Search Results (24)

Introduction: In recent decades, the burden of mental disorders has become a major determinant of population health in the European Union, generating profound clinical, socioeconomic, and institutional consequences. Despite political recognition of this silent crisis, substantial methodological challenges persist in the transnational monitoring of mental health and in linking disease burden with the resources allocated to address it. The present analysis develops a multivariate taxonomy of EU Member States from a psychosocial perspective, using an integrative quantitative approach. Methods: This cross-sectional, comparative study follows international standards for transparent and reproducible quantitative reporting and is based on 18 harmonized clinical, epidemiological, and institutional indicators collected for 27 EU Member States over the period 2014–2023. The indicators used in this study were grouped according to their position along the care continuum. Hospital-based indicators refer to inpatient activity and institutional capacity, including total hospital discharges, psychiatric admissions (affective disorders, schizophrenia, dementia, alcohol- and drug-related disorders), and hospital bed availability. Outpatient and community-level indicators reflect the capacity of systems to provide non-hospital psychiatric care and consist primarily of psychiatrist density and total specialist medical workforce. Finally, subjective perception indicators capture population-level self-assessed health status, complementing clinical and institutional measures by integrating a psychosocial perspective. After harmonization and standardization, Principal Component Analysis (PCA) with Varimax rotation was applied to identify latent dimensions of mental health. Model adequacy was confirmed using the Kaiser–Meyer–Olkin coefficient (0.747) and Bartlett’s test of sphericity (p < 0.001). Results: Three latent dimensions explaining 77.7% of the total variance were identified: (1) institutionalized psychiatric burden, (2) functional capacity of the health care system, and (3) suicidal vulnerability associated with problematic substance use. Standardized factor scores allowed for the classification of Member States, revealing distinct patterns of psychosocial risk. For example, Germany and France display profiles marked by high levels of institutionalized psychiatric activity, while the Baltic and Southeast European countries exhibit elevated suicidal vulnerability in the context of limited medical resources. These results highlight the deep heterogeneity of psychiatric configurations in Europe and reveal persistent gaps between population needs and institutional response capacity. Conclusions: The analysis provides an empirical foundation for differentiated public policies aimed at prevention, early intervention, and stigma reduction. It also supports the case for institutionalizing a European mental health monitoring system based on harmonized indicators and common assessment standards. Overall, the findings clarify the underlying structure of mental health across the European Union and underscore the need for coherent, evidence-based strategies to reduce inequalities and strengthen system performance at the continental level. Full article

Background: The decline in fertility rates is a growing concern globally, impacting family dynamics and the economy. This study assesses women’s attitudes toward fertility and childbearing in Saudi Arabia and explored their associations with sociodemographic, medical, and psychological factors. Methods: This one-year cross-sectional study involved 2172 Arabic-speaking women aged 18–50 years in Saudi Arabia, with the data collected between December 2022 and January 2023. The online survey, distributed through posts on social media apps as WhatsApp, Twitter, Telegram, Snapchat, and Facebook, measured sociodemographic characteristics, medical and psychiatric history, childbearing preference, and the Arabic version of the Attitudes toward Fertility and Childbearing Scale (AFCS). Results: Item–total correlations ranged from r = 0.124 to higher, all significant at p < 0.01, supporting the scale’s validity. Exploratory Factor Analysis (EFA) identified four emerging factors (eigenvalues > 1), and Bartlett’s test confirmed sample suitability (p < 0.001; Kaiser–Meyer–Olkin = 0.898). Cronbach’s alpha coefficient was 0.898. Participants who were young (71.5%), unmarried (72%), and had psychiatric disorders (16.5%) were more likely to perceive childbearing as less important for their future. Nevertheless, these same groups, along with students (61%), frequently regarded childbearing as a present hindrance that necessitates preparation. Furthermore, participants who were undecided about having children (22.5%) exhibited lower scores in the female identity domain. Conclusions: The Arabic version of the Attitudes toward Fertility and Childbearing Scale appears to be psychometrically sound, encompassing four factors: importance for the future, hindrance at present, childbearing preparation, and female identity. This study found that younger women and those with psychiatric disorders showed lower scores regarding the importance of future childbearing, while college students exhibited more concerns about hindrance and preparation. Full article

