Search Results (9,238)

Objective: Feeding-tube weaning is conducted in both inpatient and outpatient settings, with significant logistical, financial, and structural barriers to both approaches. We sought to assess whether remote patient monitoring (RPM), using a mobile application, which would overcome many of these barriers, could be effective in helping patients tube wean. Methods: We prospectively enrolled patients with a feeding tube, aged 0–3 years. Enrolled families entered data daily into the remote application. Data were monitored by a nurse and reviewed weekly by a multidisciplinary team. A standard hunger provocation protocol was used, paired with medical, behavioral, oral motor, and nutrition interventions, as needed. We conducted a retrospective chart review to identify a comparison cohort. The chart review was collected first, then compared to the prospective, non-randomized trial of RPM tube weaning. Results: The chart review identified 141 children seen with a feeding tube from January 2023–June 2023. Of those, 17 children attempted a tube wean. The post-intervention group consisted of 38 children prospectively enrolled from the same clinic between November 2023–2024. In the pre-intervention group, 41% of the children (7/17) were successful in achieving all calories by mouth and 90% of children (34/38) in the post-intervention group were successful in tube weaning. Conclusions: RPM is a feasible and incredibly promising model for feeding-tube weaning in pediatric patients with a wide range of medical comorbidities, including patients with multiple comorbidities. RPM allowed for high-quality medical monitoring and for a dynamic intervention in response to patient data transferred to the medical team in real time. Full article

Urban parks are key components of metropolitan green infrastructure, contributing to residents’ well-being. However, perceptions of disorder and safety may substantially shape how these spaces are experienced, particularly during evening hours. This study investigates the structural relationships between perceived disorder, fear of crime, avoidance behaviors, perceived safety, and service satisfaction. The primary objective is to disentangle the pathways linking disorder perceptions to behavioral and perceptual outcomes using a Structural Equation Modeling (SEM) framework. A structured survey was administered to users of a large metropolitan urban park (N = 742). Latent constructs representing Perceived Disorder, Fear of Crime, Avoidance Behaviors, and Service Satisfaction were specified, controlling for Age and Gender. The SEM was estimated using robust methods for ordinal indicators. The measurement model demonstrated good reliability and validity. Results indicate that Perceived Disorder acts as a strong precursor to Fear of Crime. Fear of Crime emerged as a pivotal mediator, significantly increasing Avoidance Behaviors and strongly reducing Perceived Safety at night. Furthermore, significant demographic effects were observed: female users reported significantly higher levels of fear, while age showed a direct positive association with perceived safety. While disorder strongly impacted the emotional and behavioral dimensions (fear and avoidance), its direct link to Service Satisfaction was less prominent compared to safety perceptions. The findings suggest that the impact of disorder on the park experience is largely channeled through psychological mechanisms of fear. Integrated policies addressing social disorder and fear reduction are likely to be more effective than purely physical interventions to enhance safety perceptions and park usage. Full article

Background: Parental knowledge and perceptions towards Functional Foods (FFs) play a critical role in shaping children’s dietary behaviors. This study aimed to investigate dietary habits, FFs knowledge and perceptions among Greek primary school children and their parents and to evaluate the feasibility of a one-month pilot asynchronous nutrition education program. Methods: A cross-sectional study included 374 children aged 9–11 years and 159 parents from urban (Thessaloniki) and rural (Lemnos) areas. Children completed questionnaires on dietary habits, FFs knowledge and Mediterranean Diet (MD) adherence (KIDMED score), while parents provided sociodemographic information, BMI, dietary habits, FFs knowledge and perceptions. A pilot asynchronous nutrition education intervention was delivered via pre-recorded videos on FFs, the MD, portion sizes and food label interpretation, with participation tracked and program evaluation conducted among parents. Data was analyzed using IBM SPSS Statistics (version 28). Descriptive statistics were calculated, group differences were assessed with t-tests and ANOVA and associations between variables were examined using chi-square tests and Pearson correlations (p < 0.06). Results: Children showed moderate MD adherence, frequent fast-food and soft drinks consumption and low FF knowledge, with a substantial gap between perceived and actual understanding. Parental FF knowledge was uneven, higher among normal-weight participants and largely limited to fortified products. Positive associations were found between children’s and parents’ diet quality and natural FF consumption, as well as between parental and child physical activity. The asynchronous intervention was positively rated; substantial attrition was observed across sessions and follow-up, which limited the ability to assess the intervention’s effects on behavioral change. Conclusions: This study highlights critical gaps in FFs knowledge among families and demonstrates that asynchronous, family-based nutrition education is feasible but challenged by engagement attrition. Targeted interventions are needed to clarify FF concepts and promote healthier family dietary behaviors. Full article

