approaches, indicating limited discrimination in this diagnostically enriched population. Paired analyses demonstrated significant differences in sensitivity and specificity between several of the threshold-based approaches, whereas continuous discrimination did not differ significantly between PLCOm2012 and the Bach model; overall discrimination remained limited in this diagnostically enriched cohort. <b>Conclusions:</b> These findings highlight the context-dependent performance of screening-oriented risk assessment tools and indicate that results derived from asymptomatic screening populations should not be directly extrapolated to hospitalized patients undergoing diagnostic evaluation.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 19","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192974","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":"Forms of Workplace Violence in Veterinary Organisations in Slovenia.","authors":"Miha Dvojmoč, Valentina Kubale, Ajda Šulc, Breda Jakovac Strajn, Ožbalt Podpečan","doi":"10.3390/healthcare14193357","DOIUrl":"10.3390/healthcare14193357","url":null,"abstract":"<p><strong>Background/objectives: </strong>Workplace violence is a recognised psychosocial risk across many professions but remains insufficiently investigated in veterinary practice. Evidence on workplace violence among veterinary employees in Slovenia is limited. This study aimed to examine reported exposure to different forms of workplace violence involving animal owners, co-workers, and supervisors among employees of veterinary organisations in Slovenia and to assess associated emotional responses.</p><p><strong>Methods: </strong>A cross-sectional online survey was conducted between December 2024 and April 2025 among employees of all 182 registered veterinary practices and clinics in Slovenia. Of 1351 eligible employees, 178 completed the questionnaire (overall response rate: 13.17%), including 155 of 873 eligible veterinarians (veterinarian response rate: 17.75%). Respondents rated their agreement with statements describing verbal, physical, and psychological violence involving animal owners, co-workers, and supervisors, as well as associated negative emotional responses. Data were analysed using one-sample and paired-samples <i>t</i>-tests, principal component analysis, and multiple linear regression.</p><p><strong>Results: </strong>Respondents reported exposure to workplace violence involving animal owners, co-workers, and supervisors, with verbal and psychological forms particularly evident in interactions with animal owners. Fear, helplessness, and uncertainty were prominent emotional responses associated with violence involving animal owners, while violence involving co-workers and supervisors was also associated with negative emotional responses. Greater work experience was significantly associated with less intense negative emotional responses across all three perpetrator groups. Higher education and male gender were additionally associated with less intense emotional responses to violence involving animal owners.</p><p><strong>Conclusions: </strong>Workplace violence represents an important psychosocial concern in Slovenian veterinary organisations and may originate from both external and internal sources. Training, written protocols, and organisational and psychological support may warrant consideration as potential preventive measures; however, their effectiveness was not evaluated in this study and requires further investigation. The low response rate and potential non-response and self-selection bias limit the generalisability of the findings. Further research using validated event-based measures and stronger recruitment strategies is warranted.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 19","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193042","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":"Effect of Age on Physical Function Improvement in Older Veterans Enrolled in the Gerofit Exercise Program.","authors":"Angela J Guo, Stacy S Wilkins, Rebecca J Melrose, Daniel Fernandez, Steven C Castle, Katherine S Hall, Cathy C Lee","doi":"10.3390/healthcare14193348","DOIUrl":"10.3390/healthcare14193348","url":null,"abstract":"<p><strong>Background/objectives: </strong>Aging is associated with declines in strength, balance, and mobility that contribute to falls, disability, and loss of independence. While exercise interventions improve physical function, limited data exist on community-dwelling adults aged 90 years and older. The purpose of this study was to evaluate the effect of age on physical function improvement following participation in an exercise program for older Veterans.