Background: The Comprehensive Geriatric Assessment (CGA) has proven to be a valuable tool for providing a more comprehensive health evaluation of allogeneic stem cell transplantation (allo-SCT) recipients. Methods: We prospectively developed and tested a new Simplified Geriatric Score-4 (SGS-4) on 135 consecutive patients aged ≥50 years who underwent allo-SCT between 2020 and 2023. Each CGA component was individually analyzed for its association with overall survival (OS), non-relapse mortality (NRM), and cumulative incidence of relapse (CIR). Then, we performed a two-factor analysis (FA) using oblimin rotation and Bartlett estimation on all CGA components and sex. Based on component weights, a simplified geriatric score-4 score (SGS-4) was created: [Gait Speed] + 2 × [Hand Grip] + Geriatric 8 + 1.5 × [Sex]. ROC analysis defined three fitness groups, frail (≤13), prefrail (>13–22.5), and fit (>22.5). Results: Reduced hand grip strength and impaired mini mental state examination (MMSE) were associated with worse OS and higher NRM. Vulnerable Elders Survey (VES-13) and Fondazione Italiana Linfomi (FIL) scores also indicated poorer OS, though with uneven group sizes. Other CGA domains and the Hematopoietic Cell Transplantation–Comorbidity Index (HCT-CI) showed no significant prognostic value. The SGS-4 effectively stratified patients into three fitness groups, with those in the frail category experiencing lower OS and an increased risk of relapse. Conclusions: The new Simplified Geriatric Score-4 (SGS-4) based on three CGA domains (gait speed, hand grip, Geriatric 8) and sex effectively predicts OS and CIR risk in patients aged ≥50 years undergoing allo-SCT. The study’s small sample size and disease heterogeneity warrant further validation in larger cohorts. Full article

Background: The interaction between prosthetic restorations and periodontal health is a critical factor for the long-term success of dental treatments. A biologically compatible prosthetic design supports periodontal stability, whereas neglecting periodontal principles can compromise treatment outcomes. This study aimed to validate a questionnaire designed to assess dentists’ perceptions regarding the influence of prosthetic restorations on the periodontium. Material and Methods: An observational cross-sectional study was conducted using a self-administered questionnaire distributed to licensed dentists across Romania. The questionnaire underwent expert review, pilot testing (n = 50), and statistical validation, including the Content Validity Index (CVI), Cronbach’s alpha for internal consistency, and Exploratory Factor Analysis (EFA) using Principal Component Analysis (PCA) with Varimax rotation. The final sample included 39 respondents. Data was analyzed using SPSS v26.0. Results: The questionnaire demonstrated excellent internal consistency (Cronbach’s alpha = 0.900; standardized alpha = 0.917). Most items had corrected item-total correlations > 0.40. EFA revealed eight coherent factors explaining 81.68% of total variance, with high communalities (0.549–0.966), strong Kaiser–Meyer–Olkin test (KMO) values, and significant Bartlett’s test values, confirming construct validity. Descriptive statistics showed predominantly positive attitudes among dentists regarding the periodontal considerations in prosthetic treatment. The highest-rated items emphasized oral hygiene, periodontal stability, and biological adaptation of restorations. Lower scores were associated with routine use of periodontal indices and recognition of failures due to insufficient evaluation. Conclusions: The validated instrument proved reliable and demonstrated strong psychometric properties in this exploratory validation, supporting its use in research and education. Romanian dentists demonstrated a favorable perception of the role of periodontal health in prosthetic success. This tool can inform curriculum development and interdisciplinary clinical protocols in prosthodontics and periodontology. Full article

Objectives: To evaluate the psychometric properties of the Spanish version of the obstructive sleep apnea knowledge and attitudes (OSAKA) questionnaire among dental professionals in Colombia. Methods: A cross-sectional study was conducted in Manizales, Colombia, between January and June 2024. A total of 120 dental professionals, including general dentists, specialists, residents, and academic clinicians, were selected through stratified random sampling. Participants completed the Spanish-adapted OSAKA questionnaire and a structured sociodemographic survey. Internal consistency was assessed using Cronbach’s alpha (α) and McDonald’s Omega (Ω). Construct validity was examined through exploratory factor analysis (EFA), with Kaiser Meyer Olkin (KMO) values and Bartlett’s test. Results: The knowledge subscale (18 items) showed good reliability (α = 0.83; Ω = 0.83), while the attitude subscale (5 items) showed near-acceptable reliability (α = 0.68; Ω = 0.59). KMO values were 0.79 for knowledge and 0.57 for attitudes; Bartlett’s test was significant in both cases (p ≤ 0.001). EFA supported structural validity: six components with eigenvalues >1 explained 61.66% of the variance for knowledge, and two components explained 79.49% for attitudes. Significant differences in attitude scores were found among professional groups (p ≤ 0.001, η² = 0.13), with specialists scoring highest ($\overline{X}$ = 17.66) and general dentists lowest ($\overline{X}$ = 14.62). Knowledge scores did not significantly differ between groups (p = 0.47). Conclusions: The Spanish OSAKA questionnaire is a valid and reliable tool to assess knowledge and attitudes toward obstructive sleep apnea in Colombian dental professionals. Its use may support improved education, screening, and interdisciplinary collaboration in dental settings. Full article

