Search Results (325)

Background: Environmental exposures, such as per- and polyfluoroalkyl substances (PFAS), in conjunction with social and behavioral factors, can significantly impact liver health. This research investigates the combined effects of PFAS (perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS), alcohol consumption, smoking, income, and education on liver function among the U.S. population, utilizing data from the 2017–2018 National Health and Nutrition Examination Survey (NHANES). Methods: PFAS concentrations in blood samples were analyzed using online solid-phase extraction combined with liquid chromatography–tandem mass spectrometry (LC-MS/MS), a highly sensitive and specific method for detecting levels of PFAS. Liver function was evaluated using biomarkers such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyltransferase (GGT), total bilirubin, and the fatty liver index (FLI). Descriptive statistics and multivariable linear regression analyses were employed to assess the associations between exposures and liver outcomes. Bayesian Kernel Machine Regression (BKMR) was utilized to explore the nonlinear and interactive effects of these exposures. To determine the relative influence of each factor on liver health, Posterior Inclusion Probabilities (PIPs) were calculated. Results: Linear regression analyses indicated that income and education were inversely associated with several liver injury biomarkers, while alcohol use and smoking demonstrated stronger and more consistent associations. Bayesian Kernel Machine Regression (BKMR) further highlighted alcohol and smoking as the most influential predictors, particularly for GGT and total bilirubin, with posterior inclusion probabilities (PIPs) close to 1.0. In contrast, PFAS showed weaker associations. Regression coefficients were small and largely non-significant, and PIPs were comparatively lower across most liver outcomes. Notably, education had a higher PIP for ALT and GGT than PFAS, suggesting a more protective role in liver health. People with higher education levels tend to live healthier lifestyles, have better access to healthcare, and are generally more aware of health risks. These factors can all help reduce the risk of liver problems. Overall mixture effects demonstrated nonlinear trends, including U-shaped relationships for ALT and GGT, and inverse associations for AST, FLI, and ALP. Conclusion: These findings underscore the importance of considering both environmental and social–behavioral determinants in liver health. While PFAS exposures remain a long-term concern, modifiable lifestyle and structural factors, particularly alcohol, smoking, income, and education, exert more immediate and pronounced effects on hepatic biomarkers in the general population. Full article

Periodontal disease is a common and serious oral disease among older adults. As the global older population increases, preventing periodontal disease is vital for healthy ageing. Poor oral hygiene, uncontrolled diabetes, and smoking are key risk factors of periodontal disease. Improving oral hygiene, diabetes management, and quitting smoking are essential health behavioural change interventions to manage periodontal disease. The objective of this study is to review the prevention of periodontal disease among older adults through health behavioural change interventions. Effective strategies to improve oral hygiene include personalised education on proper brushing and interdental cleaning. Educating caregivers is equally important as they supervise care-dependent older adults to maintain oral health. For those with diabetes, physical activity improves glycated haemoglobin levels and clinical periodontal parameters by reducing reactive oxygen species and systemic inflammation. Smoking cessation could be achieved through a multi-faceted approach. Effective smoking cessation combines brief interventions with intensive behavioural/pharmacological support for long-term success, especially in highly dependent individuals. Tailored strategies for older adults, integrated care, and expanded research improve outcomes and health equity in ageing populations. In conclusion, health behavioural change interventions are non-invasive preventive measures that include oral hygiene reinforcement, diabetic management, and smoking cessation. Prioritising these interventions empowers older adults to maintain oral health, reducing disease burden and enhancing overall well-being for healthy ageing. Full article

Background: As global populations age, addressing societal attitudes towards older adults becomes increasingly crucial. Ageism negatively impacts both older and younger individuals. Aging simulation has been proposed as a means to challenge ageist attitudes and promote intergenerational solidarity. This study examines the effectiveness of a brief aging simulation in altering adolescents’ perceptions of aging and older adults. Methods: A prospective interventional study was conducted with 63 high school students aged 15–18. Participants completed the Fraboni Scale of Ageism (FSA) before and after intervention. A subset of 20 students was randomly selected to wear an aging simulation suit. Results: Post-intervention FSA scores significantly decreased from 63.50 to 51.00, indicating a reduction in ageist attitudes. Participants showed significant changes in beliefs related to cognitive decline, the prevalence of Alzheimer’s disease, and the perception that older adults are homogeneous. Additionally, 80% of participants reported a positive shift in their attitude toward aging. The simulation experience was rated highly (average score: 9/10). Conclusions: The findings support the effectiveness of aging simulation in reducing ageist attitudes among adolescents. Given the role of adolescence in shaping long-term perceptions, incorporating aging simulations into educational curricula could be a valuable strategy for promoting intergenerational understanding. Full article

