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Search Results (207)

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15 pages, 394 KiB  
Review
Contemporary Approaches to Obstructive Sleep Apnea: A Review of Orthodontic and Non-Orthodontic Interventions in Children and Adults
by Janvier Habumugisha
Oral 2025, 5(3), 55; https://doi.org/10.3390/oral5030055 (registering DOI) - 1 Aug 2025
Viewed by 195
Abstract
Background: Obstructive sleep apnea (OSA) is a prevalent disorder in both pediatric and adult populations, characterized by substantial morbidity encompassing cardiovascular, neurocognitive, and metabolic impairments. Management strategies vary by age group and underlying etiology, with orthodontic and non-orthodontic interventions playing key roles. [...] Read more.
Background: Obstructive sleep apnea (OSA) is a prevalent disorder in both pediatric and adult populations, characterized by substantial morbidity encompassing cardiovascular, neurocognitive, and metabolic impairments. Management strategies vary by age group and underlying etiology, with orthodontic and non-orthodontic interventions playing key roles. This narrative review synthesizes the current evidence on orthodontic and non-orthodontic therapies for OSA in pediatric and adult populations, emphasizing individualized, multidisciplinary care approaches and highlighting future research directions. Methods: A narrative review was conducted using PubMed, Scopus, and Google Scholar to identify studies on diagnosis and management of OSA in children and adults from 2000 to 2025. Results: In pediatric patients, treatments such as rapid maxillary expansion (RME), mandibular advancement devices (MADs), and adenotonsillectomy have shown promising outcomes in improving airway dimensions and reducing apnea–hypopnea index (AHI). For adults, comprehensive management includes positive airway pressure (PAP) therapy, oral appliances, maxillomandibular advancement (MMA) surgery, and emerging modalities such as hypoglossal nerve stimulation. Special attention is given to long-term treatment outcomes, adherence challenges, and multidisciplinary approaches. Conclusions: The findings highlight the need for individualized therapy based on anatomical, functional, and compliance-related factors. As the understanding of OSA pathophysiology evolves, orthodontic and adjunctive therapies continue to expand their role in achieving durable and patient-centered outcomes in sleep apnea management. Full article
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48 pages, 753 KiB  
Review
Shaping Training Load, Technical–Tactical Behaviour, and Well-Being in Football: A Systematic Review
by Pedro Afonso, Pedro Forte, Luís Branquinho, Ricardo Ferraz, Nuno Domingos Garrido and José Eduardo Teixeira
Sports 2025, 13(8), 244; https://doi.org/10.3390/sports13080244 - 25 Jul 2025
Viewed by 321
Abstract
Football performance results from the dynamic interaction between physical, tactical, technical, and psychological dimensions—each of which also influences player well-being, recovery, and readiness. However, integrated monitoring approaches remain scarce, particularly in youth and sub-elite contexts. This systematic review screened 341 records from PubMed, [...] Read more.
Football performance results from the dynamic interaction between physical, tactical, technical, and psychological dimensions—each of which also influences player well-being, recovery, and readiness. However, integrated monitoring approaches remain scarce, particularly in youth and sub-elite contexts. This systematic review screened 341 records from PubMed, Scopus, and Web of Science, with 46 studies meeting the inclusion criteria (n = 1763 players; age range: 13.2–28.7 years). Physical external load was reported in 44 studies using GPS-derived metrics such as total distance and high-speed running, while internal load was examined in 36 studies through session-RPE (rate of perceived exertion × duration), heart rate zones, training impulse (TRIMP), and Player Load (PL). A total of 22 studies included well-being indicators capturing fatigue, sleep quality, stress levels, and muscle soreness, through tools such as the Hooper Index (HI), the Total Quality Recovery (TQR) scale, and various Likert-type or composite wellness scores. Tactical behaviours (n = 15) were derived from positional tracking systems, while technical performance (n = 7) was assessed using metrics like pass accuracy and expected goals, typically obtained from Wyscout® or TRACAB® (a multi-camera optical tracking system). Only five studies employed multivariate models to examine interactions between performance domains or to predict well-being outcomes. Most remained observational, relying on descriptive analyses and examining each domain in isolation. These findings reveal a fragmented approach to player monitoring and a lack of conceptual integration between physical, psychological, tactical, and technical indicators. Future research should prioritise multidimensional, standardised monitoring frameworks that combine contextual, psychophysiological, and performance data to improve applied decision-making and support player health, particularly in sub-elite and youth populations. Full article
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19 pages, 1654 KiB  
Article
The Emotional Anatomy of Diagnosis: A Medical Humanities Approach to Empathy in Pathology
by Iuliu Gabriel Cocuz, Raluca Niculescu, Maria Cătălina Popelea, Adrian-Horațiu Sabău, Maria-Elena Cocuz, Martin Manole, Alexandru-Constantin Ioniță, Giordano Altarozzi, Maria Tătar-Dan, Ovidiu Simion Cotoi and Dorina Maria Pașca
Diagnostics 2025, 15(15), 1842; https://doi.org/10.3390/diagnostics15151842 - 22 Jul 2025
Viewed by 240
Abstract
Background/Objectives: Pathology is often perceived as a technical medical specialty that lacks direct contact with the patient. However, oncological histopathological diagnosis requires a high degree of moral and emotional responsibility. The objective of this study was to investigate how empathy is manifested toward [...] Read more.
