Healthcare

22 pages, 4413 KB

Open AccessArticle

Evaluation of DAid^® Smart Socks for Foot Plantar Center of Pressure Measurements in Football-Specific Tasks: A Preliminary Validation Study

by Anna Davidovica, Guna Semjonova, Aleksejs Kataševs, Aleksandrs Okss, Darja Nesterovica and Signe Tomsone

Healthcare 2026, 14(1), 76; https://doi.org/10.3390/healthcare14010076 (registering DOI) - 27 Dec 2025

Abstract

Background/Objectives: Accurate plantar pressure assessment is essential for injury prevention and rehabilitation monitoring in sports. Wearable sensor technologies, such as DAid^® Smart Socks, offer portable, real-time biomechanical feedback and enable data collection in field conditions. However, there is limited evidence on their [...] Read more.

Background/Objectives: Accurate plantar pressure assessment is essential for injury prevention and rehabilitation monitoring in sports. Wearable sensor technologies, such as DAid^® Smart Socks, offer portable, real-time biomechanical feedback and enable data collection in field conditions. However, there is limited evidence on their level of agreement with a gold standard in measuring the foot plantar center of pressure (CoP) in football-specific tasks. This study aimed to determine the preliminary validity of DAid^® Smart Socks compared with a gold-standard force platform in measuring plantar center of pressure (CoP) during functional football FIFA 11+ Part 2 exercises. Methods: Ten male volunteer youth football players (mean age 12.2 ± 0.42 years; height 158.7 ± 7.72 cm; weight 46.46 ± 8.78 kg; shoe size EU 39.8 ± 2.68) from the Latvian Football Federation Youth League participated. Eight players had right-leg dominance, two had left-leg dominance; three reported past lower-limb injuries. Plantar pressure was measured simultaneously using DAid^® Smart Socks and a 1.5 m entry-level force platform with a calibration factor of 3.2. Center of pressure (CoP) data from the force platform were recorded using Footscan software version 9.10.4. Participants performed two selected FIFA 11+ Part 2 exercises—a single-leg squat (unilateral) and a squat with heel raise, performed bilaterally—under standardized conditions. Each exercise was performed twice, with sock removal and reapplication between trials. Agreement between the DAid^® Smart Socks and the force platform was examined using waveform synchronization, root mean square error (RMSE), Bland–Altman analysis, and Lin’s Concordance Correlation Coefficient (CCC) to quantify both relative waveform correspondence and absolute CoP measurement accuracy. Results: Across 160 paired recordings, the DAid^® Smart Socks showed moderate-to-high correlation with the force platform for relative CoP dynamics, with 79% of waveforms demonstrating CCC ≥ 0.60. Absolute agreement was limited, with only 16% of recordings reaching CCC ≥ 0.90, and RMSE values ranging from 2.1 to 18.9 mm (X) and 4.3–34.2 mm (Y). Conclusions: DAid^® Smart Socks showed moderate-to-high correspondence with the force platform in capturing the directional and temporal characteristics of plantar CoP during functional football tasks, with agreement varying across individuals. Full article

(This article belongs to the Special Issue Physical Therapy and Rehabilitation in Sports)

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15 pages, 252 KB

Open AccessArticle

Artificial Intelligence and Emotional Support: A Comparative Study of University Students with and Without Disabilities

by Raquel Suriá-Martínez, Fernando García-Castillo, Carmen López-Sánchez and José A. García del Castillo

Healthcare 2026, 14(1), 75; https://doi.org/10.3390/healthcare14010075 (registering DOI) - 27 Dec 2025

Abstract

Background/Objectives: This study explores the perceived usefulness and use of artificial intelligence (AI)-based technologies as informational and emotional support among university students with and without disabilities. Methods: The sample consisted of 358 students from the University of Alicante, aged between 16 and [...] Read more.

Background/Objectives: This study explores the perceived usefulness and use of artificial intelligence (AI)-based technologies as informational and emotional support among university students with and without disabilities. Methods: The sample consisted of 358 students from the University of Alicante, aged between 16 and 30 years; 88 participants identified as having a disability, while 270 reported no disability. The gender distribution was balanced, with 53% women and 47% men. An ad hoc questionnaire was applied to evaluate familiarity, frequency of use, and perceived usefulness of AI as a means of obtaining informational and emotional support. Results: The results of the multivariate analyses indicated that students without disabilities reported greater familiarity with and more frequent use of AI tools compared to students with disabilities. Significant differences were found in perceived usefulness for obtaining both informational and emotional support, with higher ratings among students without disabilities, and a moderate effect size. Moreover, frequency of use was positively associated with perceived usefulness in both groups, suggesting that practical experience influences users’ evaluations. Discussions: The findings suggest that students perceive AI as a useful resource for informational and emotional support. However, as with other technologies, addressing accessibility and perception gaps is crucial to promote effective inclusion in university settings. Full article

(This article belongs to the Special Issue AI, Emotion, and Health: Applying Algorithmic Intelligence to Improve Well-Being)

12 pages, 425 KB

Open AccessArticle

Factors for Returning to Work for Patients with Physical Disabilities and Brain Damage After Industrial Accidents

by Dahyeon Koo, Jun Hwa Choi, Eun Suk Choi and Dougho Park

Healthcare 2026, 14(1), 74; https://doi.org/10.3390/healthcare14010074 (registering DOI) - 27 Dec 2025

Abstract

Background/Objectives: Return to work (RTW) after an industrial accident is crucial for an individual’s well-being and socioeconomic recovery. This study investigated factors influencing RTW among workers who sustained physical or brain lesion-related disabilities following industrial accidents. Methods: Using five-year panel data [...] Read more.

