Search Results (921)

Background: Adolescence is a critical period of rapid physical and psychological change, yet it is also when many health and well-being problems first emerge, often setting limits on lifelong opportunities and achievements as youth transition into adulthood. The ground-breaking adverse childhood experiences (ACEs) study has significantly shaped the development of programs and policies aimed at fostering adolescent health. Nonetheless, there has been limited exploration into the heterogeneity among individuals experiencing a high number of ACEs, such as four or more. This study employs Latent Profile Analysis (LPA) to examine the diverse outcome profiles of adolescents who have been exposed to a substantial number of ACEs. Method: The data were from participants who experienced at least four ACEs by age 9 in the Future of Families and Child Wellbeing Study (N = 1427; 54% male; 59% Black; 15.3% Hispanic; 2.4% other). We applied LPA using the manual three-step method within Mplus 8 to establish profiles based on six developmental indicators at age 15. These indicators included optimism, perseverance, academic performance, internalizing and externalizing behavioral competence, and social skills. The full information maximum likelihood method was used to handle missing data. Results: The study identified three distinct profile groups according to model fit indices and interpretability: Multidimensional Competence Group (61.0%), Low Personality and Social Competence Group (23.8%), and Low Behavioral Competence Group (15.2%). Racial and ethnic backgrounds were significant predictors of membership in these different profile groups. Conclusions: In a research landscape often focused on the cumulative harm of ACEs, our study underscores the heterogeneity of trauma profiles among adolescents with substantial ACE exposure. Given that adolescence is a critical stage when health and well-being challenges emerge, tailored early interventions are important to supporting a successful transition into adulthood. We advocate for the importance of comprehensive screening for social-cognitive and behavioral health difficulties in trauma-affected youth, enabling practitioners to implement timely prevention strategies and tailored interventions that foster resilience and long-term well-being. Full article

Background: Sepsis with Urinary Tract Infection (UTI) is a serious condition with high morbidity and mortality, increasingly complicated by multidrug-resistant (MDR) infections. Prompt diagnosis and appropriate treatment are key to improving outcomes and limiting antimicrobial resistance. The URO-RESIST study aimed to assess the relationship between clinical features, inflammatory biomarkers (C-reactive protein and procalcitonin, CRP and PCT, respectively), microbiological profiles, and outcomes in patients with sepsis with UTI. A secondary aim was to compare microbiological patterns between institutionalized patients and those living at home without known MDR risk factors. Methods: A retrospective cohort study was conducted on 231 patients with sepsis with UTI. admitted to the Infectious Diseases Unit of Chieti Hospital, Italy, between 2014 and 2024 (excluding 2020–2021). Data on clinical, laboratory, and microbiological variables were collected. MDR organisms were defined per European Centre for Disease Prevention and Control (ECDC) criteria. Analyses included non-parametric tests and logistic regression. Results: MDR pathogens were identified in over 40% of cases. Patients from long-term care facilities had higher CRP levels and a higher prevalence of MDR infections. Carbapenems were frequently used, though empirical treatment was sometimes inappropriate. PCT did not differ significantly between MDR and non-MDR groups and had limited prognostic value. CRP and MDR presence were both associated with worse outcomes and longer hospital stays. Functional dependence and dementia were strongly linked to MDR infections. Age correlated with comorbidities but was not an independent predictor of outcome. Conclusions: MDR infections worsen the course of sepsis with UTI. CRP may outperform PCT in assessing severity, especially in institutionalized patients. Functional and cognitive impairments increase vulnerability to MDR pathogens. These findings support the need for rapid diagnostics, targeted antibiotic use, and personalized care strategies. Full article

The awareness of tourism’s environmental impact has increased interest in sustainable alternatives such as green hotels, yet tourists often fail to translate pro-environmental attitudes into action, reflecting the attitude–behavior gap. This study extends the Theory of Planned Behavior (TPB) by incorporating Environmental Knowledge and Climate Change-Related Risk Perceptions (CC-RRPs) as background factors and testing their effects on Green Hotel Purchase Intentions (GHPIs) among Spanish travelers. Data from 1442 respondents were analyzed using covariance-based Structural Equation Modeling (SEM) with bootstrapped mediation testing. Results show that In-Group Norms are the strongest predictor of GHPIs, followed by Eco-Hotel Attitudes, while Perceived Behavioral Control (PBC) has a weaker but significant effect. Environmental Knowledge predicts all three mediators, and CC-RRPs predict Attitudes and Norms but not PBC. Crucially, both antecedents affect GHPIs only indirectly, supporting a mediation-based framework. These findings clarify the distinct roles of Environmental Knowledge as a cognitive antecedent and CC-RRPs as cognitive–affective evaluations that motivate attitudes and norms, while also highlighting the centrality of social influence in a Southern European context. Beyond theoretical contributions, the results underscore the importance of trust and authenticity: addressing greenwashing through transparent communication and credible certification frameworks is essential to ensure sustainable hospitality choices. Full article