The emotional responses to bullying victimization are central to its impact on subsequent psychological consequences, but the role of specific emotions is insufficiently defined within a comprehensive framework. In order to enhance the understanding of the emotional experiences of bullying victims, the present review examines the role of self-conscious emotions (i.e., humiliation, shame, and guilt), the role of basic emotions (i.e., anger and fear), and various psychological consequences (e.g., anxiety, depression, suicidal ideation). A non-systematic, narrative approach was employed to synthesize the findings, with a total of 343 articles included in the review. Self-conscious emotions appear to be central to bullying victimization, with humiliation being particularly pivotal due to its link to internalized self-devaluation, perceived injustice, and attribution of cruelty to the perpetrator. In turn, anger and fear seem to constitute crucial basic emotions in response to bullying dynamics. Although anger may escalate aggression, it may also facilitate positive confrontational behaviors when properly channeled, whereas fear may contribute to avoidance and increased victimization if sustained. Adverse psychological consequences such as anxiety, depression, stress, low self-esteem, and suicidal ideation are prevalent among victims of bullying, potentially exacerbated in vulnerable groups. Future research should further explore the role of emotions in the context of bullying victimization, examining their impact on both mental health outcomes and behavioral patterns over time. Exploring how different emotional responses interact and influence each other within bullying dynamics could provide insights into effective intervention strategies, and a more comprehensive understanding of the sociocultural factors influencing emotional responses to bullying might help in customizing prevention and support measures across diverse contexts. Full article

Esports are a rapidly expanding form of competitive activity that demand high levels of cognitive alertness, motor precision, stress management, and resilience to mental and physical fatigue. At the same time, the sedentary lifestyle, extended screen exposure, and psychological pressures associated with competitive gaming raise concerns for both performance and long-term health. Growing evidence highlights the importance of nutrition and lifestyle behaviors in supporting cognitive performance and overall competitive demands. While balanced dietary patterns and adequate hydration are essential, dietary supplements may provide additional benefits when used appropriately and under professional guidance. However, the current research is limited by a predominance of cross-sectional and self-reported studies, short-term or acute interventions, small sample sizes, and insufficient emphasis on esports-specific and personalized strategies. This review examines existing evidence on individualized nutrition, supplementation, and lifestyle strategies in esports, identifies key methodological limitations, and outlines future directions to inform evidence-based practice for athletes, practitioners, and organizations seeking to optimize cognitive performance, well-being, and long-term sustainability in this emerging field. Full article

Substance use disorder (SUD) is a global problem with serious psychological, physiological, and social consequences. Seeking professional help is often delayed due to a lack of self-recognition of addiction, frequently sustained by self-deception. Although self-deception is a core feature of SUD, the mechanisms underlying it remain insufficiently studied. This research examines the role of impulsivity and self-efficacy in predicting self-deceptive behaviors—manipulation and mystification—in individuals undergoing addiction rehabilitation. The sample consisted of 122 Spanish participants from therapeutic communities (Mage = 44.99, SD = 10.58; 82.8% male) who completed the Self-Deception Questionnaire (SDQ-12), the Impulsive Control Scale Ramón y Cajal (ECIRyC), and the Drug Taking Confidence Questionnaire (DTCQ). Results showed that impulsivity significantly predicted both manipulation and mystification. Manipulation was also associated with self-efficacy in managing temptation and duration of addiction, highlighting its multifaceted nature. In contrast, mystification was predicted solely by impulsivity, suggesting a stronger dependence on internal psychological processes rather than contextual factors. These findings underscore the importance of targeting impulsivity and enhancing self-efficacy in addiction treatment. Interventions such as Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), and mindfulness-based approaches may be particularly effective in reducing self-deceptive behaviors and supporting long-term recovery. Full article

