The article is distributed under the Creative Commons Attribution 4.0 License. Unless otherwise stated, associated published material is distributed under the same licence.
Effects of a Community Physical Activity, Sports, and Recreational Program in Vulnerable Urban Neighborhoods
Introduction: a group of physical activity professionals promotes community programs to foster health and well-being in neighborhoods in the southern area of Quito facing physical inactivity and social isolation. Objective: to analyze the effects of a community physical, sports, and recreational activity program on participants’ physical condition and social well-being, based on an intervention organized by a specialized professional team. Method: a pre-experimental, longitudinal design without a control group was applied, involving 64 adult and older adult participants. The 20-week intervention included physical-recreational sessions. Two instruments, the IPAQ-E and the Keyes Social Well-Being Scale, were used to assess physical condition and social well-being. Results: the results showed improvements in physical condition, with a 23.5% increase in active minutes and a 6.4% reduction in sedentary behavior. All social well-being indicators increased, particularly community integration, social contribution, and perceived social utility in the environment. Conclusions: the community intervention generated positive effects on human well-being, consolidating itself as an effective strategy for social transformation. It integrated professional expertise and territorial action, demonstrating its feasibility in vulnerable urban contexts through active and committed participation.
Copyright (c) 2025 Ximena Patricia León Quinapallo, Luis Gerardo Cabrera Maya, Bernardino Guillermo Herrera Villarrea, Alexandra Patricia Manzano Aguas, Jorge Luis Mateo Sánchez, Héctor Alfonso Simbaña Cabrera (Author) https://creativecommons.org/licenses/by/4.0
High Levels of Burnout and Protective Emotional Resources among Teacher Education Students
Introduction: this study focuses on the development and validation of an instrument designed to evaluate burnout and self-reported emotional skills among early childhood education students in Chile. Objective. To analyze the relationship between burnout and protective emotional abilities in teacher education students, aiming to strengthen their socioemotional well-being during initial teacher training. Methods: this research was conducted as a cross-sectional study with a sample of 171 students (92,9 % female), who completed the adapted and validated instruments. To measure burnout, the instrument included (54 items) and to measure emotional skills the instrument included (48 items). Because the data did not follow a normal distribution, descriptive analyses, reliability assessments, confirmatory factor analysis, and non-parametric tests were performed. Results: Spearman’s analysis revealed significant negative correlations between emotional exhaustion and emotional regulation (ρ = −.46, p < .001) and empathy (ρ = −.41, p < .001). Depersonalization also showed significant inverse associations with emotional connection and verbal emotional expression. No significant correlations were found for reduced personal accomplishment. No statistically significant differences in burnout were observed by gender or university, although women scored higher in emotional regulation and empathy. Conclusions: although students possess protective emotional resources, the high levels of burnout observed highlight the need to integrate emotional education programs into initial teacher training. The findings provide relevant evidence to promote socioemotional well-being and to strengthen inclusive and sustainable pedagogical practices in Chilean higher education.
Copyright (c) 2025 Daniel Serey, Patricia Zuñiga, M. Francisca Moreno, Cynthia Adlerstein, Lorena Vásquez, Maritza Escobar , Gilda Padilla, Patricia Leal, M. de los Ángeles Cortes (Author) https://creativecommons.org/licenses/by/4.0
The "Three Seconds to Die Game": A Theoretical Analysis of the Psychological Impact on Adolescents
Introduction: The popularity of the "three-second death game" among teenagers has attracted widespread attention. Literature review shows a lack of research on the psychological impact of this game on adolescents, while similar dangerous games often produce negative psychological effects. Related theories also demonstrate their applicability in explaining adolescent risk-taking behavior. Methods: This study employs in-depth theoretical analysis, selecting five theories, including social learning theory, to explore the influence mechanisms of individual factors (cognitive traits, psychological needs, stress coping) and social factors (peer influence, group norms, and stress). Results: Existing literature on the psychological impact of this game is insufficient, but the selected theories effectively construct a framework for analyzing the individual and social driving factors behind adolescent participation in this game. Conclusion: Prevention and intervention measures are proposed. Future research should deepen theoretical mechanisms, conduct empirical studies, explore cross-cultural influences, and strengthen interdisciplinary research to protect the mental and physical health of adolescents.
Copyright (c) 2025 TakHong Cheang, FatFai Ieong (Author) https://creativecommons.org/licenses/by/4.0
Application of Nursing Cold Therapy Intervention to Reduce Pain in Pneumothorax Patients
Introduction: Pneumothorax patients commonly experience acute chest pain due to increased intrathoracic pressure, which significantly impacts their quality of life. Cold pack therapy has emerged as a promising non-pharmacological intervention for pain management. Objective: To evaluate the effectiveness of cold pack therapy in reducing pain intensity among pneumothorax patients. Methods: A descriptive case study was conducted involving two pneumothorax patients at Padang Pariaman Regional General Hospital. Cold packs (5-10°C) were applied to the affected chest area for 10-15 minutes, three times daily for three consecutive days. Pain intensity was assessed using Visual Analogue Scale (VAS) before and after each intervention. Results: Patient 1 (45-year-old male) showed pain reduction from scale 4 to 2 (50% reduction), while Patient 2 (51-year-old female) demonstrated pain reduction from scale 6 to 3 (50% reduction) over the three-day period. Both patients maintained stable vital signs with no adverse reactions. Conclusions: Cold pack therapy effectively reduced pain intensity in pneumothorax patients, supporting its use as a safe, cost-effective non-pharmacological intervention complementary to standard medical care.