Cardiotoxicity is a leading cause of mortality in the growing populations of elderly breast cancer (BC) patients. Breast cancer treatment in the elderly is highly challenging due to its heterogeneous nature and the lack of specific evidence, as this population is usually underrepresented in randomized clinical trials. Decision making requires a comprehensive approach, considering the type and stage of BC, the patient’s overall health status, life expectancy, geriatric and frailty assessment, the risk of cancer recurrence, comorbidities, cardiotoxicity risk, and the patient’s preferences. The cardiotoxic effects of BC treatments cover the whole spectrum of cardiovascular diseases: heart failure, hypertension, arrhythmias, and myocardial ischemia. Cardiotoxicity risk in these patients is defined by several factors: anticancer therapies, polypharmacy, established cardiovascular disease, comorbidities, frailty, cellular senescence, hormonal changes, and genetic predisposition. Preventive oncological and cardio-oncological strategies, as well as patients’ education, are critical for improved outcomes. Prospective clinical trials in this population are urgently needed. Full article

Introduction: The major cause of obesity is excessive calorie intake. Inappropriate dietary habits, like increased meal frequency, portion sizes, or amount of snacks consumed contribute to obesity development. Potential differences in the perception of snacks by people with different BMIs may be one of the causes of obesity. Assessment of the perception of snacks by people with excessive and normal body weight will allow us to check whether this parameter actually has an impact on the development of obesity. Materials and Methods: A survey study was conducted to check differences in assessing different snacks and beverages by individuals with varied BMIs. Participants analyzed snacks on presented photographs and assessed portion sizes, estimated caloric content, assessed whether the meal was healthy, and determined whether the indicated portion would be sufficient to satisfy their hunger. The study population was divided according to body mass index (BMI) into individuals with normal weight, overweight, and obesity. Additionally, the study group was divided according to gender and age. Results: There were no statistically significant differences in the majority of the studied parameters concerning BMI; however, the study revealed relatively low education level regarding caloric assessment. Conclusions: BMI seems not to have an influence on calorie and portion size perception of snacks. The majority of the population wrongly assessed the calorific value of snacks, which might contribute to obesity development. People have a tendency to overestimate the caloric value of snacks. Women assess the portion size of highly processed snacks as larger than men do. Full article

The selection of a suitable site for a new university in southern Jordan involves a comprehensive approach to ensure sustainability, accessibility, and community service. This study applies a Geographic Information System (GIS)-based weighted overlay analysis, integrating multiple spatial criteria to identify optimal locations. Key factors include terrain characteristics, such as elevated or moderately sloped areas; proximity to main roads for accessibility; and distance from industrial zones, water bodies, and existing universities to minimize environmental and educational overlap. Additionally, proximity to populated areas, health facilities, and banking services is prioritized to enhance convenience and support for the university community. The criteria were assigned different weights, with population and residential areas receiving the highest priority (30%), followed by terrain, roads, and existing institutions (14% each). The results showed that around 8% of the study area was classified as highly suitable, 22% as moderately suitable, and 70% as unsuitable. The top three locations achieved suitability scores exceeding 85%, being situated near major roads, within 2 km of populated areas, and in terrain with slopes under 15%. The GIS-based model offers a replicable framework for similar projects, facilitating data-driven decision-making in higher education planning. Full article

Although electronic cigarettes have been banned in Brazil since 2009, their use is increasing, particularly among youth. We conducted a biomarker-based study to profile exclusive e-cigarette users in São Paulo and to examine the associations of e-cigarette use with salivary nicotine and cotinine levels. A population-based, cross-sectional study was conducted between April and September 2024 in six municipalities in São Paulo, Brazil. Randomly selected participants who reported exclusive use of electronic cigarettes completed a questionnaire and provided oral fluid samples for the determination of their nicotine and cotinine concentrations using LC-MS/MS. The cohort consisted of N = 417 participants. Significant associations were found between nicotine and cotinine concentrations and variables such as knowledge of nicotine content and product type. Addiction status significantly influenced the nicotine and cotinine concentrations, as well as smoking history, last consumption, recharge/purchase frequency, and consumption duration (all p < 0.001). Participants who perceived themselves to have a moderate or severe addiction exhibited higher nicotine and cotinine concentrations compared with those who did not perceive that they had an addiction (p < 0.001). Most participants were young, predominantly White, and highly educated and earned higher incomes. The findings reveal a correlation between perceived nicotine dependence and salivary nicotine and cotinine concentrations, underscoring the physiological and behavioral markers of electronic cigarette addiction. High salivary concentrations of nicotine appear to be independent of duration of e-cigarette use, smoking history, and age. These findings underscore the urgent need for surveillance and public health interventions, even in jurisdictions where these products remain illegal. The study limitations include its cross-sectional design and potential selection bias due to convenience sampling. Full article

