Search Results (546)

This study highlights how socio-demographic, information, and government factors play different roles in people’s health during COVID-19 between Asian countries and non-Asian countries by employing the Hierarchical Linear Regression. This study finds that government factors play a more significant role in shaping wellness and happiness in Asian countries, whereas they have a stronger impact on health status in non-Asian countries. Second, information factors—such as knowledge about vaccines, medical professionals, and reliable sources—have a more substantial effect on health status in Asian countries, while they are more strongly associated with wellness and happiness in non-Asian contexts. Third, socio-demographic variables exert a greater influence on overall health outcomes in non-Asian countries compared to Asian countries. In particular, gender, occupation, socioeconomic placement, height, and weight consistently play a significant role across all health dimensions in non-Asian countries, whereas their impact varies across different health domains in Asian settings. Full article

Background: Maintaining long-term exercise adherence in occupational settings remains a challenge, particularly in remote or unsupervised environments. This study aimed to investigate the effect of individualized feedback on exercise adherence, body composition, and physical function during a remote home-based training intervention utilizing the video-based exercise system “SUKUBARA^®”. Methods: In total, 66 care facility workers were randomly categorized into either a feedback (FB) group or a non-feedback (NF) group. Both groups performed a combined exercise program comprising low-load resistance training (slow squats) and balance exercises (one-leg standing time of closed eye) for approximately 15 min, thrice weekly over 12 weeks. The FB group received individualized feedback sheets visualizing total video play time (TT), exercise frequency, and interruptions, alongside reminder emails. The primary outcome was TT. Secondary outcomes included body composition measures (body weight, fat-free mass, and body fat mass rate) and one-leg standing time of opened eye. Results: The FB group demonstrated significantly greater TT, approximately 1.5 times that of the NF group, indicating enhanced exercise adherence. Moreover, significant improvements in fat-free mass and body fat mass rate were observed in the FB group. A significant correlation was identified between changes in TT and body composition parameters, suggesting TT as a valid proxy for exercise engagement. Conclusions: Individualized feedback within a remote monitoring home exercise program effectively improved exercise adherence and body composition among care workers. The “SUKUBARA^®” system shows promise as a tool to support exercise continuity in occupational health and long-term care settings. Full article

By 2040, more than 80 million Americans will be aged ≥65, yet contemporary senior living communities still operate on a hospitality-first model developed for healthier cohorts three decades ago. This commentary argues that the next generation of senior living must pivot from hotel-style amenities to person-centric health platforms that proactively coordinate medical, functional, and social support. We outline four mutually reinforcing pillars. (1) Data infrastructure that stitches together clinical, functional, and social determinants of health enables continuous risk stratification and early intervention. (2) Ambient and conversational artificial-intelligence tools can extend sparse caregiving workforces while preserving resident autonomy. (3) Value-based contractual arrangements—for example, Medicare Advantage special-needs plans embedded within senior living sites—can realign financial incentives toward prevention rather than occupancy. (4) Targeted policy levers, including low-income housing tax credits for the “forgotten middle” and outcomes-based regulatory frameworks, can catalyze adoption at scale. Ultimately, re-architecting senior living around integrated technology, value-based financing and supportive regulation can transform these communities into preventive-care hubs that delay nursing home entry, improve quality of life, and reduce total cost of care. Full article

Background: This study aimed to assess the illness perceptions of patients diagnosed with hypertension from a primary care perspective. It also sought to identify the sociodemographic and clinical factors associated with illness perception. Methods: A cross-sectional descriptive study was conducted between February and March 2025, involving 116 hypertensive patients who attended family medicine outpatient clinics at Rize Training and Research Hospital, Turkey. Data were collected using a sociodemographic questionnaire and the Brief Illness Perception Questionnaire (BIPQ). Nonparametric tests, including the Mann–Whitney U test, Kruskal–Wallis H test with Dunn’s post hoc analysis, and Spearman’s correlation analysis, were employed to evaluate the data. Results: The mean age of the participants was 69.01 ± 6.07 years, with 76.7% of the participants aged over 65 years. The median total BIPQ score was 47.0, indicating a moderate illness perception. A significant negative correlation was observed between age and the total BIPQ score (Rho = −0.443, p < 0.001). Higher illness perception levels were significantly associated with lower educational attainment, shorter duration of antihypertensive treatment, and attribution of hypertension to stress, genetic predisposition, diet, and occupational factors (p < 0.05). Conclusions: Illness perceptions among patients with hypertension are shaped by various sociodemographic and clinical determinants. Enhancing awareness of these perceptions in primary care may support improved treatment adherence and better health outcomes. Interventions that strengthen health literacy and offer psychosocial support may contribute to more effective hypertension management. Full article