Copyright (c) 2025 Rosmi Eni, Aulia Asman, Ridhyalla Afnuhazi, Vivi Yuderna, Auzia Asman, Yudhi Diputra, Hariet Rinancy (Author) https://creativecommons.org/licenses/by/4.0
Lack of protection of the right to health of persons deprived of liberty in Santo Domingo
This qualitative study analyzes the violation of the right to health at the Bellavista 1 Social Rehabilitation Center. Admission procedures, medical care, financial resources and available medical personnel were evaluated. Through inductive-deductive, historical-logical and scientific methods, and interviews with former inmates, lawyers and the former director of the center, insufficient care, lack of medicines for chronic diseases and shortage of medical personnel were evidenced. The investigation reveals deficiencies in the coordination between SNAI and the Ministry of Health, violating rights protected by the Ecuadorian Constitution and international treaties, considering this population as a priority
Copyright (c) 2023 Cristoval Fernando Rey Suquilanda , Salomón Alejandro Montece Giler , José Luis Robalino Villafuerte (Author) https://creativecommons.org/licenses/by/4.0
Impact of compassion support program on compassion fatigue, job satisfaction and turnover of psychiatric nurses
Psychiatric Mental health hospital in Saudi Arabia suffer fundamental problem of increased rates of mental health nurses turnover that seriously affect the quality of psychiatric patients’ care. Objective: This study aimed to examine the Impact of Compassion Support Program ( CSP) on Compassion Fatigue, Job Satisfaction, and Turnover of Psychiatric Nurses at El Taif Mental Hospital, Makkah city, SAUDI Arabia Method: A quasi-experimental (pre-post one-group) research design is used to evaluate the impact of Compassion Support Programs on compassion fatigue, job satisfaction, and turnover of psychiatric nurses in Taif Mental hospital, Makkah province of Saudi Arabia. The sample: consisted of all nurses who accepted to voluntary participate in the study, their number amounted to 40 nurses out of total 80 nurses after following the procedure of sampling size and G. power analysis. They represented different age groups, fluent in Arabic or English languages and represented the different hospital departments. Tools of data collection were four self-rating questionnaires (Arabic & English). Three of them were administrated pre and post implementation of the CSP program to evaluate its efficacy on the three specified variables. Results: statistical analysis using paired-samples t-test revealed significant differences at p. <0.05 between pre and post program implementations regarding all three variables. Pearson correlation test also showed significant correlation at (p˂ 0.05) among nationality, education, income, intention to leave, job satisfaction, and compassion fatigue. Multiple Regression analysis confirmed that lack of job satisfaction is the most highly correlated factor to the intention to leave work among Psychiatric nurses in this hospital. Conclusion: Compassion Support Program proved a significant impact on reducing psychiatric nurses’ compassion fatigue, turn over as well as significantly improved job satisfaction
Copyright (c) 2025 Mansour Al Manea, Nelly Mahgoub , Mona Talat (Author) https://creativecommons.org/licenses/by/4.0
Frequency of self-medication in students of the Medical School of the Universidad Abierta Interamericana, Rosario (Argentina) in the year 2023
Introduction: Self-medication is the use of medications on one's own initiative without medical prescription, treatment supervision, or diagnosis. Although in some cases it may be convenient to treat minor symptoms, irresponsible self-medication can lead to serious health consequences. Objective: To describe the frequency of self-medication in students of the Medical School of the Universidad Abierta Interamericana (UAI) - Rosario campus in the year 2023. Materials and methods: A quantitative, observational, descriptive, cross-sectional, retrospective, retrospective study was carried out at the UAI, Rosario, Argentina, from January to June 2023. The population consisted of 2nd and 5th year students of the 1st semester of the Medical School. The data collection instrument consisted of an anonymous, voluntary, self-administered survey consisting of 6 multiple-choice questions. The variables were summarized through measures of central position (mean) and measures of dispersion (range and standard deviation) and were expressed in absolute and relative frequency. Results: A total of 53 students were surveyed, of which 72% (n=38) were female and 28% (n=15) were male. The mean age was 28.58 ± 6.59 years (min: 20; max: 43). Fifty-seven percent (n=30) belonged to the fifth year of medicine and 43% (n=23) to the second year. Of these, 81% reported that the reason for self-medication was to have learned that the drug was useful for the reason for its use. The main illnesses that motivated self-medication were headache (94%), muscle pain (70%), flu (66%) and fever (64%). The types of self-medicated drugs reported were analgesics (91%), anti-influenza (66%), anti-inflammatory drugs (66%), antacids (53%), antibiotics (42%) and vitamins (34%). Ninety-eight percent stated that they had acquired medicines from pharmacies without a prescription, 26% from family medicine cabinets and 23% from relatives or friends, respectively Conclusions: It was found that all of the medical students surveyed had self-medicated at some point in their lives, with headache being the most common cause. The students reported using analgesics, anti-flu, anti-inflammatory, antacids, antibiotics and vitamins for self-medication
Copyright (c) 2023 Emir Dayub, Ariel Blajos (Author) https://creativecommons.org/licenses/by/4.0
Level of knowledge of parents of chronically ill children about sugary medicines as a risk factor for tooth decay
Introduction: An observational descriptive study was conducted at the Juan P. Garrahan Paediatric Hospital in the Autonomous City of Buenos Aires during the period August - December 2023 to determine the level of parental knowledge of caries risk factors associated with chronic consumption of sugary medicines in hospitalised and outpatient children. Methodology: A total of 75 parents were evaluated for the study. Inclusion criteria: infants from 6 months to 13 years of age. Results: 73% prolonged hospitalisation, 67% average chronic use of medication, 55% use of sugary medication, 75% of parents do not know what care should be taken for children who chronically use sugary medication and 86% did not receive oral health education during hospitalisation. Conclusion: These results should be considered in the design of a preventive intervention for Oral Health that contributes to deepen the knowledge of parents.