Chronic pain is a prevalent public health concern in the United States, frequently managed with over-the-counter (OTC) painkillers without professional medical supervision. This study investigates household-level patterns of over-the-counter painkiller use utilizing a nationally representative dataset from NielsenIQ, focusing on how reported health conditions, whether self-identified or professionally diagnosed, affect purchasing behaviors. By linking consumer purchase data with self-reported ailment information, this study analyzed painkiller expenditures across different ailment types and demographic groups. Results show that over-the-counter painkiller purchases were highly symptom-driven, particularly for headache-related products, which were the most frequently purchased category across all household types. Nearly one-third of single-member households purchased over-the-counter painkillers for headaches, regardless of diagnosis type, indicating a strong role of perceived need in driving behavior. Females and older individuals more frequently reported ailments, with consistently higher proportions across both pain-related and other conditions. Nonetheless, a notable share of households reported over-the-counter painkiller use without any reported ailments. The findings suggest that diagnostic status plays a limited role in determining over-the-counter painkiller usage, emphasizing the need for improved public health messaging around safe self-medication. These insights can inform targeted education, labeling regulations, and policy interventions to support safer and more equitable pain management practices at the population level. Full article

Background and Objectives: Obesity is a health condition that significantly augments the risk of several chronic diseases and is a major public health concern. In Italy, this phenomenon has highly increased in the last few decades, raising alarm about both NHS sustainability and population health. We investigate whether and to what extent obesity impacts three different categories of outcomes, namely healthcare consumption, quality of life and the presence of relevant comorbidities. Materials and Methods: We use data from the European Health Interview Survey, 2019, a micro dataset that displays more than 45,000 observations, providing detailed information on the health status and healthcare access, demographics and socioeconomic characteristics among Italian individuals aged 15 and over. We first provide a descriptive analysis of the socioeconomic gradient of obesity, and then we implement propensity score matching to detect the effects of this condition on healthcare use, quality of life and comorbidities. To the best of our knowledge, this is the first empirical paper to jointly consider the healthcare consumption, declared comorbidities and quality of life of Italian obese individuals. Results: The findings show that obese individuals consume more health services, have a lower quality of life and present a higher rate of comorbidities compared to non-obese individuals with the same observable characteristics. We also find that obesity is rooted in socioeconomic drivers, with richer and more educated individuals being less likely to present with this condition. Conclusions: The findings call for policy measures aimed at monitoring and contrasting the rising phenomenon of obesity in Italy, with a tailored approach across socioeconomic groups. Full article

Background: Low back pain (LBP) and musculoskeletal disorders are highly prevalent among agricultural workers. However, there is limited epidemiological evidence from rural regions of Ecuador, where working and living conditions may differ substantially from those in other settings. This study aimed to identify predictors of LBP among farmers in rural Ecuador to inform locally relevant prevention strategies. Methods: Participants aged 30 to 60 years (n = 103) were recruited through a traveling health clinic. Participants were assessed with behavioral and sociodemographic self-report questionnaires and anthropometric measurements. Low back pain (LBP) was assessed using the Standardized Nordic Musculoskeletal Questionnaire, which asked about symptoms experienced in the past 12 months. Bivariate (Chi-square and Fisher exact tests) and multivariate (binary logistic regression) analyses were conducted to explore associations between risk factors and LBP in individuals aged 30 to 60 years. Results: LBP was highly prevalent, affecting 78.6% of participants. Behavioral patterns were mixed, with low rates of smoking and moderate alcohol and coffee consumption associated with LBP. A normal body mass index (BMI) was observed in 66% of the sample, and over half reported stable mood and good self-perceived health. In the binary logistic regression analysis, only education level significantly predicted LBP, with secondary education acting as a protective factor. Conclusions: While lower back pain was widespread in the population studied, most risk factors that were analyzed were not significantly associated with its presence. Full article