Background/Objectives: Pathology is often perceived as a technical medical specialty that lacks direct contact with the patient. However, oncological histopathological diagnosis requires a high degree of moral and emotional responsibility. The objective of this study was to investigate how empathy is manifested toward the “invisible” patient, the emotional impact on pathology staff, and potential repercussions in their personal lives. Method: We conducted a descriptive, cross-sectional study with a quantitative component, using an anonymous 22-item questionnaire among Romanian pathologists and medical personnel working in pathology services. The questionnaire was focused on three research directions: professional empathy in the absence of direct patient contact, the emotional impact of oncologic diagnosis on medical personnel in pathology departments, and the carryover of emotions from professional to personal life. A total of 165 respondents were included in the study (physicians, technicians, registrars). Results: Most of the respondents consider that the absence of the patient’s direct contact does not cancel the empathy, this being felt in a cognitive and more natural way. Over 60% of the respondents see oncologic histopathological diagnosis as an emphatic medical act. Over 80% of the respondents experience a sense of emotional responsibility and 70% consider that professional training does not include adequate emotional support. There is a high interest in empathy and psychological support. The professional activity of a pathologist may influence sleep, dreams, and the perception on their own health status. Diagnosing pediatric or young patients is perceived as particularly emotionally challenging. Collegial support is moderate and discussion about professional stress is rare. Conclusions: Empathy is present and relevant in pathology, despite the absence of direct patient interaction. Oncological diagnostics has a significant emotional impact on pathology department personnel, with the need to acknowledge the emotional dimension of the profession and to integrate psychological support mechanisms into pathology practice. Full article
(This article belongs to the Special Issue Hot Topics in Modern and Personalized Pathology)
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14 pages, 240 KiB  
Article
Biopsychosocial Determinants and Comorbid Risks of Obesity Among University Students: A Cross-Sectional Study
by Osama Albasheer, Mohamed Salih Mahfouz, Turki I. Aljezani, Mohammed Hassan Ghasham, Idris Harun Samily, Majid Muhammad Hakami, Naif Muslih Alshamrani, Shaima Abdu Hantul, Haneen A. Almutairi, Amal H. Mohamed, Nagla Abdalghani, Lamyaa A. M. El Hassan, Gassem Gohal, Ali Ali Ahmad Al-Makramani and Abdelkhalig Elhilu
Healthcare 2025, 13(14), 1736; https://doi.org/10.3390/healthcare13141736 - 18 Jul 2025
Viewed by 344
Abstract
Background/Objectives: Obesity among university students is a growing concern, often influenced by biological, psychological, and social factors. Few studies in Saudi Arabia have addressed this issue using a comprehensive framework. This study aims to examine the prevalence of obesity and its biopsychosocial predictors [...] Read more.