Copyright (c) 2024 Eva Yolanda Velásquez, María Isabel Brusca, María Laura Garzón, Atilio Vela Ferreira (Author) https://creativecommons.org/licenses/by/4.0
Medical tourism for regional leadership from a financial and business perspective: a literature review in Scopus
Medical tourism is an increasingly important economic and social phenomenon, characterized by the combination of health services and tourism experiences. However, to date it has been insufficiently studied from the management perspective. This article analyzes global trends in medical tourism in multiple fields of economic sciences, using a bibliometric and scientometric approach to identify patterns in the academic literature indexed in Scopus during the period 2017-2022. The design included the collection and analysis of data on publications, citations, keywords, institutions, disciplinary areas, predominant languages, and types of documents. The results showed an increase in academic production related to the topic, highlighting the growing participation of Latin American institutions and the predominance of research in English. The most used keywords reflected a focus on topics such as sustainability, health economics, and business management. Significant gaps in the regulation and standardization of services were identified, as well as the need for greater technological integration to improve the competitiveness and sustainability of the sector. Finally, the importance of addressing medical tourism from the perspective of economic and financial sciences is highlighted, with an emphasis on the analysis of capital flows, strategic planning and long-term sustainability
Copyright (c) 2024 Januario Arámburo De los Ríos, Cynthia Michel Olguín-Martínez , Adriana Chávez-Hernández , Denisse Viridiana Osuna-Velarde (Author) https://creativecommons.org/licenses/by/4.0
Methodology with an integrative approach for the work of the family doctor in the prevention of pregnancy in adolescence
Introduction: In Cuba, comprehensive adolescent care and the prevention of early pregnancy are priorities within public policy. Despite ongoing efforts in primary healthcare, adolescent pregnancy remains a problem requiring special attention from a preventive and promotional perspective. Objective: To develop an integrated methodology for improving adolescent pregnancy prevention efforts, based on an assessment of the family physician's prevention competency. Methods: A developmental research study was conducted in the Comprehensive General Medicine specialty at the Faculty of Medical Sciences of Isla de la Juventud, during the 2022-2024 academic year. The study population consisted of 23 professionals, including a purposive sample of 7 health area managers who served as Basic Work Group Leaders and faculty members in the health area where the study was conducted. The adolescent population included 530 adolescents, representing 18.8% of the study population. Methods at the theoretical level (analytical-synthetic, inductive-deductive), empirical level (document analysis, observation, modeling, surveys, and expert consultation), and statistical methods were used for data collection and information processing. Results: The functioning of the adolescent support group is inadequate, according to observations made in 56.5% of cases. The specialty program demonstrates an insufficient approach to the competency of adolescent pregnancy prevention. 65.2% of the physicians surveyed showed theoretical inconsistencies in this regard. Preventive training for family physicians requires strengthening the educational and community dimensions (30% of the indicators), resulting in insufficient preparation for a comprehensive approach to adolescent care, with a predominantly curative focus in their professional practice. Conclusions: The proposed methodology is based on pedagogical, philosophical, psychological, and medical education principles for comprehensive adolescent care through intersectoral collaboration and biopsychosocial integration. Validation by specialists indicates its viability for contributing to positive changes in the practice of family physicians for this purpose.
Copyright (c) 2025 Ennis Ivonnet-Gutiérrez, Doris Yisell Rubio-Olivares, Francisco Abel Pérez-Álvarez, Aliana Peña-Méndez (Author) https://creativecommons.org/licenses/by/4.0
Effect of Energy Drink Consumption on Executive Functions in Health Science Students
Introduction: The aim of this study was to analyze the relationship between energy drink consumption and executive function performance in Health Sciences students. Methods: A quantitative, non-experimental, cross-sectional, and correlational-causal design was applied, with a sample of 200 students from the Autonomous University of the State of Quintana Roo. Of these, 105 were women (52.5%) and 95 were men (47.5%), with an average age of 21 years. Data were collected using the Energy Drink Consumption Scale (EDCS) and the EFE-CO Scale, which assesses executive functions. The analysis included descriptive statistics, Pearson’s correlation, and a Structural Equation Model (SEM). Results: Significant correlations (p < .001) were found between higher energy drink consumption and poorer performance in functions related to monitoring, inhibition, and emotional control. The SEM model confirmed a moderate direct effect of energy drink consumption on executive functions, with a factor loading of λ = 0.66. Conclusions: It was concluded that frequent consumption of energy drinks is associated with significant cognitive impairment in university students. These findings highlight the importance of promoting preventive and educational strategies from a public health and academic perspective, in order to reduce the risks associated with their consumption.