Despite its central role in fostering effective social support, support-seeking behavior has received limited empirical attention—particularly among older adults, who have heightened needs for support due to age-related cognitive and physical decline. This study identified and examined key predictors of four types of support-seeking behaviors—direct and indirect instrumental and emotional support-seeking. Long-term married couples, with at least one partner aged 65 or older, participated in a laboratory-based discussion about a personal life stressor, during which support-seeking behaviors were coded. We examined both the support-seeker’s and support-provider’s attachment orientation, as well as the support-seeker’s stress level and relationship quality (e.g., satisfaction, commitment, and trust), as predictors of observed support-seeking behaviors. Results indicated that greater stress and higher relationship quality were associated with more direct instrumental support-seeking, while lower relationship quality and greater attachment insecurity in both partners predicted more indirect instrumental and emotional support-seeking. However, support-seekers also showed more direct emotional support-seeking with avoidantly attached partners, possibly as a compensatory effort to elicit needed support. This study contributes to the limited literature focusing on support-seeking behaviors, particularly in older adulthood, and has implications for interventions aimed at promoting effective communication and support-seeking. Full article

The successful implementation of digital transformation initiatives depends critically on public trust in experts guiding these processes. In today’s digital media environment, expert trust faces significant challenges, potentially hindering sustainable innovation adoption. This study investigates how expert credibility dimensions and information characteristics shape trust in digital transformation experts among Chinese social media users. We employed a mixed-methods approach combining a survey of 850 Chinese social media users, a quasi-experiment testing a digital expert verification feature, and secondary data analysis. The study measured multiple dimensions of expert trust while examining relationships with expert cognition factors and media usage variables through regression, mediation, and structural equation modeling. Expert trust in digital transformation exists at moderate levels (M = 6.82/10), with higher trust in digital innovation research (M = 7.12) than specific sustainability recommendations (M = 6.59). Expert authenticity emerged as the strongest predictor of trust (β = 0.27), followed by professional competence (β = 0.21). A “digital exposure paradox” emerged whereby higher volumes of expert information negatively predicted trust (β = −0.18), while information quality positively predicted trust (β = 0.25). The digital verification feature causally enhanced trust (DID = 0.57), with institutional sources strengthening trust while user-generated content diminished it. The findings reveal that digital transformation expert trust involves multi-dimensional evaluations beyond traditional credibility assessments. The “digital exposure paradox” suggests that prioritizing information quality over quantity, demonstrating expert authenticity, and implementing verification mechanisms can enhance trust and accelerate sustainable digital transformation adoption. Full article

Background/Objective: This study examined whether a brief measure combining subjective cognitive concerns and financial interference, termed Subjective Cognitive Decline-Financial (SCD-F), is associated with excess spending behavior in older adults. Methods: Community-dwelling older adults, some with early memory loss and some with no cognitive complaints (N = 150, M age = 72.6), provided 12 months of checking account statements and participated in interviews to clarify aspects of their personal financial behaviors. SCD-F was defined by asking if memory decline was interfering with financial decision-making or transactions. A 3-point SCD-F measure was created. Excess spending was determined by checking whether account expenditures exceeded all sources of income. Nonparametric tests (Kruskal–Wallis and Mann–Whitney U) and multiple regression models assessed group differences and predictors. Results: Group differences in excess spending were pronounced (H(2) = 15.75, p < 0.001). Those in the high SCD-F group had a significantly greater likelihood of excess spending (Z = −4.11; r = 0.43) and higher excess spending percentages (Z = −4.11; r = 0.43) compared to those with no memory loss. Regression analyses indicated that SCD-F was the strongest predictor of excessive spending (β = 0.40, t = 5.43, p < 0.001), even after controlling for age, gender, race, and education (R² = 0.235, F(5,144) = 8.86, p < 0.001). Conclusions: A brief self-report measure, SCD-F, effectively identifies older adults at risk of financial mismanagement, even absent formal cognitive impairment. Monitoring subjective cognitive concerns together with financial interference could enable early intervention. This brief measure may be useful in clinical settings as a screening tool, and in large national surveys. Full article