</p><p><strong>Methods: </strong>We analyzed baseline and 3-month follow-up physical function data from 62 community-dwelling Veterans aged 60-99 years enrolled in the Veterans Affairs Gerofit, a supervised, individualized exercise program incorporating aerobic, resistance, balance, and flexibility training. Outcomes included lower extremity strength (30-s chair stands), mobility and balance (8-foot up-and-go), and cardiovascular endurance (6-min walk). Participants were grouped by age (60-69, 70-79, 80-89, 90-99). Paired samples <i>t</i>-tests assessed changes over time, and repeated-measures general linear models examined the effect of age on physical function improvement.</p><p><strong>Results: </strong>Across all participants, significant improvements were observed in chair stand and 8-foot up-and-go performance (both <i>p</i> < 0.001), whereas 6-min walk distance did not change significantly (<i>p</i> = 0.14). Chair stand performance improved in all age groups, including adults aged 90-99 (<i>p</i> < 0.01). Although baseline physical function declined with age, we did not detect differences in the rate of improvement in chair stand performance by age group (<i>p</i> = 0.69). Improvements in 8-foot up-and-go performance were observed in younger age groups and not in participants aged 90-99 years.</p><p><strong>Conclusions: </strong>Participation in a supervised exercise program was associated with significant improvements in lower extremity strength across all age groups, including adults aged 90-99 years. These findings support the inclusion of even the oldest adults in exercise programs to promote physical function.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 19","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192919","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":"Clinical Decision Making, Red-Flag Recognition, and Scope-of-Practice Perspectives for Direct Access Physical Therapy in Saudi Arabia.","authors":"Msaad Alzhrani","doi":"10.3390/healthcare14193347","DOIUrl":"10.3390/healthcare14193347","url":null,"abstract":"<p><p><b>Background/Objectives:</b> This survey examined referral decisions, the recognition and screening of warning features (red flags) of serious disease, regulatory interpretations, and barriers to direct-access physical therapy in Saudi Arabia. <b>Methods:</b> An English-language cross-sectional convenience survey (May-July 2026) used an investigator-developed questionnaire with 12 clinical vignettes (written patient cases) and 20 warning-feature items paired with screening questions. The primary outcome was choosing medical referral before physical therapy in all four urgent/critical vignettes: suspected gastrointestinal bleeding, cauda equina syndrome, abdominal aortic aneurysm, and spinal infection. This definition was finalised after data collection. <b>Results:</b> Of 131 Saudi physical therapists, 77 (58.8%; 95% confidence interval [CI] 50.2-66.8) chose referral before treatment in all four vignettes. Another 36 included referral in every vignette but would also start treatment while arranging referral in at least one; 18 chose treatment without referral at least once. In an exploratory six-predictor analysis, postgraduate academic qualifications were associated with higher odds of meeting the primary outcome (adjusted odds ratio 4.14, 95% CI 1.63-10.51; Holm-adjusted <i>p</i> = 0.017) and older age with lower odds (0.92/year, 95% CI 0.86-0.98; Holm-adjusted <i>p</i> = 0.047). Across 17 core warning features, 74.0% of responses identified a red flag; 49.1% of screening responses indicated checking often or always. Regulatory views differed: 45.8% believed direct access was permitted in limited settings. The highest-rated barriers concerned policy, law, reimbursement, and physician support. <b>Conclusions:</b> These findings identify priorities for evaluating training, clarifying regulations, and coordinating referral pathways. Vignettes and self-reported practices cannot establish safety in clinical practice, show that qualifications improve decisions, or determine workforce readiness.