Neurodevelopmental disorders are one of the most prevalent conditions today, and among the limitations in activity and restrictions in the participation of children and their families, we find intervention in activities of daily living; therefore, research focused on outcome measurement is one of the most active lines, and after COVID-19, telerehabilitation has garnered special interest. Background/Objectives: The study objective was to evaluate the effectiveness of a mobile health (mHealth) application in improving the performance of activities of daily living in children with neurodevelopmental disorders. Methods: The study employed a quasi-experimental design with a control group, using a fully remote mHealth-based intervention. The instruments used were a sociodemographic ad hoc, Pediatric Evaluation of Disability Inventory Computer, Family Outcomes Survey, Family Confidence Scale, and System Usability Scale. The final sample consisted of 13 participants. Results: The mHealth intervention showed significant improvements in occupational performance in the experimental group, especially in the global score and in the Responsibility dimension of the PEDI-CAT. No relevant differences were observed in the CON-FAN and FOS scales between groups, although the latter showed improvements over time. The usability of the app was rated positively (SUS = 69.75). Conclusions: The developed application presents good usability for families of children with neurodevelopmental disorders, but to obtain better outcome measures, the intervention should combine face-to-face sessions and the use of mHealth, as well as employing the family-centered model. Full article

This study compares the LEED, BREEAM, and WELL certification systems using the Triple Bottom Line (TBL) framework to assess their performance across environmental, social, and economic dimensions and their alignment with sustainable development goals. A structured secondary analysis was conducted on over 50 peer-reviewed articles, case studies, and official certification manuals. Inclusion criteria required documented design targets and post-occupancy outcomes for certified buildings (2014–2024). A two-phase analytical model was applied: first, evaluating each system’s structure and priorities; then benchmarking them using the TBL framework to assess how holistically each addresses sustainability. Results show that LEED leads to energy optimization, BREEAM to lifecycle integration, and WELL to occupant health and indoor environmental quality. However, all systems exhibit post-occupancy performance gaps: LEED and BREEAM underperform by 15–30% in energy use, while WELL-certified projects may exceed 30% due to stringent indoor comfort demands. These findings highlight the need to integrate real-time post-occupancy evaluation into certification protocols. To improve overall effectiveness, the study proposes enhancements such as adaptive performance tracking, occupant feedback loops, and dynamic benchmarking aligned with actual building use. By identifying both the comparative strengths and systemic limitations of the three frameworks, this research contributes to the refinement of green building assessment tools. Practical implications include (1) integrating post-occupancy evaluation into certification renewal cycles, (2) adopting hybrid certification strategies to improve sustainability coverage, and (3) designing benchmarking tools that reflect real-world operational data. Full article

Agricultural workers in the United States (U.S.) are exposed to occupational heat stress, increasing their risk of adverse kidney outcomes. The aim of this integrative review was to explore the relationship between occupational heat stress and kidney health among U.S. agricultural workers. PubMed, EMBASE, Scopus, and Google Scholar were searched for original research articles on this relationship among U.S. agricultural workers. Studies were screened and reviewed by two independent reviewers in three phases: title and abstract screening, full text screening, and data extraction. The search yielded 278 articles; 14 were included in the final analysis. Heat stress was commonly measured using core body temperature changes, heat index, and wet-bulb globe temperature. Acute kidney injury (AKI) incidence following a single work shift was up to 43%. Occupational heat stress and piece-rate compensation increased the odds for developing AKI. The use of cooling bandanas and water mixed with electrolytes are promising interventions for mitigating the effect of heat stress on kidney health outcomes. The results confirm that occupational heat stress influences kidney health for U.S. agricultural workers. The mechanisms of this relationship have not been fully elucidated. More studies exploring heat protection interventions are needed. Full article

