Search Results (615)

With the increasing adoption of telework and growing attention to sustainable development, understanding how telework relates to employees’ green innovation has become an important research issue. Drawing on Self-Determination Theory and Social Cognitive Theory, this study develops a moderated mediation model to examine the relationships among telework, voluntary green behavior, green self-efficacy, and employees’ green innovation performance. Questionnaire data were collected from 322 employees in the Beijing–Tianjin–Hebei region of China and analyzed using SPSS 26.0, AMOS, and hierarchical regression analysis, structural equation modeling, and PROCESS macro analyses. The results indicate that (1) telework is positively associated with employees’ green innovation performance, with voluntary green behavior partially mediating this relationship; (2) green self-efficacy positively moderates the relationship between telework and voluntary green behavior, such that the relationship is stronger among employees with higher levels of green self-efficacy; and (3) green self-efficacy significantly moderated the indirect effect of telework on employees’ green innovation performance through voluntary green behavior. Theoretically, this study integrates Self-Determination Theory and Social Cognitive Theory to explain both how telework is associated with employees’ green innovation performance through voluntary green behavior and when this relationship becomes stronger under different levels of green self-efficacy. Practically, the findings suggest that organizations should support employees’ voluntary green behavior by providing appropriate telework practices, green-skills training, supportive management, and opportunities to strengthen green self-efficacy. Full article

Background/Objectives: Cognitive training provides a framework for examining how repeated practice relates to changes in cognitive performance and task-related brain activation, yet age-stratified patterns of neural effects remain unclear. Methods: We conducted a three-level behavioral meta-analysis and a coordinate-based Seed-based Mapping (SDM) meta-analysis of task-based neuroimaging studies to jointly examine behavioral improvement and task-related activation convergence following cognitive training. Results: Cognitive training was associated with reliable behavioral improvement at the aggregate level (Hedges’ g = 0.546, 95% CI [0.414, 0.678]) and within both children/adolescents and young adults. SDM results indicated that task-related activation changes were spatially heterogeneous and included both increases and decreases across distributed brain regions. In age-stratified analyses, spatial convergence within children/adolescents involved occipital and frontoparietal regions; within young adults, it involved cingulo-insular and posterior midline regions. Exploratory behavioral moderator analyses indicated outcome-dependent variation, with smaller effects for transfer outcomes and larger effects in studies with greater training exposure. Conclusions: Behavioral improvements across included designs were observed in both age groups, whereas task-related activation convergence exhibited spatially heterogeneous, age-stratified patterns. These findings suggest that training-related neural effects are better characterized as spatial convergence patterns across studies rather than as a single uniform activation change. The age-stratified maps describe spatial convergence within each age group and should not be interpreted as statistically established developmental differences. Full article

The adoption of agroecological practices has recently gained increasing attention. However, significant disparities persist between farmers’ awareness and actual implementation. This study addresses this gap by developing an integrated analytical framework to identify farmer typologies and explain the heterogeneity of agroecological adoption among Romanian tomato growers, considered as a case study within the broader context of Romanian vegetable production. Based on a survey of 196 active cultivators, the analysis combines principal component analysis (PCA) and cluster analysis to identify latent behavioral dimensions and classify farmers into distinct typologies. In addition, an Agroecological Adoption Index (AAI) is constructed to assess and compare adoption levels across groups. The results reveal four statistically distinct farmer typologies: informed farmers with low adoption, practice-oriented low-constraint farmers, high-adoption agroecological farmers, and pragmatic adopters. The findings demonstrate that adoption is not solely determined by knowledge levels but is strongly shaped by perceived barriers, particularly limited access to information, financial constraints, and uncertainty. By moving beyond single-factor explanations, this study highlights the multidimensional nature of agroecological adoption and provides empirical evidence of the interaction between cognitive, economic, and structural determinants. The results offer important policy implications, suggesting that effective interventions should combine targeted training, advisory services, and financial support tailored to specific farmer profiles within horticultural production systems. Full article