Background/Objectives: Return to work (RTW) after an industrial accident is crucial for an individual’s well-being and socioeconomic recovery. This study investigated factors influencing RTW among workers who sustained physical or brain lesion-related disabilities following industrial accidents. Methods: Using five-year panel data (2018–2022) from the Panel Study of Workers’ Compensation Insurance of South Korea, we analyzed 340 individuals with physical or brain lesion-related disabilities sustained from industrial accidents. We used logistic regression models to identify factors associated with RTW and return to employed (RTE) status. Results: The RTW and non-RTW groups comprised 160 and 180 participants, respectively. Factors associated with non-RTW included female sex (adjusted odds ratio [aOR], 0.33; 95% confidence interval [CI], 0.13–0.86; p = 0.023), injury caused by disease (aOR, 0.18; 95% CI, 0.05–0.66; p = 0.010), long recovery periods (aOR, 0.27; 95% CI, 0.10–0.72; p = 0.009), low self-confidence (aOR, 0.16; 95% CI, 0.07–0.35; p < 0.001), and older age (aOR, 0.08; 95% CI, 0.02–0.34; p = 0.001). Workers with no blood pressure problems (aOR, 2.21; 95% CI, 1.11–4.38; p = 0.024) and longer employment durations (aOR, 3.84; 95% CI, 1.15–12.81; p = 0.029) had a higher chance of RTW. Similar factors were associated with RTE, with more emphasis on older age, long recovery periods, low self-confidence, and injury caused by disease. Conclusions: Our findings contribute to developing targeted support services and informing policy decisions to improve RTW for workers with physical or brain lesion-related disabilities caused by industrial accidents. Full article

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15 pages, 567 KB

Open AccessSystematic Review

Impact of Social Media on HPV Vaccine Knowledge and Attitudes Among Adolescents and Young Adults: A Systematic Literature Review

by Blessing Oluwatofunmi Apata, Anagha Hemant Tupe, Oluwabusayomi Akeju and Kelly L. Wilson

Healthcare 2026, 14(1), 73; https://doi.org/10.3390/healthcare14010073 (registering DOI) - 27 Dec 2025

Abstract

Objective: Human Papillomavirus (HPV), a leading cause of sexually transmitted infections (STIs) and various cancers, including cervical cancer, remains prevalent in the US. Despite the HPV vaccine’s effectiveness in preventing persistent HPV infections, vaccination rates remain low. Given the significant role of [...] Read more.

Objective: Human Papillomavirus (HPV), a leading cause of sexually transmitted infections (STIs) and various cancers, including cervical cancer, remains prevalent in the US. Despite the HPV vaccine’s effectiveness in preventing persistent HPV infections, vaccination rates remain low. Given the significant role of social media in reaching younger populations, this systematic review examines its influence on adolescents’ and young adults (AYAs) awareness, knowledge, and attitudes toward HPV vaccination. Methods: Following the PRISMA guidelines, we conducted a comprehensive search across six electronic databases (ERIC, APA PsycInfo, Child Development & Adolescent Studies, CINAHL Ultimate, MEDLINE Ultimate, and PubMed) from 2011 to 2024. Empirical studies that examined the association between social media use and HPV were included. Data extraction captured the study’s purpose, design, population, outcome measures, and key results. Results: Seven studies satisfied the review’s inclusion criteria. Our findings reveal mixed effects of social media on AYAs’ knowledge and vaccination intentions. Some studies indicated positive associations between social media interventions and increased vaccination knowledge and intentions, while others found no significant impact. Additionally, exposure to anti-vaccine content was linked to lower vaccination intentions, especially among individuals with lower knowledge who were more vulnerable to misinformation. Interventions incorporating interactive content and loss-framed messaging were more effective in increasing vaccine intentions. Conclusions: This review underscores the potential of social media to influence AYAs knowledge and perceptions regarding HPV vaccination, while also highlighting the challenges posed by misinformation. Further research is needed to optimize social media interventions and combat misinformation to improve vaccination uptake. Full article

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23 pages, 352 KB

Open AccessArticle

by Merve Berika Kadıoğlu, Meyra Durmaz and Mahmut Kadıoğlu

Healthcare 2026, 14(1), 72; https://doi.org/10.3390/healthcare14010072 (registering DOI) - 27 Dec 2025

Abstract

Background/Objectives: Dental training is known for its demanding academic pace, early clinical exposure, and constant performance pressure. These stressors may contribute to behavioral and physical manifestations, including bruxism and temporomandibular disorder (TMD). This study aimed to better understand the multidimensional burden experienced in [...] Read more.

