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Keywords = sex differences in education

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20 pages, 1352 KB  
Article
Healthy Lifestyle Behaviors and Technostress: A Combined Lifestyle Score Analysis in 104,175 Spanish Workers
by Marta González Rivas, Ángel Arturo López-González, Diego González Carrasco, Carla Busquets-Cortés, Lluis Rodas Cañellas and José Ignacio Ramírez-Manent
Nutrients 2026, 18(17), 2754; https://doi.org/10.3390/nu18172754 (registering DOI) - 23 Aug 2026
Abstract
Background: Technostress has emerged as a major occupational health concern in increasingly digitalized workplaces. Although organizational and technological determinants of technostress have been widely investigated, the potential influence of healthy lifestyle behaviors remains poorly understood. This study aimed to evaluate the association between [...] Read more.
Background: Technostress has emerged as a major occupational health concern in increasingly digitalized workplaces. Although organizational and technological determinants of technostress have been widely investigated, the potential influence of healthy lifestyle behaviors remains poorly understood. This study aimed to evaluate the association between a combined Healthy Lifestyle Score (HLS) and technostress in a large cross-sectional sample of Spanish workers. Methods: A cross-sectional study was conducted among 104,175 workers who underwent routine occupational health examinations between January 2021 and December 2024. The Healthy Lifestyle Score was constructed by assigning one point each for regular physical activity, high adherence to the Mediterranean diet, and non-smoking status, resulting in scores ranging from 0 to 3. Technostress was assessed using the Technostress Short Questionnaire (TCS-Short) and categorized as low, moderate, high, or very high. Logistic regression models were used to estimate crude and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for high-to-very high technostress according to HLS categories. Results: Significant differences in technostress levels were observed across HLS categories (p < 0.001). The prevalence of high-to-very high technostress was 50.8% among workers with HLS = 0 and 50.7% among those with HLS = 1, decreasing markedly to 7.5% and 7.2% among workers with HLS = 2 and HLS = 3, respectively. After adjustment for sex, age, educational level, and social class, participants with HLS = 2 and HLS = 3 exhibited substantially lower odds of high technostress (OR = 0.073, 95% CI 0.068–0.078 and OR = 0.074, 95% CI 0.069–0.079, respectively) compared with those with HLS = 0. The categorical analysis suggested a threshold-like rather than progressive association, with substantially lower odds of high-to-very high technostress observed among workers with HLS = 2 and HLS = 3, whereas HLS = 1 did not show lower odds compared with HLS = 0. The final model demonstrated excellent discrimination (AUC = 0.902). Conclusions: Healthy lifestyle profiles were strongly associated with technostress in this large cross-sectional occupational sample. Workers with HLS = 2 and HLS = 3 showed markedly lower odds of high-to-very high technostress than those with HLS = 0, whereas HLS = 1 did not show lower odds. Component-specific analyses indicated that the associations differed substantially across the behaviors comprising the score, supporting interpretation of the HLS as an unweighted behavioral count rather than as a measure of equivalent contributions from each component. Full article
(This article belongs to the Special Issue Adherence to the Mediterranean Diet and Health Status)
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22 pages, 964 KB  
Article
Lifestyle Characteristics and Dietary Habits in Romanian Patients with Periodontitis: A Cross-Sectional Study
by Ana Maria Hofer, Andrei Picos, Bogdana Adriana Nasui, Alexandra Dădârlat-Pop and Monica Popa
Healthcare 2026, 14(17), 2676; https://doi.org/10.3390/healthcare14172676 (registering DOI) - 22 Aug 2026
Abstract
Background/Objectives: Periodontitis is a multifactorial chronic inflammatory disease influenced by behavioral, metabolic, and lifestyle-related factors. This study aimed to examine the associations of selected dietary habits, body mass index (BMI), physical activity, smoking, and oral hygiene behaviors with clinical periodontal parameters in [...] Read more.