Artificial intelligence (AI) is increasingly being applied in healthcare, with growing relevance to clinical nutrition. This narrative review examines current and emerging uses of AI in nutrition care within the Nutrition Care Process framework, with attention to assessment, monitoring and evaluation, diagnosis, intervention, and clinical support tools. Current applications include AI-assisted dietary assessment using image recognition, wearable sensors, analysis of continuous glucose and other physiologic data for early risk detection, and support for malnutrition screening and diagnosis. AI is also being explored for identifying micronutrient deficiencies and complications of nutrient excess, as well as for screening and early intervention in eating disorders. In nutrition intervention, AI has potential to support personalized dietary planning, nutrition support in intensive care settings, behavioral interventions, and precision nutrition approaches such as digital twins. Additional applications include clinical decision support and documentation assistance. However, despite its usefulness, concerns about AI systems exist. Its performance depends on the quality of the data used to train it; it can introduce bias, and it can produce inaccurate or misleading outputs. In addition, overreliance on AI may also reduce clinician attentiveness and contribute to cognitive errors. For these reasons, AI should be regarded as a support tool rather than a replacement for human clinical care. Overall, AI offers substantial opportunities to improve the personalization, efficiency, and scalability of clinical nutrition practice, but its safe and effective implementation will require continued validation, careful oversight, and integration with clinical expertise. Full article

Background/Objectives: Neurofeedback (NFB) modulates electroencephalographic activity and has been proposed to enhance cognitive performance. This study investigated the effects of repeated sensorimotor rhythm (SMR; 12–15 Hz) neurofeedback training on selective auditory attention in healthy adults aged 25–40 years, utilizing both electrophysiological and behavioral assessments. Methods: A prospective, controlled factorial design with repeated measures was employed, including a sham NFB intervention to control for placebo effects. Electrophysiological evaluation measured the amplitudes and latencies of event-related potentials (N100, N200, and P300) during an auditory Go/No-Go task. Speech-in-noise perception, which demands a higher level of selective auditory attention, was further assessed using the QuickSIN test. Results: Electrophysiological results revealed that SMR training statistically significantly reduced latencies of the N200 component at the Cz and Pz electrodes, and the P300 component at the Fz, Cz, and Pz electrodes, in a dose-dependent manner. No significant amplitude effects were observed for any ERP component. Behavioral results demonstrated a linear improvement in speech perception in noise (QuickSIN test) in the experimental group, a task that indirectly engages auditory selective attention mechanisms, as a function of training sessions, with significant group differences favoring the experimental group. These effects were maintained at the one-month follow-up. Conclusions: These findings indicate that SMR-based NFB modulates neural activity and improves selective attention, supporting its potential as an effective intervention for improving attentional performance and auditory processing in healthy populations, with effects persisting at least one month post-training. Full article

We conducted an exploratory evaluation of short-term changes following participation in a two-day intensive training programme aimed at addressing sustainability-oriented and project-management-related psychological outcomes, focusing on self-efficacy and behavioral intentions among university staff and researchers. A repeated-measures pre-post design was adopted. A total of 28 participants took part in the training, which covered the fundamentals of project management (including its main phases and processes) and the integration of sustainability principles into project management practices. Participants were assessed at two time points: prior to the training (T1) and immediately after its completion (T2). Primary outcomes included project sustainability self-efficacy, project management self-efficacy, pro-sustainability behavioral intentions, and behavioral intentions to adopt new project management practices. Cognitive fatigue and perceived training utility were assessed at T2 to capture participants’ immediate post-training experiences. Changes over time were examined using paired-samples t-tests and regression models controlling for baseline (T1) levels of each outcome variable. Participants showed significant increases from T1 to T2 across all outcome variables, with a moderate effect for project sustainability self-efficacy (Cohen’s d = 0.42) and large to very large effects for project management self-efficacy (d = 1.35), pro-sustainability behavioral intentions (d = 2.08), and behavioral intentions to adopt new project management practices (d = 1.38). Baseline levels generally predicted post-training scores, suggesting partial temporal stability, whereas perceived training utility showed weak and non-significant associations with post-training outcomes. Cognitive fatigue did not emerge as a significant predictor of any outcome. Overall, these exploratory findings provide preliminary evidence of short-term changes observed following participation in the training programme in sustainability- and project-management-related psychological outcomes. However, given the small convenience sample, single-group pre-post design, and immediate post-training assessment, the findings should be interpreted cautiously and do not allow causal conclusions regarding the effects of the training programme. Larger controlled and longitudinal studies are needed to determine whether these changes can be replicated and sustained over time. Full article