Copyright (c) 2025 Nissa Yaing Torres-Soto, Edgar Fernando Peña-Torres, Beatriz Martínez-Ramírez, María de Lourdes Rojas-Armadillo, Daniela León-Rojas, Ana Luiza Corrales-Baldenebro (Author) https://creativecommons.org/licenses/by/4.0
Prevalence of Scoliosis in Adolescents Aged 12 to 16: Influence of Physical Activity Level and Type of Educational Institution
Introduction: Scoliosis is a structural deformity of the spine whose prevalence may be influenced by socioeconomic factors and physical activity levels. Previous evidence suggests that physical inactivity could be a risk factor in adolescents.Objective: To analyze and quantify the prevalence of scoliosis in students aged 12–16 years from public and private schools in Santiago, Chile, and to explore its association with physical activity levels. Methods: A cross-sectional observational study was conducted with 81 adolescents (48.1% male; 51.9% female). The mean age was 15.28 ± 0.85 years, with an average height of 163.8 ± 6.9 cm and mean weight of 66.0 ± 12.2 kg. Inclusion and exclusion criteria were applied, and four evaluation tools were used: Adams Forward Bend Test, scoliometer, Spine Screen mobile application, and the International Physical Activity Questionnaire (IPAQ).Results: A positive Adams Test was found in 43.2% of participants, while 14.8% showed out-of-range alterations in Spine Screen. According to IPAQ, 25.9% reported low physical activity, 51.9% moderate, and 22.2% high. A significant association was found between lower physical activity and scoliosis presence (p = 0.025 in Adams Test; p = 0.020 in Spine Screen). Furthermore, scoliosis prevalence was higher in public school students (54.3%) compared to private school students (34.8%) (p = 0.043). Conclusions: These findings suggest that lower levels of physical activity are associated with a higher prevalence of scoliosis in adolescents, particularly in public school settings. The results highlight the need for preventive strategies to promote structured physical activity in school environments with limited access.
Copyright (c) 2025 Ignacio Astudillo-Ganora, Pedro Cataldo-Orellana, Christian Martínez, Paloma Salazar (Author) https://creativecommons.org/licenses/by/4.0
Hybrid Machine Learning Approaches for Classification of Retinal Vascular Occlusions Using Multisource Clinical Text Data
Predictive models that incorporate a variety of clinical data have grown in significance as a means of improving healthcare decision-making. There is still a sizable amount of unstructured patient data that is either in the form of handwritten records that have been digitized or free-text doctor notes. This research builds a framework for the two data sources, digital clinical notes and scanned handwritten notes to perform predictive analysis. The data chosen for the research is related to Painless sudden loss of vision which is considered to be a serious ophthalmic emergency and is frequently associated with retinal vascular occlusions. Improving patient outcomes and facilitating prompt intervention need early distinction between its primary causes, which are Central Retinal Artery Occlusion (CRAO), Central Retinal Vein Occlusion (CRVO), Branch Retinal Artery Occlusion (BRAO), and Branch Retinal Vein Occlusion (BRVO). In the first stage, the unstructured clinical data from the textual/scanned format are converted into one single structured data frame using natural language processing (NLP). Structured data is then evaluated with machine learning algorithms and tested with different variations in order to identify the model that delivers the highest predictive accuracy, guided by the characteristics of the clinical data itself.
Copyright (c) 2025 Santosh Khanal, Rabindra Bista (Author) https://creativecommons.org/licenses/by/4.0
Hospital Accountability for Medical Actions: A Justice-Oriented Approach Based on the Doctrine of Vicarious Liability
Health is a human right that must be guaranteed by the state, as stipulated in the 1945 Constitution and Law No. 17 of 2023. Hospitals play a crucial role as providers of medical services and are responsible for patient safety. However, the increasing number of alleged medical malpractice cases demonstrates a gap between legal norms and practice, particularly regarding applying the vicarious liability doctrine in determining hospital liability for medical personnel's negligence. This study employed a normative juridical method with a statute and a conceptual approach. Secondary data in laws and regulations, literature, and journals were analyzed descriptively and analytically to examine legal norms, liability doctrine, and distributive and corrective justice principles. The results show that although Article 193 of Law No. 17 of 2023 has affirmed hospital liability, its practice still faces legal ambiguity, particularly regarding the status of non-employee physicians. This condition, which we refer to as 'jurisprudential inconsistencies '- a situation where legal decisions or practices are contradictory or unclear-creates a heavy burden of proof for patients and legal uncertainty. This study concludes that a loyalty-based, tiered accountability model is needed, where hospitals are fully responsible for monoloyal physicians, while multiloyal practices implement shared responsibility. This model is expected to strengthen patient protection, increase legal certainty, and encourage equitable hospital governance.
Copyright (c) 2025 Eko Krisnarto, Edy Lisdiyono, Anggraeni Endah Kusumaningrum, Afif Noor (Author) https://creativecommons.org/licenses/by/4.0
Mental aspects of impactful methods in cognitive treatment
Introduction: in modern psychotherapeutic practice, there has been growing interest in integrating suggestive methods into cognitive behavioral therapy (CBT). This trend was driven by the need to enhance the effectiveness of interventions with clients of different profiles, particularly in the transition to digital therapy formats where suggestion acquired new forms of implementation. Methods: the study was based on qualitative and content analysis of contemporary scientific sources addressing empirical and clinical aspects of suggestion in CBT. Results: the analysis identified the main forms of suggestive influence and highlighted the key psychological mechanisms of their action. The effectiveness of suggestive techniques was established in the treatment of anxiety, depression, post-traumatic states, and eating disorders. A summarizing table of psychological mechanisms and an author’s scheme reflecting the stages of suggestion in the CBT process were constructed. It was shown that suggestion could be successfully integrated into both traditional and digital formats of therapeutic interaction, particularly through affirmations, metaphors, visualizations, and resource messages. Conclusions: suggestive techniques were found to enrich CBT interventions by enhancing motivation and emotional engagement. The results provided practical opportunities for adapting therapeutic programs, including online applications, with suggestive elements. The proposed generalizations may serve as a basis for developing personalized CBT models that are responsive to the client’s emotional state and level of motivation.