Background/Objectives: Periodontitis is a multifactorial chronic inflammatory disease influenced by behavioral, metabolic, and lifestyle-related factors. This study aimed to examine the associations of selected dietary habits, body mass index (BMI), physical activity, smoking, and oral hygiene behaviors with clinical periodontal parameters in a clinical sample of adults with periodontitis from northwestern Romania. Methods: This cross-sectional study included 204 adults with clinically diagnosed periodontitis. Sociodemographic characteristics, smoking status, physical activity, toothbrushing frequency, tooth mobility, and selected dietary habits were assessed using a structured questionnaire. Periodontal status was clinically evaluated using periodontal probing depth (PPD), clinical attachment loss (CAL), and bleeding on probing (BOP), while BMI was calculated from anthropometric measurements. Descriptive and inferential statistical analyses were performed to evaluate associations between the investigated factors and periodontal parameters. Multivariable linear regression models were constructed separately for PPD, CAL, and BOP, simultaneously including age, sex, BMI, smoking status, physical activity frequency, toothbrushing frequency, tooth mobility, education level, and the assessed dietary habits. Results: In the fully adjusted multivariable analyses, fish consumption 1–3 times/week was independently associated with lower PPD, whereas sweets consumption 1–3 times/week was independently associated with higher PPD. Carbonated beverage and sweets consumption 1–3 times/week were independently associated with higher BOP. Although the multivariable model for CAL was statistically significant overall, none of the individual predictors included in the model reached statistical significance. BMI and physical activity frequency were not independently associated with PPD, CAL, or BOP after simultaneous adjustment for the other variables. Age group was significantly associated with CAL category (χ2(2) = 13.28, p = 0.001, Cramér’s V = 0.255), while educational level was significantly associated with toothbrushing frequency (χ2 = 62.26, p < 0.001, Cramér’s V = 0.39). Conclusions: Selected dietary habits were independently associated with PPD and BOP after adjustment for demographic, anthropometric, lifestyle, and oral hygiene factors, whereas no individual predictor was independently associated with CAL in the fully adjusted model. BMI and physical activity were not independently associated with the periodontal parameters examined. These findings emphasize the multifactorial nature of periodontal status and suggest that specific dietary habits may be associated with different clinical dimensions of periodontal disease. However, causal relationships cannot be established due to the cross-sectional design of the study. Prospective studies using validated dietary assessment methods are needed to confirm these associations. Full article
(This article belongs to the Special Issue Advances in Preventive and Therapeutic Oral Health Care)
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14 pages, 594 KB  
Article
Awareness of Coronary Artery Disease Risk Factors Among Adults in the Jazan Region of Saudi Arabia
by Luai Alhazmi, Mohammed H. Ghasham, Mohammed A. Huzaymi, Ghada Ageeli, Fai Mahdi, Retaj A. Alameer, Raffan M. Hamzi, Reem Z. Alshalan, Raneem A. Bajobeir, Abdulbasit A. Jaabur, Ali W. Hakami, Omar Oraibi, Mohammed A. Madkhali and Mostafa Mohrag
Healthcare 2026, 14(16), 2613; https://doi.org/10.3390/healthcare14162613 - 19 Aug 2026
Viewed by 191
Abstract
Background: Coronary artery disease (CAD) remains a leading global health burden largely driven by modifiable risk factors, and public awareness plays a critical role in its prevention and early risk reduction. However, gaps in knowledge and behavioral practice persist. Objective: This [...] Read more.
Background: Coronary artery disease (CAD) remains a leading global health burden largely driven by modifiable risk factors, and public awareness plays a critical role in its prevention and early risk reduction. However, gaps in knowledge and behavioral practice persist. Objective: This study aims to assess awareness of CAD risk factors and examine its relationship with the socio-demographic characteristics, lifestyle behaviors, personal medical history, and family history among residents of the Jazan Region, Saudi Arabia. Methods: A cross-sectional study was conducted among 559 participants between April and May of 2026. Data were collected using a structured questionnaire assessing awareness of behavioral, clinical, and non-modifiable risk factors. Awareness was scored out of 12 and categorized as poor (<50%), moderate (50–75%), or high (>75%). Chi-square tests were applied to analyze associations, and binary logistic regression analysis was performed to determine independent factors associated with high awareness. The results are expressed as adjusted odds ratios (aORs) with 95% confidence intervals. Statistical significance was set at p < 0.05, and data were analyzed using IBM SPSS Statistics v.29. Results: Among the 559 participants, 67.3% demonstrated high awareness, 29.9% moderate awareness, and 2.9% poor awareness of CAD risk factors. Awareness of modifiable factors was high, including smoking (96.8%), obesity (95.5%), hypertension (94.6%), and high cholesterol (93.4%), while non-modifiable factors such as family history (54.6%) and sex (60.3%) were less recognized. In the bivariate analysis, significant associations with awareness were found for age, body mass index (BMI), education, marital status, and employment status. Exercise was significantly associated with awareness (p = 0.020), with higher awareness levels observed in individuals with greater activity. High awareness was independently linked to a higher educational level (aOR = 1.76, p = 0.009) and a previous diagnosis of CAD (aOR = 6.28, p = 0.014). Conclusions: This study found moderate to high CAD risk factor knowledge among adult residents in the Jazan Region. Self-reported preventative practices differed among health behaviors, demonstrating that awareness alone may not always lead to healthy lifestyles. As the cross-sectional nature of the study precludes causal conclusions, more longitudinal, qualitative, or theory-informed research is needed to understand the drivers of healthy behavior adoption. Full article
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19 pages, 1594 KB  
Article
Effects of a Multicomponent Lifestyle Intervention on Behavioral and Cardiometabolic Outcomes in Adults with Type 2 Diabetes Mellitus in the Peruvian Amazon
by Mónica Yenji Chia Sánchez, Alexander Javier Iman Torres, Wilson Guerra Sangama, Carlos Antonio Li Loo Kung, Susy Karina Dávila Panduro, Oscar Huaman Gutierrez, Antonio Castillo-Paredes and Jose Jairo Narrea Vargas
Nutrients 2026, 18(16), 2699; https://doi.org/10.3390/nu18162699 - 18 Aug 2026
Viewed by 183
Abstract
Introduction: Lifestyle interventions are a fundamental component of type 2 diabetes mellitus management; however, evidence from real-world clinical settings regarding multicomponent interventions that simultaneously evaluate behavioral, metabolic, and anthropometric outcomes remains limited. Objective: To evaluate the effect of a multicomponent lifestyle intervention program [...] Read more.