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 19","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193054","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":"The Relationship of Grief Reactions with Cognitive Emotion Regulation Strategies and Intolerance of Uncertainty in Adults.","authors":"Elif Yöyen, Rana Şan","doi":"10.3390/healthcare14193342","DOIUrl":"10.3390/healthcare14193342","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Background/Objectives&lt;/b&gt;: Grief following the death of a loved one may be associated with cognitive emotion regulation strategies and responses to uncertainty. This study examined the relationships between grief, cognitive emotion regulation strategies, and intolerance of uncertainty among adults who had lost a loved one and whether grief differed according to demographic and loss-related characteristics. &lt;b&gt;Methods&lt;/b&gt;: The sample comprised 304 adults aged 18-65 years who had experienced the death of a loved one 6-24 months previously. Data were collected using the Demographic Information Form, Grief Scale, Cognitive Emotion Regulation Questionnaire, and Intolerance of Uncertainty Scale. Independent-samples &lt;i&gt;t&lt;/i&gt;-tests, one-way analysis of variance, Pearson correlation, and regression analyses were conducted. &lt;b&gt;Results&lt;/b&gt;: After adjustment for multiple comparisons, grief was not significantly associated with age (&lt;i&gt;r&lt;/i&gt; = -0.012) or time since loss (&lt;i&gt;r&lt;/i&gt; = -0.053), but was positively associated with emotional closeness (&lt;i&gt;r&lt;/i&gt; = 0.549, Holm-adjusted &lt;i&gt;p&lt;/i&gt; &lt; 0.001) and perceived social support (&lt;i&gt;r&lt;/i&gt; = 0.202, Holm-adjusted &lt;i&gt;p&lt;/i&gt; = 0.001). Grief was positively associated with self-blame (&lt;i&gt;r&lt;/i&gt; = 0.445), rumination (&lt;i&gt;r&lt;/i&gt; = 0.157), catastrophizing (&lt;i&gt;r&lt;/i&gt; = 0.532), and blaming others (&lt;i&gt;r&lt;/i&gt; = 0.348), and negatively associated with acceptance (&lt;i&gt;r&lt;/i&gt; = -0.162), positive refocusing (&lt;i&gt;r&lt;/i&gt; = -0.192), refocus on planning (&lt;i&gt;r&lt;/i&gt; = -0.148), and positive reappraisal (&lt;i&gt;r&lt;/i&gt; = -0.192); these associations remained significant after Holm adjustment. Putting into perspective was not significantly associated with grief after adjustment for multiple comparisons. Intolerance of uncertainty was positively associated with grief (&lt;i&gt;r&lt;/i&gt; = 0.447, &lt;i&gt;p&lt;/i&gt; &lt; 0.001). In the hierarchical regression analysis, demographic and loss-related covariates accounted for 44.7% of the variance in grief scores (&lt;i&gt;R&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0.447). Adding cognitive emotion regulation strategies accounted for an additional 18.2% (Δ&lt;i&gt;R&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0.182, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), and intolerance of uncertainty accounted for a further 1.1% (Δ&lt;i&gt;R&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0.011, &lt;i&gt;p&lt;/i&gt; = 0.020). The final model accounted for 64.0% of the variance (&lt;i&gt;R&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0.640, adjusted &lt;i&gt;R&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0.603). &lt;b&gt;Conclusions&lt;/b&gt;: Specific cognitive emotion regulation strategies and greater intolerance of uncertainty were associated with grief levels, with self-blame, rumination, catastrophizing, and blaming others showing positive associations with grief, whereas acceptance, positive refocusing, refocus on planning, and positive reappraisal showed negative associations. These findings highlight the relevance of cognitive emotion regulation and intolerance of uncertainty to individual differences in grief; however, given the cross-sectional design, the observed associations should not be interpreted as establishing temporal or causal rel","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 19","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193186","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":"Real-World Anthropometric Outcomes, Safety, and Use Patterns of GLP-1 and Dual GIP/GLP-1 Receptor Agonists in Obesity and Glucose Metabolism Disorder: A Nationwide Multicentre Community Pharmacy Study.","authors":"Olatz Vergniory-Trueba, Carlos Treceño-Lobato","doi":"10.3390/healthcare14193355","DOIUrl":"10.3390/healthcare14193355","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have transformed the management of obesity and type 2 diabetes mellitus (T2DM). Although randomized clinical trials have demonstrated substantial weight loss and metabolic benefits with incretin-based therapies, real-world evidence is needed to characterize anthropometric outcomes, safety, prescribing patterns, and treatment use under routine clinical conditions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;The objective of this study was to characterize real-world anthropometric outcomes, safety, and use patterns of GLP-1 receptor agonists and dual GIP/GLP-1 receptor agonists in patients with obesity or glucose metabolism disorder receiving treatment through Spanish community pharmacies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A