Copyright (c) 2025 Petro Rogozhan, Olga Drobot, Olena Kostiuchenko, Viktoriia Stamat, Oleg Nazarov (Author) https://creativecommons.org/licenses/by/4.0
The Dark Side of Performance Metrics: Dehumanisation and Its Impact on Faculty Engagement
This study investigates the impact of organisational dehumanisation on work engagement among faculty members in private higher educational institutions. Drawing upon the Conservation of Resources (COR) theory, the research explores how work stress mediates the relationship between organisational dehumanisation and work engagement. A cross-sectional survey was conducted with over 500 faculty members across private institutions in southern India. Organisational dehumanisation, work engagement, and work stress were measured using validated scales, and the data were analysed using Structural Equation Modelling (SEM, AMOS). The results reveal that organisational dehumanisation significantly increases work stress, which in turn negatively impacts work engagement. While the direct influence of organisational dehumanisation on work engagement was not statistically significant, the indirect effect, mediated through organisational work stress, was significant, highlighting stress as a key mechanism through which dehumanisation erodes engagement. The study contributes theoretically by extending COR theory to the academic context and practically by underscoring the need for human-centred organisational practices in higher education. Organisational culture and institutional leaders are urged to minimise dehumanising practices and foster psychologically supportive environments to sustain faculty motivation and institutional effectiveness. These findings hold critical implications for addressing the growing faculty burnout and attrition in India's higher education sector.
Copyright (c) 2025 K.S. Daru , K. Praveena (Author) https://creativecommons.org/licenses/by/4.0
Consumption of ultra-processed foods and anthropometric results in pregnant women treated at a public hospital in Asunción
Introduction: Ultra-processed foods are high in sodium, sugars, and fats. The Pan American Health Organization warns that they jeopardize the quality of the diet. Objective: To determine the consumption of ultra-processed foods and nutritional status by anthropometry in pregnant women who attended the Loma Pyta Maternal and Child Hospital between September and December 2024. Methodology: Observational, descriptive, cross-sectional study with cross-association, non-probabilistic sampling, including pregnant women after informed consent. Sociodemographic data, obstetric history, frequency of consumption of ultra-processed foods according to the NOVA classification, and anthropometric measurements were recorded. The data were analyzed using Epi Info® software version 7.2.5.0. Results: One hundred pregnant women were evaluated, with a mean age of 27 years ± 6 SD; mean gestational age of 24 weeks ± 10 SD. One hundred percent consumed some type of ultra-processed food; 94.0% reported consuming “soft drinks,” 87.0% “packaged sweet cookies,” 95.0% “salty snacks,” and 80.0% “cold cuts.” Overweight was observed in 18.0% and obesity in 44.0%. Pregnant women who consumed these foods frequently (≥4 times per week) had a higher average weight (74.6 kg ± 17.8 SD) compared to those who consumed them moderately (1 to 3 times per week) (68.2 kg ± 12.6 SD), with a statistically significant difference (p= 0.03). Conclusion: The consumption of ultra-processed foods was distributed throughout the total sample, and the average weight was significantly higher in pregnant women with a high frequency of consumption, with malnutrition due to excess being the main anthropometric result. Dietary guidelines for pregnant women are needed, with a focus on the food environment and in line with sustainable development goals 2 and 3.
Copyright (c) 2025 María Isabel López-Ocampos (Author) https://creativecommons.org/licenses/by/4.0
Ovarian teratoma in an adult patient: case presentation and literature review
This paper reports the clinical case of a 26-year-old adult female diagnosed with a mature ovarian teratoma. Ovarian teratomas are germ cell tumors composed of tissues derived from all three embryonic layers, more frequently seen in young women but rare in adults. The patient presented with severe lower abdominal pain; imaging revealed a 20 cm heterogeneous mass in the right ovary with hyperechoic areas suggestive of fat and calcifications. Emergency laparotomy with cystectomy and ovarian tissue preservation was performed due to suspected torsion. Histopathological examination confirmed a mature teratoma without malignancy. The postoperative course was favorable, with preserved ovarian function and no tumor recurrence during follow-up. This case highlights the relevance of early diagnosis and timely surgical management to prevent complications and preserve fertility in young women.
Copyright (c) 2025 María Adela Pérez Velilla, Paola Toffoletti, Luciana Daniela Garlisi Torales, Rosanía Piedade Carvalho Santana (Author) https://creativecommons.org/licenses/by/4.0
Purple urine bag syndrome in urinary tract infection. Case report from Bolivia
Purple bag syndrome is a rare manifestation of urine discoloration associated primarily with chemical reactions caused by the indoxyl sulfatase/phosphatase activity of some bacteria or as secondary metabolites of food or supplement intake, whether oral or parenteral. Its presence causes confusion, leading to unnecessary laboratory tests and treatments. Is reported the clinical case of a 49-year-old oncology patient admitted to the trauma service for a pathological fracture and urinary tract infection. She was fitted with a urinary catheter, which contained purple urine. Laboratory tests were requested to identify the causative bacteria. The catheter was replaced, and antibiotic treatment was started, leading to resolution of the clinical picture.