Background: Motor decline associated with ageing compromises mobility, postural control and the ability, thereby increasing risk among older adults. Biomechanical characterization of movement, particularly using non-linear methods, offers a process-oriented approach capable of detecting subtle changes in motor coordination. The MIND&GAIT programme has previously demonstrated benefits in physical function in frail older individuals; however, its potential to improve motor coordination parameters that underpin fall risk remains insufficiently explored. Objectives: To analyse the impact of the MIND&GAIT program on motor coordination during sit-to-stand (STS) and walking tasks, two daily activities strongly associated with fall risk, using advanced non-linear and biomechanical metrics in institutionalized older adults. Methods: Fourteen institutionalized older adults (82.21 ± 7.14 years) participated. Three-dimensional acceleration and angular velocity were recorded using inertial sensors. Motor variability and predictability were quantified using the multivariate Lyapunov exponent (LyEM) and multivariate incremental entropy (MIE). STS (30 s) and walking-in-place (2 min) tasks were assessed pre- and post-intervention following a three-month, thrice-weekly programme. Results: Although no statistically significant differences emerged (ps > 0.05), trends were observed suggesting increases in LyEM during STS and in both MIE and LyEM during walking were found post-intervention. These exploratory findings may indicate enhanced motor complexity, stability and adaptability, features associated with reduced fall vulnerability. Conclusions: Despite the absence of statistical significance, the biomechanical trends observed suggest improvements in motor coordination patterns relevant to fall risk reduction in institutionalized older adults following the MIND&GAIT programme. These findings highlight the potential of structured exercise-based interventions for promoting safer movement behaviors in frail populations. Full article

Background: Encouraging fruit and vegetable (FV) consumption early in childhood is important for long-term healthy eating. Though parents play an important role in shaping children’s FV-related taste preferences and consumption, validated instruments assessing the range of parenting practices that specifically support young children’s FV intake are scarce. Furthermore, little attention has been given to low-income families, cultural inclusivity, and FV practices across different settings. The current study sought to conduct an initial examination and explore the measurement equivalency of a new FV parenting practices questionnaire (FVPPQ) across racially/ethnically diverse groups that address these gaps. Methods: Data for this paper came from a large project focused on parents’ FV parenting practices with young children enrolled in Head Start programs in the southern part of the U.S. Inclusion criteria were (a) parent/legal guardian being eighteen or older, (b) being the primary person responsible for child feeding, and (c) the child not requiring a special diet (e.g., diabetic). Using a multi-phases project approach, we (1) developed a preliminary conceptual map of parenting practice domains by reviewing existing measures on FV parenting practices; (2) completed and content-analyzed data from 18 focus groups (n = 62) to identify and further revise the preliminary conceptual map of domains, (3) administered a questionnaire with 11 domains of FV parenting practices, and then (4) empirically explored and reduced the measure while evaluating its content, construct, and criterion validity, and cultural equivalency across Non-Hispanic White, Hispanic White, and Black parents (n = 281). Results: Findings from Phases 1 and 2 generated a 107-item questionnaire that was reduced during phase 3 through a series of principal component and confirmatory factor analyses to the final FVPPQ with 21 items in four unique domains, showing good variability and inter-item consistency reliability: (1) Availability (5 items); (2) modeling (5 items); child-focused (5 items); and pressure (6 items). Three of the four domains evidenced cultural equivalency. Conclusions: The FVPPQ with four unique subscales demonstrated good content, construct validity, and partial measurement equivalency across racially/ethnically diverse groups of parents. Further confirmatory validation is warranted in larger samples, but the FVPPQ might be a promising and easily administered measure for research and applied interventions in nutrition, health behavior, and parenting contexts. Full article

Background/Objectives: Young adulthood is a critical developmental period during which lifestyle behaviors may shape intrinsic brain network dynamics that support cognition. This pilot longitudinal intervention study examined whether variability in physical activity and sedentary behavior during an 8-week exercise and/or cognitive intervention protocol was associated with changes in intrinsic brain dynamics and cognitive and mood outcomes in undergraduate young adults. Methods: Participants (n = 32) completed resting-state functional magnetic resonance imaging (rs-fMRI) at baseline (T1) and post-intervention (T2). Dynamic functional network connectivity (dFNC) was estimated from 53 intrinsic connectivity networks derived using spatially constrained independent component analysis (ICA). Ten recurring dynamic connectivity states were identified and individualized using constrained dynamic double functional independent primitives (c-ddFIPs). State occupancy and dynamic convergence and divergence metrics were computed to characterize network flexibility. Results: Greater moderate-to-vigorous physical activity was modestly but consistently associated with increased occupancy of integrative higher-order states, particularly States 6 and 7, and reduced occupancy of more segregated configurations. More physically active individuals also demonstrated greater divergence between integrative and low-engagement states, whereas greater sedentary time corresponded to increased similarity among segregated configurations. Working memory performance showed parallel associations with more integrative and better-differentiated dynamic patterns. Conclusions: These findings suggest that dynamic functional network reconfiguration may represent a neurobiological mechanism linking lifestyle behaviors and cognitive health in young adulthood. Furthermore, they highlight the translational promise of engagement-driven, low-burden programs for college-aged young adults, showing that even modest variability in habitual physical activity corresponds to greater engagement and differentiation of integrative connectivity states linked to executive and broader cognitive functions. Full article