Background/Objectives: Obesity among university students is a growing concern, often influenced by biological, psychological, and social factors. Few studies in Saudi Arabia have addressed this issue using a comprehensive framework. This study aims to examine the prevalence of obesity and its biopsychosocial predictors among university students, as well as their perceptions, behaviors, and comorbidities. Methods: A cross-sectional study was conducted at Jazan University during the 2024–2025 academic year. A total of 819 undergraduate students completed a structured, self-administered Arabic questionnaire. The tool assessed sociodemographic variables, body mass index (BMI) (calculated from self-reported height and weight), biological and psychological factors, social influences, lifestyle behaviors, and comorbidities. Bivariate associations were tested using chi-square analyses, and multivariate logistic regression was used to identify independent predictors of obesity. Results: The prevalence of obesity was 19.6%, and 22.6% of students were overweight. Obesity was significantly more prevalent among males (26.7%) than females (9.6%, p < 0.001) and among students aged 24 years and above (24.0%, p = 0.024). Independent predictors of obesity included being overweight in childhood (AOR = 5.23, 95% CI: 3.47–7.90), belief in a genetic predisposition (AOR = 4.66), emotional eating (AOR = 2.57), academic or personal stress (AOR = 5.36), and social pressures related to body image (AOR = 2.96). Comorbidities significantly associated with obesity included high cholesterol (AOR = 5.40), sleep disorders (AOR = 2.99), and joint pain (AOR = 1.96). More than 80% of students with obesity reported current or past weight loss attempts, and nearly 60% received medical advice to lose weight. Conclusions: Obesity among Jazan University students is significantly associated with male gender, early-life weight history, emotional and academic stress, and social pressures. Students with obesity also experience a higher burden of comorbid conditions, even at a young age. These findings highlight the need for integrated, student-centered interventions that address both the psychological and social dimensions of weight management in university settings. Full article
22 pages, 568 KiB  
Review
A Review of Methods for Unobtrusive Measurement of Work-Related Well-Being
by Zoja Anžur, Klara Žinkovič, Junoš Lukan, Pietro Barbiero, Gašper Slapničar, Mohan Li, Martin Gjoreski, Maike E. Debus, Sebastijan Trojer, Mitja Luštrek and Marc Langheinrich
Mach. Learn. Knowl. Extr. 2025, 7(3), 62; https://doi.org/10.3390/make7030062 - 1 Jul 2025
Viewed by 1008
Abstract
Work-related well-being is an important research topic, as it is linked to various aspects of individuals’ lives, including job performance. To measure it effectively, unobtrusive sensors are desirable to minimize the burden on employees. Because there is a lack of consensus on the [...] Read more.
Work-related well-being is an important research topic, as it is linked to various aspects of individuals’ lives, including job performance. To measure it effectively, unobtrusive sensors are desirable to minimize the burden on employees. Because there is a lack of consensus on the definitions of well-being in the psychological literature in terms of its dimensions, our work begins by proposing a conceptualization of well-being based on the refined definition of health provided by the World Health Organization. We focus on reviewing the existing literature on the unobtrusive measurement of well-being. In our literature review, we focus on affect, engagement, fatigue, stress, sleep deprivation, physical comfort, and social interactions. Our initial search resulted in a total of 644 studies, from which we then reviewed 35, revealing a variety of behavioral markers such as facial expressions, posture, eye movements, and speech. The most commonly used sensory devices were red, green, and blue (RGB) cameras, followed by microphones and smartphones. The methods capture a variety of behavioral markers, the most common being body movement, facial expressions, and posture. Our work serves as an investigation into various unobtrusive measuring methods applicable to the workplace context, aiming to foster a more employee-centric approach to the measurement of well-being and to emphasize its affective component. Full article
(This article belongs to the Special Issue Sustainable Applications for Machine Learning)
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12 pages, 444 KiB  
Article
Translation and Validation of the Richards–Campbell Sleep Questionnaire for Intensive Care Unit Patients in Morocco: Reliability and Validity Assessment
by Abdelmajid Lkoul, Keltouma Oum’barek, Mohamed Amine Baba, Asmaa Jniene and Tarek Dendane
Clocks & Sleep 2025, 7(3), 31; https://doi.org/10.3390/clockssleep7030031 - 23 Jun 2025
Viewed by 553
Abstract
Introduction: For patients in intensive care units, the Richards–Campbell Sleep Questionnaire (RCSQ) seems to be a useful tool for assessing sleep quality. However, its application in the Moroccan medical context could be limited due to the lack of a dialectal Arabic version for [...] Read more.
Introduction: For patients in intensive care units, the Richards–Campbell Sleep Questionnaire (RCSQ) seems to be a useful tool for assessing sleep quality. However, its application in the Moroccan medical context could be limited due to the lack of a dialectal Arabic version for Morocco. This study’s objective was to translate and validate the RCSQ into Arabic for Moroccan speakers. Patients and methods: For this investigation, a cross-sectional design was adopted. The RCSQ was translated and validated into Arabic for Morocco in accordance with the recommendations. For every scale, psychometric properties were computed. The Cronbach’s α coefficient was utilized to evaluate the internal consistency of multi-item measures. Results: The study involved 224 patients, whose mean age was 47 ± 18.3 years. The RCSQ’s internal consistency, or Cronbach’s alpha, was computed, and all dimensions showed good reliability over the 0.92 (0.894–0.983) level. The items demonstrated good reliability and validity, with correlation values larger than 0.4, according to the data. Conclusion: The RCSQ translated into Arabic for Morocco appears to have good psychometric qualities, making it useful for assessing the quality of sleep of patients in intensive care units within Moroccan healthcare settings. Full article
(This article belongs to the Section Society)
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11 pages, 252 KiB  
Article
The Association Between Mental Health Indices and the Chronotypes Measured by Single-Item Chronotyping in Young Adults
by Katarzyna Nowakowska-Domagała, Małgorzata Juraś-Darowny, Jacek Koprowicz, Aleksandra Lewandowska, Tadeusz Pietras and Łukasz Mokros
J. Clin. Med. 2025, 14(13), 4447; https://doi.org/10.3390/jcm14134447 - 23 Jun 2025
Cited by 1 | Viewed by 580
Abstract
Background: Chronotype reflects individual variations in daily activity and sleep patterns, influenced by underlying circadian rhythms. While chronotype is often reduced to the morningness–eveningness spectrum, recent evidence suggests more diverse circadian typologies. Chronotype is linked to mental health, frequently associated with psychiatric disorders [...] Read more.
