Search Results (583)

Background: Despite its crucial role in overall health, oral health is frequently overlooked within healthcare systems, partly due to the misconception that oral diseases are neither life-threatening nor directly disabling. This perception has led to an underestimation of the psychological, social, and economic burden associated with oral diseases. Τhe present study aimed to assess oral health status and oral health-related quality of life among dental patients attending a public Special Care Center in Greece. Methods: A cross-sectional study was conducted among 400 dental patients aged 18 years and older who visited a public Special Care Center for a routine check-up or a dental problem between September and October 2024. Data was collected through personal interviews and clinical examinations after informed consent was obtained. Oral health-related quality of life was evaluated using the Oral Health Impact Profile-14 (OHIP-14) and the Oral Impacts on Daily Performance (OIDP) questionnaires. Categorical variables were presented as absolute and relative frequencies, while quantitative variables were summarized as mean, standard deviation, median, minimum, and maximum. Normality was assessed using the Kolmogorov–Smirnov test. Bivariate analyses and multivariate linear regression models were performed, with statistical significance set at p < 0.05. Statistical analyses were conducted using IBM SPSS 23.0. Results: The majority of participants were female (56.3%) with a mean age of 50.4 years (SD = 14.9). Overall oral health-related quality of life was moderate (OHIP-14: Mean = 21.0, SD = 14.8; OIDP: Mean = 14.0, SD = 12.8). Patients who attended the center due to a dental problem reported significantly poorer oral health outcomes than those attending routine check-ups (p < 0.001). Poorer self-rated oral health, having ≥12 missing teeth, prosthetic restoration, and foreign nationality were significantly associated with worse oral health-related quality of life. Conclusions: Dental patients attending the Special Care Center demonstrated moderate oral health status, which was associated with psychological distress, physical disability, and social limitations. These findings underline the need for targeted public oral health interventions, especially for vulnerable population groups. Full article

Background: Multimorbidity (the co-occurrence of two or more chronic conditions) is increasingly common among older adults and contributes to diminished well-being and greater healthcare use. While national data highlight regional variation, few studies have examined how multimorbidity is patterned within provinces like Saskatchewan or how it relates to access and acute care use. Objective: To describe sociodemographic and geographic patterns of multimorbidity among older adults in Saskatchewan and examine its association with healthcare access, unmet needs, and recent emergency department (ED) visits and hospitalizations. Methods: We conducted a secondary analysis of a population-based telephone survey of 1093 adults aged 65+ across Saskatchewan. Respondents were categorized by chronic disease burden (none, one, or multimorbidity). Descriptive statistics and postal code-level mapping explored health status, access, and utilization. Results: Multimorbidity (10.6%) was more prevalent among older adults aged 75+, Indigenous respondents, and those with lower education. It was associated with poorer self-rated health, greater unmet needs, and higher ED visits (20.7%) and hospitalizations (12.1%) compared to those without chronic conditions. Northern regions had proportionally higher multimorbidity, despite smaller populations. Conclusions: Findings highlight social and spatial disparities in chronic disease burden and underscore the need for equity-focused strategies in Saskatchewan’s rural and northern communities. Full article

Background: Identifying factors associated with cognitive impairment among older adults is critical. This study investigates both concurrent and longitudinal associations between sleep quality, sleep duration, and cognitive performance among older adults in China, with particular emphasis on the moderating role of fruit and/or vegetable intake (FVI), a factor rarely examined in previous research. Methods: We pooled five waves of a specially designed nationwide sample of adults aged 65 years or older (N = 64,690; mean age: 86.3 years; men: 43.5%) in 2005, 2008, 2011, 2014, and 2018 in China. Cognitive impairment was assessed by the Mini-Mental State Examination. Among the sample, 10.7% were cognitively impaired. FVI was dichotomized into frequent (almost daily) versus infrequent (other low frequencies). Sleep hours were grouped into short (≤6 h), normal (7–9 h), and long (≥10 h) durations. Both concurrent and cross-lagged analyses were performed after adjusting for a wide set of covariates (demographics, socioeconomic status, family/social connections, health practices, disability, self-rated health, and chronic conditions). Analyses were further stratified by gender, age group, and urban–rural residence. Results: When all covariates were present (the full model), good sleep quality was associated with 22% lower odds of the prevalence of cognitive impairment, whereas the long sleep duration was associated with 24% higher odds as compared with the normal sleep duration. Although the short sleep duration was not associated with the prevalence of cognitive impairment in the full model, it was associated with 8% higher odds of cognitive impairment when health condition was not controlled for. Interaction analyses revealed that frequent FVI buffered the adverse cognitive effects of poor sleep quality and both short and long sleep durations. Subgroup analyses further show similar patterns across subpopulations, with more pronounced protective associations in older women and the oldest-old. Conclusions: Good sleep quality, normal sleep durations, and frequent FVI jointly contribute to better cognitive functioning at older ages. While the observed relationships are largely concurrent rather than causal, promoting both healthy sleep and dietary habits may be important for cognitive health among older adults. Full article