Introduction: Lifestyle interventions are a fundamental component of type 2 diabetes mellitus management; however, evidence from real-world clinical settings regarding multicomponent interventions that simultaneously evaluate behavioral, metabolic, and anthropometric outcomes remains limited. Objective: To evaluate the effect of a multicomponent lifestyle intervention program on dietary habits, biochemical parameters, physical activity, and anthropometric indicators in adults with type 2 diabetes mellitus in the Peruvian Amazon. Methods: A quasi-experimental study with a non-randomized control group and pre–post assessments was conducted among 144 adults with type 2 diabetes mellitus (72 in the intervention group and 72 in the control group) receiving care at a hospital in the Peruvian Amazon. The three-month intervention included nutrition education sessions, practical workshops, group-based physical activity sessions involving traditional dance and Zumba, home visits, and follow-up through telephone calls and WhatsApp. Dietary habits, fasting blood glucose (FBG), glycated hemoglobin (HbA1c), lipid profile, physical activity (PA), body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) were assessed. Intervention effects were estimated using linear mixed-effects regression models adjusted for age, sex, and disease duration. Results: Compared with the control group, participants receiving the intervention experienced greater improvements in dietary habits (β = 17.85; 95% CI: 16.80 to 18.89; p < 0.001), together with greater reductions in FBG (β = −84.23 mg/dL; 95% CI: −100.45 to −68.01; p < 0.001) and HbA1c (β = −2.32 percentage points; 95% CI: −2.74 to −1.90; p < 0.001). Greater reductions were also observed in triglycerides (β = −53.68 mg/dL), total cholesterol (β = −31.73 mg/dL), BMI (β = −1.67 kg/m2), WC (β = −5.31 cm), and WHtR (β = −0.034) (all p < file0.001). PA increased to a greater extent among participants receiving the intervention (β = 3015.40 MET-min/week; 95% CI: 2769.81 to 3260.99; p < 0.001), whereas no significant between-group difference in change was observed for serum creatinine (p = 0.075). Conclusions: Participation in a three-month multicomponent lifestyle intervention was associated with greater improvements in dietary habits, physical activity, glycemic control, lipid profile, and anthropometric indicators compared with usual care among adults with type 2 diabetes mellitus in the Peruvian Amazon. Full article
(This article belongs to the Special Issue Lifestyle Interventions for Diabetes in Physical Activity and Beyond)
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23 pages, 548 KB  
Review
Methods Used to Assess Physical Abilities in Police Students: A Scoping Review
by Emilia Martinsson, Haris Pojskic, Anna Hafsteinsson Östenberg and Jesper Augustsson
Sports 2026, 14(8), 356; https://doi.org/10.3390/sports14080356 - 18 Aug 2026
Viewed by 276
Abstract
Physical ability testing is an essential part of police education, as fitness assessments indicate students’ preparedness for police work. Clear documentation and reporting of test protocols and measurement properties are essential for interpreting, evaluating, and comparing the usefulness of different test batteries. Therefore, [...] Read more.
