Search Results (15,191)

This study systematically reviews 129 peer-reviewed empirical studies examining tourism and hospitality (T&H) students’ perceptions of their employment prospects and future career paths. A systematic review was conducted using the RePEc database, which provides comprehensive coverage of economics, tourism, and hospitality research, ensuring broad and interdisciplinary representation of relevant studies. By synthesizing evidence across three decades, the review identifies persistent and emerging themes shaping students’ career outlooks. Negative perceptions, particularly regarding pay, working hours, job security, and career progression, remain the most frequently reported concerns and are strongly associated with employment anxiety. At the same time, the analysis highlights a significant rise in entrepreneurial intentions after 2015, reflecting students’ growing preference for autonomy and innovation. Internships and real-world experiences consistently emerge as pivotal in shaping perceptions, either reinforcing commitment to the sector or exposing mismatches between expectations and workplace realities. The review further underscores the influence of cultural, social, and personal factors, including family background, gender norms, and self-efficacy, in shaping career decisions. This study contributes by offering a comprehensive thematic synthesis, identifying patterns and transitions over time, and outlining research gaps. The findings provide actionable insights for educators, industry practitioners, and policymakers seeking to strengthen career pathways and ensure the long-term sustainability of the T&H workforce. Full article

Background: Jordan is increasingly recognized as a climate-vulnerable setting in the region, yet evidence on the psychosocial dimensions of climate change among young adults remains limited. Led by the Jordan Center for Disease Control, this study assessed climate change perceptual awareness and climate-related anxiety among university students and explored perceptions of climate impacts at global and national levels. Methods: In a cross-sectional survey conducted between April and May 2025, 1305 students were recruited from universities across Jordan using a questionnaire incorporating the 15-item Climate Change Perceptual Awareness Scale and the 13-item Climate Change Anxiety Scale. Results: Awareness of climate change and global warming was high (87% and 96%, respectively), yet only 23% were familiar with Jordan’s National Climate Change Policy 2022–2050. In regression analyses, higher climate anxiety was associated with female sex, married status, larger household size, diagnosed mental health conditions, and central-region university enrolment. Higher perceptual awareness was associated with female sex, older age, and the recognition of multidimensional climate impacts. Students identified heatwaves, drought, and forest fires as principal environmental threats, and respiratory and heat-related illnesses as foremost health concerns. Conclusions: Our findings position climate change as not only an environmental concern, but also as an educational, psychological, and public health priority. To support effective adaptation and resilience, climate awareness must be translated into informed engagement and action. Integrating climate and climate-health education into university curricula, improving youth-responsive communication of national climate strategies, and creating formal pathways for youth participation in climate governance are essential investments in Jordan’s climate resilience, health security, and long-term sustainable development. Full article

Objective: We examined the psychological mechanisms underlying cyberchondria by testing whether rumination mediates the association between intolerance of uncertainty and cyberchondria and whether this indirect effect is moderated by prior medical experiences and perceived access to healthcare. Methods and Measures: A cross-sectional design was employed with a non-clinical sample of 96 Romanian adults. Participants completed validated self-report measures of intolerance of uncertainty (IUS-12), rumination (Ruminative Responses Scale), and cyberchondria (Cyberchondria Severity Scale). Additional items assessed medical history and perceived access to healthcare. Moderated mediation analyses with bootstrapped confidence intervals were conducted, controlling for relevant sociodemographic variables. Results: Higher intolerance of uncertainty was associated with higher cyberchondria both directly and indirectly through rumination, which accounted for more than half of the total effect. The rumination–cyberchondria association, and the indirect effect of IU, were significantly stronger among individuals who had experienced a recent acute medical episode, whereas chronic illness did not significantly moderate this pathway. Cyberchondria levels were lowest among participants reporting very good access to healthcare. Conclusions: Cyberchondria appears to arise from the interaction of intolerance of uncertainty, ruminative thinking, and contextual health experiences. Targeting rumination and uncertainty tolerance may be particularly important following acute medical events. Full article