Background/Objectives: Dental training is known for its demanding academic pace, early clinical exposure, and constant performance pressure. These stressors may contribute to behavioral and physical manifestations, including bruxism and temporomandibular disorder (TMD). This study aimed to better understand the multidimensional burden experienced in this educational setting by investigating the relationship between education-related stress, bruxism patterns, and temporomandibular symptoms (TMD-related symptoms) in dental students. Methods: A cross-sectional survey was conducted at the Ankara University Faculty of Dentistry in 2025 and completed by 287 undergraduate dental students. The questionnaire collected sociodemographic information, self-reported bruxism status, TMD-related symptoms via the Fonseca Anamnestic Index (FAI), and education-related stressors using the Dental Environment Stress (DES) scale. Descriptive statistics, group comparisons, and Spearman correlation analyses were conducted. Results: Bruxism was reported by 76% of students and was significantly more common among females (p < 0.05). Students with bruxism demonstrated higher DES (3.34 ± 0.84) and FAI (41.81 ± 20.32) scores compared with those without bruxism (p < 0.001). DES and FAI scores showed a significant positive correlation (r = 0.229, p < 0.001). Stressors related to workload, examinations, limited rest time, clinical uncertainty, patient responsibility, and financial concerns were strongly associated with bruxism, while inconsistent academic feedback emerged as a key distinguishing factor. Conclusions: Education-related stress is closely linked to bruxism and TMD-related symptoms among dental students. Beyond overall stress intensity, the nature of experienced stressors plays a critical role. These findings highlight the importance of supportive learning structures, targeted stress-management strategies, and curriculum-level improvements to promote student wellbeing and resilience. Full article

(This article belongs to the Special Issue Promoting Wellness and Excellence in Health Education for Medical Students and Healthcare Professionals)

9 pages, 369 KB

Open AccessReview

The Utilization, Application, and Impact of Institutional Special Needs Plans (I-SNPs) in Nursing Facilities: A Rapid Review

by Michael Mileski, Roland Shapley, Bradley Beauvais, Joseph Baar Topinka, Ramalingam Shanmugam, Jose A. Betancourt, Matthew Brooks and Rebecca McClay

Healthcare 2026, 14(1), 71; https://doi.org/10.3390/healthcare14010071 (registering DOI) - 27 Dec 2025

Abstract

Background/Objectives: Institutional Special Needs Plans (I-SNPs) are designed to enhance the quality of care for long-term nursing facility (NF) residents. However, utilization patterns vary significantly, and their broader impact remains only partially understood. This rapid review aims to identify, map, and synthesize [...] Read more.

Background/Objectives: Institutional Special Needs Plans (I-SNPs) are designed to enhance the quality of care for long-term nursing facility (NF) residents. However, utilization patterns vary significantly, and their broader impact remains only partially understood. This rapid review aims to identify, map, and synthesize the existing literature on the use of I-SNPs in nursing homes. Methods: Following Arksey and O’Malley’s framework and PRISMA-ScR guidelines, we conducted a comprehensive search of academic and gray literature using a predefined Boolean string. The extracted data were organized and analyzed thematically. Results: The synthesized literature (n = 12 studies) revealed four primary themes: (1) Market Penetration and Enrollment; (2) Models of Care Application; (3) Impact on Clinical and Financial Outcomes; and (4) Barriers to Utilization. Conclusions: I-SNP utilization represents a shift from fragmented FFS payment models toward integrated managed care within nursing facilities. Evidence shows a reduction in acute care transfers, although findings for other outcomes are mixed, underscoring the need for further research and policy development. Full article

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15 pages, 591 KB

Open AccessSystematic Review

The Contribution of Yoga to the Psychosocial Rehabilitation and Social Reintegration of Incarcerated Individuals: A Systematic Review

by Konstantinos Georgiadis, Giorgos Tzigkounakis, Katerina Simati, Konstantinos Tasios, Ioannis Michopoulos, Vasileios Giannakidis and Athanasios Douzenis

Healthcare 2026, 14(1), 70; https://doi.org/10.3390/healthcare14010070 (registering DOI) - 27 Dec 2025

Abstract

Background/Objectives: Incarcerated people experience high rates of trauma, psychological distress, and social marginalization. Yoga has been introduced in prisons as a trauma-sensitive mind–body practice, yet its rehabilitative contribution remains uncertain. This systematic review aimed to synthesize evidence on the feasibility and effectiveness [...] Read more.

Background/Objectives: Incarcerated people experience high rates of trauma, psychological distress, and social marginalization. Yoga has been introduced in prisons as a trauma-sensitive mind–body practice, yet its rehabilitative contribution remains uncertain. This systematic review aimed to synthesize evidence on the feasibility and effectiveness of yoga interventions delivered in correctional settings. Methods: Following PRISMA guidelines and a preregistered PROSPERO protocol, we searched PubMed, PsycINFO, Cochrane CENTRAL, and Scopus for peer-reviewed publications from May 2012 to November 2025. Eligible studies involved structured yoga interventions for incarcerated populations and reported psychological, behavioral, or institutional outcomes. Two reviewers independently performed screening, data extraction, and quality appraisal using the Mixed-Methods Appraisal Tool (MMAT). Results: Ten studies reported in twelve publications and involving 1815 incarcerated individuals met the inclusion criteria. Interventions included Hatha-based protocols, Krimyoga, trauma-informed approaches, and multicomponent programs. Across randomized, quasi-experimental, and pre–post designs, yoga was feasible and acceptable. Reported benefits included reduced psychological distress, negative affect, anger, and trauma-related symptoms, as well as improved mood, self-regulation, and mindfulness. Evidence specific to women and girls was limited, but the available trauma-informed and gender-responsive studies suggested potential reductions in post-traumatic stress, depression, and anxiety, alongside increases in self-compassion. One large quasi-experimental cohort found lower reincarceration rates among yoga participants, although institutional outcomes were otherwise limited. Evidence was constrained by small samples, heterogeneous intervention formats, short follow-up, and variable outcome measures. Conclusions: Yoga appears to be a promising adjunct to rehabilitation in correctional settings. However, methodological limitations prevent firm conclusions. Larger, well-controlled studies with standardized outcomes and longer follow-up are needed to clarify effectiveness and support integration into correctional health and rehabilitation policy. Full article