Background: Dental professionals face high levels of occupational stress, which intensified during the COVID-19 pandemic, contributing to increased burnout, diminished well-being, and signs of accelerated biological aging. This systematic review explores the role of physical activity as a protective factor for mental and physical health, with a focus on promoting resilience and long-term occupational sustainability in a post-pandemic volatile, uncertain, complex, and ambiguous (VUCA) environment. Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines. Studies published between 2000 and 2024 were identified through PubMed, Scopus, and the Cochrane Library using MeSH terms related to dentistry, physical activity, stress management, and occupational health. Of 850 records screened, 28 studies were included: 24 cross-sectional, 2 systematic reviews, 1 retrospective, and 1 case–control study. Inclusion and quality appraisal followed standardized criteria. Results: The included studies consistently showed that physical activity was associated with reduced burnout, improved psychological well-being, enhanced postural function, and potential markers of slowed biological aging in dental professionals. Several studies reported moderate-to-strong associations, with effect sizes ranging from small improvements in perceived stress scores to substantial reductions in MSD prevalence. Interventions combining exercise with ergonomic education, stress management, and institutional support demonstrated the stronger and more consistent benefits for professional sustainability. Conclusions: Physical activity, when integrated into comprehensive workplace wellness frameworks, significantly enhances the mental and physical resilience of dental professionals. Embedding movement, ergonomics, and psychosocial support into practice environments offers a promising strategy for safeguarding long-term workforce sustainability and improving public health outcomes. Full article

Autism Spectrum Disorder (ASD) remains significantly underdiagnosed in women, resulting in a persistent gender gap with important clinical, functional, and psychosocial implications. This narrative review explores the multifactorial barriers contributing to diagnostic disparities, including the male-oriented structure of current diagnostic criteria, the prevalence of co-occurring psychiatric conditions, and the phenomenon of social camouflaging shaped by culturally reinforced gender norms. These factors frequently lead to delayed identification, clinical misinterpretation, and suboptimal care. The review synthesizes evidence from clinical, psychological, and sociocultural research to demonstrate how the under-recognition of ASD in women impacts mental health outcomes, access to education, occupational stability, and overall quality of life. Special emphasis is placed on the consequences of missed or late diagnoses for healthcare delivery and the educational needs of clinicians involved in ASD assessment and care. This article concludes with actionable, evidence-based recommendations for enhancing diagnostic sensitivity, developing gender-responsive screening strategies, and integrating training on female autism presentation into medical and allied health education. Addressing these challenges is essential to reducing diagnostic inequities and ensuring timely, accurate, and person-centered care for autistic women throughout their lifespan. Full article

Hospital in the Home (HITH) programs are emerging as a key pillar of smart city healthcare infrastructure, leveraging technology to extend care beyond traditional hospital walls. The global healthcare sector has been conceptualizing the notion of a care without walls hospital, also called HITH, where virtual care takes precedence to address the multifaceted needs of an increasingly aging population grappling with a substantial burden of chronic disease. HITH programs have the potential to significantly reduce hospital bed occupancy, enabling hospitals to better manage the ever-increasing demand for inpatient care. Although many health providers and hospitals have established their own HITH programs, there is a lack of research that provides healthcare executives and HITH program managers with management models and frameworks for such initiatives. There is also a lack of research that provides strategies for improving HITH management in the health sector. To fill this gap, the current study ran a systematic literature review to explore state-of-the-art with regard to this topic. Out of 2631 articles in the pool of this systematic review, 20 articles were deemed to meet the eligibility criteria for the study. After analyzing these studies, nine management models were extracted, which were then categorized into three categories, namely, governance models, general models, and virtual models. Moreover, this study found 23 strategies and categorized them into five groups, namely, referral support, external support, care model support, technical support, and clinical team support. Finally, implications of findings for practitioners are carefully provided. These findings provide healthcare executives and HITH managers with practical frameworks for selecting appropriate management models and implementing evidence-based strategies to optimize program effectiveness, reduce costs, and improve patient outcomes while addressing the growing demand for home-based care. Full article