Physical ability testing is an essential part of police education, as fitness assessments indicate students’ preparedness for police work. Clear documentation and reporting of test protocols and measurement properties are essential for interpreting, evaluating, and comparing the usefulness of different test batteries. Therefore, this scoping review aimed to map the fitness tests used in police education programs internationally, including reporting standards of test protocols, reliability, validity, and sex-based test specificity, thereby providing insight into the physical abilities considered important for police work. The main searches were conducted in the databases CINAHL, PubMed, SPORTDiscus, and Web of Science. The database search yielded 1323 articles, of which 92 met the inclusion criteria. An additional nine articles were included through citation and hand searching. Of the 101 studies, 95 used an average of 4–5 general fitness tests, and 29 included work-related police tests. Test protocols were generally well documented across studies. However, only a few studies included in this review assessed test–retest reliability, and only a limited number of studies, whose primary aim was to validate the tests, evaluated test validity. The most commonly used assessments were upper-body and core muscular endurance (60 s push-up, maximum pull-up, and 60 s sit-up tests), upper-body muscular strength (hand-grip test), lower-body power (standing long jump, and vertical jump tests), and aerobic capacity (20 m multistage fitness, 2400 m Cooper, and 12 min Cooper tests. Only 19 studies reported sex-specific performance standards, including differences in test execution, scoring systems, VO2max estimation, or time limits. The findings indicate that tests of upper-body muscular endurance and strength, lower-body power, and aerobic capacity are among the most frequently measured physical abilities in police education programs internationally, while also highlighting the need for more standardized reporting of test protocols, reliability, and validity. Full article
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16 pages, 637 KB  
Article
Moderate-to-Vigorous Physical Activity and School Engagement in Adolescents Attending Rural and Urban Schools in Southern Spain
by José Luis Solas-Martínez, Pablo Ramírez-Espejo, Rosa Gómez-Martínez and Alberto Ruiz-Ariza
Children 2026, 13(8), 1074; https://doi.org/10.3390/children13081074 - 13 Aug 2026
Viewed by 237
Abstract
Background/Objectives: Adolescence is a key period for the development of physical activity habits and school-related behaviors. Moderate-to-vigorous physical activity (MVPA) has been associated with cognitive and educational outcomes, but its relationship with different dimensions of school engagement in rural and urban contexts remains [...] Read more.
Background/Objectives: Adolescence is a key period for the development of physical activity habits and school-related behaviors. Moderate-to-vigorous physical activity (MVPA) has been associated with cognitive and educational outcomes, but its relationship with different dimensions of school engagement in rural and urban contexts remains unclear. This study aimed to examine the association between weekly MVPA and behavioral, emotional, and cognitive engagement among adolescents attending rural and urban schools in southern Spain. Methods: A cross-sectional quantitative study was conducted with 282 adolescents (199 from urban schools and 83 from rural schools). School engagement was assessed using the Spanish version of the School Engagement Measure, and weekly MVPA was measured using the PACE+ Adolescent Physical Activity Measure. Adolescents were classified as active or inactive according to whether they reported at least five days per week of MVPA. ANCOVA and binary logistic regression analyses were performed separately by school context, adjusting for age, sex, and BMI. Complementary interaction analyses were conducted to test whether the associations differed across school contexts. Results: No significant differences were found between rural and urban adolescents in MVPA or school engagement. In urban schools, active adolescents showed significantly higher cognitive engagement than inactive adolescents. Lower weekly MVPA was also associated with higher odds of low cognitive engagement in urban adolescents. No significant associations were observed for behavioral or emotional engagement, or among rural adolescents. Conclusions: In subgroup-specific analyses, weekly MVPA was associated with cognitive engagement among adolescents attending urban schools. Given the cross-sectional design, convenience sampling, and self-reported assessment of MVPA, these findings should be interpreted as correlational and cannot establish causality. Moreover, the interaction analyses provided no evidence that the association differed significantly between rural and urban school contexts. Full article
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20 pages, 346 KB  
Article
Sexuality Education, Problematic Pornography Use, and Body Self-Esteem Among Catalan Adolescents in Spain: Sex Differences and Digital Contexts
by Sandra Sedano Colom, Lluís Ballester Brage, Maria Francesca Criach Singla, Paula Benedico-Peydró and Berta Aznar-Martínez
Youth 2026, 6(3), 117; https://doi.org/10.3390/youth6030117 - 12 Aug 2026
Viewed by 221
Abstract
Problematic pornography consumption (PPC) during adolescence has been associated with negative perceptions of one’s own body image, pressure to conform to beauty standards, self-objectification, and dissatisfaction with one’s own image, whereas sexuality education may promote critical thinking, self-knowledge, and healthy relationships. This cross-sectional [...] Read more.
Problematic pornography consumption (PPC) during adolescence has been associated with negative perceptions of one’s own body image, pressure to conform to beauty standards, self-objectification, and dissatisfaction with one’s own image, whereas sexuality education may promote critical thinking, self-knowledge, and healthy relationships. This cross-sectional study analyzed the relationship between received sexuality education, body self-esteem, and problematic pornography use among 1177 adolescents and young people aged 12 to 21 years, including 541 women and 636 men. The Body Self-Esteem Scale, the short version of the Problematic Pornography Consumption Scale, and an ad hoc questionnaire on received sexuality education were administered. Overall, 50.30% of adolescents reported having received sexuality education training, although it was mostly brief and had limited capacity to address their questions. In total, 19.63% of adolescents were at risk of negative body-image evaluation, and 10.62% were at high risk of body self-esteem problems. Moreover, 31.08% showed indicators of problematic pornography use, with higher levels among male adolescents and an increase associated with age. No significant associations were observed between the perceived quality of sexuality education and body self-esteem or PPC. However, PPC was negatively associated with body self-esteem among women. The results suggest the need to strengthen systematic, early, and comprehensive sexuality education programs. Full article
13 pages, 260 KB  
Article
Association of Periodontal Disease with Sleep Quality and Oral Health-Related Quality of Life: A Cross-Sectional Study
by Vedat Yüksekkaya, Ebru Sarıbaş, Ramazan Ağırağaç, Bülent Ulaştan and Hatice Ortaç
Healthcare 2026, 14(16), 2456; https://doi.org/10.3390/healthcare14162456 - 9 Aug 2026
Viewed by 267
Abstract
Background/Objectives: This study aimed to comprehensively evaluate the interaction between periodontal disease, sleep quality, and quality of life and to investigate the effects of the presence and severity of periodontal disease on individuals’ sleep patterns and oral health-related quality of life. Materials and [...] Read more.