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15 pages, 893 KB

Open AccessArticle

Sleep Quality and Cardiopulmonary Responses During Exercise Testing: Exploring the Chronotropic and Ventilatory Response Relationship with Sleep Quality in Healthy Young Men: A Cross-Sectional Study

by Ahmad M. Osailan

Healthcare 2026, 14(1), 69; https://doi.org/10.3390/healthcare14010069 (registering DOI) - 27 Dec 2025

Abstract

Background: Sleep quality is critical to health, and its disturbances may affect multiple systems, including autonomic and respiratory regulation. However, its relationship with chronotropic and ventilatory responses in healthy young men remains underexplored. Thus, the study aimed to investigate the relationship between sleep [...] Read more.

Background: Sleep quality is critical to health, and its disturbances may affect multiple systems, including autonomic and respiratory regulation. However, its relationship with chronotropic and ventilatory responses in healthy young men remains underexplored. Thus, the study aimed to investigate the relationship between sleep quality, as measured by the Pittsburgh Sleep Quality Index (PSQI), and chronotropic and ventilatory responses during cardiopulmonary exercise testing (CPET) in a healthy young male population and to explore group differences between good and poor sleepers. Methods: Thirty-three healthy men completed the PSQI and a graded CPET with breath-by-breath gas analysis. Pearson correlation was used to examine relationships between the PSQI and CPET outcomes: chronotropic response (%), tidal volume (VT), minute ventilation (VE), VO₂, VCO₂, expired O₂/CO₂, VE/VO₂, and VE/VCO₂. After accounting for age, height, and weight, the correlation was reassessed. Secondary analyses using a standard cut-off point compared good (PSQI < 5) vs. poor sleepers (PSQI ≥ 5) with Welch’s t-tests. Results: Participants were predominantly poor sleepers (84.8%; PSQI 7.3 ± 3.2). A higher PSQI correlated with lower chronotropic response (r = −0.35, p = 0.04), lower VT (r = −0.42, p = 0.02), lower expired O₂ (r = −0.46, p = 0.01), and lower expired CO₂ (r = −0.33, p = 0.05). Associations with VE, VO₂, VCO₂, VE/VO₂, and VE/VCO₂ were small and non-significant (p > 0.05). When age, height, and weight were controlled for, the attenuated chronotropic response association with the PSQI was not significant; however, the PSQI association remained significant for expired O₂ (r = −0.32, p = 0.04), with a trend for VT. In group comparisons, chronotropic response was higher but not significant; good sleepers showed higher VT and greater expired O₂/CO₂ (p < 0.05). Conclusions: Poorer sleep quality was initially associated with multiple cardiopulmonary responses at peak during CPET. However, after controlling for age and anthropometry measures, only expired O₂ remained linked. The findings suggest that routine sleep quality screening may add interpretive value to CPET by flagging individuals with reduced ventilatory depth, warranting prospective studies to test whether improving sleep quality can enhance exercise responses. Full article

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12 pages, 541 KB

Open AccessArticle

Impact of LHRHa Therapy on Relationship Dynamics and Sexual Coercion in Premenopausal Breast Cancer Patients: A Multicenter Cross-Sectional Study

by Mustafa Ersoy and Canan Kaş

Healthcare 2026, 14(1), 68; https://doi.org/10.3390/healthcare14010068 (registering DOI) - 26 Dec 2025

Abstract

Background/Objectives: Luteinizing hormone-releasing hormone agonists (LHRHa) are widely used to induce ovarian suppression in premenopausal women with hormone receptor-positive breast cancer. Although effective, abrupt medical menopause may negatively affect sexual health and intimate partner interactions. Sexual coercion—ranging from manipulation to explicit pressure—remains an [...] Read more.

Background/Objectives: Luteinizing hormone-releasing hormone agonists (LHRHa) are widely used to induce ovarian suppression in premenopausal women with hormone receptor-positive breast cancer. Although effective, abrupt medical menopause may negatively affect sexual health and intimate partner interactions. Sexual coercion—ranging from manipulation to explicit pressure—remains an underrecognized psychosocial burden in oncology. This multicenter study aimed to evaluate the association between LHRHa therapy and sexual coercion, including relational dynamics measured through the Sexual Coercion in Intimate Relationships Scale (SCIRS). Methods: This cross-sectional study included 81 premenopausal breast cancer patients receiving endocrine therapy at three tertiary centers in Türkiye. Participants were categorized into tamoxifen monotherapy users (n = 39) and LHRHa users (n = 42). Sexual coercion was assessed using the validated Turkish SCIRS, which includes Resource Manipulation/Violence, Defection Threat, and Commitment Manipulation domains. Mann–Whitney U, Kruskal–Wallis, and ANCOVA analyses were performed, adjusting for age, treatment duration, surgery type, chemotherapy, radiotherapy, and education level. The study was ethically approved (2023-KAEK-148) and prospectively registered (NCT06840847). Results: LHRHa users demonstrated significantly higher SCIRS scores across all domains compared with non-users (RM/V: p = 0.039; DT: p = 0.001; CM: p < 0.001; Total: p = 0.004). ANCOVA confirmed LHRHa therapy as an independent predictor after adjusting for covariates (p = 0.001–0.006). The largest effect was observed in the Commitment Manipulation domain (partial η² = 0.177). Younger patients (≤ 36 years) reported significantly greater coercion exposure across all domains (p = 0.018–0.042). Conclusions: LHRHa therapy is associated with increased sexual coercion and strained relational dynamics in premenopausal breast cancer patients, particularly among younger women. These findings emphasize the need for routine sexual health assessment, confidential psychosocial screening, and age-sensitive supportive interventions in endocrine therapy management. Full article