The global consumption of highly (ultra) processed foods (HPFs) is increasing, and it is associated with non-communicable diseases. This study aimed to assess the validity and reliability of the Screening Questionnaire of Highly Processed Food Consumption (sQ-HPF). This study included 94 adults. Sociodemographic data were collected, and anthropometric and blood pressure measurements were performed. The sQ-HPF was translated into Turkish and culturally adapted. Dietary intake was assessed using three-day dietary records. Factor analysis and Cronbach’s alpha were used to evaluate the validity and consistency of the sQ-HPF. Test–retest reliability was assessed with the intraclass correlation coefficient (ICC). Three items from the original sQ-HPF were excluded due to low factor loadings. The Kaiser–Meyer Olkin (KMO) coefficient for the measure of sample adequacy was found to be 0.642 and Bartlett’s test of sphericity was found to be significant (p < 0.001). A significant correlation was found between the sQ-HPF score and HPF consumption derived from the 3-day dietary records (p < 0.05). Cronbach’s alpha was found to be 0.65. Individuals with higher sQ-HPF scores consumed a significantly greater percentage of energy from HPFs (kcal/day) (p < 0.001). The sQ-HPF demonstrated good test–retest reliability (ICC = 0.76). The Turkish version of the sQ-HPF is a valid and reliable tool for assessing HPF consumption patterns and can be used in epidemiological and clinical studies. Full article

Background: Patients with myeloproliferative neoplasms (MPNs) experience a high disease-related symptom burden. A specific instrument to evaluate quality of life (QoL), i.e., the MPN Symptom Assessment Form Total Symptom Score (MPN-SAF TSS; MPN-10), was developed. We conducted the translation, cultural adaptation, and validation into Romanian of the MPN-10. Methods: We translated the MPN-10 and tested its psychometric properties. Results: We recruited 180 MPN patients: 66 polycythemia vera (36.67%), 61 essential thrombocythemia (33.89%), 51 primary and secondary myelofibrosis (SMF) (28.33%), and 2 MPN-unclassifiable (1.11%). The mean TSS was 19.51 ± 16.51 points. Fatigue, inactivity, and concentration problems were the most cumbersome symptoms. We detected scoring differences between MPN subtypes regarding weight loss (p < 0.001), fatigue (p = 0.006), early satiety (p = 0.007), night sweats (p = 0.047), pruritus (p = 0.05), and TSS (p = 0.021). There were strong positive associations between TSS and inactivity, fatigue, and concentration problems, and moderate negative correlations between QoL scores and all MPN-10 items. Cronbach’s α internal consistency coefficient was 0.855. The Kaiser–Meyer–Olkin construct validity test result was 0.870 and the Bartlett Sphericity Test was significant (p < 0.001). Symptom scores were loaded into one single factor according to the exploratory factor analysis. Conclusions: The Romanian MPN-10 version displayed excellent psychometric properties and is a reliable instrument for assessing symptom burden and QoL in Romanian MPN patients. Full article

The Kingdom of Saudi Arabia (KSA) grapples with the challenge of achieving sustainable housing delivery amidst rapid urbanization and rising construction costs. Current housing strategies have failed to offer a lasting solution to the crisis. To address these issues, this study advocates the adoption of fourth industrial revolution (4IR) technologies for sustainable housing. The previous literature highlights the versatility of 4IR technologies, prompting an examination of their suitability and benefits for housing delivery. Thus, this study was aimed at evaluating suitable 4IR technologies for housing delivery and the benefits of adopting the technologies for sustainable housing delivery. The data used were collected via random sampling from stakeholders in the housing sector and analyzed using SPSS V 24, including mean scores, frequencies, and principal component analysis (PCA). The KMO and Bartlett’s test of sphericity confirmed that the data were appropriate for PCA and identified three key components of 4IR technology: Immersive technologies, smart connectivity, and automated construction sites suitable for sustainable housing delivery. These components enhance decision-making, operational efficiency, and project management throughout the housing delivery process. The study emphasizes the potential of 4IR technologies to transform the housing sector in the KSA sustainably, offering insights for both practice and research. Full article