Background/Objectives: This study aimed to comprehensively evaluate the interaction between periodontal disease, sleep quality, and quality of life and to investigate the effects of the presence and severity of periodontal disease on individuals’ sleep patterns and oral health-related quality of life. Materials and Methods: A total of 195 individuals were included in the study. Participants’ sociodemographic data and dental habits were recorded. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), while the impact of oral health on quality of life was evaluated using the Oral Health Impact Profile-14 (OHIP-14). Results: A significant difference was observed in OHIP-14 scores among the groups (p < 0.001), with median values of 6, 13, and 22 in the healthy, gingivitis, and periodontitis groups, respectively. OHIP-14 scores also increased significantly with the stage and grade of periodontitis (p < 0.001). PSQI scores differed significantly among the groups (p < 0.001), with median values of 4, 8, and 10 in the healthy, gingivitis, and periodontitis groups, respectively. However, no significant differences were observed in total PSQI scores across the stages or grades of periodontitis. In addition, a strong positive correlation was found between total PSQI and OHIP-14 scores (r = 0.63, p < 0.001). Multiple linear regression analysis confirmed that periodontal status remained independently associated with both PSQI and OHIP-14 scores after adjusting for age, sex, education level, and smoking status, with periodontitis showing the strongest association in both models (PSQI: B = 5.03; OHIP-14: B = 15.80, both p < 0.001). Conclusions: A significant relationship was identified between periodontal disease, sleep quality, and oral health-related quality of life. Furthermore, the strong positive correlation between sleep quality and oral health-related quality of life suggests that deterioration in sleep quality may be associated with poorer oral health-related quality of life. These findings indicate that periodontal health is not limited to oral tissues but is also closely associated with an individual’s overall well-being. Full article
12 pages, 446 KB  
Article
Perceived Stress and Domain-Specific Physical Activity in Relation to Anxiety and Somatic Symptom Burden Among Romanian Adults: A Cross-Sectional Online Survey
by Mihaela Fadgyas Stanculete, Octavia Căpățînă and Catalin Alexandru Chihaia
Medicina 2026, 62(8), 1530; https://doi.org/10.3390/medicina62081530 - 9 Aug 2026
Viewed by 188
Abstract
Background and Objectives: Physical activity may relate to mental health differently depending on whether it is performed at work, for transport, or during leisure. Evidence regarding this distinction in Romanian community samples remains limited, and it is unclear whether these associations persist [...] Read more.
Background and Objectives: Physical activity may relate to mental health differently depending on whether it is performed at work, for transport, or during leisure. Evidence regarding this distinction in Romanian community samples remains limited, and it is unclear whether these associations persist after accounting for perceived stress. We examined domain-specific physical activity, sedentary time and perceived stress in relation to anxiety and somatic symptom burden. Materials and Methods: This cross-sectional online survey included 307 Romanian adults aged 18–65 years. Physical activity was measured with the Global Physical Activity Questionnaire, perceived stress with the 14-item Perceived Stress Scale, anxiety with the Beck Anxiety Inventory, and somatic symptoms with the Patient Health Questionnaire-15. Spearman correlations were adjusted for multiple testing with the Benjamini–Hochberg false-discovery-rate procedure. Multivariable linear models used HC3 robust standard errors and included sex, age group, education, body mass index and religious affiliation as covariates. Scores for each physical activity domain were log(1 + x)-transformed and standardized. Sensitivity analyses considered participation versus non-participation, symptom severity categories, total activity and exclusion of an extreme activity value. Results: Median scores were 24 for perceived stress, 10 for anxiety and 7 for somatic symptoms. Perceived stress correlated with both anxiety (rho = 0.486) and somatic symptoms (rho = 0.428; both false-discovery-rate-adjusted p < 0.001). Vigorous