University students worldwide experience considerable health challenges. We examined health inequalities in a nationwide, gender-balanced sample of 1105 German students, considering negative (stress, depression, burnout) and positive health outcomes (self-rated health [SRH], well-being) alongside vertical (subjective social status [SSS], parental academic background) and horizontal (gender) determinants. Analyses used bivariate statistics, multivariate regressions, and interaction terms. Higher SSS was associated with better SRH (β = 0.322) and well-being (β = 0.355), and lower stress (β = −0.154), depression (β = −0.127), and burnout (β = −0.219). First-generation students reported highly significant poorer SRH and well-being than students with one (β = 0.114; β = 0.112) or two academic parents (β = 0.162; β = 0.192). Students with two academic parents showed lower stress (β = −0.087, p = 0.007) and burnout (β = −0.099, p = 0.002). Interactions suggest a protective effect of higher SSS on depression (β = −0.219, p = 0.026) and burnout (β = −0.264, p = 0.006), more pronounced among male students, who additionally benefited more from an academic household regarding SRH (β = 0.100, p = 0.044). These findings underscore intersectional and multifaceted inequalities among German students and the need for interventions. Full article

Background: Periodontal disease is prevalent among elite athletes globally, yet its status in Japanese athletes remains unclear. This study assessed periodontal risk in Japanese university athletes and its association with oral health-related quality of life (QOL), sports performance, and immune status. Methods: A cross-sectional study was conducted with 313 university athletes (basketball, volleyball, athletics). Periodontal risk was evaluated using a Trypsin-Like Peptidase activity assay (TLP-AA) kit; a score ≥ 1.5 indicated the presence of Red Complex bacteria (positive risk). Participants completed the Oral Impacts on Daily Performance (OIDP), Oslo Sports Trauma Research Centre (OSTRC) overuse injury, and Immune Status Questionnaires (ISQ). Results: Positive periodontal risk was identified in 25.9% (81/313) of athletes. While overall prevalence was not statistically different from the general population (17.8%), specific associations emerged. Positive risk was significantly associated with “pain related to sports” (OSTRC) overall (p = 0.016) and specifically in males (p = 0.004). Among track and field athletes, positive risk was associated with difficulty “smiling/laughing” (OIDP, p = 0.033) and lower self-rated general health (p = 0.032) and immune functioning (p = 0.047). Conclusions: Periodontal risk is notable in Japanese university athletes and is significantly associated with sports-related pain and specific QOL domains. Regular oral health monitoring may be crucial for maintaining athletic performance and well-being. Full article

Background/Objectives: Oral health-related quality of life (OHRQoL) may influence mental health outcomes, yet longitudinal evidence on its association with depression remains limited. This study aimed to examine whether oral health status and OHRQoL are associated with a change in self-reported depression status among adults in Japan. Methods: We analyzed data from the Japan COVID-19 and Society Internet Survey (JACSIS), conducted in 2022 and 2023. A total of 15,068 participants aged ≥20 years without depression at baseline were included. Depression status was identified by self-reported measures between the two survey waves. Logistic regression models estimated odds ratios (ORs) and 95% confidence intervals (CIs) for change in self-reported depression status in relation to OHRQoL and oral health status, adjusting for sociodemographic and behavioral factors. Results: During follow-up, 218 participants (1.45%) reported a change in self-reported depression status. Poorer OHRQoL was significantly associated with a change in self-reported depression status (OR: 1.018; 95% CI: 1.001–1.036; p = 0.039). Additional risk factors included younger age (OR: 0.974; 95% CI: 0.964–0.985), participation in hobbies and cultural activities (OR: 2.224; 95% CI: 1.498–3.302), habitual use of sleeping pills or anxiolytics (current use OR: 3.512; 95% CI: 2.267–5.442), increased loneliness (OR: 1.217; 95% CI: 1.140–1.299), lower life satisfaction (OR: 0.900; 95% CI: 0.836–0.969), and poor self-rated health (OR: 2.921; 95% CI: 1.810–4.715). Conclusions: Impaired OHRQoL was associated with a change in self-reported depression status, potentially through psychosocial mechanisms. These findings suggest that oral health and OHRQoL may be relevant factors to consider in integrated oral and mental health approaches in clinical practice. Full article