The Short Functional Geriatric Evaluation (SFGE) is a multidimensional and short questionnaire to assess biopsychosocial frailty in older adults. This paper aims to clarify the latent factors of SFGE. Data were collected from January 2016 to December 2020 from 8800 community-dwelling older adults participating in the “Long Live the Elderly!” program. Social operators administered the questionnaire through phone calls. Exploratory factor analysis (EFA) was carried out to identify the quality of the structure of the SFGE. Principal component analysis was also performed. According to the SFGE score, 37.7% of our sample comprised robust, 24.0% prefrail, 29.3% frail, and 9.0% very frail individuals. Using the EFA, we identified three main factors: psychophysical frailty, the need for social and economic support, and the lack of social relationships. The Kaiser–Meyer–Olkin measure of sampling adequacy was 0.792, and Bartlett’s test of sphericity had a statistically significant result (p-value < 0.001). The three constructs that emerged explain the multidimensionality of biopsychosocial frailty. The SFGE score, 40% of which is social questions, underlines the crucial relevance of the social domain in determining the risk of adverse health outcomes in community-dwelling older adults. Full article

This study sought to link neurocognitive profiles in sickle cell disease (SCD) patients with clinical characteristics. We conducted a prospective cohort study of adults with SCD who underwent comprehensive neuropsychological assessment at the UMGGR clinic at Henri Mondor Hospital, Créteil (France). A cluster analysis was performed based on neuropsychological testing scores. The association between clusters and clinical profiles was assessed. Between 2017 and 2021, 79 patients with a mean age of 36 [range 19–65] years were included. On principal component analysis, a 5-factor model presented the best fit (Bartlett’s sphericity test [χ² (171) = 1345; p < 0.001]), explaining 72% of the variance. The factors represent distinct cognitive domains and anatomical regions. On hierarchical classification, three clusters emerged. Cluster 1 (n = 24) presented deficits in all five factors compared to Cluster 3 (n = 33). Cluster 2 (n = 22) had deficits in all factors, but to a lesser extent than Cluster 1. MoCA scores mirrored the severity of these cognitive deficits. Age, genotype and stroke prevalence did not differ significantly between clusters. However, the time of first stroke occurrence differed significantly between Cluster 1 and 2–3: 78% of strokes occurred during childhood, whereas 80% and 83% occurred during adulthood in Clusters 2 and 3, respectively. Educational attainment was also reduced in Cluster 1. SCD patients with childhood stroke seem to be at increased risk of a global cognitive deficit profile. In addition to existing methods of primary and secondary stroke prevention, early neurorehabilitation should be prioritized in order to reduce the long-term cognitive morbidity of SCD. Full article

Promoting the implementation of education for sustainable development (ESD) in schools is necessary to educate future generations about sustainability. In cases where ESD is integrated into science lessons or ESD has to be taught by science teachers, science teachers have to integrate ESD teaching competencies with their science teaching competencies. The absence of an instrument to assess science teacher competencies to teach ESD makes it difficult for schools to assign the right science teacher to teach ESD or to support science teachers to integrate ESD into their lessons. This study aims to develop an instrument for measuring science teacher competencies to teach ESD. The instrument was developed by combining frameworks of science teacher competencies and ESD teacher competencies issued by several countries and ESD teacher competencies proposed by Okayama University ESD Promotion Center. A four-scale questionnaire comprising 96 statements was developed to assess seven competencies, i.e., content knowledge, content pedagogy, inquiry, professional practice, professional development, assessment and evaluation, and attitude. The instrument was tested on 234 science teachers nationwide, consisting of 166 females and 68 males from different schools, teaching years, and educational levels. The results show that the Cronbach’s alpha of the instrument is 0.99 (very good category), person reliability 0.96 (good category), and item reliability 0.67 (fairly good category). Based on explanatory and confirmatory factor analysis, six competency dimensions are identified. The score of explanatory factor analysis based on Kaiser–Meyer–Olkin (KMO) was 0.966 and the significance on Bartlett’s test of sphericity was 0.00. This means that there are significant correlations among the items. This suggests that the instrument is suitable to identify science teachers’ competencies as indicators of their readiness to teach ESD. Full article

