Search Results (1,122)

Background: Parental loss in childhood is a significant developmental risk factor, underscoring the need for evidence-based knowledge to guide support. Although social responses play a central role in children’s adjustment to loss, little is known about how parentally bereaved children in Israel experience social support in school. Methods: This qualitative study examined how parentally bereaved children in elementary and middle school experience social responses in the school context. Thirty-six participants were interviewed: 20 children who participated in dyadic interviews with their 16 surviving parents. Linguistic analysis, combined with Grounded Theory, was used to analyze the data. Results: Peer support was found to lie on a continuum ranging from support, through an unintentional lack of support, to deliberate nonsupport (teasing). These patterns shaped children’s experiences of returning to school, their sense of belonging, and their ability to share their grief. Conclusions: The findings, discussed in light of the Dual Process Model of Coping with Bereavement, highlight the crucial role of peers in children’s adaptation to parental loss. Developing evidence-based knowledge in this area may inform policy change and tailored school-based training to promote optimal support for parentally bereaved children. Full article

Background/Objectives: Self-care is central to chronic illness management and is particularly relevant in osteoporosis to prevent complications and improve quality of life. Grounded in Riegel’s middle-range theory of self-care of chronic illness, the study sought to understand the contextual, emotional, and structural influences shaping self-care in people living with osteoporosis. Aim: The aim of this study was to explore patient-reported barriers and facilitators to self-care behaviors among individuals living with osteoporosis. Methods: A qualitative descriptive design was conducted using in-depth, semi-structured interviews with 20 patients with osteoporosis recruited via convenience sampling. Data were coded deductively and analyzed using Mayring’s qualitative content analysis with a deductive approach. Results: Participants identified several factors related to both barriers and facilitators of self-care behaviors. Four barrier sub-themes emerged: ineffective coping strategies, difficulties in osteoporosis management, inadequate physical activity, and ineffective self-efficacy. Six facilitator sub-themes were identified: self-care management strategies, osteoporosis management after a fracture, osteoporosis control, osteoporosis treatment, exercise, and confidence in one’s ability. Main barriers included fear of falling, ineffective self-efficacy, and poor care continuity, whereas key facilitators included support networks, motivation, and tailored care. Conclusions: Self-care behaviors in individuals with osteoporosis are influenced by emotional, contextual, and structural factors. Person-centered interventions integrating emotional and educational components may strengthen patients’ engagement and enhance self-care behaviors in osteoporosis. Identifying barriers and facilitators enables nurses to design empathetic, tailored strategies that enhance empowerment and disease management. Understanding these factors can improve autonomy for patients and adherence, promoting long-term health outcomes across clinical and community settings. Full article

Grapevine (Vitis vinifera L.) is a globally significant crop increasingly affected by a variety of biotic and abiotic stresses. Plant biostimulants offer a promising approach to enhance plant resilience by modulating key physiological and metabolic processes. This study aimed to demonstrate that the preventive application of a Fabaceae-based biostimulant can prime grapevine defense pathways, thereby improving plants’ ability to endure potential stress conditions. Indeed, resistance to both biotic and abiotic stresses in plants involves common pathways, including Ca²⁺ and ROS signaling, MAPK cascades, hormone cross-talk, transcription factor activation, and induction of defense genes. Grapevine leaves were subjected to high-throughput transcriptomic analysis coupled with qPCR validation 6 and 24 h following treatment application. Differentially expressed genes were visualized using MapMan to identify the major metabolic and signaling pathways responsive to the treatment. This integrative analysis revealed several defense-related pathways triggered by the biostimulant, with representative protein families showing both up- and downregulation across key functional categories. Overall, the results indicate that a wider array of pathways associated with stress tolerance and growth regulation were stimulated in treated plants compared to untreated controls. These findings support the conclusion that a preventive biostimulant application can effectively prime grapevine metabolism, enhancing its preparation to cope with forthcoming environmental challenges. Full article