Background/Objectives: The functionalization of various forms of graphene, such as graphene nanoplatelets, graphene oxide, and reduced graphene oxide, in biomaterials is a promising strategy in dentistry, particularly regarding their antimicrobial potential. However, conclusive studies on the toxicity and biocompatibility of graphene-based materials remain limited, and standardized guidelines for their production, handling, and dental applications are still lacking. This scoping review aims to map the available studies on various types of graphene, synthesize evidence on their antimicrobial effectiveness, and describe the main biological responses when functionalized in dental biomaterials. Methods: An electronic search was conducted in the Clarivate, PubMed, and Scopus databases using the descriptors as follows: ‘graphene’ AND ‘antimicrobial effect’ AND ‘bactericidal effect’ AND (‘graphene oxide’ OR ‘dental biofilm’ OR ‘antibacterial properties’ OR ‘dental materials’). Article screening and eligibility assessment were performed based on predefined inclusion and exclusion criteria, following the PRISMA-ScR guidelines. Results: The search identified 793 articles. After removing duplicates, applying the eligibility criteria, and performing a full-text analysis of 64 articles, 21 studies were included in the review. Graphene oxide, particularly at low concentrations, was the most commonly studied graphene variant, demonstrating significant antimicrobial efficacy against S. mutans, S. faecalis, E. coli, P. aeruginosa, and C. albicans. Both mechanical and chemical mechanisms have been linked to the biological responses of graphene-doped biomaterials. The biocompatibility and cytotoxicity of these compounds remain controversial, with some studies reporting favorable outcomes, while others raise significant concerns. Conclusions: Graphene shows great promise as an antimicrobial agent in dental biomaterials. Despite encouraging results, more in vitro and in vivo studies are needed to better understand its biocompatibility and cytotoxicity in dental applications. Additionally, standardized production protocols, clearly defined clinical applications in dentistry, and regulatory guidelines from the World Health Organization concerning handling procedures and occupational risks remain necessary. Full article

Background and Objectives: Multiple sclerosis (MS) is a chronic immune-mediated neurological disorder that primarily affects young adults and is frequently accompanied by psychiatric comorbidities such as depression and anxiety, both of which significantly diminish patients’ quality of life (QoL). This study investigated the effect of two oral disease-modifying therapies (DMTs), fingolimod and cladribine, on mental health and QoL in patients with relapsing-remitting MS (RRMS). The aim of the study was to compare levels of depression, anxiety, and health-related quality of life (HRQoL) in RRMS patients treated with fingolimod or cladribine, and to evaluate their associations with clinical and radiological parameters. Materials and Methods: Eighty RRMS patients aged 18 to 50 years with Expanded Disability Status Scale (EDSS) scores of 3.0 or less, no recent disease relapse, and no history of antidepressant use were enrolled. Forty patients were treated with fingolimod and forty with cladribine. Depression and anxiety were assessed using the Hamilton Depression Rating Scale (HDRS) and the Hamilton Anxiety Rating Scale (HARS). QoL was evaluated using the Multiple Sclerosis QoL-54 (MSQOL-54) instrument. Additional clinical data, including MRI-based lesion burden, EDSS scores, age, disease duration, and occupational status, were collected. Results: No statistically significant differences were observed between the two groups regarding HDRS and HARS scores (p > 0.05). However, patients treated with fingolimod had significantly higher scores in the Energy/Fatigue subdomain (7.55 ± 2.02 vs. 6.56 ± 2.57, p = 0.046) and Composite Mental Health (CMH) score (64.73 ± 15.01 vs. 56.00 ± 18.93, p = 0.029) compared to those treated with cladribine. No significant differences were found in the independent items of the MSQOL-54. A negative correlation was identified between total lesion load and QoL scores. Conclusions: Although fingolimod and cladribine exert comparable effects on depression and anxiety levels, fingolimod may be associated with better mental health outcomes and reduced fatigue in RRMS patients. Furthermore, lesion burden and clinical parameters such as age and EDSS score may independently influence QoL, regardless of the DMT used. Full article