leisure-time activity was inversely correlated with somatic symptoms (rho = −0.205; adjusted p = 0.002), whereas total physical activity was not associated with either outcome. In the fully adjusted models, a one-standard-deviation-higher PSS-14 score was associated with 5.57 more BAI points (95% CI 4.50–6.63) and 2.12 more PHQ-15 points (95% CI 1.62–2.63). Vigorous leisure-time activity remained associated with a lower PHQ-15 score (−0.84 points per standard deviation; 95% CI −1.35 to −0.32), but its association with BAI was no longer statistically significant after adjustment for perceived stress. Conclusions: Perceived stress showed the strongest association with both anxiety and somatic symptom burden. The use of a single total activity score concealed a more specific inverse association between vigorous leisure-time activity and somatic symptoms. Longitudinal studies using more representative sampling, objective measures of activity and broader confounder assessment are needed to clarify directionality and determine the potential relevance of vigorous leisure-time activity to somatic symptom burden. Full article
(This article belongs to the Section Psychiatry)
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15 pages, 259 KB  
Article
Determinants of Public Knowledge About Root Canal Treatment: A Cross-Sectional Survey of Croatian Adults
by Júlia Saravanja, Lidia Gavic, Ana Glavina and Antonija Tadin
Oral 2026, 6(4), 103; https://doi.org/10.3390/oral6040103 - 7 Aug 2026
Viewed by 208
Abstract
Aim: Root canal treatment preserves the natural tooth and avoids the consequences of extraction, yet its acceptance depends on public knowledge, attitudes, and perceptions. This cross-sectional online survey assessed the knowledge, attitudes, and experiences of Croatian adults recruited online via social media regarding [...] Read more.
Aim: Root canal treatment preserves the natural tooth and avoids the consequences of extraction, yet its acceptance depends on public knowledge, attitudes, and perceptions. This cross-sectional online survey assessed the knowledge, attitudes, and experiences of Croatian adults recruited online via social media regarding root canal treatment and their association with sociodemographic characteristics. Material and Methods: A self-administered questionnaire (38 items, including an eight-item true/false knowledge scale) was distributed via social media between March and June 2025, and 1004 adults were included. Data were analyzed using the chi-square test or Fisher’s exact test and logistic regression (p < 0.05). Results: The mean knowledge score was 5.60 ± 2.45 of 8. Participants with prior endodontic experience scored higher (6.36 vs. 5.15) and answered all knowledge items correctly more often (p < 0.001). In logistic regression, a higher level of knowledge was associated with female sex (OR = 1.78, 95% CI 1.34–2.36), older age, affiliation with a medical profession (OR = 3.16; 95% CI 2.32–4.32), prior endodontic experience (OR = 2.91; 95% CI 2.18–3.90), and considering the preservation of natural teeth important. Among treated participants, the level of knowledge did not differ significantly by the type of clinician who performed the treatment. Although fear and misconceptions (e.g., that the procedure is painful) were common, 88.3% of treated participants would recommend it. Conclusions: Overall knowledge was moderate rather than low. Targeted public education—delivered primarily through the dental office and reinforced by popular-science and social-media campaigns addressing treatment indications, the role of the endodontist, and misconceptions about pain—could reduce misconceptions and support the preservation of natural teeth. Full article
16 pages, 678 KB  
Article
Exploring Multidimensional Diabetes Self-Management and Health-Related Functioning in Relation to Vascular Complications
by Claudiu Cobuz, Mădălina Ungureanu-Iuga, Iuliana Costescu, Alina Cornea and Maricela Cobuz
J. Clin. Med. 2026, 15(15), 6125; https://doi.org/10.3390/jcm15156125 - 6 Aug 2026
Viewed by 233
Abstract
Background/Objectives: Diabetes mellitus is associated with complex behavioral, psychosocial, and functional challenges that may influence disease burden and complication profiles. This study aimed to identify latent dimensions of diabetes self-management and health-related functioning and to evaluate their association with the type of [...] Read more.