Background: Chronotype reflects individual variations in daily activity and sleep patterns, influenced by underlying circadian rhythms. While chronotype is often reduced to the morningness–eveningness spectrum, recent evidence suggests more diverse circadian typologies. Chronotype is linked to mental health, frequently associated with psychiatric disorders such as depression and suicide. This study aims to examine differences among six chronotypes (as defined by Single-Item Chronotyping) in mental health outcomes, including depression, anxiety, interpersonal relations, general functioning, suicidal behavior, and suicide acceptance. Methods: The study sample consisted of 306 young adults. Chronotype was determined using the Polish version of Single-Item Chronotyping (SIC). Mental health was assessed with the 30-item General Health Questionnaire (GHQ-30), which evaluates three dimensions: depression and anxiety, interpersonal relations, and general functioning. The Suicide Behavior Questionnaire (SBQ-R) measured past and potential future suicidal tendencies, while the Suicide Acceptance Questionnaire (SAQ) assessed attitudes toward the act of suicide. Results: The “daytime sleepy” and “moderately active” chronotypes were identified as at higher risk for mental health issues. These types exhibited greater levels of depression and anxiety, more general dysfunction, and a higher risk of suicidal behavior. The “daytime sleepy” type also experienced more interpersonal relationship difficulties compared to the “daytime active” type. Conclusions: Recognizing the “daytime sleepy” and “moderately active” types as risk factors highlights the importance of considering chronotype in mental health assessments. The SIC provides a concise method for monitoring circadian rhythm changes during treatment, facilitating tailored interventions such as modifying treatment schedules or lifestyle adjustments in alignment with an individual’s circadian rhythm. Full article
(This article belongs to the Section Mental Health)
16 pages, 4737 KiB  
Article
Horn Use Patterns and Acoustic Characteristics in Congested Urban Traffic: A Case Study of Ho Chi Minh City
by Thulan Nguyen, Yuya Nishimura and Sohei Nishimura
Acoustics 2025, 7(2), 36; https://doi.org/10.3390/acoustics7020036 - 16 Jun 2025
Viewed by 552
Abstract
Motorcycle horns are a dominant source of urban noise in many Southeast Asian cities, driven by high two-wheeler density and limited public transport infrastructure. Although automobiles have been in use for over a century, regulations governing horn design and volume control remain inadequate. [...] Read more.
Motorcycle horns are a dominant source of urban noise in many Southeast Asian cities, driven by high two-wheeler density and limited public transport infrastructure. Although automobiles have been in use for over a century, regulations governing horn design and volume control remain inadequate. This study investigates horn use behavior in Vietnamese urban traffic, identifying distinct acoustic patterns categorized as “attention” and “warning” signals. Measurements conducted in an anechoic chamber reveal that these patterns can increase sound pressure levels by up to 17 dB compared to standard horn use, with notable differences in frequency components. These levels often exceed the daytime noise thresholds recommended by the World Health Organization (WHO), indicating potential risks for adverse health outcomes, such as elevated stress, hearing damage, sleep disturbance, and cardiovascular effects. The findings are contextualized within broader efforts to manage traffic noise in rapidly developing urban areas. Drawing parallels with studies on aircraft noise exposure in Japan, this study suggests that long-term exposure, rather than peak noise levels alone, plays a critical role in shaping community sensitivity. The study results support the need for updated noise regulations that address both the acoustic and perceptual dimensions of road traffic noise. Full article
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12 pages, 602 KiB  
Article
Effects of SGLT2 Inhibitors on Sleep Apnea Parameters and Cheyne–Stokes Respiration in Patients with Acute Decompensated Heart Failure: A Prospective Cohort Study
by Petar Kalaydzhiev, Tsvetelina Velikova, Yanitsa Davidkova, Gergana Voynova, Angelina Borizanova, Natalia Spasova, Neli Georgieva, Radostina Ilieva, Elena Kinova and Assen Goudev
Biomedicines 2025, 13(6), 1474; https://doi.org/10.3390/biomedicines13061474 - 14 Jun 2025
Viewed by 614
Abstract
Background: Sleep-disordered breathing (SDB), particularly Cheyne–Stokes respiration (CSR), is highly prevalent among patients hospitalized with acute decompensated heart failure (ADHF) and is associated with worse clinical outcomes. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have demonstrated cardiorenal benefits in heart failure, but their effects on nocturnal [...] Read more.
