Healthcare最新文献

{"title":"Physical Activity, Body Mass Index, and Bullying in Higher Education: A Comparative Analysis of Students with and Without Structured Sports Training.","authors":"Raluca Mijaica, Lorand Balint","doi":"10.3390/healthcare13182304","DOIUrl":"10.3390/healthcare13182304","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Organized physical activity is frequently considered a protective factor against bullying behaviors, yet evidence within the university context remains limited. This study investigates the relationships between physical activity levels, body mass index (BMI), and involvement in traditional and digital bullying, taking into account the differences between students with and without structured sports training. <b>Methods:</b> A total of 2767 first-year students from Transylvania University of Brașov participated. The sports group (n = 161; 65 females, 96 males) was compared to the non-sports group (n = 2606; 1472 females, 1134 males). Instruments included the Physical Activity Questionnaire for Adolescents (PAQ-A), validated scales for traditional and cyberbullying and victimization, and BMI calculation. Statistical analyses involved <i>t</i>-tests (two-tailed), 2 × 2 factorial ANOVA, and sex-stratified multiple linear regressions. <b>Results:</b> Students with sports training reported higher physical activity (PAQ-A 4.2-4.6), lower BMI, and lower bullying involvement (traditional ≈ 14-21% vs. ≈32%; cyber ≈ 8-17% vs. ≈25%). Group differences were large for physical activity (Hedges' g ≈ 1.5) and moderate for BMI and bullying (g ≈ 0.68-0.96; point-biserial r² ≈ 3-4%). ANOVA showed sports status main effects (partial η_p² ≈ 4-5% for bullying/BMI; ≈20% for PAQ-A). In regressions, sports status (B = -0.30 to -0.44) and physical activity (B = -0.22 to -0.32) predicted lower aggression/victimization, whereas BMI showed positive associations (B = 0.11 to 0.18) (all <i>p</i> < 0.001). Sex × sports interactions were significant for PAQ-A and for traditional and cyber-victimization. <b>Conclusions:</b> Structured physical activity contributes to reducing the risk of bullying involvement and supports better psychosocial adjustment among students. These findings underscore the educational and preventive potential of university sports programs.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 18","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12469962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174775","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":"A Thirty-Year Forensic Case Report of Chronic Psychosis: Systemic Implications for Italian Forensic Psychiatry.","authors":"Luigi Buongiorno, Anna Margari, Gabriele Mandarelli, Roberto Catanesi, Anna Cassano, Francesco Carrieri, Lia Parente, Felice Carabellese","doi":"10.3390/healthcare13182302","DOIUrl":"10.3390/healthcare13182302","url":null,"abstract":"<p><p><b>Background:</b> Italy's forensic psychiatric system has undergone major reforms over recent decades, shifting from custodial institutions to a right-based, community-oriented model. While internationally praised for its commitment to dignity, recovery, and social reintegration, this framework presupposes a degree of clinical recoverability that is not always achievable. Individuals with chronic, treatment-resistant disorders-particularly those who remain socially dangerous-pose complex challenges that strain the system. <b>Methods:</b> We report a thirty-year longitudinal case of G.D.M.: a man initially diagnosed with schizophrenia and later with chronic delusional disorder. Clinical data, forensic assessments, institutional records, and community-based rehabilitation reports were reviewed to reconstruct his clinical, criminological, and forensic trajectory. <b>Results:</b> The patient committed a femicide in early adulthood and, decades later, engaged in stalking behavior toward the victim's family. Despite prolonged institutionalization, pharmacological treatment, multiple forensic evaluations, and rehabilitation programs, his psychopathology remained substantially unchanged. He persisted with fixed delusional ideation, exhibited minimal insight, and maintained a high level of social dangerousness. <b>Conclusions:</b> This case exemplifies structural gaps in Italy's forensic psychiatric system, particularly the absence of stratified security levels, long-stay therapeutic facilities, and post-custodial continuity of care for individuals who do not recover. It also highlights the increasing burden placed on the Dipartimenti di Salute Mentale (DSM, Italian Mental Health Departments), which must manage both general psychiatric and high-complexity forensic cases, often without adequate resources or training. Targeted reforms-including secure long-term care pathways, systematic outcome monitoring, and clearer forensic mandates-are needed to ensure proportionate, ethical, and effective management of such cases.