(This article belongs to the Section Mental Health and Psychosocial Well-being)

17 pages, 559 KB

Open AccessArticle

Mindful Eating and Healthy Lifestyle Behaviors Among Women with and Without Regular Exercise Habits

by Handan Isiklar, Meral Kucuk Yetgin and Zuhal Aydan Saglam

Healthcare 2026, 14(1), 67; https://doi.org/10.3390/healthcare14010067 (registering DOI) - 26 Dec 2025

Abstract

Background/Objectives: Eating mindfulness and healthy lifestyle behaviors play a key role in preventing unhealthy weight gain. Understanding how these behaviors differ according to exercise habits can guide interventions targeting women’s health. This study aimed to compare healthy lifestyle behaviors and eating mindfulness between [...] Read more.

Background/Objectives: Eating mindfulness and healthy lifestyle behaviors play a key role in preventing unhealthy weight gain. Understanding how these behaviors differ according to exercise habits can guide interventions targeting women’s health. This study aimed to compare healthy lifestyle behaviors and eating mindfulness between women with and without regular exercise habits. Methods: A cross-sectional, analytical, and descriptive study was conducted with 156 women: a Regular Exercise Group (REG, n = 68) and a Non-Exercise Group (NEG, n = 88). Data were collected through face-to-face interviews using the Mindful Eating Questionnaire (MEQ-30) and the Healthy Lifestyle Behavior Scale II (HLBS-II), along with dietary records and anthropometric measurements. Results: The REG scored significantly higher in eating discipline (p = 0.003) and in HLBS-II subscales of physical activity, nutrition, and stress management (p < 0.05). No significant differences were found in total MEQ scores, BMI-related nutrient intake, or other HLBS-II dimensions (p > 0.05). BMI values and smoking rates were lower in the REG (p < 0.05). Univariate logistic regression showed that BMI, eating discipline, physical activity, nutrition, stress management, and total HPLP-II scores were significantly associated with regular exercise (p < 0.05). In the multivariate model, BMI (OR = 1.114, 95% CI: 1.021–1.216) remained independently associated with regular exercise status. Conclusions: Although eating discipline was higher in the REG, overall mindful eating levels did not differ between groups. BMI were the strongest independent variables associated with regular exercise status, suggesting that while exercise supports positive lifestyle patterns, enhancing mindful eating may require additional targeted interventions. Full article

(This article belongs to the Special Issue Psychophysiological Responses to Physical Activity, Exercise and/or Nutrition Interventions in Individuals with Cardiometabolic Health Impairments)

26 pages, 786 KB

Open AccessSystematic Review

From Social Robotics to Ecological Cognitive Care: An Enaction-Based Umbrella Review on Neurocognitive Disorders

by Giuseppe Romeo, Daniela Conti and Santo F. Di Nuovo

Healthcare 2026, 14(1), 66; https://doi.org/10.3390/healthcare14010066 (registering DOI) - 26 Dec 2025

Abstract

Background: As ageing populations grow, the prevalence of dementia and pre-dementia conditions is rising. Emerging approaches to neurorehabilitation emphasize not only performance-based outcomes but also holistic, experiential, and person-centred aspects of care. The extended mind thesis further highlights the potential role of external [...] Read more.

Background: As ageing populations grow, the prevalence of dementia and pre-dementia conditions is rising. Emerging approaches to neurorehabilitation emphasize not only performance-based outcomes but also holistic, experiential, and person-centred aspects of care. The extended mind thesis further highlights the potential role of external tools in supporting impaired cognitive functions. Within this ecological and experiential perspective, Social Assistive Robotics (SAR) may offer a multidimensional approach to address cognitive, emotional, and social needs in neurocognitive disorders. Objective: To synthesize current evidence on the effects of robotic interventions within an enactive framework integrating mind, body, environment, and technology. Methods: A systematic search was conducted in PubMed, Ovid Medline, Scopus, ScienceDirect, Springer, Wiley, IEEE Xplore, ACM Digital Library, and the Cochrane Library. Due to heterogeneity among included studies, an umbrella review was performed using vote-counting by direction of effect as a non-quantitative synthesis method. Methodological rigour followed JBI and Cochrane guidelines. Results: Sixteen reviews were included. The strongest and most consistent benefits emerged for affective outcomes, particularly emotional response and social interaction p = 0.007 (two-sided). Conversely, outcomes related to cognition, anxiety, agitation, depression, and quality of life showed mixed or non-significant effects, while neuropsychiatric symptoms demonstrated no benefit. Conclusions: Discrepancies across reviews seem driven by methodological limitations in primary studies, limiting interpretability. The strength of this umbrella review lies in identifying systematic gaps that can guide future research. With stronger evidence, integrating SAR into experiential neurorehabilitation may offer a promising avenue for holistic, ecologically grounded care that extends beyond traditional task-based performance. Trial Registration: PROSPERO CRD420251165419. Full article

(This article belongs to the Special Issue Revolutionizing Cognitive Rehabilitation: The Role of Digital Technologies)