Copyright (c) 2025 Leonel Rivero Castedo, Jhossmar Cristians Auza-Santivañez, Daniel Ramiro Elías Vallejos-Rejas, Carla Lorena Suarez Aponte, Shirley Nicole Andrade Azcui, Marlon Carbonell González, Ingrid Neysa Cabezas-Soliz, Roger Mamani Plata (Author) https://creativecommons.org/licenses/by/4.0
Assessment of the Psychometric Validity of the OIT-WHO Work Stress Scale in Teachers in the Ñuble Region, Chile
Introduction: The detrimental effects of job stress on the physical and mental health of workers, especially in an educational setting, have been widely documented. This study aimed to analyse the psychometric validity of the ILO-WHO Work Stress Scale in a sample of teachers in the Ñuble Region of Chile. Methods: A cross-sectional validation study was carried out with 384 teachers. Sample adequacy was assessed using the Kaiser–Meyer–Olkin (KMO) test, while exploratory factor analysis (EFA) employed orthogonal rotation and unweighted robust least squares. Results: The results revealed a valid unidimensional structure, with an internal reliability coefficient of 0,977. The variance explained was 63,4%, indicating that teachers' perceived stress is concentrated in a single factor. Conclusions: These findings suggest that the scale is an effective instrument for assessing and managing stress in education professionals, and it could inform future interventions aimed at mitigating the effects of job stress in this population.
Copyright (c) 2025 Gabriel Lagos, Yasna Sandoval, Bárbara Farías , Carolina Luengo, Carlos Rojas (Author) https://creativecommons.org/licenses/by/4.0
Maternal, Knowledge, and Cultural Factors Affecting Primigravida Readiness for Early Initiation of Breastfeeding in Buleleng Regency, Bali
Introduction: Early initiation of breastfeeding (EIBF) is a crucial step in ensuring the continuation of exclusive breastfeeding for six months. A newborn’s ability to independently reach the mother’s nipple and begin suckling within the first hour after birth is a key indicator that must be observed by every birth attendant. Several studies have indicated that maternal factors, knowledge, and cultural practices can influence the success of EIBF. This study aims to examine the maternal, knowledge, and cultural factors associated with the readiness of primigravida mothers to perform EIBF in the Buleleng Regency, Bali. Methods: This is a quantitative study using an analytical observational method with a cross-sectional approach. The study population included all third-trimester primigravida mothers who visited primary healthcare facilities in the Buleleng Regency. A total of 110 respondents were selected using multistage random sampling. Data collection was conducted from February to March 2025 using a structured questionnaire and analyzed using SPSS software. Due to non-normal data distribution, the relationship between variables was tested using Spearman’s Rank Correlation at a significance level of p<0,05 to assess the correlation between maternal, knowledge, and cultural factors and primigravida mothers’ readiness to perform EIBF. Results: There was a significant correlation between educational background (r=0,482), antenatal care visits (r=0,947), knowledge (r=0,721), and cultural factors (r=-0,713) with readiness to perform EIBF, with p=0,000. Conclusion: These findings emphasize the need for culturally sensitive health education and community-based interventions that support first-time mothers in adopting early breastfeeding practices.
Copyright (c) 2025 Ni Wayan Dewi Tarini , Esti Yunitasari , Ilya Krisnana (Author) https://creativecommons.org/licenses/by/4.0
Critique Of The Concept Of Efficiency In Public Health Management: A Qualitative Review Of Social Justice-Based Health Policy
Introduction: the concept of efficiency in public health management is increasingly central to global health policy. However, it often creates tension with social justice, particularly in contexts where cost-effectiveness takes precedence over equitable access to care. This research highlights the importance of examining how efficiency-driven health policies may unintentionally exacerbate social inequalities. Methods: this study uses a qualitative literature review to analyze 35 peer-reviewed articles, policy documents, and global health reports published between 2010 and 2024. Thematic analysis was employed to identify patterns and tensions between efficiency goals and social justice principles in public health policy. Results: the review reveals three key findings: (1) Efficiency-focused policies often deprioritize marginalized populations; (2) Technocratic policy design tends to overlook structural inequalities; (3) Integrated approaches that combine cost-effectiveness with equity considerations remain limited but are emerging in some contexts. Conclusion: this study emphasizes the need for health policies that balance efficiency with equity. Embedding social justice in health policy design is critical for ensuring that public health systems are both effective and fair. The findings call for a paradigm shift towards inclusive health governance that does not sacrifice justice for the sake of efficiency.
Copyright (c) 2025 Robert One Daniesha Mahendra, Dini Aulia Cahya, Nurhidayati Ningsih, Lely Setyawati Kurniawan, Loso Judijanto (Author) https://creativecommons.org/licenses/by/4.0
Character Formation Through Value Education in Physical Education
This study explores how character formation can be achieved through values education in physical education. Employing a qualitative case study approach, the research involved 30 purposively selected physical education teachers from elementary, junior high, and senior high schools in West Sumatera. Data collection was conducted through semi-structured interviews, classroom observations, and document analysis to examine how values are taught, modeled, and reinforced during physical education lessons. Thematic analysis was used to identify key patterns and themes in the data, supported by triangulation, member checking, and peer debriefing to ensure trustworthiness. The findings reveal that physical education provides a unique and effective platform for integrating value-based learning. Teachers play a vital role in modeling positive behaviors such as honesty, discipline, respect, and teamwork. Character development is fostered through practical activities, guided reflections, structured feedback, and building positive relationships. Furthermore, values are contextualized to students’ daily lives, making the lessons more meaningful and applicable beyond the classroom. Teachers also reported challenges, including limited resources and lack of training support. Overall, the study highlights the transformative potential of physical education in shaping students' moral and social development. It calls for a greater emphasis on teacher preparation, curriculum design, and institutional support to ensure that character education is effectively embedded in physical education programs. This integration not only enhances students' physical well-being but also contributes to nurturing ethical, empathetic, and responsible individuals.