Background/Objectives: Sleep problems and physical activity are key lifestyle behaviors associated with children’s socioemotional development. However, their relative contribution to emotional regulation and emotional instability during middle childhood remains insufficiently clarified. This study aimed to examine the associations between sleep problems, habitual physical activity, and emotional regulation in elementary school children, while controlling for sociodemographic and lifestyle confounding variables. Methods: A cross-sectional study was conducted with 386 elementary school children (mean age = 11.15 ± 0.66 years; 45.6% boys) from southern Spain. Emotional regulation was assessed using the Emotion Regulation Checklist (ERC), sleep problems were measured with the Children’s Sleep Habits Questionnaire (CSHQ), and habitual physical activity was evaluated using the Physical Activity Questionnaire for Children (PAQ-C). Age, sex, socioeconomic status, and daily screen time were included as covariates. Pearson correlations and multiple linear regression analyses were performed. Results: Sleep problems were strongly associated with lower adaptive emotional regulation and higher emotional lability. In adjusted regression models, sleep problems emerged as the most robust independent predictor of both emotional regulation and lability. Although habitual physical activity was significantly associated with emotional outcomes at the bivariate level, its predictive strength decreased after adjustment for covariates and did not independently predict adaptive emotional regulation. Conclusions: Sleep problems appear to play a central role in children’s emotional functioning during middle childhood. Interventions aimed at promoting socioemotional well-being may benefit from prioritizing sleep health alongside physical activity within a comprehensive 24 h movement behavior framework. Full article

This study reveals that a primarily ignored but crucial environmental situation—social crowding—can affect consumers’ sustainable behavior. The present research proposes a causal relationship between social crowding and consumer recycling behavior. Drawing on resource depletion theory and self-affirmation theory, three experiments were conducted across product recycling, participation in a brand-sponsored recycling program, and waste sorting activities. The results show that consumers exposed to crowded (vs. uncrowded) environments are less likely to engage in recycling. Study 1 provides initial evidence of this negative effect, demonstrating that it stems from crowd density rather than from the sheer number of people in the environment. Study 2 identifies ego depletion as the underlying mediating mechanism. Study 3 further demonstrates that self-affirmation attenuates the negative effect of social crowding on recycling behavior by mitigating ego depletion. These findings suggest that social crowding is an important situational barrier to recycling and that self-affirmation may serve as an effective intervention for promoting sustainable disposal behavior in dense consumption settings. This article concludes with a general discussion of the findings and practical implications for extending the relevant literature and benefiting consumer well-being, as well as promoting sustainable development. Full article

This study explores the influence of congruence and incongruence in father–mother co-parenting on adolescent depression, as well as the mediating effect of self-esteem. A total of 1389 adolescents completed questionnaires assessing their levels of depression and self-esteem, while their fathers and mothers correspondingly reported on their own co-parenting behaviors using the Parental Co-parenting Scale in this cross-sectional study. Dates were analyzed using LPA, RSA, and mediation consecutively. The results show that: (1) We identified three distinct co-parenting profiles: positive parental co-parenting, negative parental co-parenting, and mixed parental co-parenting. (2) In cases of congruent parental co-parenting, high positive parental co-parenting was associated with lower adolescent depression, whereas high negative parental co-parenting was linked to higher depression, and the difference manifests in different forms among boys and girls. Girls showed nonlinear changes in depression while boys exhibited linear trends. (3) In cases of incongruence in parental co-parenting, mothers’ co-parenting exerted a stronger influence on boys’ depression, while girls were not affected by mothers’ and fathers’ discrepancies. (4) Self-esteem mediated the relationship between parental co-parenting (in)congruence and depression across both genders. This study provides evidence for the mechanism through which parental coparenting influences adolescent depression and offers a basis for future interventions targeting adolescent depression. Full article