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 18","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12469453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174766","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":"High Cardiovascular Disease Risk Among Men and Women Experiencing Poverty and Homelessness in Medically Underserved Areas of West Texas.","authors":"Eli Heath, Abdulkader Almosa, Rebecca Joseph, Duke Appiah","doi":"10.3390/healthcare13182303","DOIUrl":"10.3390/healthcare13182303","url":null,"abstract":"<p><strong>Background: </strong>While women are among the fastest-growing subgroups of the homeless population and have a higher prevalence of poverty than men, most studies of cardiovascular disease (CVD) risk in this vulnerable population are conducted primarily among men. We evaluated differences in CVD risk between men and women experiencing poverty and homelessness in West Texas, a medically underserved region.</p><p><strong>Methods: </strong>Data were collected from 152 adults (50% women) aged 30-74 years, who were seen at free health clinics. Prevalence ratios (PR) and 95% confidence intervals (CI) were calculated. The Framingham risk algorithm was used to estimate the risk for incident CVD in the next 10 years.</p><p><strong>Results: </strong>The mean age of participants was 55.3 years. The prevalence of CVD risk factors was high among participants and tended to be similar between men and women: diabetes (34%), current smokers (47%), obesity (50%), and hypertension (83%). After controlling for demographic factors, behavior/lifestyle factors, and health conditions, the high (>20%) 10-year risk of CVD was two-fold higher among men (PR: 2.41, 95%CI: 1.75-3.32). While the association was consistent among men regardless of the number of comorbid conditions, among women, those with three or more comorbid conditions had an elevated 10-year risk for CVD compared to those with no comorbid conditions (PR: 11.68, 95%CI: 1.88-72.60, p interaction = 0.001).</p><p><strong>Conclusions: </strong>This study found that CVD risk was elevated among poor and homeless adults, with men having a higher risk than women. Comorbid conditions had a greater impact on women than men who were at high risk for CVD.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 18","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174791","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 the Paramedic Role on Athlete Care, Emergency Response, and Injury Prevention in Sports Medicine: A Scoping Review.","authors":"Yasir Almukhlifi, Maher Alsulami, Adnan Alsulami, Nawaf A Albaqami, Abdulrahmn M Bahmaid, Salman A Aldriweesh, Sharifah Albounagh, Krzysztof Goniewicz","doi":"10.3390/healthcare13182301","DOIUrl":"10.3390/healthcare13182301","url":null,"abstract":"<p><p><b>Introduction:</b> Paramedics are increasingly being recognized as essential contributors to sports medicine, where their role extends beyond emergency response to prevention, planning, and collaboration with other medical professionals. Yet their scope of practice and effectiveness across sporting levels and regions remain insufficiently synthesized. <b>Methods:</b> This scoping review mapped international evidence on paramedics in sports medicine. Literature published in English between 2013 and 2023 was systematically searched in PubMed, Scopus, and ScienceDirect, and eligible studies were analyzed thematically. Thirty studies were included, spanning professional and amateur sports in North America, Europe, Asia, Oceania, and Africa. <b>Results:</b> The findings demonstrate that paramedics provide critical value across six domains. First, rapid emergency response, supported by innovations such as motorcycle-based ambulances, significantly reduced access times and improved survival rates. Second, preparedness and ongoing training, including physical fitness and interprofessional education, were shown to enhance effectiveness in demanding sporting environments. Third, collaboration with athletic trainers and other professionals improved on-field care and reduced unnecessary hospital transfers. Fourth, paramedics contributed to injury prevention programmes that lowered injury incidence and healthcare costs. Fifth, their involvement at mass gatherings ensured safety, streamlined triage, and reduced pressure on hospitals. Finally, evidence indicates that paramedic-led initiatives are cost-effective, generating both clinical and economic benefits. <b>Conclusions:</b> Paramedics play a multifaceted role in athlete care, emergency response, and injury prevention. Strengthening their integration through targeted training, protocol standardization, and equitable resource allocation can improve both athlete safety and system efficiency. Future research should focus on grassroots contexts and the use of paramedic-generated data to inform prevention and policy.