Background: Sleep-disordered breathing (SDB), particularly Cheyne–Stokes respiration (CSR), is highly prevalent among patients hospitalized with acute decompensated heart failure (ADHF) and is associated with worse clinical outcomes. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have demonstrated cardiorenal benefits in heart failure, but their effects on nocturnal respiratory parameters remain underexplored. Objectives: This study aims to evaluate the impact of SGLT2i therapy on key respiratory and cardiac indices including CSR burden, oxygenation, and right heart function in patients with ADHF and reduced left ventricular ejection fraction. Methods: In this single-center prospective cohort study, 60 patients with ADHF, LVEF < 40%, and a baseline apnea–hypopnea index (AHI) > 5 were assessed before and three months after the initiation of SGLT2i therapy. Sleep respiratory parameters were measured using home polygraphy (ApneaLinkTM), while cardiac and renal indices were evaluated by echocardiography, NT-proBNP, and the estimated glomerular filtration rate (eGFR). Structural and functional echocardiographic changes were analyzed both at baseline and following the 3-month treatment period. Patient-reported outcomes were assessed using the Epworth Sleepiness Scale (ESS) and Kansas City Cardiomyopathy Questionnaire (KCCQ). Results: After 3 months of SGLT2i therapy, significant improvements were observed in daytime sleepiness (ESS: −2.68 points; p < 0.001), CSR index (−5.63 events/h; p < 0.001), AHI (−3.07 events/h; p < 0.001), ODI (−6.11 events/h; p < 0.001), and mean nocturnal SpO2 (+1.95%; p < 0.001). KCCQ scores increased by 9.16 points (p < 0.001), indicating improved quality of life. Cardiac assessments revealed reductions in NT-proBNP (−329.6 pg/mL; p < 0.001) and E/e′ ratio (−1.08; p < 0.001), with no significant change in LVEF or chamber dimensions. Right ventricular function improved, as evidenced by the increased TAPSE/sPAP ratio (+0.018; p < 0.001). Renal function remained stable, with a non-significant upward trend in eGFR. Conclusions: This exploratory study suggests that SGLT2 inhibitors may be associated with the attenuation of Cheyne–Stokes respiration and an improvement in right heart function in patients with ADHF, warranting further investigation in controlled trials. These findings highlight the potential of SGLT2is to address overlapping cardio-respiratory dysfunction in this high-risk population. Full article
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17 pages, 3070 KiB  
Article
Virtual Guided and Customized Orthognathic Surgery in Patients with Obstructive Sleep Apnea Syndrome: Accuracy and Clinical Outcomes
by Marta Benito Anguita, Saad Khayat, Soledad López Martín, Natalia Bravo Quelle, Ignacio Navarro Cuéllar, Ana López López, José Luis Cebrián Carretero, José Luis del Castillo Pardo de Vera, Pablo Montes Fernández-Micheltorena, Manuel Tousidonis Rial, Giovanni Dell’Aversana Orabona, Farzin Falahat, José Zamorano León and Carlos Navarro Cuéllar
J. Clin. Med. 2025, 14(11), 3780; https://doi.org/10.3390/jcm14113780 - 28 May 2025
Viewed by 732
Abstract
Background: This preliminary case series aimed to evaluate the clinical and morphometric outcomes of maxillomandibular advancement (MMA) surgery in patients with severe obstructive sleep apnea (OSA) using virtual surgical planning (VSP), patient-specific cutting guides, and customized titanium plates. Primary outcomes included changes in [...] Read more.