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4 pages, 150 KB

Open AccessEditorial

Psychological Health and Social Wellbeing Among Older Adults

by Doreen W. H. Au

Healthcare 2026, 14(1), 65; https://doi.org/10.3390/healthcare14010065 (registering DOI) - 26 Dec 2025

Abstract

In contemporary health discourse, the terms “mental health,” “psychological health,” and “social wellbeing” are prominent, collectively representing the emotional, cognitive, and social facets of overall wellness [...] Full article

(This article belongs to the Special Issue Psychological Health and Social Wellbeing Among Older Adults)

17 pages, 356 KB

Open AccessReview

Non-Invasive Methods for the Secondary and Tertiary Prevention of Early Childhood Caries: A Scoping Review

by Agnieszka Wasiluk, Katarzyna Domosławska-Żylińska and Dominik Olejniczak

Healthcare 2026, 14(1), 64; https://doi.org/10.3390/healthcare14010064 (registering DOI) - 26 Dec 2025

Abstract

Background: Early childhood caries is defined as a carious disease affecting primary teeth in children under 6 years of age. It may lead to pain, infections, and difficulties with eating. Despite its burden, evidence on simple, non-invasive preventive approaches which can be implemented [...] Read more.

Background: Early childhood caries is defined as a carious disease affecting primary teeth in children under 6 years of age. It may lead to pain, infections, and difficulties with eating. Despite its burden, evidence on simple, non-invasive preventive approaches which can be implemented both in dental clinics and outreach services is fragmented. The aim of this review was to identify and map such methods for the secondary and tertiary prevention of ECC and to define priorities for future research. Material and Methods: The scoping review followed the PCC framework (Population–Concept–Context). Two databases were searched: PubMed and Scopus. A systematic search was conducted in PubMed and Scopus between 1 August and 30 September 2025. Eligible studies included children under 6 years of age with existing carious lesions, evaluated non-invasive methods for secondary and tertiary ECC prevention (such as sodium fluoride (NaF), silver diamine fluoride (SDF), nano-silver fluoride (NSF), and motivational techniques), requiring simple armamentarium, and reported data on the effectiveness in the context of ECC. Only publications from the past 5 years, available in English, and in open access, were considered. The results of the analysis were summarized narratively, outlining intervention types based on their characteristics, impact, and usage context. Results: Fifteen studies were included. Most were randomized controlled trials (eight studies), focusing primarily on silver diamine fluoride (SDF), often compared with other non-invasive methods, followed by systematic reviews (two studies), reviews (two studies), cross-sectional studies (two articles), and one qualitative study. Only one publication examined the use of motivational interviewing within the context of ECC. While the evidence on non-invasive approaches is growing, significant gaps remain. Small sample sizes, short follow-up periods, and heterogenous interventions and outcomes limit comparability. To strengthen the evidence base, future studies should recruit larger cohorts, adhere to standardized procedures, and use consistent reporting. Conclusions: The majority of studies focused on SDF, reflecting the increasing interest in its use. Research on motivational interviewing in ECC is particularly scarce. Further research under standardized conditions is needed to enable reliable comparisons across treatment protocols. Full article

(This article belongs to the Section Women’s and Children’s Health)

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18 pages, 662 KB

Open AccessArticle

The Association of Outpatient Cost-Sharing Policy with Health and Economic Outcomes for Rural Children in China: A Cross-Sectional Study

by Chen Wu and Lixiong Yang

Healthcare 2026, 14(1), 63; https://doi.org/10.3390/healthcare14010063 (registering DOI) - 26 Dec 2025

Abstract

Background/Objectives: Under the urban–rural dual structure, rural children’s health security faces multiple challenges. These stem from geographical disadvantages, inadequate resources, and systemic flaws in medical insurance design. The outpatient cost-sharing policy is a key design to address these issues. Methods: Using [...] Read more.

Background/Objectives: Under the urban–rural dual structure, rural children’s health security faces multiple challenges. These stem from geographical disadvantages, inadequate resources, and systemic flaws in medical insurance design. The outpatient cost-sharing policy is a key design to address these issues. Methods: Using data from the 2018 China Household Income Project (CHIP), this study employs Propensity Score Matching, Ordered Probit, Logit, and a Two-Part Model to examine the association between the policy and the health and economic outcomes of rural children. Conclusions: The results show that the policy is significantly associated with better child health scores and a higher probability of reimbursement. These positive associations appear to be connected to three potential factors: higher use of outpatient services, better mother’s health, and greater school-related food and accommodation expenses. In contrast to adult populations, no significant substitution between outpatient and inpatient services was observed for children, suggesting the non-discretionary and rigid nature of pediatric hospitalization decisions. This research provides robust empirical evidence for the policy’s potential benefits, offering important implications for optimizing the child medical security system. Full article

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10 pages, 461 KB

Open AccessArticle

Evaluation of Parents and Child Satisfaction Toward Primary Molar Restoration with Preformed Metal Crowns and Its Impact on Child Bullying

by Abdulfatah Alazmah

Healthcare 2026, 14(1), 62; https://doi.org/10.3390/healthcare14010062 (registering DOI) - 26 Dec 2025

Abstract

Objective: This study aimed to assess the psychosocial impact of stainless steel crowns (SSCs) among primary school children in Dammam, Saudi Arabia, focusing on bullying experiences, child satisfaction, and parental perception. Methods: A cross-sectional survey was conducted in June 2025 among 123 children [...] Read more.