Background/Objectives: The placement of central venous access devices, including peripherally inserted central catheters (PICCs) and PICC-PORTs, is a routine procedure in oncology care. Usually associated with limited physical pain, these procedures may nevertheless generate significant anxiety and negatively influence the overall procedural experience. Virtual reality (VR) has emerged as a non-pharmacological intervention capable of modulating attentional and emotional responses during medical procedures; however, evidence in adult oncology patients undergoing vascular access placement remains scarce. The aim of this study is to evaluate the effect of VR on an oncological patient’s overall procedural experience. Methods: This manuscript outlines the design and methodology of a prospective, single-centre randomised controlled trial. Adult oncology patients scheduled for PICC/PICC-PORT placement are randomised to receive standard care alone or standard care combined with an immersive VR intervention delivered via a head-mounted display during the procedure under pragmatic, real-world clinical conditions. The primary outcome is a composite patient-reported procedural experience endpoint, assessed through a non-aggregated framework encompassing procedural anxiety, comfort, satisfaction and procedural tolerability. Procedural anxiety constitutes the main quantitative driver; the remaining domains are analysed as individual component dimensions and interpreted jointly to contextualise the overall experience. Secondary outcomes include procedural pain, physiological parameters and procedural characteristics. A mixed-methods approach integrates quantitative assessment with qualitative phenomenological analysis. Results: The study is expected to provide methodological and clinical insight into the role of immersive VR in improving procedural experience and support future multicentre trials. Conclusions: This trial will contribute to the expanding field of digital and immersive health technologies by evaluating VR as a patient-centred adjunct intervention in oncological procedural care using a predefined patient-reported experience-based primary endpoint. The protocol has been submitted to ClinicalTrials.gov with the registration number NCT07384741. Full article

This article reexamines Liang Fa’s Riji Yanxing (Record of Words and Deeds, 1830) from the perspective of narrative structure rather than solely as a historical missionary document. Previous scholarship has shown that the diary was produced within the institutional framework of the London Missionary Society and functioned primarily as a record of early Protestant evangelization in China. Building on these studies, this article argues that the diary simultaneously records missionary work and narrates the formation of Christian faith. Through close readings of Liang Fa’s reflections, prayers, and recorded dialogues with potential converts, the study demonstrates how an institutional testimonial text develops a narrative configuration shaped by Christian theology. Within this framework, missionary responsibility, anxiety over divine judgment, and reflections on death and salvation form recurring cycles of crisis, repentance, and renewed commitment. Dialogues with potential converts further dramatize this theological logic by transforming doctrinal arguments into scenes of spiritual confrontation and hesitation. Although Riji Yanxing was not originally composed as a literary work, it reveals the emergence of a new mode of Christian narrative in Chinese writing. The diary thus illustrates how Christian concepts of sin, redemption, and judgment reshaped narrative consciousness in early nineteenth-century China. Full article

Background/Objectives: Sleep problems, cognitive deficits, and mood disorders are prevalent in justice-involved populations, especially among individuals with a history of traumatic brain injury (TBI), though the association between these variables remains understudied. This retrospective study examined the relationship between subjective sleepiness and mood state on neuropsychological functioning in a forensic population with self-reported TBI. Methods: Data were obtained from 419 inmates and probationers with a self-reported history of TBI using the Ohio State University Traumatic Brain Injury Identification Method and Automated Neuropsychological Assessment Metrics (ANAM). Multiple linear regression models examined associations between cognitive performance across domains (i.e., reaction time, learning, attention, processing speed, working memory, delayed memory, and inhibition) and subjective sleepiness and mood states (i.e., depression, anxiety, fatigue, restlessness, anger, happiness, and vigor) measured by self-report scales embedded in the ANAM. Results: Negative mood state was most associated with impaired performance on tests of learning, delayed memory, spatial working memory, and reaction time, as well as global neurocognitive test performance. Subjective sleepiness was predictive of poorer performance on reaction time tasks, while positive mood states were related to better performance on the same task. Regression models were statistically significant (p < 0.05), with subjective sleepiness and mood accounting for approximately 1–5% of the variance in cognitive performance. Conclusions: Subjective sleepiness and mood symptoms are significantly related to cognitive performance among justice-involved individuals with self-reported TBI. While these factors can contribute to the need for rehabilitation, they may also reduce the likelihood of successful engagement. Importantly, both sleepiness and mood are modifiable treatment targets, and adapting interventions to accommodate cognitive inefficiencies can improve engagement and overall treatment benefit. Full article