E-commerce is quickly increasing purchasing behavior across the globe, but little is known about how psychological paradigms underscore online buying intentions for locally essential items as nomadic local foods. The primary goal of this research is to examine the effects of some important psychological constructs and motivational values on predicting consumers’ intention to purchase nomadic and local foods via online e-commerce platforms, such as Ashayershop. This study followed the Theory of Planned Behavior (TPB) and looked at direct and mediated effects of attitudes, perceived behavioral control, and subjective norms on intention to purchase. Structural Equation Modeling (SEM) was conducted, based on data collected from a representative sample of consumers who were familiar with online shopping for local foods. The results highlight that attitude towards online shopping for local foods was the strongest direct predictor of intention to purchase (β = 0.383, T = 9.487, p < 0.001). Perceived behavioral control (β = 0.220, T = 5.316, p < 0.001), hedonic value (β = 0.213, T = 4.907, p < 0.001), utilitarian value (β = 0.187, T = 3.719, p < 0.001), and subjective norms (β = 0.149, T = 3.493, p < 0.001), received a significant positive effect on intention. In addition, hedonic and utilitarian values bountifully mediated the relation between psychological antecedents (attitudes, perceived behavioral control, and subjective norms) and purchase intention. For instance, attitude indirect effect via hedonic value was β = 0.080 (T = 3.783, p < 0.01), and indirect effect via utilitarian value was β = 0.040 (T = 3.058, p < 0.01), indicating the importance of these values as mediators. This research makes a contribution to the literature by showing that motivational values serve as not only an outcome but also as cognitive–affective mediators in the behavioral process thus expanding the TPB in the context of digital food markets. In general, these results provide valuable insights to e-commerce platforms and policymakers who desire to promote consumer engagement with products stemming from culture and tradition on line by developing new integrated strategies that address the cognitive, emotional, and social components. Full article

Mobile learning (m-learning) technologies are gaining popularity in universities but not uniformly across institutions because of cognitive, affective, and behavior obstacles. This research tested and applied an expansion of the Technology Acceptance Model (TAM) with technostress (TECH) and resistance to change (RTC) as affective obstacles, as well as the core predictors of perceived usefulness (PU), perceived ease of use (PE), and perceived risk (PR). By employing a cross-sectional survey of Greek university students (N = 608) and partial least squares structural equation modeling (PLS-SEM), we tested direct and indirect impacts on behavioral intention (BI) to apply m-learning applications. The results affirm that PU and PE are direct predictors of BI, while PR has no direct impact on BI but acts indirectly through TECH and RTC. Mediation is partial in terms of PE and PU and indirect-only (complete) in terms of PR with respect to the impact of affective states on adoption. Multi-group comparisons found differences in terms of gender, age, confidence, and years of use but not frequency of use, implying that psychological and experiential characteristics have a greater impact on intention than habitual patterns. These results offer theory-driven and segment-specific guidelines for psychologically aware, user-focused m-learning adoption in higher education. Full article

Background/Objectives: Attention-deficit/hyperactivity disorder (ADHD) is increasingly recognized for its impact on social functioning, including deficits in social cognition and empathy. Emerging neurobiological evidence highlights the potential role of oxytocin in these impairments. However, the influence of pharmacotherapy, particularly methylphenidate (MPH) and atomoxetine (ATX), on these domains remains underexplored. This study aimed to examine the effects of MPH and ATX on social cognition, empathy, and serum oxytocin levels in children with ADHD. Methods: This study included 152 children aged 6–12 years diagnosed solely with ADHD. The patient group consisted of 102 children, comprising n = 52 receiving MPH and n = 50 receiving ATX for at least 3 months. The control group comprised 50 newly diagnosed, untreated children. A sociodemographic form, the Social Skills Rating Scale (SRSS), the Reading the Mind in the Eyes Test (RMET), the Bryant Empathy Index (BEI), and the Swanson, Nolan, and Pelham Questionnaire (SNAP-IV) were applied. Serum oxytocin levels were measured via venous blood samples. Results: Medicated children exhibited significantly elevated SRSS scores, irrespective of the pharmacotherapy administered. RMET scores were significantly higher in the ATX group. No significant differences were found between the three groups in terms of empathy scores and serum oxytocin levels. A significant negative correlation was identified between ADHD symptom severity and RMET and SRSS-Total scores. Regular medication use was a significant predictor of SRSS scores, while empathy and serum oxytocin levels were nonsignificant predictors. Conclusions: Pharmacotherapy may enhance social cognition among children with ADHD. Longitudinal studies are warranted to assess the long-term effects of medication on social cognition and empathy. Full article