Objectives: This systematic review examined studies combining transcranial direct current stimulation (tDCS) with virtual reality (VR) in healthy or non-clinical populations. The aim was to evaluate whether active tDCS provides additional benefits when delivered during VR-based tasks or interventions aimed at improving behavioral abilities. Methods: Following PRISMA guidelines, a comprehensive search of electronic databases (2000–September 2025) identified randomized and non-randomized studies employing simultaneous tDCS and VR in healthy individuals. Studies reporting psychological or cognitive quantitative outcomes were included. Risk of bias was assessed using RoB-2 and ROBINS-I tools. Results: Twelve studies met inclusion criteria. The included studies were highly heterogeneous in terms of sample size, VR systems, stimulation parameters, targeted cortical regions, outcome measures, and control conditions. Most designs compared active tDCS during VR with sham tDCS during the same VR exposure. Therefore, the available evidence mainly addresses whether tDCS adds value to VR-based procedures, rather than whether tDCS and VR exert independent or synergistic effects. Some studies reported favorable between-group effects on emotional control or skill acquisition. However, in other cognitive domains both active and sham/control VR groups improved, suggesting that VR training or exposure itself may have contributed substantially to the observed changes. Moreover, small sample sizes, multiple outcome testing, and limited correction for multiple comparisons reduce confidence in borderline findings. Conclusions: Current evidence suggests that active tDCS may incrementally enhance selected VR-based outcomes in healthy populations, particularly in emotional control and skill-learning domains. However, the literature does not yet support strong claims of synergistic interaction between tDCS and VR. Future studies should use adequately powered factorial designs including VR-only, tDCS-only, combined, and sham/no-intervention conditions to disentangle independent, additive, and interaction effects. Full article

Background and Objectives: Generative artificial intelligence (AI) chatbots have entered medical education faster than guidance for their responsible use. Although a rapidly expanding 2024–2026 literature has examined generative AI adoption, attitudes, and AI literacy among healthcare students, comparatively little is known about which specific tools medical students prefer or whether reliance on them carries measurable cognitive risks. We characterized adoption patterns, tool preferences, perceived benefits, and determinants of cognitive overdependence among medical students. Methods: A single-center cross-sectional survey was administered to 141 medical students across preclinical and clinical years at a single institution. A 28-item instrument captured usage patterns, perceived learning benefit, output trust, verification behavior, and AI overdependence risk. Analyses included t-tests, ANOVA, chi-square tests, Pearson correlations, and hierarchical regression. Results: Unless otherwise specified, values are reported as group mean scores on 1–5 Likert agreement scales or as percentages of respondents. ChatGPT was the primary tool for 69.5% of respondents, followed by Claude (12.1%). Daily users reported greater perceived learning benefit than infrequent users (4.14 vs. 3.36; p < 0.001). Clinical students verified AI outputs more often than preclinical students (3.69 vs. 3.21; p < 0.001), while preclinical students showed higher reliance (p = 0.002); verification moderated overdependence risk across academic years (interaction p = 0.041). AI familiarity (β = 0.31) and verification habit (β = −0.22) were the strongest predictors of integration acceptance (R² = 0.34). Conclusions: Reliance and verification habits diverge by training stage; curricula should pair AI literacy with explicit verification training to mitigate overdependence. As a single-center, self-report study, these findings require multi-center confirmation; nonetheless, to our knowledge, this is among the first studies to jointly profile students’ tool-specific reliability perceptions and to identify verification behavior as a moderator that buffers familiarity-driven overdependence. Full article

Introduction: A high prevalence of motor deficits has been documented in individuals with Autism Spectrum Disorder (ASD); these deficits negatively impact participation and functional performance. Conventional interventions, which are often fragmented, may limit skill acquisition and generalization. The Global Integration Method (MIG) proposes an integrative approach that combines motor training, proprioceptive stimulation, and cognitive–behavioral strategies mediated through narrative. This study evaluated its effectiveness compared with conventional treatments. Methods: This study was designed as a three-arm randomized controlled clinical trial with assessor blinding, including 66 children with ASD aged 6–12 years. Participants were allocated to MIG, conventional physiotherapy, or conventional psychology groups. Interventions were delivered over five weeks. Assessments were performed at baseline, post-intervention, and at a three-month follow-up. Primary outcomes included motor skills (TGMD-2) and functional performance (COPM). Secondary outcomes included balance (PBS) and socio-communicative skills (PROC, ABFW). Analyses followed the intention-to-treat principle using repeated-measures ANOVA. Results: The MIG group showed significant improvement compared with control groups in the primary outcomes, with a significant group × time interaction for fundamental motor skills and functional performance (p < 0.05), maintained at follow-up. Improvements were also observed in balance and socio-communicative skills (p < 0.05). No significant differences were found for adaptive behavior or self-reported motor coordination. Adherence was high, and adverse events were mild. Conclusions: MIG was associated with greater improvements in motor and functional outcomes compared with conventional interventions. However, these findings should be interpreted as preliminary evidence of an intensive, multicomponent intervention package, in which treatment dose and combined therapeutic components may jointly contribute to the observed effects. Full article

