Search Results (19,250)

Background: Since the outbreak of war in Ukraine, countless forcibly displaced individuals facing not only material loss, but also deep psychological distress, have sought refuge across Europe. For those traumatized by war, the absence of a shared language in therapy can hinder healing and exacerbate suffering. While cultural diversity in psychotherapy has gained recognition, the role of native-language communication—especially from a person-centered perspective—remains underexplored. Methods: This narrative review with a thematic analysis examines whether and how psychotherapy in the mother tongue facilitates access to therapy and enhances therapeutic efficacy. Four inter-related clusters emerged: (1) the psychosocial context of trauma and displacement; (2) language as a structural gatekeeper to care (RQ1); (3) native-language therapy as a mechanism of change (RQ2); (4) potential risks such as over-identification or therapeutic mismatch (RQ2). Results: The findings suggest that native-language therapy can support the symbolic integration of trauma and foster the core conditions for healing. The implications for multilingual therapy formats, training in interpreter-mediated settings, and future research designs—including longitudinal, transnational studies—are discussed. Conclusions: In light of the current crises, language is not just a tool for access to therapy, but a pathway to psychological healing. Full article

Most research on domestic dog (Canis familiaris) behavior has focused on pets with restricted movement. However, free-ranging dogs exist in diverse cultural contexts globally, and their interactions with humans are less understood. Tourists can facilitate unrestricted dog movement into wilderness areas, where they may negatively impact wildlife. This study investigated which stimuli—namely, voice, touch, or food—along with inherent factors (age, sex, sociability) motivate free-ranging dogs to follow a human stranger. We measured the distance (up to 600 m) of 129 free-ranging owned and stray dogs from three villages in southern Chile as they followed an experimenter who presented them one of the above stimuli or none (control). To evaluate the effect of dog sociability (i.e., positive versus stress-related or passive behaviors), we performed a 30 s socialization test (standing near the dog without interacting) before presenting a 10 s stimulus twice. We also tracked whether the dog was in the company of other dogs. Each focus dog was video-recorded and tested up to three times over five days. Generalized linear mixed-effects models revealed that the food stimulus significantly influenced dogs’ motivation to follow a stranger, as well as a high proportion of sociable behaviors directed towards humans and the company of other dogs present during the experiment. Juveniles tended to follow a stranger more than adults or seniors, but no effects were found for the dog’s sex, whether an owner was present, the repetition of trials, the location where the study was performed, or for individuals as a random variable. This research highlights that sociability as an inherent factor shapes dog–stranger interactions in free-ranging dogs when food is given. In the context of wildlife conservation, we recommend that managers promote awareness among local communities and tourists to avoid feeding dogs, especially in the context of outdoor activities close to wilderness. Full article

Low uptake of pre-exposure prophylaxis (PrEP) for HIV prevention among Black women has been partly attributed to barriers related to patient-provider communication. The goal of this paper was to investigate the association between exposure to the #ShesWell campaign and Black women’s communication about PrEP with a healthcare provider (HCP). We conducted a cross-sectional survey of 403 sexually active, Black women after the initial phase of #ShesWell and used multivariable regression models to analyze whether exposure to #ShesWell was associated with talking to an HCP about PrEP or intention to discuss PrEP with an HCP in the future. Approximately 33% of women surveyed reported exposure to #ShesWell. Campaign exposure was significantly associated with talking to an HCP in the past year about PrEP (OR = 4.96, p = 0.001) and intention to discuss PrEP with an HCP in the next six months (B = 0.29, p = 0.038). Stronger beliefs that doctors should initiate sexual health conversations were positively associated with past PrEP conversations (OR = 2.32, p < 0.001) and future intention (B = 0.11, p = 0.029). Greater comfort discussing prevention (B = 0.35, p < 0.001), self-efficacy discussing PrEP (B = 0.29, p = 0.001), and concern about getting HIV (B = 0.51, p < 0.001) were also associated with intention to discuss PrEP with an HCP. Findings highlight the potential for communication campaigns to motivate patient-provider communication about PrEP, addressing a reported barrier to PrEP uptake among Black women. Full article

Background/Objectives: Frailty is a prevalent geriatric syndrome associated with impaired postural control and elevated fall risk. Although conventional exercise is a core strategy for frailty management, adherence remains limited. Virtual reality (VR)-based interventions have emerged as potentially engaging alternatives, but their effects on objective postural control and task-specific confidence in frail populations remain understudied. This study aimed to evaluate the effectiveness of a supervised VR training program using the Nintendo Ring Fit Plus™ on postural control, functional mobility, and balance confidence among frail community-dwelling older adults. Methods: Fifty-one adults aged ≥65 years classified as frail or prefrail were enrolled in a four-week trial. Participants were assigned to either a VR intervention group (n = 28) or control group (n = 23). Participants were non-randomly assigned based on availability and preference. Outcome measures were collected at baseline and post-intervention. Primary outcomes included center of pressure (CoP) metrics—sway area, mean velocity, and sway path. Secondary outcomes were the Timed Up and Go (TUG), Berg Balance Scale (BBS), Activities-specific Balance Confidence (ABC), and Falls Efficacy Scale–International (FES-I). Results: After adjusting for baseline values, age, and BMI, the intervention group showed significantly greater improvements than the control group across all postural control outcomes. Notably, reductions in sway area, mean velocity, and sway path were observed under both eyes-open and eyes-closed conditions, with effect sizes ranging from moderate to very large (Cohen’s d = 0.57 to 1.61). For secondary outcomes, significant between-group differences were found in functional mobility (TUG), balance performance (BBS), and balance confidence (ABC), with moderate-to-large effect sizes (Cohen’s d = 0.53 to 0.73). However, no significant improvement was observed in fear of falling (FES-I), despite a small-to-moderate effect size. Conclusions: A supervised VR program significantly enhanced postural control, mobility, and task-specific balance confidence in frail older adults. These findings support the feasibility and efficacy of VR-based training as a scalable strategy for mitigating frailty-related mobility impairments. Full article