nationwide multicentre cross-sectional study with retrospective data collection was conducted between January and April 2026 across community pharmacies in Spain. Adult patients receiving GLP-1 receptor agonists or dual GIP/GLP-1 receptor agonists were consecutively enrolled and classified according to therapeutic indication (obesity or glucose metabolism disorder). Changes in body weight and body mass index (BMI) were assessed using paired-sample &lt;i&gt;t&lt;/i&gt;-tests, while multivariable linear regression explored independent determinants of weight loss. Crude safety signals were initially evaluated using exploratory crude safety association analysis based on Odds Ratios (ORs). Subsequently, multivariable logistic regression was performed to identify independent predictors of suspected digestive adverse drug reactions after adjustment for demographic characteristics, treatment-related variables, lifestyle factors, and concomitant glucose-lowering therapies. Baseline body weight was retrospectively reported by participants and was not independently verified against clinical records or other objective sources, whereas current body weight was measured by the pharmacist at the study visit.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 531 patients were included (52.2% with obesity; 47.8% were classified in the glucose metabolism disorder (GMD) cohort, comprising 200 patients with type 2 diabetes mellitus and 54 with prediabetes/fasting glucose disturbance; the mean age was 56.5 ± 12.5 years; and 66.7% were women). The mean observed reduction in body weight from treatment initiation to the study assessment was 12.17 ± 10.64 kg, corresponding to an 11.71% ± 9.40% reduction relative to retrospectively reported baseline weight. Overall, 73.9% and 54.1% of participants achieved ≥5% and ≥10% weight loss, respectively. No statistically significant unadjusted difference in relative weight loss was detected across treatment groups; however, equivalence was not formally assessed. Gastrointestinal suspected adverse drug reactions were the most frequently reported safety outcomes. Exploratory crude analyses showed nominal associations between Wegovy&lt;sup&gt;®&lt;/sup&gt; and nausea/vomiti","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 19","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193194","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":"Psychosocial Burden of Duchenne Muscular Dystrophy on Caregivers in Australia: A Cross-Sectional Study.","authors":"Hansoo Kim, Arun Jones, Melinda Fulthorp, Daniel Tan, Leonard Lee","doi":"10.3390/healthcare14193352","DOIUrl":"10.3390/healthcare14193352","url":null,"abstract":"<p><strong>Background: </strong>Duchenne muscular dystrophy (DMD) is a rare, progressive neuromuscular disorder associated with substantial psychosocial demands for family caregivers. Australian evidence remains limited. This study quantified caregiver burden, health-related quality of life, depressive symptoms and work impairment, with a primary comparison by ventilation status and exploratory analyses across functional stages.</p><p><strong>Methods: </strong>A cross-sectional online survey was conducted from February to March 2025 through national advocacy groups. Validated instruments included the Oberst Caregiving Burden Scale (OCBS), Work Productivity and Activity Impairment Questionnaire (WPAI), EuroQol-5 Dimensions-5 Levels (EQ-5D-5L) and Beck Depression Inventory-II (BDI-II). Responses were screened using IP address, completion status and internal consistency before reanalysis.</p><p><strong>Results: </strong>Seventy-three caregivers were included. Most were mothers (67%) and were aged 35-44 years (51%). Mean OCBS difficulty scores were higher among caregivers of ventilated than unventilated patients (39.6 vs. 33.1, <i>p</i> = 0.023). Clinically relevant depressive symptoms (BDI-II ≥ 14) were observed in 13 of 19 caregivers of ventilated patients (68.4%) and 46 of 54 caregivers of unventilated patients (85.2%). The odds ratio was 0.38 (95% CI 0.095-1.59, <i>p</i> = 0.17). After covariate adjustment, higher OCBS difficulty and time scores remained associated with lower EQ-5D-5L scores, whereas BDI-II and WPAI domains did not. Global interaction tests did not provide evidence that associations differed by DMD stage.</p><p><strong>Conclusions: </strong>Caregiver psychosocial burden was substantial in both ventilation groups. Ventilation status was associated with caregiving difficulty, but the clinical importance of the observed difference is uncertain. Depressive symptoms were common irrespective of ventilation status. These cross-sectional findings support attention to caregiver wellbeing across DMD care but do not establish change over the disease course.