Objective: This study aimed to assess the psychosocial impact of stainless steel crowns (SSCs) among primary school children in Dammam, Saudi Arabia, focusing on bullying experiences, child satisfaction, and parental perception. Methods: A cross-sectional survey was conducted in June 2025 among 123 children (mean age 7.8 years; 52% male) from two randomly selected schools. Schools were chosen using simple random sampling from a Ministry of Education-approved list. All children aged 6–10 years with at least one SSC placed for six months or more were eligible. A validated, self-administered questionnaire completed by children and their parents assessed bullying related to SSCs, satisfaction with the crown’s appearance, and perceived impact. Statistical analyses included descriptive statistics, Chi-square tests, and logistic regression to evaluate associations between variables (p < 0.05). Results: Bullying was reported by 39.0% of children, primarily verbal (58.1%), followed by social exclusion (29.1%). Although gender differences in bullying were not statistically significant (p = 0.829), boys more often reported nickname-based teasing (p < 0.001). Only 35.0% of children were satisfied with the crown’s shape and 29.3% with its color. Nearly half (48.8%) felt uncomfortable when asked about it. In contrast, parental satisfaction was higher (69.1%), though only 42.3% believed their child had fully accepted the crown. Conclusions: While SSCs are clinically effective and accepted by most parents, a notable proportion of children experience bullying and aesthetic dissatisfaction. These findings highlight the need for child-centered care and consideration of esthetic alternatives. Full article

(This article belongs to the Special Issue Oral Medicine in Focus: Improving Diagnosis and Treatment Through Continued Education)

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19 pages, 596 KB

Open AccessArticle

What You Can Do: A Qualitative Study on Black Maternal Mental Health and Equity

by Amittia Parker

Healthcare 2026, 14(1), 61; https://doi.org/10.3390/healthcare14010061 (registering DOI) - 26 Dec 2025

Abstract

Background/Objectives: Maternal mental health concerns are a leading cause of maternal morbidity and mortality, disproportionately impacting Black mothers in the United States. Structural racism and social determinants of health contribute to increased risks of perinatal mental health issues, limited access to formal [...] Read more.

Background/Objectives: Maternal mental health concerns are a leading cause of maternal morbidity and mortality, disproportionately impacting Black mothers in the United States. Structural racism and social determinants of health contribute to increased risks of perinatal mental health issues, limited access to formal services, and adverse health outcomes for Black mothers. While formal mental health services are underutilized, Black mothers employ a variety of culturally relevant and context-specific strategies to support their mental health. This study seeks to understand the barriers, preferences, and experiences that guide their decision-making and inform culturally responsive care. Methods: This qualitative study employed thematic analysis of in-depth interviews conducted with 12 Black mothers aged 20–39 residing in a midwestern metropolitan area. The research explored individual experiences, preferences for support, and perspectives on healthcare to identify pathways for advancing mental health equity. Results: Three major themes emerged: (1) Expanding conceptions of mental health support beyond traditional services, emphasizing preferences for culturally congruent, convenient, and stress-decreasing interventions; (2) The salience of past experiences and identities in shaping support preferences and decisions; (3) What healthcare professionals can do, the knowledge and skills healthcare professionals can gain, and the actions that they can to become more helpful to Black mothers. The importance of healthcare professionals embodying nonjudgmental, patient, and caring attributes, as well as strengths-based, culturally responsive approaches in care. Conclusions: Advancing mental health equity for Black mothers requires increased awareness of existing disparities, barriers to care, and the strengths embedded within their communities. This research provides actionable insights for healthcare providers, policy makers, and researchers to identify, assess, and respond to the unique needs of Black mothers through culturally responsive and participatory approaches. Findings have implications for intervention design, theory development, and policy reform to improve mental health outcomes. Full article

(This article belongs to the Special Issue Advancing Mental Well-Being and Health Equity in Marginalized Communities)

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16 pages, 919 KB

Open AccessArticle

12-Month Weight Loss and Adherence Predictors in a Real-World UK Tirzepatide-Supported Digital Obesity Service: A Retrospective Cohort Analysis

by Louis Talay, Jason Hom, Tamara Scott and Neera Ahuja

Healthcare 2026, 14(1), 60; https://doi.org/10.3390/healthcare14010060 (registering DOI) - 26 Dec 2025

Abstract

Background: Obesity management is evolving with the integration of dual GIP/GLP-1 receptor agonists (Tirzepatide) into comprehensive Digital Weight-Loss Services (DWLSs). This model leverages virtual, app-based multidisciplinary care (MDT) to deliver continuous, supervised treatment, distinguishing it from traditional, intermittent clinic-based care. While clinical [...] Read more.