Background: Health literacy is increasingly recognized as an essential determinant of health, readiness, and safety in the military, especially as health systems become more digitalized. However, evidence on general and digital health literacy in the armed forces remains limited. This study examined levels of general health literacy and digital health literacy among Lithuanian soldiers and explored their associations with sociodemographic, service-related, and health characteristics. Methods: A cross-sectional survey was conducted among 603 military personnel serving in the national armed forces. General and digital health literacy were measured with HLS19-Q12 and HLS19-DIGI. Data on sociodemographic and military characteristics, self-rated health, and self-reported long-term illnesses were collected. Descriptive statistics, correlation analyses, and multivariable regression models were used to analyze the data. Results: The sample was predominantly male (81.9%) with a mean age of 39.08 years (SD = 8.89). The mean general health literacy score was 80.1 (SD = 19.17), whereas the mean digital health literacy score was 67.81 (SD = 30.05). Overall, 45.0% of soldiers had excellent general health literacy, and 12.0% had inadequate general health literacy; 42.1% had excellent digital health literacy, and 35% had inadequate digital health literacy. Higher levels of health literacy were positively associated with better self-rated health and social status. No statistically significant associations were found between health literacy and gender, age, education, length of service, type of military service, and self-reported long-term health complaints. Conclusions: Military personnel in this study displayed relatively high general health literacy, yet digital health literacy was lower and more unevenly distributed, indicating a potential vulnerability for health outcomes as access to information, communication, and care increasingly relies on digital platforms. Given the cross-sectional design, causal inferences cannot be drawn. Military health services may build on existing health literacy strengths while considering strategies to address digital health literacy gaps (e.g., targeted training, tailored support, and user-friendly digital solutions, including service design), acknowledging that feasibility and implementation depend on organizational context and resources. Full article

Background: Depression in older adults is a multifactorial condition influenced by health status, functional capacity, and lifestyle factors. This study aimed to investigate the individual and combined associations of these factors with late-life depression. Methods: Using data from the National Health and Nutrition Examination Survey (NHANES), this study evaluated the associations of general health, chronic conditions, functioning, and lifestyle behaviors (including physical activity, sleep, diet quality, smoking, and alcohol use) with depressive symptoms among U.S. adults 65 years and older. Weighted logistic regression models, accounting for the complex survey design of NHANES, were used to examine the factors both individually and in combination. Results: Depressive symptoms were more prevalent among individuals with poor self-rated health, physical and cognitive functional limitations, hypertension, obesity, current smoking, physical inactivity, and alcohol abstinence. A clear cumulative risk gradient was observed with increasing numbers of risk factors: older adults with six or more risk factors had at least 20-fold higher likelihood of depressive symptoms compared with those with one or no risk factors. Conclusions: These findings highlight the interdependent influences of health, function, and lifestyle on late-life depressive symptoms and underscore the need for integrative prevention and intervention strategies to promote mental well-being in aging populations. Full article

The national obesity prevalence for children between 2 and 5 years old was 12.7% from 2017 to 2020. These prevalence rates are concerning because as obesity in youth increases, so do long-term health and psychosocial risks. Preschool children can spend up to 50% of their day in childcare with their educators, consuming meals and snacks together. Therefore, the role modeling of healthy eating behaviors by these educators may have an impact on children’s eating behaviors and future weight status. The purpose of this paper is to examine the relationship between Head Start educators’ self-reported dietary intake patterns and BMI. Variables included BMI and 8 items from the Starting the Conversation brief dietary assessment screener. Data were collected at educators’ respective Head Start centers in the spring of 2019. Pearson correlations were calculated to examine the relationship between educators’ self-reported dietary intake patterns and BMI. Of 66 teachers and teacher assistants who completed all items and BMI assessment, significant relationships were found between consumption of snack chips or crackers and fast food (r = 0.33, p = 0.007 and r = 0.27, p = 0.031, respectively). This study’s findings call attention to the importance of supporting healthier diets among early childhood educators. Full article