Background/Objectives: Diabetes mellitus is associated with complex behavioral, psychosocial, and functional challenges that may influence disease burden and complication profiles. This study aimed to identify latent dimensions of diabetes self-management and health-related functioning and to evaluate their association with the type of diabetes-related complications. Methods: A cross-sectional study was conducted in 300 patients with type 2 diabetes, classified into microvascular and macrovascular complication groups. A questionnaire comprising DSMQ (diabetes self-management questionnaire) derived items, SF-36-derived items, and other questions was administered to all participants. Exploratory factor analysis was performed to identify latent dimensions related to self-management, emotional burden, dietary behavior, glycemic control challenges, glucose monitoring, and functional status. Composite scores were calculated for factors with acceptable internal consistency. Between-group comparisons, Spearman correlation analysis, and binary logistic regression models adjusted for age, sex, residence area, marital status, education, diabetes duration, and treatment type were applied. Results: Six latent factors were identified: Emotional Burden, Dietary Self-Management, Functional Limitations, Glycemic Control Challenges, Glucose Monitoring, and General Health Perception. However, only the factors demonstrating acceptable internal consistency were retained for subsequent analyses: Emotional Burden, Functional Limitations, and Glycemic Control Challenges. Functional Limitations showed the strongest association with complication type, with patients with macrovascular complications reporting greater functional impairment. After adjustment for potential confounders and correction for multiple comparisons, higher adherence to the recommended meal plan (DSMQ2) and greater functional limitations remained the principal differences between the complication groups. Functional Limitations Score remained independently associated with complication type in both unadjusted and adjusted logistic regression models. Conclusions: These cross-sectional findings support the integration of functional, psychosocial, and behavioral assessment into comprehensive diabetes care and highlight differences in patient-reported outcomes across complication groups. Full article
(This article belongs to the Special Issue Clinical Advances in Diabetes, Obesity, and Hypertension)
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15 pages, 782 KB  
Article
Quality of Life and Its Correlates in Iraqi Medical Students with Chronic Rhinosinusitis
by Ahmed Al-Imam and Nawfal Al-Hadithi
J. Oman Med. Assoc. 2026, 3(2), 15; https://doi.org/10.3390/joma3020015 - 6 Aug 2026
Viewed by 406
Abstract
Background: Chronic rhinosinusitis (CRS) impairs the quality of life (QoL), but its impact and risk factors remain unknown among Iraqis, including medical students. We aim to assess the QoL using the Sino-Nasal Outcome Test-22 (SNOT-22) in CRS-affected Iraqi medical students, categorize impairment severity, [...] Read more.
Background: Chronic rhinosinusitis (CRS) impairs the quality of life (QoL), but its impact and risk factors remain unknown among Iraqis, including medical students. We aim to assess the QoL using the Sino-Nasal Outcome Test-22 (SNOT-22) in CRS-affected Iraqi medical students, categorize impairment severity, and identify associated correlates via multivariable analysis. Methods: We surveyed 435 Iraqi undergraduates with CRS to identify QoL correlates, SNOT-22 severity strata, associated symptoms, seasonality, and treatment history. Data analysis, including multivariable models, was conducted in IBM SPSS version 27. Results: Among 435 surveyed individuals, 76.6% had impaired QoL. Binary logistic regression identified key correlates: immune disturbances (OR = 2.68; p = 0.028), family history (OR = 2.12; p = 0.003), chronic comorbidities (OR = 2.07; p = 0.037), and pre-clinical (basic) educational level (OR = 1.95; p = 0.007). In sex-stratified models, chronic comorbidities predominated in females (OR = 4.64; p < 0.001) and immune disturbances in males (OR = 3.89; p = 0.014). Ordinal regression confirmed immune disturbances (β = 0.65; p = 0.017), chronic comorbidities (β = 0.58; p = 0.023), and family history (β = 0.57; p = 0.003). Logistic and ordinal regression exhibited good model fitting (p > 0.05) and showed comparable statistical accuracy (76.8% vs. 76.1%). Conclusions: Impaired QoL was common among CRS-affected medical students, with immune disturbances and family history as the strongest correlates. Sex-specific differences existed. Findings highlight the need for personalized management of high-risk groups. Full article
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15 pages, 5123 KB  
Article
The Association Between Added Sugars Intake and the Healthy Eating Food Index 2019 Among Canadians: Analyses from the 2015 Canadian Community Health Survey—Nutrition Public Use Microdata File
by Ye (Flora) Wang, Zhongqi Fan, Sandra Marsden, Chiara DiAngelo, Laura Chiavaroli, Mavra Ahmed and Mei Chung
Nutrients 2026, 18(15), 2570; https://doi.org/10.3390/nu18152570 - 6 Aug 2026
Viewed by 361
Abstract
Background/Objectives: There is continuing debate regarding the association between added sugars (AS) consumption and overall diet quality, which remains a research gap within the Canadian population. This study aimed to assess the association between intakes of added sugars and the Healthy Eating Food [...] Read more.