Understanding alcohol consumption patterns is critical for developing effective public health strategies, particularly in countries like Spain where cultural and regional drinking norms vary widely. This study examined sociodemographic factors affecting alcohol consumption patterns across Spain, employing a cross-sectional design. A total of 22,181 Spanish adults over 18 years of age were recruited between August 2020 and November 2021, using non-probabilistic snowball sampling through social media networks. Data were gathered via a validated questionnaire (NutSo-HH Scale) encompassing sociodemographic details, health indicators, and lifestyle habits, with a focus on alcohol use. The sample included n = 22,181 participants, 80.8% women, with a mean age of 34.9 years. Most respondents (48.2%) reported no or very occasional alcohol consumption, 33% drank 2–4 times per month, 13.8% consumed alcohol 2–3 times weekly, and 5% drank daily or nearly daily. Alcohol consumption was significantly higher among men (72.1% consuming fermented beverages) and individuals with higher income and education (p < 0.001 for all variables). Regional differences were also notable, with the highest percentage of regular drinkers in Asturias (80.9%) and the Valencian Community (73.3%) as revealed by a Kruskal–Wallis test (p < 0.001). Fermented beverages were the most popular, with 68.4% of alcohol consumers preferring these, compared to distilled beverages (18.8%), fortified beverages (15.1%), and liqueurs (3.3%). A Gaussian graphical model was used to explore conditional relationships between alcohol consumption and other beverages in the Spanish population. Alcohol showed strong positive associations with fermented and distilled beverages, and with the habit of getting drunk. Weaker negative correlations were observed with water and soft drinks, suggesting contrasting consumption patterns. These findings underscore significant sociodemographic and regional variations in alcohol consumption patterns across Spain, suggesting the need for public health interventions tailored to different population segments. Full article

As China’s regional development enters a critical stage of population redistribution and urban transformation, the impact of population mobility on regional demographic structures and urban functional restructuring has become increasingly prominent. Against this backdrop of accelerating Beijing–Tianjin–Hebei integration, cities of varying types have been confronted with growing complexity in demographic transitions and socioeconomic stratification during their processes of absorbing or exporting populations. This study employed microdata from the National Bureau of Statistics to construct migration flow matrices and utilized a decomposition quantification approach to explore the impact of internal migration on the population structure and quality in 13 cities within the Beijing–Tianjin–Hebei region. The findings indicated that, while Beijing has achieved some success in population control, it overall exhibits a “large inflow and large outflow” pattern. Langfang has attracted a large number of highly educated individuals and male migrants under the spillover effect from Beijing. Shijiazhuang’s population attractiveness has increased, yet the outflow of highly educated individuals remains unmitigated. Meanwhile, the internal migrant structures in industrial cities such as Tianjin and Tangshan have undergone significant changes following the industrial transformation. Cities in the passive outflow area and agricultural transformation area have experienced siphoning effects, but they face different potential risks due to their unique characteristics. This study further enriches the understanding of the impact mechanisms underlying domestic population mobility and provides differentiated policy references for cities to reconcile their development objectives with demographic realities. Full article

Background and Objectives: Stroke is a common and fatal condition impacting millions worldwide. Understanding the risk factors, symptoms, and consequences at an earlier stage, specifically in highly at-risk populations such as smokers, is crucial for mitigating the stroke burden. Materials and Methods: A cross-sectional study was conducted in Saudi Arabia on more than 1000 smokers. The survey was randomly shared across the kingdom. Multiple logistic regression models were applied to assess the association and find the variables associated with poor stroke awareness. Results: The study included 1029 smokers, with 88% (904) being male. The majority (61%; 630) are between the ages of 18 and 30 years, with a university degree (84%, 862). Cigarettes (33.9%; 349), shisha (25.9%; 267), and e-cigarettes (40.1%; 413) were the most common smoking types. About 30% of smokers have never heard of stroke, and 44% were unaware that stopping smoking can prevent stroke. Smokers (55%) perceive smoking as the top risk factor, followed by heart disease (41%), and high blood pressure (40.8%), while 26% of the smokers did not identify any risk factors. Around 58% of the smokers did not identify any stroke symptoms. Only 20% of smokers were capable of identifying 50% of both stroke risk factors and symptoms. Around 8% reported all stroke-related consequences, whereas 44% were unable to identify any. Current smokers were more likely than ex-smokers to identify ≥1 stroke risk factor (OR = 1.95, p = 0.001), with no significant associations found for other variables. Males, university degrees, and current smokers were the only significant predictors for the identification of ≥1 stroke symptom. University education, current smokers, employment, and smoking types were significant predictors in identifying ≥1 stroke consequence. Compared to E-cigarette users, cigarette smokers exhibited twice the awareness of stroke consequences (OR = 2.01, p = 0.001), whereas shisha smokers demonstrated lower awareness (OR = 0.63, p = 0.01). Conclusions: Smokers’ awareness of stroke in Saudi Arabia is suboptimal. Targeted educational and smoking cessation initiatives are essential to address this gap and mitigate the impact of smoking-related strokes in Saudi Arabia. Full article