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 18","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12469333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174789","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":"Home Difficulties Experienced by Male Firefighters in South Korea: A Qualitative Study on Work-Family Conflict.","authors":"Nayoon Lee, Hyun-Ju Lee","doi":"10.3390/healthcare13182300","DOIUrl":"10.3390/healthcare13182300","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Family is a key protective factor for firefighters' mental health, yet the home-related challenges of firefighting's occupational demands remain underexplored in South Korea. This study aimed to establish an initial understanding of these challenges by conducting in-depth interviews with male firefighters and analyzing their lived experiences using a phenomenological approach. <b>Methods</b>: Twenty-nine married male firefighters (mean age = 43.4 years, range = 31-55) affiliated with the Busan Fire Department participated in individual telephone interviews between April and July 2022 during the COVID-19 pandemic. Data were analyzed using Giorgi's descriptive phenomenological method, with NVivo Pro 12.0 employed for coding and organization. <b>Results</b>: Six themes were identified: (1) acting as an emergency commander at home, (2) reinterpreting traumatic experiences after marriage, (3) physical and emotional exhaustion from irregular schedules, (4) being national heroes misunderstood by families, (5) guilt-ridden and indebted Superman, and (6) striving to be Superman at home as well. These themes reflected the overarching meaning of a \"lonely breadwinner struggling to be Superman both at work and home.\" Participants described hyperarousal, emotional withdrawal, strained relationships, guilt over missed family events, and compensatory overextension. Distress was often concealed to protect families, but this limited emotional support. <b>Conclusions</b>: Korean male firefighters face significant work-family conflict shaped by cultural and occupational factors. These findings highlight the need for family-centered counseling, psychoeducation, and organizational interventions. Policy measures such as guaranteed rest after shifts, couple-based communication programs, and resilience-building initiatives are recommended to strengthen families as vital sources of psychological resilience.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 18","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12469647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174786","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 a Multi-Faceted Training Program on Falls in Senior Pickleball Players.","authors":"Betsy Myers, June Hanks","doi":"10.3390/healthcare13182298","DOIUrl":"10.3390/healthcare13182298","url":null,"abstract":"<p><strong>Background/objectives: </strong>Over half of older adults who play pickleball report falling during play, yet little is known regarding the ability of training programs to reduce the incidence of falls or fear of falling (FOF). The purpose of this study was to determine the effect of a multi-faceted training program for senior pickleball players who reported falling while playing pickleball or self-limiting play due to FOF.</p><p><strong>Methods: </strong>This cohort study included 12 participants in the training group (TG) and 17 in the control group (CG) who were at least 55 years of age, regularly played pickleball, and reported falling while playing or limiting play due to FOF. Hip abduction strength, change in direction (COD), and agility were assessed. Participants completed a survey regarding fall history and FOF. The TG participated in a 10-week program focused on strength, balance, COD, and agility.</p><p><strong>Results: </strong>At baseline, there were no between-group differences except that the CG participated in walking for exercise more often than the TG. The strength analysis showed no significant main effects of time or group, but there was a significant Group × Time interaction, F(1, 25) = 14.86, <i>p</i> < 0.001, η² = 0.240. Simple effects analysis showed that the TG demonstrated a strong trend toward improvement (9.9 Nm increase, +5%, <i>p</i> = 0.091) while the CG significantly declined (18.4 Nm decrease, -12%, <i>p</i> < 0.001). The COD analysis revealed no significant main effects of time or group, but there was a significant Group × Time interaction, F(1, 26) = 8.21, <i>p</i> < 0.001, η² = 0.373. Simple effects analysis showed that the TG significantly improved their COD time (0.7 s faster, <i>p</i> = 0.045) while the CG showed no significant change (0.25 s slower, <i>p</i> = 0.168). The TG had a significant decrease in FOF, z = -2.427, <i>p</i> = 0.015, r = 0.701. The agility analysis revealed no significant effects for time, group, or Group × Time interaction, F(1, 26) = 0.89, <i>p</i> = 0.354, with both groups showing minimal non-significant changes. At the end of training, the TG was playing 50% more pickleball than the CG, z = -2.192, <i>p</i> = 0.028. At the 5-month follow-up, 25% of the TG reported falling during play compared to 44% of the CG.