Background: This preliminary case series aimed to evaluate the clinical and morphometric outcomes of maxillomandibular advancement (MMA) surgery in patients with severe obstructive sleep apnea (OSA) using virtual surgical planning (VSP), patient-specific cutting guides, and customized titanium plates. Primary outcomes included changes in the Apnea–Hypopnea Index (AHI), airway dimensions, surgical accuracy, and quality of life. Methods: In this preliminary case series, six patients with severe OSA underwent MMA surgery planned using three-dimensional VSP, and executed with the aid of CAD-/CAM-generated surgical guides and patient-specific osteosynthesis. Clinical variables included AHI, Epworth Sleepiness Scale (ESS), and computed tomography-based airway morphometry. Surgical accuracy was assessed by comparing planned and achieved skeletal movements. Statistical analysis was performed using Wilcoxon signed-rank tests and Spearman’s correlation. Results: The mean preoperative AHI decreased significantly from 48.8 ± 23.6 to 12.4 ± 10.0 (p = 0.035), and ESS scores improved from 14.5 ± 4.6 to 7.8 ± 2.1 (p = 0.029). Mean airway area increased significantly from 51.8 ± 9.0 mm2 to 91.8 ± 26.6 mm2 (p = 0.035). A strong but non-significant correlation was observed between airway gain and ESS improvement (p = 0.754, p = 0.084). No patients required CPAP at 6-month follow-up, and all were asymptomatic. The anteroposterior accuracy of skeletal movements was high: 82.6% for the maxilla and 85.8% for the pogonion, with mean absolute errors of 1.25 mm and 1.95 mm, respectively. Vertical accuracy was lower, particularly in the chin region, where error analysis showed greater variability. No statistically significant differences were found between planned and achieved movements in any vector. Conclusions: MMA surgery performed with VSP, cutting guides, and customized titanium plates offers a highly effective, safe, and precise treatment modality for selected OSA patients. This approach leads to a significant reduction in AHI, expansion of the upper airway, and improvement in patient-reported daytime functioning. High accuracy in skeletal repositioning—particularly in anteroposterior vectors—supports the reliability and reproducibility of digitally guided orthognathic surgery. These findings reinforce the role of technologically assisted MMA as a definitive treatment for severe OSA. Full article
(This article belongs to the Special Issue Innovations in Maxillofacial Surgery)
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14 pages, 301 KiB  
Article
What Shapes Quality of Life in Youth? A Multidimensional Approach from Lifestyle to Residential Context—Cor-School Study
by Alvaro Pano-Rodriguez, Saül Aixa-Requena, Jose Vicente Beltran-Garrido, Abraham Batalla-Gavaldà, Vicenç Hernández-González, Enric Conesa-Milian, Isaac López-Laval and Joaquin Reverter-Masia
Healthcare 2025, 13(11), 1256; https://doi.org/10.3390/healthcare13111256 - 26 May 2025
Viewed by 457
Abstract
Background: Health-related quality of life is a key indicator of well-being that integrates physical, emotional, and social dimensions. Identifying its determinants during childhood and adolescence is essential to guide effective health promotion strategies. Objective: To analyze the association between health-related quality [...] Read more.
Background: Health-related quality of life is a key indicator of well-being that integrates physical, emotional, and social dimensions. Identifying its determinants during childhood and adolescence is essential to guide effective health promotion strategies. Objective: To analyze the association between health-related quality of life and demographic, anthropometric, biochemical, lifestyle, and environmental variables in school-aged children and adolescents. Methods: A cross-sectional study was conducted during the 2023–2024 academic year in northeastern Spain. A total of 571 children and adolescents participated in the study (mean age = 11.64 ± 1.64 years), of whom 254 were girls (44.48%). Health-related quality of life was assessed using the Revised Children’s Quality of Life Questionnaire (KINDL-R), a validated instrument for assessing perceived well-being in pediatric populations. Independent variables included waist-to-height ratio, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, adherence to the Mediterranean diet, weekly physical activity, sleep quality, and residential context (i.e., large urban areas, small urban areas, and municipalities). Multiple linear regression analysis was performed to explore the associations. Results: Older age was associated with lower health-related quality of life (β = −1.07; 95% CI: −1.61 to −0.53; p < 0.001). In contrast, better adherence to the Mediterranean diet (β = 0.72; 95% CI: 0.09 to 1.37; p = 0.023), better sleep quality (b = −2.48; p < 0.001), and participants living in cities and large urban areas reported compared to those in municipalities were associated with higher HRQoL (p < 0.05), with moderate effect sizes. No significant associations were found for sex, waist-to-height ratio, cholesterol levels, or physical activity. Conclusions: This study highlights the importance of adopting a multidimensional approach to promote health-related quality of life in young populations, addressing dietary habits, sleep quality, and environmental factors within health promotion strategies. Full article
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19 pages, 1864 KiB  
Article
Impact of Psychosocial Factors on Mental Health and Turnover Intention Among Health Workers at Different Occupational Statuses: An Exploratory Cross-Sectional Study in China
by Fuyuan Wang, Min Zhang, Yiming Huang, Yuting Tang, Chuning He, Xinxin Fang, Xuechun Wang and Yiran Zhang
Eur. J. Investig. Health Psychol. Educ. 2025, 15(5), 73; https://doi.org/10.3390/ejihpe15050073 - 7 May 2025
Viewed by 1378
Abstract
Workplace psychosocial hazards pose significant risks to the well-being of health workers (HWs). This study aimed to explore the levels of psychosocial factors experienced by Chinese and international workers and examine associations between psychosocial factors, health-related outcomes (mental problems and general health), and [...] Read more.