Background: Parents caring for preterm infants during hospital admission have unique needs. How these are addressed plays an important role in parents’ ability to cope with caregiving responsibilities. Educational programmes have proven beneficial to parents during their infant’s stay in the neonatal intensive care unit (NICU), for both parental and neonatal outcomes. Key components of parenting education during the NICU stay have been described; however, less is known about our understanding of parents’ educational needs, specifically in the South African context. Objectives: To explore parental needs and perceptions regarding a parenting education intervention provided to them while in the NICU, with a focus on programme content, structure, and mode of delivery. Methods: Three focus group discussions were conducted with mothers of preterm infants admitted to the NICU of a referral hospital in the North West province, South Africa. Inclusion criteria comprised parents of infants born in the hospital, singletons or multiples, with a gestational age below 37 weeks, and expected to stay in the NICU for at least 7 days. Discussions centred on mothers’ perceived needs regarding parenting education based on their experiences during their baby’s NICU admission. Results: Twenty-five mothers of singletons or multiples born before 37 weeks of gestation participated in the study. Three main themes were identified: (1) preference for content topics to include basic infant care, infant health and behaviours, and post-discharge related information; (2) education programme structure, which included instructional approaches and training logistics; and (3) support needs, including intrapersonal motivators, communication, and psychosocial and physical support. Conclusions: Participants recognised educational content needs that align with existing literature. However, they also emphasised the importance of addressing basic physical and emotional needs while receiving educational content, ensuring that parents feel empowered and capable of engaging with the information. Full article

Background: Frailty is a geriatric syndrome of increased physiological vulnerability, decreasing an older adult’s ability to successfully cope with health stressors. Social determinants of health (SDOH), including rural residence, can amplify healthcare disparities for older adults due to less accessibility to resources and lead to worse health outcomes. While the impact of rurality on older adult health is well-established, little is known about how the interaction of SDOH and geographical residence impact frailty status in older adults. Methods: Older adults (65+ years) in the National Health and Aging Trend Study (2011–2021) were categorized using Fried’s frailty phenotype (robust, pre-frail, frail). Rurality was defined using the 2013 Rural–Urban Continuum Codes. Generalized estimation equations with generalized logit link function determined the relationship between SDOHs (healthcare access, community support, income, education) and frailty status. Results: Of n = 6082 participants (56.4% female), the mean age was 75.12 years (SE 0.10), 1133 (18.6%) lived in rural residence, and 2652 (53.0%) had pre-frailty. Although there was no relationship between geographical residence and frailty status (p = 0.73), we did observe lower associated odds of worse frailty status for those with Medigap insurance coverage (0.81, SE 0.08; p = 0.04) and inconsistent frailty status trends for those of divorced (1.12, SE 0.05; p = 0.007) and never married (0.20, SE 0.03; p < 0.001) status in urban areas. Conclusions: Our findings suggest that geographic residence may modify the relationship between SDOH and frailty status in older adults, providing novel insight into the complexity of these interactions. This work is important for identifying modifiable areas where additional support interventions may be important for mitigating frailty development and progression for older adults with efforts at both the individual and system levels. Full article

Toxic romantic relationships, a popular term referring to intimate partner violence (IPV) characterized by psychological, physical, and sexual violence, are a growing concern among young people. This pilot study aimed to preliminarily validate the vignette task on IPV, the “Mind 4 partner abuse” task, and to investigate the cognitive patterns and emotional profiles concerning IPV. Our research involved 228 university students from the University of L’Aquila who participated in an online psychoeducational program to raise awareness of the risks of IPV. Participants completed the “Mind 4 partner abuse” task, which included five vignettes depicting escalating violence in relationships. The task assessed participants’ emotional responses (anger, anxiety/fear, sadness, shame/guilt) and cognitive responses (functional-assertive or dysfunctional) to each vignette. In addition, for convergent validation, the Interpersonal Reactivity Index (IRI) was administered to assess empathic abilities. Five distinct factors were identified: active coping and legal awareness (ACLA), emotional distress (ED), assertiveness and autonomy defense (AAD), assertive reaction and self-empowerment (ARSE), and refusal of public humiliation and dignity assertion (RDA). One factor out of the five, emotional distress (ED), identified a dysfunctional cognitive pattern. The instrument showed a good convergent validity with the IRI. The correlation analysis showed that the IRI personal distress scale was negatively associated with ACLA and positively associated with ED. The IRI Empathic Concern scale was positively associated with RDA. In the dysfunctional cognitive pattern, as measured by the “Mind 4 Partner Abuse” vignette task, the ED factor was positively correlated with anxiety, sadness, shame, and guilt. The potential of the vignette task to identify high-risk cognitive profiles is promising, but it has yet to be confirmed. Given the limitations of the study, the findings offer only preliminary indications of cognitive patterns in young adults and their perceptions of romantic relationships, as assessed through a psychoeducational intervention. Further research with larger and more diverse samples, as well as more robust task designs, is necessary before firm conclusions can be drawn. Full article