</p><p><strong>Conclusions: </strong>A multi-faceted training program can effectively reduce FOF and improve physical performance in senior pickleball players.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 18","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12469448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174484","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":"Job Satisfaction Among Healthcare Professionals in Community-Based Care for Older People: Evidence from Greece.","authors":"Eirini Michaela Foukaki, Argyroula Kalaitzaki, George Markakis, Athanasios Alegakis, Sofia Koukouli","doi":"10.3390/healthcare13182299","DOIUrl":"10.3390/healthcare13182299","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the level of job satisfaction and the associated factors among health and social care employees of the public sector providing services in open care community settings and home-based care for the older people in Greece.</p><p><strong>Method: </strong>The self-administered questionnaire, Job Satisfaction Survey (JSS), was distributed to personnel across all four prefectures in the Region of Crete (Greece). In total, 228 valid responses were received.</p><p><strong>Results: </strong>Overall job satisfaction was moderate (mean = 134, SD = 24). Employees reported greater satisfaction with the supervision (mean = 19.3), nature of work (mean = 19.2), and coworkers (mean = 19.0). Lower satisfaction was observed in relation to promotion (mean = 9.7). Women scored significantly higher satisfaction than men in pay (mean = 10.9) and fringe benefits (mean = 12.3), while age was associated with differences in pay and promotion satisfaction. Variations were also found according to service unit and contract type, with permanent staff reporting higher satisfaction (mean = 11.3) in the Promotion scale than temporary staff (mean = 9.2) (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Findings emphasize the need to institute targeted short- and long-term measures to improve job satisfaction in community-based care for older people. Short-term actions should include the introduction of fair and competitive pay structures, improvements in fringe benefits, and the implementation of supportive leadership practices. Meanwhile, long-term strategies should focus on transparent promotion systems, structured professional development and continuing education opportunities, and the provision of stable contracts to retain skilled personnel.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 18","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12469454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174564","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":"Motor Innervation of the Trapezius by Cervical Sensitive Nerves: An Intraoperative Neuromonitoring Study and Postoperative Functional Outcomes.","authors":"Enver Can Öncül, Ersoy Doğan, Aslı Çakir Çetin, Aybüke Cansu Kalkan, Seher Özyürek, Arzu Genç, Ahmet Ömer İkiz","doi":"10.3390/healthcare13182297","DOIUrl":"10.3390/healthcare13182297","url":null,"abstract":"<p><strong>Background/objectives: </strong>We investigated whether cervical sensitive nerves (CSN) provide motor input to the trapezius muscle and how this relates to short-term functional outcomes after neck dissection.</p><p><strong>Methods: </strong>A total of 22 neck dissections were performed in 17 patients; the SAN was preserved. CSN roots (C2-C4) were stimulated intraoperatively using IONM. Shoulder and neck function were evaluated preoperatively and at 3 months in 15 operated necks using goniometry, an IMU-based motion analysis system (iSen), trapezius isometric strength, the Modified Constant-Murley Score (MCMS), and the Shoulder Pain and Disability Index (SPADI).</p><p><strong>Results: </strong>CSN-evoked trapezius responses were detected in 10/22 (45.5%) dissections (C2: 6/22, 27.2%; C3: 4/22, 18.2%; C4: 0/22). Postoperatively, neck extension/rotation and shoulder abduction/external rotation decreased significantly within groups; upper and middle trapezius strength and MCMS also declined. Shoulder flexion loss was smaller when CSN motor participation was present. Median shoulder flexion (goniometry) changed from 162°→140° in CSN(+) vs. 170°→131° in CSN(-) (between-group <i>p</i> = 0.024). With iSen, shoulder flexion changed 120°→116° in CSN(+) vs. 122°→97° in CSN(-) (<i>p</i> = 0.033).</p><p><strong>Conclusions: </strong>Approximately half of the neck dissections exhibited CSN-related motor responses. Short-term shoulder flexion was better preserved when CSN motor participation was present, suggesting that documenting CSN motor input intraoperatively may inform early rehabilitation planning.