Workplace psychosocial hazards pose significant risks to the well-being of health workers (HWs). This study aimed to explore the levels of psychosocial factors experienced by Chinese and international workers and examine associations between psychosocial factors, health-related outcomes (mental problems and general health), and turnover intention across various occupational stages. A cross-sectional study was conducted using stratified cluster sampling methods at four hospitals in southern China. Psychosocial factors, mental health, general health, and turnover intention were assessed using the Chinese version of the Copenhagen Psychosocial Questionnaire III. Multivariate linear and logistic regression analyses were conducted. A total of 1054 HWs participated in this study (response rate: 80.21%). Compared to international samples, Chinese HWs showed significant differences in nine psychosocial dimensions, particularly interpersonal relations, leadership, and the work–individual interface. Senior hospital managers reported significantly higher stress (51.09 ± 23.88, p < 0.001), sleep troubles (53.26 ± 24.92, p = 0.003), and poorer general health (57.61 ± 37.26, p = 0.035) than other occupational stages. Work–life conflict (β = 0.172), emotional demands (β = 0.132), and role clarity (β = −0.132) were the strongest predictors of mental health issues. Hiding emotions demands (β = −0.141) and leadership quality (β = 0.130) most strongly predicted general health. The turnover intention rate was 11.01%, with job satisfaction (OR = 0.964) being the strongest negative predictor. Reducing psychosocial stressors, particularly in work–life balance, role clarity, emotional demand, and leadership quality, could improve HWs’ well-being and reduce turnover intention. Full article
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15 pages, 288 KiB  
Article
Exploring Factors Affecting Health-Related Quality of Life in Coronary Artery Disease Patients
by Geetha Kandasamy, Thangamani Subramani, Mona Almanasef, Khalid Orayj, Eman Shorog, Asma M. Alshahrani, Tahani S. Alanazi and Anusha Majeed
Medicina 2025, 61(5), 824; https://doi.org/10.3390/medicina61050824 - 29 Apr 2025
Viewed by 621
Abstract
Background and Objectives: Coronary artery disease (CAD) significantly impacts health-related quality of life (HRQoL), with lifestyle factors and comorbidities influencing various dimensions of well-being. This study aimed to assess HRQoL and its association with sociodemographic and lifestyle factors in CAD patients. Materials and [...] Read more.
Background and Objectives: Coronary artery disease (CAD) significantly impacts health-related quality of life (HRQoL), with lifestyle factors and comorbidities influencing various dimensions of well-being. This study aimed to assess HRQoL and its association with sociodemographic and lifestyle factors in CAD patients. Materials and Methods: A cross-sectional study was conducted at the Rajiv Gandhi Co-operative Multispecialty Hospital, South India, from July 2022 to April 2023, where lifestyle factors were assessed, and HRQoL was measured using the EQ-5D-3L. The differences and associations of sociodemographic and lifestyle factors with HRQoL were analyzed using the chi-square test and multivariate regression. Results: A total of 212 CAD patients were included in this study. Female gender and comorbid disease were more likely to be associated with reported problems in mobility (89.7%, 78.8%) and anxiety/depression (97.4%, 92.7%) (p < 0.05). Factors such as age ≥ 50 years, family history of CAD, current smoking, comorbid disease, and a moderate- to high-risk diet significantly influenced anxiety/depression (p < 0.05). Patients with comorbid disease and moderate- to high-risk dietary intake were significantly associated with all five dimensions (p < 0.05). Gender, educational level, alcohol intake, and sleep duration did not show a significant association with all dimensions (p > 0.05). Conclusions: This study found that CAD patients undergoing treatment for secondary prevention exhibited inadequate HRQoL, particularly in terms of mental health. Factors such as comorbid disease and moderate- to high-risk dietary intake were significantly associated with reduced HRQoL. Older age, family history of CAD, current smoking habit, comorbid disease, and a moderate- to high-risk diet were significantly associated with anxiety/depression. Full article
(This article belongs to the Special Issue Advances in Chronic Coronary Syndrome and Coronary Heart Disease)
24 pages, 1196 KiB  
Review
The Global Burden of Obstructive Sleep Apnea
by Giannicola Iannella, Annalisa Pace, Mario Giuseppe Bellizzi, Giuseppe Magliulo, Antonio Greco, Armando De Virgilio, Enrica Croce, Federico Maria Gioacchini, Massimo Re, Andrea Costantino, Manuele Casale, Antonio Moffa, Jerome R. Lechien, Salvatore Cocuzza, Claudio Vicini, Alberto Caranti, Rosario Marchese Aragona, Mario Lentini and Antonino Maniaci
Diagnostics 2025, 15(9), 1088; https://doi.org/10.3390/diagnostics15091088 - 25 Apr 2025
Cited by 3 | Viewed by 3793
Abstract
This study reviewed the global prevalence, health and socioeconomic impact, and management approaches of obstructive sleep apnea. The narrative review examined three key dimensions: (1) worldwide OSA prevalence across different regions, accounting for variations in diagnostic standards; (2) OSA’s effects on health outcomes [...] Read more.