Secondary metabolites produced by endophytic fungi living in medicinal plants are important resources in the field of biological control. In this study, Achaetomium sophora HY17, an endophytic fungus of Sophora alopecuroides, was taken as the research object and Botrytis cinerea HM1 as the target pathogen, and the response characteristics and antifungal mechanism of secondary metabolites produced during their interaction were explored through a co-culture system combined with metabonomic analysis. The key findings are as follows: (1) A. sophora HY17 produces many kinds of secondary metabolites, such as alkaloids, flavonoids, and phenolic acids, among which 10 different metabolites, such as Sophoridine, Matrine, and Luteolin, are significantly up-regulated during the interaction process and are the core antifungal active substances; (2) KEGG pathway enrichment analysis revealed that the phenylalanine metabolic pathway was significantly enriched during the interaction between the two fungi, and the activation of this pathway was the key regulatory mechanism underlying A. sophora HY17′s ability to cope with pathogen stress and synthesize antifungal metabolites. This study reports A. sophora HY17 as a new species, confirms its broad application prospects as a multifunctional and efficient biocontrol strain, and provides a core theoretical basis and target direction for mining antifungal substances from endophytic fungi to develop new biocontrol agents. Full article

Background/Objectives: Adults with type 1 diabetes (T1D) often experience psychological distress that interferes with their ability to maintain optimal self-care. The purpose of this study was to evaluate the effectiveness of the Diabself-care, a nurse-led structured diabetes self-management education (DSME) intervention designed to improve glycemic control, self-care practices and mental health among adults with T1D. Methods: A total of 224 adults with type 1 diabetes were randomized and final analyses included 110 participants in the intervention group and 106 in the control group. The intervention group received the Diabself-care program, consisting of five daily 90 min sessions integrating education, skill training, self-management and coping strategies in addition to usual care. The control group received standard diabetes care. Outcomes were assessed at baseline, 1 month and 3 months. The primary measure was glycemic control and secondary outcomes including self-management, anxiety and depressive symptoms. Results: The intervention group achieved a significant increase in time in range at both 1 and 3 months. Self-management adherence improved significantly in the intervention group (p < 0.001). Anxiety and depression scores decreased significantly in the intervention group at 1 and 3 months, while they remained unchanged in controls. Regression analyses identified depressive symptoms as the strongest predictor of anxiety (OR = 4.34, 95% CI = 2.99–6.28, p < 0.001), while female sex, older age, and low self-management were predictors of depression. Belonging to the intervention group was strongly protective against depression (OR = 0.11, 95% CI = 0.05–0.24, p < 0.001). Conclusions: The Diabself-care program significantly improved glycemic control, self-management, and psychological outcomes in adults with T1D. These findings highlight the dual clinical and mental health benefits of structured nurse-led DSME, supporting its integration into routine diabetes care. The trial is registered at ClinicalTrials.gov, ID: NCT05159843. Full article

Recovery in osteoarthritis (OA) is a multidimensional construct that extends beyond symptom reduction to encompass how individuals make sense of, adapt to, and live with their condition. Patient expectations appear to play a central role in shaping this process, influencing how individuals define recovery, cope with functional limitations, and evaluate treatment outcomes. Understanding these expectations is essential for improving satisfaction and functional progress in OA management. This scoping review synthesized evidence on patient expectations in knee, hip and generalized OA and examined how these expectations influence treatment outcome and satisfaction. A PRISMA-ScR–informed scoping review was conducted across PubMed, Embase, CINAHL, PsycINFO, and Web of Science up to September 2025. Eligible studies included adults with OA reporting on treatment expectations, expectation fulfillment, or expectations about their ability to cope (self-efficacy). Both qualitative and quantitative designs were included. Data were extracted and organized for study characteristics, population, expectation domains, and outcomes. Sixteen studies met the inclusion criteria, encompassing qualitative syntheses, cohort studies and systematic reviews. Across study designs, higher or fulfilled expectations were consistently associated with greater satisfaction, pain reduction, and functional improvement. Unrealistic or unfulfilled expectations predicted poorer clinical outcomes and dissatisfaction. Expectations surrounding treatment and clinical outcomes may plausibly influence recovery by shaping physiological responses, emotional reactions and patient engagement with rehabilitation. These findings highlight the importance of aligning clinical interventions with patient expectations. Integrating expectation assessment and recalibration into OA care may enhance adherence and patient satisfaction. Future research should further explore expectations as modifiable therapeutic targets and examine how they interact with factors such as symptom duration, severity and pain extension. Such combinations may clarify which patient profiles are most responsive to expectation-focused interventions. Overall, expectations emerge as a central component of recovery and a promising avenue for more person-centered physiotherapy and rehabilitation practice. Full article