Background: Financial stress can lead to emotional and psychosocial distress among informal caregivers of older adults and can have a profound impact on their overall well-being. While social support may buffer financial stress, the role of gender in moderating these relationships is less understood. This study examined whether gender moderates the associations between psychosocial distress, social support, and financial well-being among informal caregivers of older adults. Methods: A cross-sectional survey was conducted between December 2023 and March 2024 among 589 informal caregivers of older adults residing in twelve rural states in the North Central United States. After applying listwise deletion for missing data, 533 caregivers with complete responses were retained for the final analysis. Financial well-being was measured using the Consumer Financial Protection Bureau (CFPB) Financial Well-Being Scale, psychosocial distress with a five-item distress scale, and social support with the OSSS-3. Gender, sociodemographic characteristics, and caregiving status were also collected. Independent t-tests, ANOVA, Pearson correlations, and multivariable linear regressions with interaction terms were used to assess the relationships among the study variables. Results: Male caregivers reported significantly higher financial well-being than females (52.66 vs. 50.12, p = 0.036). Stronger social support was associated with greater financial well-being (mean difference = 11.80, p < 0.001). Psychosocial distress was negatively correlated with financial well-being (r = –0.49, p < 0.001). Regression analyses revealed significant gender moderation: distress reduced financial well-being more sharply for males, while strong social support benefited females more substantially than males. Older age, higher income, and better self-rated health were also positively associated with financial well-being. Conclusions: Findings highlight gender-specific patterns in how psychosocial distress and social support influence financial well-being among informal caregivers. Future programs should consider gender-specific needs while addressing psychosocial and financial well-being of informal caregivers of older adults. Full article

This study examines the perceived mental health of Ukrainian female forced migrants in Ireland through the lens of the socio-ecological model (SEM). Using binomial logistic regression on a 2023 online survey dataset (N = 656), it explores multi-level predictors across individual, relationship, community, and societal domains. Results indicate that individual-level factors explain the largest proportion of variance in perceived mental health (Nagelkerke R² = 0.399). Employment status, self-rated physical health, and coping strategies were key determinants: part-time employment and good physical health were associated with higher odds of good perceived mental health. In contrast, avoidant coping and worsening health were associated with poorer outcomes. Relationship-level factors (R² = 0.194) also contributed significantly; lack of social support and deteriorating family or friendship ties were linked to poorer mental health, whereas participation in refugee meetings was strongly protective. Community-level factors (R² = 0.123) revealed that unstable housing, living with strangers, and declining neighbourhood relationships were associated with reduced mental well-being. At the societal level (R² = 0.168), insufficient access to psychological support and excessive exposure to Ukrainian news were associated with poorer outcomes, while moderate news engagement was protective. The findings highlight the multifaceted nature of refugees’ perceived mental health, emphasising the interdependence of personal resilience, social connectedness, and systemic support. Full article

Several studies worldwide have shown that adolescents have low levels of mental health literacy (MHL). This is a worrying situation, given the significant prevalence of mental health disorders among adolescents and the role of MHL in identifying these problems early and seeking help. This study aims to characterize MHL in Portuguese adolescents according to sociodemographic variables. The participants were 608 adolescents from the 7th to 12th grade, who filled in questionnaires on sociodemographics, MHL, and positive MHL. Bivariate analysis and hierarchical logistic regression models were conducted. A high level of adequate beliefs was found to be more likely in girls and in those whose mothers had higher levels of education. High rates of knowledge about self-help strategies were related to older age, having a mother who had a high level of education, greater subjective socioeconomic status (SSES), and better self-perception of mental health (SPMH). Help-seeking/first-aid skills were predicted by higher SSES, and lower SPMH predicted high levels of knowledge about mental health problems. Different MHL dimensions were related to diverse sociodemographic variables, and SPMH played a key role in enhancing the models’ ability to explain variation in MHL—particularly in knowledge on self-help strategies. Those topics require further research. These results can be useful in the development of MHL programs tailored to the specific knowledge needs of different adolescent groups. Full article