Background: Medical nutrition therapy (MNT) is crucial for diabetes management. This study evaluated a hands-on nutrition education program that incorporated cooking demonstrations for glycemic control, anthropometrics, and dietary behavior over a 2-month period. Methods: Nineteen type 2 diabetes patients (four males and 15 females; 79% female) participated. The median [IQR] age was 70.0 [65.5–73.0] years; the duration of diabetes was 12.0 [8.5–14.0] years; the body mass index (BMI) was 24.3 [21.05–27.90] kg/m², and the baseline HbA1c level was 6.90 [6.55–7.50%]. Approximately 20–25% of patients used injectable therapies. Pre- and post-treatment comparisons were performed via Wilcoxon signed-rank tests, while effect sizes were quantified via rank–biserial correlation (RBC). Results: In females (n = 15), carbohydrate intake decreased significantly (RBC = −0.583; p = 0.050). The protein levels per 1000 kcal exhibited a strong positive effect (RBC = 0.550; p = 0.065). HbA1c levels improved significantly (overall: RBC = −0.689 and p = 0.009; females: RBC = −0.725 and p = 0.014), and while body fat increased significantly (overall: RBC = 0.979 and p < 0.001; females: RBC = 0.983 and p < 0.001), the skeletal muscle index tended to decrease in females (RBC = −0.333; p = 0.268). Conclusions: Short-term hands-on nutrition education resulted in significant HbA1c improvement and dietary behavior changes but was accompanied by body composition deterioration. The findings of this study clarify the potential risks of nutritional interventions in elderly diabetic patients and provide important insights for improving future programs. Full article

Interventions aimed at reducing stress levels and sick leave have been implemented from different perspectives for workers. The aim of this study is to analyze the effectiveness of two interventions, including Cognitive Behavioral Therapy and strategies and workshops enhancing well-being (Well-being Route), on stress and sick leave levels. A quasi-experimental design was employed, with three conditions (control group, n = 41; Well-being Route group, n = 36; and Well-being Route + Cognitive Behavioral Therapy group, n = 17). A two-way MANCOVA with one within-subjects factor (intervention: 2 levels, pretest (Time 1), posttest (Time 2)), one between-subjects factor (group: 3 levels, CG, WBR, and WBR+CBT), and a covariate (job control) was used for analysis. Baseline differences among groups were found. The interaction between the intervention and the three conditions was statistically significant. The findings suggest that WBR+CBT within organizations can effectively mitigate stress and sick leave among workers, although sick leave was measured with a single item. Full article

Background: Adolescence represents a critical period for the adoption of lifestyle behaviors that may influence physical health, emotional well-being, and health-related behaviors later in life. However, limited evidence exists regarding the combined association of dietary habits and physical activity with motivation toward physical education, particularly among adolescent girls from different residential environments. Objective: This study aimed to examine the relationship between adherence to the Mediterranean diet, physical activity levels, and motivation toward physical education among adolescent girls from urban and rural settings. Methods: A cross-sectional study was carried out involving girls aged 12 to 14 years (n = 217; N_Urban = 108 and N_Rural = 109). Adherence to the Mediterranean diet, physical activity levels, and motivational dimensions toward PE were assessed using validated questionnaires. Differences between groups were analyzed using analysis of variance (ANOVA), and an analysis of covariance (ANCOVA) was performed controlling for physical activity levels. Effect sizes were calculated using partial eta squared (η²p). Results: Significant differences were observed in intrinsic motivation, identified regulation, introjected regulation, and amotivation according to adherence to the Mediterranean diet (p < 0.05), with small to moderate effect sizes (η²p = 0.029–0.040). Post hoc analyses indicated that girls with optimal adherence to the Mediterranean diet exhibited higher intrinsic motivation toward PE compared with those with low adherence. The ANCOVA revealed that higher physical activity levels were significantly associated with greater intrinsic motivation, particularly among girls from urban environments. No significant differences were found between urban and rural environments in overall physical activity levels or dietary adherence. Conclusions: Greater adherence to the Mediterranean diet and higher levels of physical activity are associated with more self-determined motivational profiles toward physical education in adolescent girls. These findings highlight the importance of integrated school-based interventions that promote healthy eating and active lifestyles to enhance motivation and engagement in PE among adolescent girls. Full article