Background/Objectives: During the first COVID-19 lockdown, the sudden disruption of formal care services substantially increased reliance on informal caregiving. Emerging evidence suggests that increased caregiving demands may have contributed to a higher burden of mental-health-related temporary work disability; however, population-based data from occupational health systems remain limited. This study aimed to quantify and characterise, descriptively, the sociodemographic, clinical, and territorial characteristics of mental-health-related temporary work disability among workers with informal caregiving responsibilities in Spain during the first COVID-19 lockdown, and to descriptively examine differences between episodes occurring among workers with and without caregiving responsibilities. Methods: A retrospective descriptive study was conducted using anonymised nationwide occupational health records from Mutua Asepeyo. All episodes of temporary work disability certified for mental and behavioural disorders (ICD-10 F00–F99) between 14 March and 21 June 2020 were analysed. Caregiver status was determined based on documented informal caregiving responsibilities recorded within the occupational disability records. Sociodemographic, occupational, clinical, and territorial variables were examined using descriptive statistics and non-parametric tests. Results: A total of 2857 caregiver-associated episodes were identified, representing 55.6% (95% CI: 54.2–57.0) of all mental-health-related temporary work disability episodes during the study period. The majority involved women (68.1%) and caregivers of older dependent adults (59.3%). Generalised anxiety disorder was the most frequent diagnosis, followed by adjustment disorders and acute stress reactions, with significant differences by sex and employment regime. Marked territorial variability was observed, as well as longer durations of temporary work disability in specific regions and among women. Conclusions: A substantial proportion of mental-health-related temporary work disability episodes during the lockdown occurred among workers with informal caregiving responsibilities, particularly women and those caring for older dependents. These findings suggest that informal caregiving may be a determinant of occupational mental health during crises. However, given the descriptive and unadjusted nature of the study, no causal inferences can be drawn. Further research is needed to understand these associations better and inform future occupational health strategies. Full article

Objective: This study aimed to compare the effectiveness of online cognitive behavioral therapy (CBT) delivered by an AI chatbot versus human peer counselors (participants were told it was AI) in reducing anxiety symptoms in young adults. Methods: Ninety young adults with mild-to-severe anxiety were randomized to a 4-week intervention of AI-CBT (n = 30), peer-counselor-CBT (n = 30), or a no-intervention control (n = 30). The primary outcome, anxiety, was assessed at baseline, mid-point, and post-intervention. Secondary outcomes (the self-efficacy for exercise, sleep quality), psychotherapy benefit, and qualitative user experiences were also evaluated. Results: Both AI and human-delivered interventions led to significant within-group reductions in anxiety (p < 0.05). However, in the primary intention-to-treat analysis, neither intervention demonstrated a statistically significant advantage over the no-intervention control group at post-intervention. A secondary per-protocol analysis suggested a benefit for the human-delivered intervention among study completers. Notably, participants in the AI group reported significantly lower perceived treatment benefit than the human group (p < 0.001). Qualitative analyses indicated that while AI was valued for accessibility and consistency, human intervention was perceived as more flexible in guidance, individualized, emotionally supportive, and conducive to deeper exploration. Conclusions: In this exploratory trial, both AI- and peer-counselor-CBT showed within-group promise, but the evidence does not support their efficacy over a no-intervention control. The AI’s limitations in providing flexible, emotionally supportive, and personalized interaction likely explain the efficacy gap observed between the two interventions. While AI may serve as a scalable support tool, claims of clinical efficacy require significant caution. These preliminary findings warrant replication in a prospectively registered confirmatory trial. Full article

This study presents a simulation-based framework for battery-degradation-aware routing in electric vehicles by integrating physics-informed battery state estimation with decision-level navigation logic. A hybrid estimation approach combining spatially distributed fiber-optic sensing with complementary Kalman filtering strategies is used to reconstruct core temperature, surface temperature, state-of-charge, and mechanical degradation indicators in real time. These estimated states are supplied directly to an intelligent routing module, enabling charging station selection that is both physically reachable and aware of thermal- and health-related constraints. The results demonstrate that routing decisions informed by battery state estimation consistently avoid high-risk thermal and swelling conditions while maintaining range feasibility. By explicitly incorporating mechanical degradation indicators into the routing logic, the framework addresses a key gap in prior studies where battery swelling and navigation were treated independently. Overall, the findings confirm that estimator-driven, degradation-aware routing can improve operational safety, reduce range anxiety, and support more reliable electric vehicle navigation. The study establishes a simulation-first foundation for future experimental validation, adaptive policy refinement, and broader deployment of battery-degradation-aware decision-making in electric mobility systems. Full article