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 18","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174769","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":"Revitalizing Dementia Care: Empowering Lives Through Personalized Exercise and Advanced Technologies.","authors":"Anamarija Kejžar, Vlado Dimovski, Francesco Miele, Vojko Strojnik, Katri Maria Turunen, Simon Colnar","doi":"10.3390/healthcare13182294","DOIUrl":"10.3390/healthcare13182294","url":null,"abstract":"<p><p><b>Background/Objectives</b>: The known benefits of sport and exercise for people with dementia (PwD) and their caregivers mean that physical activity could be prioritized over pharmacological treatment. Research suggests that physical activity not only enhances the overall wellbeing of PwD, but also improves the relationships and wellbeing of their caregivers. The text examines the importance of physical activity for PwD and explores whether certain types of exercise, as well as modern tools like information and communication technology (ICT) and artificial intelligence (AI), are particularly suitable for this population given their different living environments, such as at home or in institutions. <b>Methods</b>: The study employed a qualitative design, conducting three focus groups (N = 17) in Slovenia with three distinct participant groups: informal caregivers (N = 6), physiotherapists in care homes (N = 7), and people diagnosed with dementia (N = 4). Data collection involved structured focus group discussions guided by key questions on types of exercise, challenges faced, and potential ICT and AI applications. Descriptive statistics including frequencies, means and standard deviations were used to summarize demographic data of respondents. Given the qualitative nature of the focus groups the emphasis was on thematic content analysis to identify common themes and insights supported by descriptive summaries to contextualize the findings. <b>Results</b>: The results suggest that regular physical activity tailored to an individual's existing lifestyle and abilities can be essential for improving the quality of life of PwD. Although ICT and AI play an important role in promoting and monitoring regular physical activity and a sense of safety, the use of ICT and AI tools are still the exception, not the rule. Key barriers include inadequate awareness of existing solutions, cognitive decline, physical limitations, safety concerns, and limited access to appropriate programs. The study highlights the unused potential of ICT and AI for overcoming these barriers and offers solutions like personalized exercise-which refers to a physical activity program that is tailored to an individual's specific needs, abilities, preferences, and goals-tracking, adaptive programs, and AI-driven virtual assistants that promote safety and encourage regular physical activity.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 18","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12469262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174860","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":"Effects of Neighborhood Deprivation Index on Survival in Gastroesophageal Adenocarcinoma.","authors":"Sawyer Bawek, Mrinalini Ramesh, Malak Alharbi, Nour Nassour, Kayla Catalfamo, Han Yu, Beas Siromoni, Deepak Vadehra, Sarbajit Mukherjee","doi":"10.3390/healthcare13182296","DOIUrl":"10.3390/healthcare13182296","url":null,"abstract":"<p><p>Previous studies linked disadvantaged neighborhoods to poor cancer outcomes. The Neighborhood Deprivation Index (NDI) quantifies socioeconomic disadvantage, but its impact on gastroesophageal adenocarcinoma outcomes remains understudied. We conducted a retrospective analysis of 40,589 patients with esophageal or gastric adenocarcinoma from the SEER database (1996-2015), stratifying them by NDI: less disadvantaged (NDI < 60) and highly disadvantaged (NDI ≥ 60). Multivariate regression showed NDI ≥ 60 was independently associated with worse overall survival (OS) (HR 1.027, <i>p</i> = 0.017) and disease-specific survival (DSS) (HR 1.025, <i>p</i> = 0.04). Other predictors of poor OS and DSS included older age (≥60 years old), male sex, single marital status, lack of insurance, advanced stage/grade, and gastric tumor site. In contrast, Hispanic and non-Hispanic Black ethnicity, urban residence, and undergoing surgery were associated with better outcomes. Disadvantaged neighborhoods are linked to poorer survival in upper GI cancers, likely due to socioeconomic barriers. Addressing social determinants of health is crucial to reducing these disparities.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 18","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12469319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174707","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}