Background: Obesity management is evolving with the integration of dual GIP/GLP-1 receptor agonists (Tirzepatide) into comprehensive Digital Weight-Loss Services (DWLSs). This model leverages virtual, app-based multidisciplinary care (MDT) to deliver continuous, supervised treatment, distinguishing it from traditional, intermittent clinic-based care. While clinical trials demonstrate high efficacy, real-world data are necessary to evaluate long-term adherence and identify predictive markers for patient persistence in these scalable care models. Specifically, there is a knowledge gap regarding the specific behavioral factors that govern 12-month persistence in these comprehensive, medicated DWLS settings. This study retrospectively assessed the 12-month effectiveness and adherence of a Tirzepatide-supported DWLS and identified demographic, clinical, and behavioral predictors of weight loss and program attrition. Methods: Data from 19,693 patients enrolled in the Juniper UK DWLS were analyzed. Adherence was defined by a minimum of 10 medication orders and 12-month weight submission. Weight loss in the full cohort was evaluated using the Last Observation Carried Forward (LOCF) method. Binary logistic and multiple linear regression models identified predictors of adherence and weight loss, respectively, using a comprehensive set of demographic, clinical (e.g., BMI, comorbidities), and behavioral variables. Results: The 12-month adherence rate was 27%. The adherent sub-cohort (n = 5322) achieved a mean weight loss of 22.60 (±7.46) percent, compared to 13.62 (±10.85) percent in the full cohort (LOCF). This difference in 12-month mean weight loss was statistically significant (p < 0.001). Consistent weekly weight tracking and health coach communication were the strongest positive predictors of long-term adherence and weight loss. Conversely, hyper-engagement, specifically intensive tracking frequency and high weight loss velocity in the first month, was a significant inverse predictor of 12-month adherence. Reporting side effects was positively correlated with adherence, suggesting a reporting bias among engaged patients. Conclusions: The DWLS model facilitates the maximum therapeutic effectiveness for adherent patients. However, patient persistence remains the primary translational challenge. As consistent weekly engagement (tracking, coaching) is the strongest predictor of success, clinical strategies should prioritize promoting sustainable, moderate behavioral pacing (i.e., emphasizing consistent weekly engagement over intensive daily tracking and rapid early weight loss) to mitigate attrition risk and optimize the public health effectiveness of medicated DWLSs. Full article

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18 pages, 589 KB

Open AccessArticle

Symptom Experiences and Coping Strategies in Turkish Patients with Implantable Cardioverter-Defibrillators: A Cross-Sectional Study Based on Interviews

by Sebiha Aktaş Us and Sultan Taşcı

Healthcare 2026, 14(1), 59; https://doi.org/10.3390/healthcare14010059 (registering DOI) - 26 Dec 2025

Abstract

Background/Objectives: Although implantable cardioverter defibrillators (ICDs) play a critical role in reducing the risk of sudden cardiac death, patients may report various physical and psychological symptoms during the implantation process. This study aimed to examine ICD patients’ retrospective reports of pre-implantation symptoms, their [...] Read more.

Background/Objectives: Although implantable cardioverter defibrillators (ICDs) play a critical role in reducing the risk of sudden cardiac death, patients may report various physical and psychological symptoms during the implantation process. This study aimed to examine ICD patients’ retrospective reports of pre-implantation symptoms, their concurrent assessment of post-implantation symptom experiences, and the non-pharmacological methods they used to cope with these symptoms. Methods: A cross-sectional study was conducted with ICD patients who visited the arrhythmia clinic between May and August 2022. Data were collected using a questionnaire developed by the researchers and medical records. The study analyzed changes in symptoms reported by patients, individual coping methods used, the perceived effectiveness of these methods, and comparisons of methods used according to descriptive and clinical characteristics. Results: Patients reported a decrease in chest pain, palpitations, dizziness, syncope, and shortness of breath after ICD implantation (p < 0.001). However, they reported an increase in fatigue and anxiety levels (p < 0.001); no significant change was reported for insomnia (p = 0.473) and fear (p = 0.082). Furthermore, no significant difference was observed between patients who received shock therapy and those who did not in terms of changes in anxiety and fatigue levels, and the increase in anxiety was similar in both groups. The most frequently reported coping method among patients was praying, followed by drinking herbal tea and walking. A significant relationship was found between marital status and coping method preference, while no relationship was found with other descriptive and clinical characteristics. Conclusions: Although ICD implantation reduces cardiac symptoms, anxiety and fatigue continue to increase. Patients’ tendency to turn to cultural and spiritual coping methods such as prayer indicates that post-ICD care should be conducted with a holistic approach that also covers psychological and spiritual needs. Full article

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17 pages, 1480 KB

Open AccessReview

Telemedicine to Improve Medical Care of Fishermen in Pelagic Fisheries

by Po-Heng Lin and Chih-Che Lin

Healthcare 2026, 14(1), 58; https://doi.org/10.3390/healthcare14010058 - 25 Dec 2025

Abstract

Fishermen operating in pelagic fisheries often experience significant barriers to medical care due to geographic isolation, harsh environmental conditions, and the absence of onboard healthcare personnel. Telemedicine offers an effective approach to overcome these limitations by enabling remote diagnosis, monitoring, and treatment through [...] Read more.

Fishermen operating in pelagic fisheries often experience significant barriers to medical care due to geographic isolation, harsh environmental conditions, and the absence of onboard healthcare personnel. Telemedicine offers an effective approach to overcome these limitations by enabling remote diagnosis, monitoring, and treatment through satellite-based communication systems. This review summarizes the progress and applications of telemedicine in maritime and other austere environments, focusing on technological advancements, clinical implementations, and emerging trends in artificial intelligence-driven healthcare. Evidence from pilot and retrospective studies highlights the growing use of wearable devices, telementored ultrasound, digital photography, and cloud-based monitoring systems for managing acute and chronic medical conditions at sea. The integration of machine learning and deep learning algorithms has further improved fatigue, stress, and motion detection, enhancing early risk assessment among seafarers. Despite challenges such as limited connectivity, data privacy concerns, and training requirements, the adoption of telemedicine significantly improves health outcomes, reduces emergency evacuations, and promotes occupational safety. Future directions emphasize the development of 5G-enabled Internet of Medical Things networks and predictive AI tools to establish comprehensive maritime telehealth ecosystems for fishermen in pelagic operations. Full article

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