Academic performance in adolescence is influenced by both cognitive capacity and physiological factors such as sleepiness. However, the interaction between these dimensions remains understudied. This pilot study examined whether daytime sleepiness moderates the relationship between working memory and academic achievement in a sample of 601 schoolchildren aged 11 to 17 years. Participants completed a digital visuospatial working memory task and self-reported their daytime sleepiness using the Pediatric Daytime Sleepiness Scale (PDSS). Academic performance was assessed through official grades in Mathematics, Language, and Literature. Regression analyses showed that working memory (total score and average reaction time) and daytime sleepiness were independent predictors of academic performance. These findings support our hypotheses that cognitive and physiological factors each contribute to school success. However, no significant moderation effects were found in the full sample. Subgroup analyses revealed that working memory predicted academic outcomes only among students with normal sleepiness levels, whereas in high-sleepiness students, cognitive predictors lost significance and PDSS scores emerged as the dominant predictor. These results suggest that elevated daytime sleepiness can undermine the positive impact of working memory on academic performance. The findings highlight the importance of assessing both cognitive skills and physiological readiness when evaluating students. They also suggest that sleep-focused interventions may improve learning outcomes, especially during adolescence. Full article

This study examines how domain-general (processing speed and receptive vocabulary) and domain-specific (symbolic and non-symbolic comparison) cognitive skills contribute to early informal mathematical thinking in preschoolers. The aim was to assess the invariance of these predictive relationships across two sociocultural contexts: Chilean and Spanish samples. A total of 130 children participated, and structural equation modeling was used to estimate latent structures and test multigroup invariance. The results revealed a consistent latent structure across samples and a significant contribution of symbolic and non-symbolic comparison to early math performance, while processing speed and vocabulary showed context-specific variations. These findings indicate that although foundational mathematical competencies rely on common cognitive mechanisms, cultural and educational contexts modulate the strength of these associations. This study contributes to understanding the cognitive architecture underlying early numeracy and highlights the importance of culturally sensitive assessment and intervention strategies. Full article

Conventional academic warning systems in higher education often rely on end-of-semester grades, which severely limits opportunities for timely intervention. To address this, our interdisciplinary study developed and validated a comprehensive socio-technical framework that integrates social-cognitive theory with learning analytics. The framework combines educational data mining with culturally responsive, personalized interventions tailored to a non-Western context. A two-phase mixed-methods design was employed: first, predictive models were built using Learning Management System (LMS) data from 2,856 students across 64 courses. Second, a quasi-experimental trial (n = 48) was conducted to evaluate intervention efficacy. Historical academic performance, attendance, and assignment submission patterns were the strongest predictors, achieving a Balanced Area Under the Curve (AUC) of 0.85. The intervention, specifically adapted to Confucian educational values, yielded remarkable results: 73% of at-risk students achieved passing grades, with a large effect size for academic improvement (Cohen’s d = 0.91). These findings empirically validate a complete prediction–intervention–evaluation cycle, demonstrating how algorithmic predictions can be effectively integrated with culturally informed human support networks. This study advances socio-technical systems theory in education by bridging computer science, psychology, and educational research. It offers an actionable model for designing ethical and effective early warning systems that balance technological innovation with human-centered pedagogical values. Full article