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 19","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193224","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":"Radiation-Related Fear, Risk Perception, and Occupational Responses Among Healthcare Workers and Health Professions Students: A Scoping Review.","authors":"Venera M Almatova, Zhanar Kozhakhmetova, Indira M Bozheyeva, Gaukhar L Medetova, Karlygash S Absattarova, Karlygash K Toguzbaeva","doi":"10.3390/healthcare14193353","DOIUrl":"10.3390/healthcare14193353","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Radiation-related fear, anxiety, risk perception, reproductive concern, protective behaviour, and avoidance are conceptually related but not interchangeable. This scoping review mapped how these constructs have been operationalised among healthcare workers and health professions students. Methods: Following JBI guidance and PRISMA-ScR, PubMed, Scopus, Web of Science Core Collection, and the Cochrane Library were searched for English-language records published from 1 January 2000 to 4 September 2026. Of 845 records, 388 duplicates were removed and 457 unique records were screened. <b>Results:</b> Twenty-seven reports underwent full-text assessment; one was excluded because its mixed population and radiation context did not permit a healthcare-specific occupational interpretation, leaving 26 studies. The evidence was dominated by cross-sectional studies and heterogeneous measurement instruments; therefore, study-level percentages were not treated as directly comparable prevalence estimates. Reported outcomes ranged from explicit radiophobia and affective anxiety to cognitive risk appraisal, reproductive concern, protective behaviour, and avoidance. Education was associated with differing changes across settings, while dosimetry, protective equipment, workflow, and safety climate were reported alongside occupational responses. <b>Conclusions:</b> The literature does not support a standardised operational definition or common measurement framework for professional radiophobia. Future research should distinguish affective fear or anxiety from contextually appropriate occupational risk appraisal and protective behaviour, and should evaluate organisational conditions alongside education.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 19","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193234","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":"Complementary and Alternative Medicine Use Among Families of Children with Autism Spectrum Disorder Attending Five Autism Centres in Arab Countries: Associations with Sociodemographic Factors and Health Literacy.","authors":"Mais Hatahet, Nguyen Minh Chau, Andrea Sárváry, Attila Sárváry","doi":"10.3390/healthcare14193351","DOIUrl":"10.3390/healthcare14193351","url":null,"abstract":"<p><p><b>Background:</b> Complementary and alternative medicine (CAM) therapies are commonly used among children with autism spectrum disorder (ASD). This study aimed to examine parental attitudes toward CAM, in addition to patterns of its use and associated factors among children with ASD in Arab countries. <b>Methods:</b> In this cross-sectional survey, 142 questionnaires from five Arab countries (Qatar, the Kingdom of Saudi Arabia [KSA], Kuwait, Jordan, and Libya) were analysed. <b>Results:</b> The most reported CAM modalities included dietary supplements such as multivitamins and fish oil, as well as the questionnaire item labelled \"holding therapy\". The main reason for CAM use reported by parents was the desire to try all possible therapy options for their child and reduce stress (35.5%), followed by improving their child's quality of life (32.6%). The regression models showed that better verbal ability was associated with greater use of these therapies (use of short/complex sentences vs. does not talk: biologically based therapies, OR = 5.35, 95% CI 1.58-18.56; mind and body practices, OR = 4.30, 95% CI 1.66-11.23). The models also showed an association between the male sex and the use of mind and body practices (OR = 3.28, 95% CI 1.23-8.92). <b>Conclusions:</b> CAM use was common in this sample. Healthcare professionals should provide balanced, evidence-based information and encourage non-judgmental discussion of CAM use. Improving health literacy and access to reliable information may support safer decision-making.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 19","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192119","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}