Background/Objectives: Bladder cancer is a common malignancy with a high rate of recurrence and progression. Recent studies have identified that the urinary microbiome can be a key factor in tumor pathogenesis, progression, and outcomes. This narrative review is designed to summarize current evidence regarding the urobiome and explore its diagnostic and therapeutic potential. Methods: Studies between 2019 and 2024 were identified through the PubMed/MEDLINE and Google Scholar databases. Case reports and non-English-language articles were excluded. Results: The main findings revealed that specific bacteria, viruses, and taxa are linked to bladder cancer presence, progression, and response to immunotherapy treatment. Urinary microbiota differ by tumor type, sex, smoking status, and occupational exposure to toxins. Conclusions: Urinary microbiome and certain types of viruses present in urine may serve as promising tools to enhance bladder cancer diagnosis and predict treatment response. However, larger longitudinal studies are needed to confirm and establish these findings. Furthermore, integration of the urinary microbiome in clinical practice and public health strategies may reduce disease-related burden. Full article

This article describes the design, methods, and baseline characteristics of the social needs assessment (SNA) of participants enrolled in an ongoing randomized clinical trial implementing a comprehensive approach to improving diabetes self-management and providing an intensive Diabetes Self-Management Education and Support (iDSMES) Program at St. Vincent’s House Clinic, a primary care practice serving resource-challenged diverse populations in Galveston, Texas. Standardized SNA was conducted to collect information on financial needs, psychosocial well-being, and other chronic health conditions. Based on their identified needs, participants were referred to non-medical existing community resources. A series of in-depth interviews were conducted with a subset of participants. A team member independently categorized these SNA narratives and aggregated them into two overarching groups: medical and social needs. Fifty-nine participants (with a mean age of 53 years and equal representation of men and women) completed an SNA. Most (71%) did not have health insurance. Among 12 potential social needs surveyed, the most frequently requested resources were occupational therapy (78%), utility assistance (73%), and food pantry services (71%). SNA provided data with the potential to address barriers that may hinder participation, retention, and outcomes in diabetes self-management. SNA findings may serve as tertiary prevention to mitigate diabetes-related complications and disparities. Full article

Cancer disparities in low- and middle-income countries (LMICs) arise from multifaceted interactions between environmental exposures, infectious agents, and systemic inequities, such as limited access to care. The exposome, a framework encompassing the totality of non-genetic exposures throughout life, offers a powerful lens for understanding these disparities. In LMICs, populations are disproportionately affected by air and water pollution, occupational hazards, and oncogenic infections, including human papillomavirus (HPV), hepatitis B virus (HBV), Helicobacter pylori (H. pylori), human immunodeficiency virus (HIV), and neglected tropical diseases, such as schistosomiasis. These infectious agents contribute to increased cancer susceptibility and poor outcomes, particularly in immunocompromised individuals. Moreover, climate change, food insecurity, and barriers to healthcare access exacerbate these risks. This review adopts a population-level exposome approach to explore how environmental and infectious exposures intersect with genetic, epigenetic, and immune mechanisms to influence cancer incidence and progression in LMICs. We highlight the critical pathways linking chronic exposure and inflammation to tumor development and evaluate strategies such as HPV and HBV vaccination, antiretroviral therapy, and environmental regulation. Special attention is given to tools such as exposome-wide association studies (ExWASs), which offer promise for exposure surveillance, early detection, and public health policy. By integrating exposomic insights into national health systems, especially in regions such as sub-Saharan Africa (SSA) and South Asia, LMICs can advance equitable cancer prevention and control strategies. A holistic, exposome-informed strategy is essential for reducing global cancer disparities and improving outcomes in vulnerable populations. Full article