Background/Objectives: There is continuing debate regarding the association between added sugars (AS) consumption and overall diet quality, which remains a research gap within the Canadian population. This study aimed to assess the association between intakes of added sugars and the Healthy Eating Food Index (HEFI) 2019 that measures adherence to Canada’s Food Guide as an indicator of diet quality. Methods: The first 24 h dietary recalls of Canadians 2 years and older (n = 19,532) from the 2015 Canadian Community Health Survey—Nutrition were used. Added sugars intakes were calculated based on a systematic 10-step algorithm. Descriptive statistics were obtained for total HEFI and component scores across different AS intake categories. The association between AS categories and HEFI scores was tested using a generalized linear model adjusted for age, sex, education level, type of smoker, and misreporting status. Results: The association between continuous AS intake and HEFI scores was non-linear. In the categorical model, AS intake categories were inversely associated with HEFI scores among Canadians (R2 = 0.32, p < 0.001). Large overlaps in HEFI scores were observed among individuals with similar AS intakes for the whole population and each age group. Among high AS consumers (>15% EI), lower HEFI scores were largely due to higher proportions of sweetened beverages (i.e., low beverage scores) and lower intakes of vegetables and fruit and plant-based proteins. Scores for protein food and whole grains were low across all AS intake categories. Conclusions: Large variations in overall HEFI scores were observed amongst those with similar AS intakes, suggesting that added sugars alone may not fully capture overall diet quality or adherence to Canada’s Food Guide. Full article
(This article belongs to the Section Nutrition and Public Health)
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10 pages, 538 KB  
Article
Medical Students’ Hand Hygiene Knowledge at Balqa Applied University
by Yamamah Al-Hmaid, Mais Alkhalili, Safa’ Alnuaimi, Rawdah Alsheyab and Shadi Bashatwah
Hygiene 2026, 6(3), 48; https://doi.org/10.3390/hygiene6030048 - 5 Aug 2026
Viewed by 209
Abstract
This study aimed to evaluate medical students’ hand hygiene knowledge at Balqa Applied University. A cross-sectional study was conducted using the World Health Organization Hand Hygiene Knowledge Questionnaire for Health-Care Workers. Knowledge scores were calculated based on correct responses, and independent-samples t-tests were [...] Read more.
This study aimed to evaluate medical students’ hand hygiene knowledge at Balqa Applied University. A cross-sectional study was conducted using the World Health Organization Hand Hygiene Knowledge Questionnaire for Health-Care Workers. Knowledge scores were calculated based on correct responses, and independent-samples t-tests were used to examine differences in knowledge scores between groups. A total of 292 medical students participated. The mean knowledge score was 14.5 ± 2.7 out of 25. Most students demonstrated moderate knowledge (70.9%), while 24.0% had poor knowledge and 5.5% had good knowledge. Knowledge scores did not differ significantly by sex, medical year, or routine use of alcohol-based handrub (p > 0.05). However, students who had received formal hand hygiene training or education achieved significantly higher scores (p = 0.023). Overall, medical students demonstrated a moderate level of hand hygiene knowledge, and formal training or education was associated with better knowledge, emphasizing the value of incorporating hand hygiene education and training into medical curricula. Full article
(This article belongs to the Section Hygiene in Healthcare Facilities)
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14 pages, 507 KB  
Article
Toxoplasma gondii Seroprevalence Among Community-Based Adults in Kuwait
by Anfal Yousef, Haya Altawalah and Jamshaid Iqbal
Hygiene 2026, 6(3), 47; https://doi.org/10.3390/hygiene6030047 - 4 Aug 2026
Viewed by 189
Abstract
Background: Toxoplasmosis is a globally prevalent zoonotic infection caused by Toxoplasma gondii, with potentially severe consequences for pregnant women, foetuses, and immunocompromised individuals. Despite its public health importance, epidemiological data on T. gondii infection in Kuwait remain limited and restricted to [...] Read more.
Background: Toxoplasmosis is a globally prevalent zoonotic infection caused by Toxoplasma gondii, with potentially severe consequences for pregnant women, foetuses, and immunocompromised individuals. Despite its public health importance, epidemiological data on T. gondii infection in Kuwait remain limited and restricted to selected population groups. This study assessed the seroprevalence of T. gondii among community-based adult participants in Kuwait and examined potentially associated risk factors. Methods: A cross-sectional study was conducted in September 2024 in Kuwait City and Jahra governorates. Serum samples from a convenience sample of 200 adults attending governmental polyclinics were screened for T. gondii IgM and IgG antibodies using VIDAS ELISAassays, with IgG-positive samples further analysed for IgG avidity. Demographic and exposure data were collected using structured questionnaires. Univariable and multivariable associations between demographic and exposure-related factors and IgG seropositivity were statistically evaluated. Results: The overall IgG seroprevalence was 11.5% (23/200), with no significant difference between governorates. All samples were IgM-negative, and all IgG-positive and equivocal samples showed high avidity. Age >40 years was associated with seropositivity in univariable analysis, but this association was not significant after adjustment (aOR = 2.21, 95% CI: 0.88–5.89; p = 0.092). No significant associations were observed with sex, nationality, educational level, travel history, cat ownership, or contact with stray cats. Conclusions: Among the participating community-based adults in Kuwait, T. gondii seroprevalence was lower than that reported in several regional studies, with serological findings consistent with past rather than recent infection. No demographic or exposure-related factor was independently associated with seropositivity. Larger population-based studies specifically powered to investigate risk factors and incorporating dietary, occupational, environmental, and migration-related exposures are needed to better characterise transmission pathways and inform targeted One Health surveillance and prevention strategies. Full article
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