International students have the special status of being isolated in a foreign country during a pandemic. As Korea is a worldwide leader in education, it is important to understand the physical exercise behaviors of international students during this pandemic to assess the need for additional policies and support. The health belief model was used to score the physical exercise motivation and behaviors of international students in South Korea during the COVID-19 pandemic. In total, 315 valid questionnaires were obtained and analyzed for this study. The reliability and validity of the data were also assessed. For all variables, the values for combined reliability and the Cronbach’s α were higher than 0.70. The following conclusions were drawn by comparing the differences between the measures. The results of the Kaiser–Meyer–Olkin and Bartlett tests were also higher than 0.70, confirming high reliability and validity. This study found a correlation between the health beliefs of international students and age, education, and accommodation. Consequently, international students with lower health belief scores should be encouraged to pay more attention to their personal health, participate in more physical exercise, strengthen their motivation to participate in physical exercise, and increase the frequency of their participation. Full article

The aim of this study was to evaluate knowledge of oral cancer risk factors among international dental and medical students at the Lithuanian University of Health Sciences (LSMU). A cross-sectional study was conducted among international medical and dental students at the LSMU in 2018–2019. In total, 253 students participated, for a response rate of 76.2%. An anonymous self-administered English questionnaire, consisting of 18 items, covered background information (gender, faculty and academic study year), and statements about risk factors for oral cancer and attitudes towards the prevention and treatment of oral cancer. The fifteen statements had the following answer options: yes, no and I don’t know. The statistical data analysis was performed using SPSS version 22. Overall, a good, fair and poor knowledge of oral risk factors was reported by 15.02%, 56.92% and 28.06% of the participants, respectively. The mean score for knowledge of oral cancer risk factors was 10.01 (SD = 2.56), which was defined as fair knowledge. Cronbach’s alpha was found to be 0.78 (a good value). Bartlett’s sphericity test and the KMO index were adequate (χ² = 677.563, p < 0.001; KMO = 0.788). This study demonstrates a lack of knowledge of oral cancer risk factors among international medical and dental students. Full article

The FANTASTIC questionnaire is a scientific instrument that can be used by health professionals for quickly and effectively measuring the quality of life and lifestyle of people. It is a simple questionnaire that measures different dimensions including nutritional status, but the possibility of using it as a resource for studies in the nutritional field (regardless of its correlation with this) has never been considered, nor has it been used for studies in university populations. The aim was to validate the FANTASTIC questionnaire to report on the participant’s lifestyle in a Spanish university population by using a cross-sectional study. A sample of 501 participants was obtained. The study was approved by the Ethics Research Committee of Catholic University of Valencia, and written informed consent was obtained from all participants. Sociodemographic, lifestyle variables, habitual diet, and nutrition-related lifestyle were collected individually. Participants also completed the self-administered FANTASTIC questionnaire. The reliability analysis of the FANTASTIC questionnaire revealed a Cronbach’s Alpha statistic result of 0.797. The Kaiser–Meyer–Olkin (KMO) value was 0.786, with a significant Bartlett’s Test of Sphericity (p = 0.000). This shows that the FANTASTIC questionnaire has good internal consistency and good construct validity. A retest was performed in four weeks’ time, showing excellent intraclass correlation values. We consider the applicability of the FANTASTIC questionnaire for nutritional studies in Spanish university students to be appropriate, and most students have high scores in the nutritional aspects of the questionnaire, showing correct diet implementation and good cooking skills. Full article

Wireless sensor networks (WSNs) have various applications which include zone surveillance, environmental monitoring, event tracking where the operation mode is long term. WSNs are characterized by low-powered and battery-operated sensor devices with a finite source of energy. Due to the dense deployment of these devices practically it is impossible to replace the batteries. The finite source of energy should be utilized in a meaningful way to maximize the overall network lifetime. In the space domain, there is a high correlation among sensor surveillance constituting the large volume of the sensor network topology. Each consecutive observation constitutes the temporal correlation depending on the physical phenomenon nature of the sensor nodes. These spatio-temporal correlations can be efficiently utilized in order to enhance the maximum savings in energy uses. In this paper, we have proposed a Spatial and Temporal Correlation-based Data Redundancy Reduction (STCDRR) protocol which eliminates redundancy at the source level and aggregator level. The estimated performance score of proposed algorithms is approximately 7.2 when the score of existing algorithms such as the KAB (K-means algorithm based on the ANOVA model and Bartlett test) and ED (Euclidian distance) are 5.2, 0.5, respectively. It reflects that the STCDRR protocol can achieve a higher data compression rate, lower false-negative rate, lower false-positive rate. These results are valid for numeric data collected from a real data set. This experiment does not consider non-numeric values. Full article