Copyright (c) 2025 Eko Purnomo, I Kadek Suardika , Adika Fatahilah, Aditya Trinanda , Kadek Arry Anderzen, Nina Jermaina (Author) https://creativecommons.org/licenses/by/4.0
From Records to Recovery: Bibliometric Mapping of the Role of Health Information Management in Mental Health Care
Introduction: Health Information Management (HIM) in mental health has gained growing scholarly attention, particularly with the rise of digital health technologies. Objective: This study presents a bibliometric analysis of research on HIM in the context of mental health, covering the period from 1970 to July 2025. Methods: A total of 458 documents from 313 sources were analyzed using Biblioshiny, VOSviewer, and CiteSpace to examine publication patterns, authorship, citation networks, and thematic evolution. Results: The analysis revealed an annual growth rate of 7.12 percent, reflecting a steady increase in research output. Findings highlight an expanding body of literature emphasizing digital health, telemedicine, electronic health records, and data-driven interventions in mental health services. Co-authorship and collaboration networks underscore the multidisciplinary and global nature of this field, with contributions from leading researchers and institutions across diverse countries. The most influential sources are journals in public health, digital health, psychiatry, and health informatics. Highly cited works address mental health literacy, global disparities, and digital mental health innovations. Emerging topics such as COVID-19, telehealth, social media, and self-management reflect the impact of recent technological and societal shifts. Despite this progress, gaps remain in standardized practices, data privacy, and implementation in low- and middle-income countries. Conclusions: Overall, the study provides evidence-based insights into the intellectual structure, research frontiers, and future directions for advancing HIM in mental health care.
Copyright (c) 2025 Suma V. Madhavan, Rajeev Kumar N (Author) https://creativecommons.org/licenses/by/4.0
Why do interventions framed within the phonological hypothesis of dyslexia work? A treatment-focused analysis
Introduction: in the last decades, the Phonological Hypothesis of dyslexia has gained popularity into the field of psychology. This hypothesis holds that difficulties in learning to read are due to a neurocognitive disorder and, in consequence, suggests that the possibilities of learning and/or improving reading skills in these cases, depend on psychological treatments that correct or compensate for such deficiencies. The effectiveness of these interventions is often undestood as confirmatory evidence of the neurological causes of reading problems. However, the effectiveness of these interventions could be understood attending to their own properties, without the need to postulate specific effects (corrective or compensatory) at a neurological level. Objective: the aim of the present study is to characterize the interventions framed in the Phonological Hypothesis of dyslexia and to analyze the factors that influence their effectiveness. Methods: in order to achieve this objective, a content analysis was performed on a set of systematic reviews that analyzed the effectiveness of this kind of interventions. Results: the factors that influence the effectiveness of these interventions were identified and classified in three categories: 1) the dependent variable analyzed, 2) procedural aspects of their implementation and 3) the methodological rigor of the research. Conclusions: the specificity of the interventions framed in the Phonological Hypothesis of dyslexia is discussed and an alternative interpretation is proposed to understand their effectiveness. or unstructured, no longer than 250 words; written in the past tense and in the third person singular.
Copyright (c) 2025 Damián Revillo (Author) https://creativecommons.org/licenses/by/4.0
The Role of Emotional Intelligence in Psychological Rehabilitation after Traumatic Events in Military Personnel
Introduction: military personnel often experience trauma, leading to PTSD, depression, and anxiety. Emotional intelligence was believed to play a role in psychological recovery. To examine the relationship between EI and psychological rehabilitation outcomes in military personnel and to assess if higher EI correlated with reduced psychological distress. Methods: a cross-sectional survey design was used to collect data from 384 military personnel and veterans. EI was assessed using validated tools (MSCEIT, TEIQue), while PTSD, depression, and anxiety were measured using PCL-5 and DASS-21. Statistical analysis included correlation and regression modelling. Results: the results showed moderate to high levels of EI, PTSD symptoms, depression, and anxiety. EI was significantly negatively correlated with PTSD symptoms (p=0,001) but showed no significant correlations with depression or anxiety. Regression analysis revealed that EI significantly predicted PTSD symptoms (p=0,001) but did not significantly affect depression or anxiety. Additionally, individuals with higher EI experienced fewer PTSD symptoms compared to those with lower EI (p=0,000). These findings underscored the importance of EI in mitigating PTSD symptoms but not as a major predictor of depression or anxiety. Conclusions: higher emotional intelligence significantly reduced PTSD symptoms, highlighting its potential as a key factor in psychological recovery, while its impact on depression and anxiety remained limited.