Background: Ageing leads to physical, cognitive, and social changes that affect people’s functioning and social participation. Health literacy, sociodemographic, and environmental factors influence health outcomes and access to care. This study aimed to characterize the health and functioning of Portuguese adults aged 65 and over, focusing on sociodemographic factors, health status, lifestyle, fall risk, functional capacity, and social participation, and on comparing rural and urban populations. Materials and Methods: An exploratory, cross-sectional study was conducted using data from older adults who completed the FallSensing screening protocol. Participants were classified by residence type (rural vs. urban), and group comparisons were made. Results: The sample (n = 474) was predominantly female (66.5%) with a mean age of 74.62 (±6.49) years. Rural participants were older (76.87 ± 6.89 vs. 73.50 ± 5.87) and had higher body mass index (BMI) (28.32 ± 4.31 vs. 27.51 ± 4.12), lower educational attainment—for example, 22.9% had no formal education compared to 7.0% of urban participants—and a higher prevalence of hypertension (72.6% vs. 55.4%), whereas urban participants experienced higher rates of osteoporosis (24.4% vs. 14.3%), hearing loss (41.9% vs. 26.9%), and alcohol consumption (12.7% vs. 2.3%) (p ≤ 0.05). Rural residents also demonstrated significantly poorer results for grip strength (21.03 ± 7.36 vs. 23.73 ± 8.61), gait speed (1.17 ± 0.44 vs. 1.45 ± 0.39), and the Timed Up and Go (TUG) test (13.4 ± 10.40 vs. 9.62 ± 4.43), as well as lower exercise self-efficacy (12.83 ± 4.97 vs. 14.28 ± 4.40) (p < 0.001), and more pronounced moderate-to-severe restrictions in social participation (28.0% vs. 15.7%) (p = 0.013). They reported greater use of assistive devices and more severe limitations in social participation. Although falls were reported more often in urban areas, rural residents experienced greater fall frequency. Conclusions: These findings suggest that rural living is associated with lower functional capacity and poorer health, underscoring the need for targeted physiotherapy and primary care strategies in rural settings. Full article

Objective: To compare self-reported functioning, disability, and health care-seeking behavior of previously healthy and unhealthy participants after SARS-CoV-2 infection. Design: Cross-sectional design conducted in 2021–2022. Subjects/Patients: Participants 18 years or older were asked to participate in an anonymous survey after acute SARS-CoV-2 infection (at least 28 days passed). Methods: The survey was conducted using an Internet-based questionnaire distributed through Lithuanian websites, including Facebook groups, city/town/district hospitals, and media outlets. Results: The final cohort consisted of 1945 participants, almost 90% being women with higher education and approximately 89% working at the time of survey. The mean age was 43 years. Among them, 53% reported to be healthy before SARS-CoV-2 infection and 5% were hospitalized during acute infection. Individuals with chronic diseases prior to infection rated their health status significantly lower but reported similar functional capacity before infection. After infection, they reported more restricted activities and more often sought health care due to remaining symptoms. In total, 16% of the cohort applied for rehabilitation services and only 7% were accepted, more often those with chronic diseases before infection. Conclusions: Results indicate a small proportion of participants receiving rehabilitation services, more often these with prior chronic diseases. The results increase awareness of rehabilitation needs after infection, particularly for previously unhealthy people. Full article

Background/Objectives: This study examined the specific vulnerabilities and experiences of persons with disabilities (PwDs) regarding sexual violence (SV) in Belgium. Methods: Data were drawn from the nationally representative UN-MENAMAIS survey (n = 4944), which included adults aged 16–99 years. SV was assessed using behaviourally specific questions based on validated international instruments. Logistic regression analyses examined associations between SV, disability status, sociodemographic, and mental health indicators. Results: PwDs reported a significantly higher lifetime prevalence of hands-on SV (37.8%) compared with those without disabilities (29.4%; p < 0.001, V = 0.065). PwDs also reported lower quality of life (p < 0.001, V = 0.273), and higher rates of depression (p < 0.001, V = 0.214), anxiety (p < 0.001, V = 0.145), PTSD (p < 0.001, V = 0.101), sedative use (p < 0.001, V = 0.237), and suicide attempts (p < 0.001, V = 0.124), though they reported less hazardous alcohol use (p < 0.001, V = 0.103) and cannabis use (p < 0.001, V = 0.080). Regression analyses showed that individuals assigned female at birth (p < 0.001) and those identifying as LGB+ (p < 0.001) were at a higher risk of both hands-off and hands-on SV. Among mental health correlates, depression, anxiety, PTSD, substance use, self-harm, and suicide attempts were significantly (all p < 0.001) associated with increased odds of SV. Conclusions: The findings highlight the need for targeted, inclusive prevention and support strategies addressing structural inequalities, ableism, and barriers to care to effectively prevent SV and revictimization among PwDs. Full article