Background/Objectives: Sleep state misperception (SSM) is a common phenomenon in insomnia disorder (ID), characterized by a discrepancy between subjective and objective sleep metrics. Recent studies have revealed microstructural EEG alterations specifically in misperceiving ID patients, yet clinically accessible SSM markers remain limited. This study aimed to characterize SSM within ID by integrating standard polysomnography (PSG) features and cognitive-affective traits, focusing on accessible clinical tools. Methods: Twenty patients with ID and twenty healthy controls (HC) underwent a night of PSG recording and completed both sleep diaries and a comprehensive psychological assessment. SSM was quantified using the Total Sleep Time misperception index (TSTm), analyzed both dimensionally and categorically Results: IDs reported significantly altered sleep parameters compared to HCs, both subjectively and objectively. Within the ID sample, although underestimators and normoestimators had similar objective TST, underestimators showed significantly more cortical arousal density (CAd), a higher percentage of sleep stage 1 and higher non-acceptance of emotions. Notably, none of the HC reached the threshold for being classified as underestimators. Regression analyses identified CAd, latency to sleep stage 3 and to REM, percentage of REM sleep and lack of emotional clarity, as key predictors of TSTm. Conclusions: SSM in insomnia reflects a dimensional vulnerability grounded in subtle sleep fragmentation and emotional dysregulation. Recognizing SSM as a clinically meaningful phenomenon may guide more targeted, emotion-focused, interventions for insomnia. Full article

Objectives: Neurocognitive disorders (NCDs) refer to a broad spectrum of conditions characterized by declining cognitive functions, such as memory, attention, language, and executive abilities. It is estimated that up to half of patients affected by NCDs remain undiagnosed or are diagnosed at an advanced stage of the disease. This study aimed to analyze the utility of subclinical organ damage markers, which could be used in primary care for the detection and prevention of NCD. Methods: The study participants (n = 137) completed neuropsychological tests (Addenbrooke’s Cognitive Examination/ACE and Mini-Mental State Examination/MMSE), a sociodemographic survey, an interview on past illnesses, and had their ankle-brachial index (ABI) and pulse wave velocity (PWV) values measured. Results: Based on the MMSE test, 26 participants (19.0%) were diagnosed with mild cognitive impairment (MCI) and 8 participants (5.8%) with NCDs. The study found that lower ABI values were associated with worse cognitive performance, suggesting that the ABI may be a useful tool for identifying individuals at increased risk of NCDs, while PWV cannot be used as a predictor for this group of diseases. Conclusions: Lower ABI values were associated with reduced cognitive performance, whereas PWV showed no significant relationship. The secondary findings suggest that physical activity, regular computer use, and better mental well-being were linked to improved cognitive outcomes. A low ABI value could potentially serve as a predictor of cognitive disorders, and as a diagnostic tool that is easily accessible and quick, it may improve diagnostics and the overall health of primary care patients. Health education regarding modifiable risk factors for dementia is also of crucial importance. Full article

Background: Postoperative cognitive dysfunction (POCD) is a prevalent complication in elderly patients undergoing hip fracture surgery, often resulting in increased morbidity and prolonged rehabilitation. Biomarkers such as Neuron-Specific Enolase (NSE) and S100B protein have shown potential in detecting cerebral injury, yet their role in predicting long-term cognitive decline remains unclear. This study aimed to evaluate the association between biomarkers serum levels and the incidence of POCD in elderly patients undergoing proximal femur fracture surgery. Methods: A multicentric prospective observational study was conducted from January 2023 to February 2024, including 146 elderly patients with hip fractures treated surgically at ASL Bari and the University Orthopedic Department of Foggia. Biomarker levels of NSE and S100B were measured preoperatively (T0), at three days post-surgery (T1), and at one-year follow-up (T2). Cognitive function was assessed using the Pfeiffer Scale (PS) and the Mini-Mental State Examination (MMSE). Statistical analysis was performed using U Mann–Whitney tests and logistic regression to identify risk factors. Results: At three days post-surgery, 20.5% of patients exhibited POCD, with no significant differences in NSE and S100B levels compared to baseline. However, at one year, of the 96 patients investigated 37.9% of patients showed cognitive decline, with significantly elevated NSE (19.88 ± 4.03 μg/L) and S100B (1.86 ± 0.9 μg/L) compared to non-POCD patients (p = 0.01). Risk factors for long-term POCD included older age (OR: 1.24), diabetes mellitus (OR: 4.41), and lower baseline cognitive function (MMSE and PS scores, OR: 0.25 and 9.81, respectively). Conclusions: The study demonstrates that while early POCD is not associated with significant changes in NSE and S100B levels, their elevation at one-year follow-up suggests a possible correlation with chronic neuroinflammation and persistent neuronal damage. Preoperative cognitive impairment, advanced age, and diabetes mellitus are significant predictors of long-term cognitive decline. Incorporating biomarker evaluation and cognitive screening into perioperative management may enhance patient outcomes following hip fracture surgery. Full article