Copyright (c) 2025 Marat Kuznietsov, Oksana Hrytsuk, Taras Zhvaniia, Tamara Khomulenko, Liudmyla Lysenko (Author) https://creativecommons.org/licenses/by/4.0
The role of interpersonal skills and massage therapist competence on service quality: the mediating role of customer satisfaction
Customer satisfaction is a fundamental determinant of sustainability and competitiveness in the spa industry. Interpersonal skills and therapist competence are key factors influencing both the emotional experience of clients and their assessment of service quality. However, therapists often face challenges such as limited communication skills, inconsistent massage techniques, and a lack of professionalism, which may reduce satisfaction and loyalty while weakening the industry’s image. This study aims to examine the influence of interpersonal skills and therapist competence on service quality, with customer satisfaction serving as a mediating variable. A quantitative ex-post facto design was applied with a sample of 100 respondents, comprising 50 certified spa therapists and 50 spa customers in Yogyakarta, selected through probabilistic random sampling. Data were collected using an online questionnaire with a four-point Likert scale. The instrument was tested for validity and reliability, and data analysis was performed using Structural Equation Modeling (SEM) with SmartPLS 3 to evaluate variable relationships and mediation effects. The results indicate that both interpersonal skills and therapist competence significantly affect customer satisfaction. Therapist competence also directly influences service quality, whereas interpersonal skills do not. Furthermore, customer satisfaction functions as a significant mediator linking both interpersonal skills and therapist competence to service quality. This study highlights the importance of improving therapist competence in parallel with strengthening interpersonal skills to enhance customer satisfaction and overall service quality. The findings contribute practically to the development of standardized spa services and theoretically by integrating service management and wellness perspectives.
Copyright (c) 2025 Septiari Nawanksari, Komarudin, Ali Satia Graha , Christine Ulina Tarigan , Aza Azlina Md Kassim (Author) https://creativecommons.org/licenses/by/4.0
Who should lead in healthcare: Are doctors still the best fit?: A qualitative study in Indonesia
Introduction: The medical profession has traditionally dominated leadership in healthcare facilities. However, fewer doctors have shown interest in leadership roles in recent years. Objective: to analyze the perspectives on the role of doctors in healthcare leadership in Indonesia. Methods: a qualitative study involved 49 participants, both civil and non‑civil servant health leaders from 31 government institutions in Aceh, Indonesia. Data were collected through in‑depth interviews and FGDs, and were analyzed thematically using NVivo version 12. Results: the study identified five key themes, including physician engagement in leadership, the significance of physician leadership, distinctive traits, leadership development, and the criteria for an ideal healthcare leader. Conclusions: This study analyzed healthcare leadership from medical and non-medical perspectives in Indonesia. It highlights the critical yet underexplored role of physician leadership, provides culturally grounded insights, and contributes to the discourse on strengthening leadership capacity in low- and middle-income health systems.
Copyright (c) 2025 Arifatul Khorida, Kartini Hasballah, Andreasta Meliala, Nurjannah (Author) https://creativecommons.org/licenses/by/4.0
Navigating Parental Vaccine Hesitancy in Pahang, Malaysia: Insights into Childhood Vaccination Decisions
Introduction: vaccine hesitancy among parents is on the rise, with some opting for alternative vaccination schedules, selectively vaccinating their children, or rejecting vaccines altogether. Malaysia has reported 1600 cases of parents refusing to vaccinate their children, an increase from 1500 cases in 2015, with Pahang being one of the states experiencing the highest number of vaccine refusals. Method: a quantitative approach was employed, utilizing surveys to collect and analyze data from 333 parents who have at least one child under the age of 16 in Pahang, Malaysia. Results: the findings revealed that attitude and risk perception negatively influenced vaccine hesitancy, while other factors, such as subjective norms, perceived behavioral control, and safety perception, positively influenced childhood vaccine intention and negatively influenced vaccine hesitancy. Conclusions: these results have important implications for public health initiatives aimed at reducing vaccine hesitancy in Malaysia. Understanding the factors that contribute to parents' decisions can help design targeted interventions that address misconceptions, improve risk perception, and encourage positive attitudes toward vaccination.
Copyright (c) 2025 Nur Hidayahtul Nabihah Manas, Mohd Rozaimy Ridzuan, Noor Amira Syazwani Abd Rahman, Muhammad Redzuan Osman, Muhammad Iqbal (Author) https://creativecommons.org/licenses/by/4.0
Characterization of metabolic syndrome in medical students at María Auxiliadora University
Introduction: Metabolic syndrome is a set of conditions that increase the risk of developing cardiovascular disease and type 2 diabetes, and is more prevalent in young populations due to factors such as sedentary lifestyles and poor eating habits. Objective: To describe the characteristics of students with metabolic syndrome. Methods: This is a retrospective cross-sectional descriptive study with a correlational component in medical students at a private university in Paraguay. The sampling was non-probabilistic, included 151 students, and the data collected were processed using Microsoft Excel. The data were obtained through anthropometric and biochemical measurements, and the statistical analyses included correlations and regressions. The ethical aspects of the study were respected, and participants signed an informed consent form. Results: The results showed a statistically significant correlation between BMI and capillary blood glucose (r=0.280, p<0.001) and a strong relationship between BMI and blood pressure (r=0.466, p<0.001). In addition, weight gain was found to be correlated with abdominal circumference (r=0.921, p<0.001). Regression analysis indicated that abdominal circumference and blood glucose levels are important predictors of BMI. Conclusion: The study concludes that it is essential to implement preventive and control programs to address the risk factors for metabolic syndrome in this young population in order to improve the cardiovascular and metabolic health of students.
Copyright (c) 2025 Leila Wannis, Vivian Cáceres, Mario Patiño, Dra. Olga Sosa, María Adela Pérez, Randle Santos, Jonas Ramos (Author) https://creativecommons.org/licenses/by/4.0