Background: Loneliness and social isolation are major public health challenges linked to premature mortality and significant healthcare and productivity costs. However, their geographic distribution and socio-demographic determinants remain poorly understood, with few studies applying spatial methods to identify high-need areas and protective factors. Methods: This study aimed to investigate the geographic distribution and determinants of loneliness and social isolation across Australia using a spatial epidemiological approach. Utilising longitudinal data from the Household, Income and Labour Dynamics in Australia (HILDA) survey, along with Australian Bureau of Statistics (ABS) census data, greenness vegetation index and walkability index, we employed Bayesian conditional autoregressive (CAR) models to assess spatial and temporal patterns at the Statistical Area Level 3 (SA3) over a 22-year period and present the relative risks (RR) and credible intervals (CrI). Results: Our analysis revealed spatial variation in the RR of both loneliness and social isolation, with notable hotspots in socioeconomically disadvantaged areas. In multivariable models, area-level socio-economic disadvantage (as measured by the Index of Relative Socio-economic Advantage and Disadvantage, IRSAD) (RR = 0.8, 95% CrI: 0.76–0.85) for the highest quintile (most advantaged) and a higher prevalence of depression and/or anxiety (RR = 4.3, 95% CrI: 3.0–6.1) were associated independently with relative risk of loneliness but not with age structure, remoteness, green space or walkability index. For social isolation, higher average hospital admission rates per region were the strongest factor. Conclusions: The spatial heterogeneity observed in our study underscores the need for place-based public health responses, including community-based interventions and targeted resource allocation, especially in disadvantaged communities. Full article

Background: Fibromyalgia is a chronic nociplastic pain condition often accompanied by mental health comorbidities, with anxiety and depression being the most prevalent. The objective of this umbrella review is to analyze the effects of physical exercise on anxiety and depression symptoms in individuals with fibromyalgia. Methods: Following Cochrane and PRIOR guidelines, a systematic search was conducted in PubMed, Web of Science, Scopus, and CINAHL Complete up to 28 August 2025. Systematic reviews with or without meta-analyses that evaluated physical exercise interventions in adults with fibromyalgia and reported anxiety or depressive symptom outcomes were included. Risk of bias was assessed with AMSTAR-2; overlap was evaluated using MOoR and CCA. Results: Fourteen reviews (eight meta-analyses, three systematic reviews, two meta-analyses treated as descriptive, and one network meta-analysis) were included, synthesizing 98 randomized controlled trials (RCTs) with 4325 participants (in the 12 reviews that provided data). The majority of the patients were women and people aged between 10 and 65. Regarding anxiety, five of seven reviews reported significant improvements. Aquatic exercise showed the greatest effect (SMD = −1.14). Regarding depression, eight of 11 reviews reported significant benefits. Aquatic exercise again stood out with the highest effect (SMD = −1.18). Adherence varied between 64% and 97%. Methodological quality according to AMSTAR-2 showed considerable heterogeneity. Conclusions: Physical exercise, especially aerobic and aquatic modalities, may support the reduction of symptoms of anxiety and depression in people with fibromyalgia. These findings support its inclusion in rehabilitation programs, although methodological and prescription variability suggests caution in interpreting optimal parameters. PROSPERO-ID: CRD42024590799. Full article

Background: Gender discrimination in sport remains a persistent global issue, reflected in women’s limited participation, leadership representation, media visibility, salary equity, and personal safety. These forms of discrimination also negatively affect athletes’ psychological well-being, mental health, and overall sports experience. Despite growing scholarly attention over the past three decades, a comprehensive quantitative synthesis of this research area has been lacking. Methodology: A bibliometric analysis of 397 peer-reviewed documents published between 1995 and 2026 was conducted using the Scopus database. Data were analysed through the Bibliometric R package 4.2.1 and Biblioshiny interface. Science-mapping techniques including keyword co-occurrence, thematic clustering, thematic evolution, and collaboration network analysis were combined with performance indicators such as annual publication output, leading sources, author productivity, and citation impact. Results: Scientific production increased markedly after the mid-2010s, involving 187 sources and 1106 authors, with rising collaboration and citation influence. Core research themes included gender inequality, leadership exclusion, media representation, harassment and abuse, and structural discrimination in sports systems. Importantly, many of these themes are directly linked to reduced athlete well-being, including increased stress, anxiety, and decreased participation. Recent thematic developments highlighted intersectionality, safeguarding, inclusion, governance, and athlete welfare. Conclusion: Research on discrimination against women in sport has evolved into a multidisciplinary, policy-relevant field. Addressing gender discrimination is essential not only to achieving equity but also to improving athletes’ subjective well-being and long-term participation in sport. However, significant gaps remain, particularly in Global South contexts and intervention-based studies, indicating the need for stronger evidence-driven strategies to advance gender equity, inclusion, and ethical governance in sport. Full article