Gamification increasingly influences learning experiences, cognitive engagement, and behavioral performance in digital learning, cognitive training, and health intervention contexts. However, the mechanisms underlying cognitive factors, along with related research hotspots and evolutionary trends, have not been adequately synthesized. Using the Web of Science Core Collection, this study analyzes 813 publications on gamification and cognitive factors published between 2012 and 2024. Using a bibliometric method, CiteSpace was utilized to analyze publication trends, collaborations, keyword co-occurrence, cluster structures, burst terms, cited references, and knowledge-map visualizations. The cluster analysis produced 10 interrelated themes: “flipped classroom,” “active learning,” “continuance intention,” “dementia,” “executive function,” “cognitive control training,” “computational thinking,” “cognitive training,” “cognitive load” and “user experience”. Potential future directions suggested by the bibliometric patterns include: (1) expanding gamification across educational contexts; (2) refining gamification theory models that focus on cognitive processes by examining user experience and cognitive load as potential mechanisms that link gamification design features to outcomes such as motivation, self-efficacy, task performance, and continuance intention; (3) promoting applications in cognitive training, cognitive impairment intervention, and digital health; (4) optimizing experimental design, data collection, interdisciplinary collaboration, and personalized design; and (5) clarifying how gamification shapes cognitive processes such as attention allocation, cognitive load regulation, problem solving, executive function, and computational thinking. This study does not aim to establish causal effects; rather, it uses bibliometric evidence to reveal the developmental trajectory, thematic structure, and emerging directions of research on gamification and cognitive factors. Full article

Background: Contemporary adults face fragmented schedules, sedentary digital work, cognitive load, logistical barriers, and unstable routines that can make conventional session-based exercise difficult to sustain. Exercise snacks, vigorous intermittent lifestyle physical activity (VILPA), movement breaks, low-volume high-intensity interval training (HIIT), workplace exercise, and digitally mediated physical activity may reflect a broader redesign of exercise for real-world lifestyles. Objective: To develop a conceptual framework for lifestyle-congruent exercise models: approaches that intentionally modify dose, timing, setting, delivery, autonomy, or routine integration to reduce lifestyle-related friction while preserving a plausible physiological or behavioral stimulus. Methods: This evidence-based narrative review purposively identified sources through targeted searches, citation tracking, and manual verification across exercise science, sedentary behavior, workplace health, behavioral medicine, and digital health. Sources were selected for conceptual relevance, model-family representation, evidence-type diversity, and contribution to framework development, and then charted by model family, population, context, exercise architecture, delivery, outcomes, and implementation features. No systematic protocol, formal risk-of-bias assessment, or certainty grading were applied. Results: Thirty-one sources informed the framework. Five design logics were identified: dose compression, temporal distribution, routine embedding, sedentary substitution, and delivery mediation. These logics show that brief or time-efficient models are not interchangeable; they differ in intentionality, context, behavioral demand, safety considerations, implementation logic, and dominant friction addressed. Conclusions: Lifestyle-congruent exercise models are complementary strategies, not replacements for structured aerobic and muscle-strengthening exercise. Their value lies in matching exercise architecture to lifestyle-related friction while supporting progression toward guideline-consistent activity. Future research should test safety, equity, scalability, and long-term maintenance across diverse populations. Full article

Infertility is a complex health issue that extends beyond biological mechanisms, encompassing significant psychological, relational, and social aspects. Advances in assisted reproductive technologies have improved the chances of conception, yet many couples discontinue treatment due to stress, stigma, and reduced quality of life. This narrative review explores the role of rehabilitation as a complementary approach to conventional fertility care, highlighting psychological, physical, and integrated interventions. Psychological rehabilitation strategies, such as cognitive behavioral therapy, mindfulness-based interventions, and couple-focused counseling, have been shown to reduce anxiety and depression, improve coping, and, in some cases, support better adherence to fertility treatments. Physical rehabilitation approaches, including pelvic floor muscle training, structured exercise for women with polycystic ovary syndrome, lifestyle and fitness interventions for men, yoga, and sexual rehabilitation, contribute to reproductive health, reduce pain, and enhance intimacy. Integrated models that combine psychological and physical components show the greatest promise, as they address the interaction between stress, physical function, and reproductive outcomes. Overall, the evidence suggests that infertility care should not focus solely on achieving conception. Rehabilitation offers opportunities to strengthen emotional resilience, improve sexual health, and support relationship stability, ensuring that patients benefit not only medically but also in terms of long-term well-being and quality of life. Full article