Background/Objectives: Readiness for practice is an essential outcome of nursing education, yet the factors influencing it among baccalaureate nursing students in Mongolia remain underexplored. This study aimed to provide a holistic understanding of factors influencing readiness for practice among baccalaureate nursing students in Mongolia, employing both quantitative and qualitative approaches. Methods: A convergent mixed-methods design was used. The study included 150 final-year baccalaureate nursing students from 14 Mongolian universities. Quantitative data were collected via survey and analyzed using multiple regression analyses in SPSS 26.0. Concurrently, qualitative data were obtained through focus group interviews with 25 participants (nurses and faculty) and analyzed using content analysis. Results: Quantitative analyses revealed that the clinical learning environment, clinical competence, and critical thinking significantly influenced readiness for practice, explaining 40% of the variance. Qualitative findings—derived from nurses’ and faculty’s perspectives and findings—provided deeper insights: “maturity” was defined as students’ coping ability and adaptability; “competence” encompassed clinical, ethical, cultural, and communication skills; and “professional values” reflected passion, motivation, and readiness to engage in practice. These findings highlighted the essential interplay between personal, educational, and contextual factors in shaping readiness. Conclusions: Findings suggest strategies to enhance nursing students’ readiness, including fostering supportive clinical learning environments, structured mentorship, and integrating ethical and cultural training into curricula. These insights offer actionable recommendations for nursing schools and clinical institutions to strengthen collaboration, support professional development, and prepare competent, adaptable, and ethically grounded nursing graduates in Mongolia. Full article

Background: Compassion fatigue (CF) is a state of emotional and physical exhaustion in the caregiving relationship, which can negatively impact patient safety and quality of care. Maternity care professionals are particularly vulnerable to CF due to their continuous empathetic engagement with patients in an unpredictable, high-stress work environment. Despite its significance, research on CF in maternity care is limited. The aim of this study is to explore experiences of CF among maternity care professionals. Methods: A thematic analysis of semi-structured in-depth interviews was conducted. The sample consisted of seven midwives and three gynecologists from different hospitals and outpatient care in Flanders (Belgium). Results: Experiences, risk factors and protective factors were identified as three organizing themes and further refined into 12 subthemes. Participants showed limited familiarity with the term CF but recognized its symptoms, including emotional exhaustion, reduced empathy, and a diminished ability to provide care, ‘as one normally would’. Key risk factors included high workload, emotional strain from ‘energy-consuming’ patients, fear of errors, and administrative burden. A supportive team environment, compassion satisfaction (CS), job autonomy and personal coping skills were identified as protective factors. Participants emphasized the need to recognize and address signals of CF. Conclusions: CF among maternity care professionals is underrecognized but appears to impact both caregiver well-being and patient care quality. Interventions should target awareness, team communication, psychological safety, and organizational context. A multilevel approach—combining individual, team, and systemic strategies—is needed to sustainably mitigate CF in maternity care. Full article

Background: The construct of positive mental health (PMH) is defined as the basis of individuals’ psychological well-being and their ability to function effectively and cope with life’s challenges. The Positive Mental Health Questionnaire (PMHQ) is a reliable tool for assessing the PMH factors, but its length (39 items) can pose challenges in certain contexts and populations. This highlights the need for an abridged version of the questionnaire that requires less time to administer. Therefore, the main aim was to validate the Spanish 18 item-shortened version of the PMHQ (PMHQ-SF18). Methods: The sample consisted of 574 nursing students. Psychometric analyses were carried out based on construct validity, criterion validity, and internal consistency. A confirmatory factor analysis was conducted to ascertain whether the internal structure was consistent with the model of the previously validated Portuguese brief version. Results: The results supported the good psychometric properties of the instrument, with adequate validity and reliability. Confirmatory factor analysis revealed optimal goodness-of-fit values, supporting the six-factor structure. The overall Cronbach’s alpha was 0.83. Conclusions: The findings suggest that the PMHQ-SF18 is a valid and reliable instrument, comparable to the original version, but with the added benefits of being shorter, quicker, and easier to administer. Consequently, it may be particularly useful for population-based screening studies and for monitoring change following positive mental health promotion interventions. Its abridged format makes it particularly suitable for assessing individuals with specific characteristics or in contexts where time is limited, and more concise instruments are required, for example, in primary care or critical care. Full article