Background/Objectives: Adolescent mental health problems emerge early, remain undertreated, and are shaped by diverse contextual stressors. In response to calls for more youth-centered prevention, school-based health promotion, and participatory intervention design, this study explored which mental health-related problems internationally mobile adolescents prioritize and which solution ideas they generate in a structured co-creation setting, including where movement- and sport-related elements are embedded. Methods: A qualitative, participatory study was conducted during a 24 h social hackathon embedded in the Youth Empowerment Seminar for exchange students. Hackathon materials from 43 projects were analyzed using content-structuring qualitative content analysis following Kuckartz. Results: Adolescents most frequently framed problems in terms of self-image, stress and anxiety, belonging, and harassment. Solutions clustered around low-threshold group formats, while implementation segments focused strongly on staffing, funding, barriers, and feasibility. Cross-domain analyses suggested recurring problem-solution matches, such as loneliness with hobby or interest groups. Conclusions: Social hackathons can surface adolescent-prioritized mental health concerns and translate them into context-sensitive prevention ideas. The findings mainly point to social and psychosocial solution pathways, while some proposals additionally positioned shared activity or movement contexts as potentially supportive for well-being. These results provide a starting point for subsequent school-based prototyping and feasibility work. Full article

Excessive gaming (EG) is increasingly recognised as a modifiable behavioural risk among youth, with potential implications for mental health and well-being in digitally mediated environments. This study examines excessive gaming as a behavioural exposure and AI cyber-shielding (AI-CS) as a perceived digital protective factor among Generation Z university gamers. AI-CS is conceptualised as users’ perceived exposure to AI-enabled safety mechanisms embedded in gaming-related digital environments. The study investigates the associations of EG and AI-CS with four psychological outcomes: depressive symptoms (DEP), anxiety symptoms (ANX), hostile behaviours (HB), and personal well-being (PWB). Data were collected through a cross-sectional online survey of 983 university students aged 18 to 22 years from multicultural Middle Eastern backgrounds enrolled in Saudi universities. The sample included 54.2% males and 45.8% females. The proposed relationships were analysed using Partial Least Squares Structural Equation Modelling (PLS-SEM). The results show that excessive gaming is positively associated with depressive and anxiety symptoms and negatively associated with personal well-being. No significant association was found between excessive gaming and hostile behaviours. AI cyber-shielding is negatively associated with depressive and anxiety symptoms and positively associated with personal well-being, but it does not significantly predict hostile behaviours. These findings indicate that excessive gaming is primarily associated with internal psychological outcomes rather than external behavioural responses. They also suggest that perceived AI-enabled safety affordances in gaming-related digital environments are associated with lower psychological distress and higher well-being. The study contributes to research on digital well-being by introducing and empirically examining AI cyber-shielding as a perception-based environmental factor associated with psychological functioning among university students. Full article

Background: Burn injuries profoundly impact the survivors’ physical, psychological and social well-being, with sexuality, intimacy and body image remaining among the most disrupted yet least addressed areas of rehabilitation. Limited professional training, social discomfort, and a lack of clinical guidance contribute to these unmet needs. Recognizing sexuality as an essential part of health, this interdisciplinary project developed evidence-informed recommendations and communication tools to support both burn survivors and healthcare professionals in discussing intimacy, sexuality, and body image after burn injury. Methods: An interdisciplinary expert group conducted a narrative literature review, supplemented with grey literature and lived experience resources. These insights informed two practical tools: a poster for healthcare professionals and burn centers, and a patient-focused brochure. Both underwent iterative refinement through multicultural feedback from patients and professionals across Europe, Asia and Africa, followed by final validation during an interdisciplinary workshop at the 2025 European Burns Association (EBA) Conference. Results: The literature indicated that burn injuries affect sexuality and body image through interacting physiological, psychological, sensory, relational, and sociocultural factors. Common challenges included reduced desire, anxiety, fear of rejection, altered self-perception, and discomfort initiating conversations about intimacy. Professionals reported limited training, insufficient privacy and cultural barriers. Conclusions: The developed tools and these recommendations aim to normalize dialog, support proactive screening, and promote culturally sensitive patient-centered burn rehabilitation. Embedding sexuality and intimacy within burn care requires ongoing professional training and the identification of dedicated resource persons within each team. Full article