Background: Life satisfaction serves as a preventive agent against various emotional, cognitive, and behavioral challenges, making it a crucial cognitive indicator of subjective well-being, particularly during adolescence. Accurately assessing life satisfaction is essential for understanding and promoting adolescent mental health, especially in applied settings such as physical education, which plays a key role in fostering psychological well-being and positive youth development. However, additional investigation is needed to confirm the tools used for this purpose. This study aimed to analyze the psychometric properties, metric invariance, and temporal stability of the Satisfaction with Life Scale (SWLS) in adolescents from a region in southeastern Spain. Thus, the present study sought to answer the following research questions: (1) Does the SWLS demonstrate adequate psychometric properties in an adolescent population? (2) Is the SWLS invariant across gender and residential environments? (3) Does the SWLS show adequate stability over time? Methods: A sample of 400 students was assessed using exploratory and confirmatory factor analyses, multigroup comparisons, and test–retest techniques. Results: The results showed significant differences in scale scores in the sex and demographic location variables. Also, a robust unifactorial model with five items demonstrated good performance in terms of goodness of fit and internal consistency. Furthermore, full metric invariance was observed across genders, while configural invariance was supported for residential environment. Concurrent validity analyses revealed significant associations with another unidimensional well-being measure, and temporal stability was confirmed through the intraclass correlation coefficient. Conclusions: The findings support the SWLS as a potentially valid, reliable, and time-effective tool for assessing adolescent life satisfaction. Its strong psychometric properties make it highly suitable for use in mental health research, longitudinal monitoring, and large-scale studies. Moreover, its ease of administration allows its integration into educational, clinical, community-based, and physical education contexts, offering insightful information for the creation of long-lasting mental health regulations and preventive measures meant to improve the well-being of adolescents. Notwithstanding these encouraging results, some restrictions must be noted. The sample was restricted to a single geographic area, and contextual or cultural factors may have an impact on how satisfied people are with their lives. Furthermore, response biases could have been introduced by using self-report measures. Full article

Background/Objectives: With the rising prevalence of chronic diseases and an aging population, the incidence of stroke is continuously increasing, which leads to higher medical costs. Stroke carries a high risk of recurrence, necessitating ongoing self-care and lifestyle changes, for which education is crucial. The aim of this study is to identify the ICT utilization education needs, mobile health literacy, and self-care education needs of stroke patients and confirm the differences in mobile health literacy and self-care education needs according to ICT utilization to establish a basis for self-care intervention. Methods: The study included 100 stroke patients diagnosed at three general hospitals or higher in City C, hospitalized or visiting neurology and neurosurgery outpatient clinics. A survey was conducted from 7 July 2023 to 30 May 2024. The survey cites computers, the Internet, live broadcasting technology, recorded broadcasting technology, and telephony as examples of ICTs. The gathered data were analyzed using descriptive statistics, independent t-tests, one-way ANOVA, and the Pearson correlation coefficient. Results: The final analysis included 100 people, with 64 participants being men and an average age of 57.75 ± 12.30 years. Self-care education needs showed no significant differences based on general or disease-related characteristics. Many patients could use smart devices but experienced difficulties in searching for information. The main reasons for using smart devices included acquiring disease-related information and accessing resources without time limitations. The use of ICT services that provide disease-related information was low, 70% of participants were willing to use them in the future. Additionally, they preferred doctor-led education sessions once a month, lasting no longer than 30 min each. Mobile health literacy was significantly higher among those willing to use ICT services. Conclusions: Mobile health literacy was significantly higher in the group willing to use ICT services than in the group unwilling. Self-care education needs were both highly important and necessary in the group willing to utilize ICT, but no statistically significant difference was found. Full article