Background: This study compared the effects of mindfulness training (MT) and cognitive-behavioral training (CBT) on ADHD symptoms, test anxiety, and self-concept in children with ADHD and explored potential pathways of change associated with the two interventions. Methods: After a two-stage screening and eligibility confirmation procedure, 63 children with ADHD were included in the final analyses, including 19 in the MT group, 25 in the CBT group, and 19 in the control group. The MT and CBT groups received an eight-week intervention, whereas the control group continued regular classroom activities. ADHD symptoms, test anxiety, and self-concept were assessed before and after the intervention. Data were analyzed using 3 × 2 repeated-measures ANOVA and exploratory cross-lagged analyses. Results: Significant Group × Time interactions were found for ADHD symptoms, F(2, 60) = 29.74, p < 0.001, η_p² = 0.5; test anxiety, F(2, 60) = 7.77, p = 0.001, η_p² = 0.21; and self-concept, F(2, 60) = 18.9, p < 0.001, η_p² = 0.39. Simple effects analyses showed that both the MT and CBT groups showed significant reductions in ADHD symptoms and test anxiety and significant improvements in self-concept, whereas the control group showed no significant pretest-to-posttest changes. Exploratory cross-lagged analyses showed different patterns of association between ADHD symptoms and test anxiety in the two intervention groups. Conclusions: Both MT and CBT were associated with improvements in ADHD symptoms, test anxiety, and self-concept in children with ADHD. The exploratory pathway findings suggest that the two interventions may be linked to partly different patterns of change. However, further studies are needed to verify these preliminary findings. Full article

Sleep is essential for infants’ physical and cognitive development. Unlike older children or adolescents, infants sleep longer durations, including multiple daytime naps. While nighttime sleep is easier to detect due to its extended periods, identifying daytime sleep is more challenging due to its short, fragmented nature and its similarity to idle wakefulness. Moreover, parent-reported sleep estimations are prone to error as continuous monitoring is often impractical. To address these limitations, we developed a Multi-Stage Sleep–Wake (MSW) classification approach using triaxial accelerometer data collected from wearable devices placed on infants’ ankles and waists over multiple days. This method systematically refines and classifies sleep and wake states through a series of analytical steps. This systematic process generates refined proxy sleep–wake labels that account for behavioral overlaps and correct mislabeled idle periods. We trained and validated multiple machine learning models using these labels and compared the results to parent annotated labels. Models trained using MSW-derived labels achieved 96.6% accuracy using Random Forest classifier compared to 72% using parent-reported labels. These findings demonstrate that the MSW framework produces a more consistent set of proxy sleep–wake annotations for model development, although the derived labels were not validated against an independent reference standard. Furthermore, the proposed MSW framework may serve as a practical label-refinement methodology for improving noisy caregiver-reported sleep annotations in future wearable-based infant sleep studies where independent sleep labels are unavailable. Full article

Background/Objectives: Behavioral and psychological symptoms of dementia (BPSD) are highly prevalent among nursing home residents and represent a major clinical and care-related challenge. These symptoms are frequently associated with increased psychotropic drug use despite limited efficacy and important safety concerns. This study aimed to evaluate longitudinal changes in BPSD and psychotropic drug use following implementation of the “Los Filabres” protocol, a structured person-centered non-pharmacological intervention, in nursing home residents with dementia. Methods: A single-arm longitudinal pre–post observational study was conducted in five nursing homes in Andalusia, Spain, including 204 residents with dementia or cognitive impairment. After staff training, the intervention was implemented over 12 months. Outcomes were assessed at baseline (T0), 6 months (T1) and 12 months (T2) using the Neuropsychiatric Inventory (NPI), including symptom frequency, severity, clinical relevance, and caregiver-related distress. Psychotropic drug use was analyzed according to the Anatomical Therapeutic Chemical classification system. Statistical analyses included Friedman and Cochran’s Q tests, with effect sizes estimated using Cohen’s d and h. The observational nature of the study implies that observed changes may be subject to limitations such as Hawthorne effects. Results: Significant reductions were observed across all global NPI dimensions over time (p < 0.001), including symptom frequency, severity, clinical relevance, and caregiver-related distress. The proportion of participants with at least one clinically relevant symptom decreased from 93.1% at baseline to 35.8% at 12 months (p < 0.001). Significant longitudinal reductions were also observed in psychotropic drug use, with the mean number of psychotropic drugs per participant decreasing from 2.38 to 1.57 (p < 0.001). Reductions were observed in anxiolytic and antipsychotic use, as well as in as-needed prescriptions. Conclusions: The “Los Filabres” protocol was associated with significant longitudinal reductions in BPSD and psychotropic drug use in nursing home residents with dementia. These findings suggest that structured person-centered non-pharmacological interventions based on the identification of unmet needs may help support dementia care and more individualized pharmacological management in long-term care settings. These findings should be interpreted cautiously due to the observational pre–post design and absence of a control group. Full article