This study reviewed the global prevalence, health and socioeconomic impact, and management approaches of obstructive sleep apnea. The narrative review examined three key dimensions: (1) worldwide OSA prevalence across different regions, accounting for variations in diagnostic standards; (2) OSA’s effects on health outcomes and socioeconomic conditions across diverse populations and healthcare systems; and (3) current global approaches to OSA diagnosis, treatment, and public health management. Despite advances in diagnosis and treatment, a large proportion of OSA cases remain undiagnosed or inadequately managed. The findings show that untreated OSA significantly increases public safety risks, particularly regarding motor vehicle and occupational accidents, while also creating a substantial pool of patients at high risk for systemic complications with severe impacts on overall health. There is a critical need for increased public awareness, universal screening approaches, and integrated care strategies to address this global health challenge and reduce its considerable socioeconomic burden. Our review uniquely addresses global disparities in OSA prevalence, clarifies the health and socioeconomic impacts that remain underexplored in the current literature, and suggests concrete strategies for public health and clinical management improvement worldwide. Full article
(This article belongs to the Special Issue Advances in Diagnosis and Treatment of Obstructive Sleep Apnea)
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11 pages, 800 KiB  
Article
Combined Proxies for Heart Rate Variability as a Global Tool to Assess and Monitor Autonomic Dysregulation in Fibromyalgia and Disease-Related Impairments
by Emanuella Ladisa, Chiara Abbatantuono, Elena Ammendola, Giusy Tancredi, Marianna Delussi, Giulia Paparella, Livio Clemente, Annalisa Di Dio, Antonio Federici and Marina de Tommaso
Sensors 2025, 25(8), 2618; https://doi.org/10.3390/s25082618 - 21 Apr 2025
Viewed by 666
Abstract
Background: Heart rate variability (HRV) provides both linear and nonlinear autonomic proxies that can be informative of health status in fibromyalgia (FM), where sympatho-vagal abnormalities are common. This retrospective observational study aims to: 1. detect differences in correlation dimension (D2) between FM patients [...] Read more.
Background: Heart rate variability (HRV) provides both linear and nonlinear autonomic proxies that can be informative of health status in fibromyalgia (FM), where sympatho-vagal abnormalities are common. This retrospective observational study aims to: 1. detect differences in correlation dimension (D2) between FM patients and healthy controls (HCs); 2. correlate D2 with standard HRV parameters; 3. correlate the degree of HRV changes using a global composite parameter called HRV grade, derived from three linear indices (SDNN = intervals between normal sinus beats; RMSSD = mean square of successive differences; total power), with FM clinical outcomes; 4. correlate all linear and nonlinear HRV parameters with clinical variables in patients. Methods: N = 85 patients were considered for the analysis and compared to 35 healthy subjects. According to standard diagnostic protocol, they underwent a systematic HRV protocol with a 5-min paced breathing task. Disease duration, pain intensity, mood, sleep, fatigue, and quality of life were assessed. Non-parametric tests for independent samples and pairwise correlations were performed using JMP (all p < 0.001). Results: Mann-Whitney U found a significant difference in D2 values between FM patients and HCs (p < 0.001). In patients, D2 was associated with all HRV standard indices (all p < 0.001) and FM impairment (FIQ = −0.4567; p < 0.001). HRV grade was also associated with FM impairment (FIQ = 0.5058; p < 0.001). Conclusion: Combining different HRV measurements may help understand the correlates of autonomic dysregulation in FM. Specifically, clinical protocols could benefit from the inclusion and validation of D2 and HRV parameters to target FM severity and related dysautonomia. Full article
(This article belongs to the Special Issue Intelligent Medical Sensors and Applications)
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