Background: Perceived stress occurs when environmental demands are appraised as exceeding an individual’s coping resources, triggering emotional dysregulation and physiological hyperactivation with adverse mental and physical outcomes. University students are particularly vulnerable to psychological distress due to academic pressure, social transitions, and lifestyle changes. Despite increasing attention to mental health in higher education, data on perceived stress among Italian university students remain limited. This study aimed to assess stress profiles using the Italian Perceived Stress Scale—Revised (IPSS-R) and to explore associations with sociodemographic and academic variables. Methods: A multicenter cross-sectional study was conducted among 2.103 undergraduate and master’s students enrolled in Italian universities. Participants completed the 15-item IPSS-R, which measures three dimensions: general stress, coping, and academic stress. Sociodemographic and academic data were collected via a structured questionnaire. Non-parametric tests and Principal Component Analysis were employed to identify group differences and multivariate patterns. Results: Two principal components were retained through the principal component analysis, overall perceived stress (40.9% of the variance) and coping-related responses (13.7% of the variance). The mean total IPSS-R score was 30.6 (SD = 7.08, p < 0.001), reflecting moderate-to-high levels of perceived stress. Academic demands emerged as the predominant stressors. Higher stress levels were reported by female students, younger individuals, first-year undergraduates, and those enrolled in health sciences and STEM programs. Conversely, older students, postgraduate students, and those studying in Southern Italy demonstrated stronger coping abilities and lower academic stress. Students attending private universities reported elevated academic pressure, potentially due to heightened family and financial expectations. Conclusions: Italian university students experience substantial perceived stress, primarily driven by academic workload, performance expectations, and institutional pressure. Early identification using instruments such as the IPSS-R may enable targeted interventions to promote mental health and academic achievement in student support services, during triage, in wellness checks, and in psychoeducation. Full article

Cyanobacteria can pose a threat to aquatic organisms by their ability to produce toxins such as neurotoxic anatoxins. Although cyanobacteria and their effects on aquatic fauna have been a research focus for a long time, the interactions between benthic cyanobacteria and benthic invertebrates are still largely unknown, especially with regard to how invertebrates cope with cyanotoxins which they are exposed to in their habitat. This study characterizes the effects of anatoxins on the benthic macroinvertebrate Hyalella azteca. In a first test, organisms were exposed to synthetically produced anatoxins dissolved in the ambient aqueous phase. In a second test, organisms were exposed to natural anatoxins within intact Tychonema cells as their sole food source. Over 10 days of aqueous exposure to anatoxins, survival of H. azteca was not affected, even at the highest nominal concentrations of 587.37 µg/L ATX and 590.31 µg/L dhATX. Over 42 days of dietary exposure to natural anatoxins, H. azteca readily accepted Tychonema as a food source. Survival, growth, reproductive success and storage compound concentrations (glucose, glycogen, lipid and protein) in the organisms’ tissue, all assessed in the same individuals, were reduced. These findings suggest that the ecotoxicological effects of anatoxins on aquatic invertebrates not only depend on their concentration, but even more so on the type and duration of exposure. Furthermore, cyanobacteria like Tychonema seem to be insufficient as source of energy if they represent the only available food source. Full article

Low, small, and slow (LSS) unmanned aerial vehicles (UAVs) pose great challenges for conventional guidance methods. However, existing deep reinforcement learning (DRL)-based interception guidance law has mostly focused on simplified two-dimensional planes and requires strict initial launch scenarios (constructing collision triangles). Designing more robust guidance laws has therefore become a key research focus. In this paper, we propose a novel recurrent proximal policy optimization (RPPO)-based guidance law framework. Specifically, we first design initial launch conditions in three-dimensional space that are more applicable and realistic, without requiring to form a collision triangle at the initial launch. Then, considering the temporal continuity of the seeker’s observations, we introduce the long short-term memory (LSTM) networks into the proximal policy optimization (PPO) algorithm to extract hidden temporal information from the observation sequences, thus supporting the policy training. Finally, we propose a reward function based on velocity prediction and overload constraints. Simulation experiments show that the proposed RPPO framework achieves an interception rate of 95.3% and a miss distance of 1.2935 m under broader launch conditions. Moreover, the framework demonstrates strong generalization ability, effectively coping with unknown maneuvers of UAVs. Full article