The growing concern over environmental sustainability has intensified the focus on consumers’ perceptions of eco-friendly food packaging, especially among younger generations. This study aims to investigate the attitudes, preferences, and barriers faced by Greek university students regarding sustainable food packaging, a demographic considered pivotal for driving future consumption trends. An online questionnaire assessing perceptions, preferences, and behaviours related to sustainable packaging was administered to students, with responses measured on a five-point Likert scale. Three hundred and sixty-four students took part in this survey, with the majority (60%) of them being female. Principal component analysis was employed to identify underlying factors influencing perceptions, and k-means cluster analysis revealed two consumer segments: “Innovatives”, including one hundred and ninety-eight participants (54%), who demonstrate strong environmental awareness and willingness to adopt sustainable behaviours, and “Sceptics”, including one hundred sixty-six participants (46%), who show moderate engagement and remain cautious in their choices. Convenience, affordability, and clear product communication emerged as significant factors shaping student preferences. The findings suggest that targeted educational campaigns and transparent information are essential to converting positive attitudes into consistent purchasing behaviours. This research provides valuable insights for policymakers and marketers looking to design effective sustainability strategies tailored to the student population. Full article

Biofilms are structured communities of microorganisms encased in a self-produced extracellular matrix, and they represent one of the most widespread forms of microbial life on Earth. Their presence poses serious challenges in both environmental and clinical settings. In natural and industrial systems, biofilms contribute to water contamination, pipeline corrosion, and biofouling. Clinically, biofilm-associated infections are responsible for approximately 80% of all microbial infections, including endocarditis, osteomyelitis, cystic fibrosis, and chronic sinusitis. A particularly critical concern is their colonization of medical devices, where biofilms can lead to chronic infections, implant failure, and increased mortality. Implantable devices, such as orthopedic implants, cardiac pacemakers, cochlear implants, urinary catheters, and hernia meshes, are highly susceptible to microbial attachment and biofilm development. These infections are often recalcitrant to conventional antibiotics and frequently necessitate surgical revision. In the United States, over 500,000 biofilm-related implant infections occur annually, with prosthetic joint infections alone projected to incur revision surgery costs exceeding USD 500 million per year—a figure expected to rise to USD 1.62 billion by 2030. To address these challenges, surface modification of medical devices has emerged as a promising strategy to prevent bacterial adhesion and biofilm formation. This review focuses on recent advances in chemical surface functionalization using non-antibiotic agents, such as enzymes, chelating agents, quorum sensing quenching factors, biosurfactants, oxidizing compounds and nanoparticles, designed to enhance antifouling and mature biofilm eradication properties. These approaches aim not only to prevent device-associated infections but also to reduce dependence on antibiotics and mitigate the development of antimicrobial resistance. Full article

Background/Objectives: For kidney transplantation, it is very important to provide effective post-transplantation interventions to help patients achieve continuous and efficient self-management. Therefore, we review the self-management interventions applied to kidney transplant recipients and suggest the optimal approach to increase the effectiveness of future self-management interventions. Design: Systematic review. Methods: Search terms and strategies included kidney transplantation; self-management; intervention; systematic review. We searched MEDLINE via PubMed, Excerpta Media dataBASE, Cochrane Register Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, and one domestic Korean database to identify studies of self-management interventions for kidney transplant recipients aged ≥ 18 years published in English or Korean until 14 May 2025. Two reviewers independently selected related studies and extracted relevant data. Identified studies were assessed for quality and bias. Results: Of 1340 studies identified, 27 with 1912 participants met the inclusion criteria. Educational interventions were the most common self-management interventions and were provided 3 months to 1 year after kidney transplantation; most interventions were administered by nurses. Outcome variables were divided into cognitive, behavioral, affective, and health outcomes. Educational interventions were effective in improving cognitive, behavioral, and affective aspects. Some differences were observed, depending on the study. Conclusions: We recommend that nurse-involved educational interventions be included when developing self-management interventions and guidelines for kidney transplant recipients in clinical and community nursing settings. Full article

Teacher education faces persistent challenges, including limited access to authentic field experiences and a disconnect between theoretical instruction and classroom practice. While virtual reality (VR) simulations offer an alternative, most are constrained by inflexible design and lack scalability, failing to mirror the complexity of real teaching environments. This study introduces TeacherGen@i, a generative AI (GenAI)-enhanced VR simulation designed to provide pre-service teachers with immersive, adaptive teaching practice through realistic GenAI agents. Using an explanatory case study with a mixed-methods approach, the study examines the simulation’s usability, design challenges, and instructional utility within a university-based teacher preparation course. Data sources included usability surveys and reflective journals, analyzed through thematic coding and computational linguistic analysis using LIWC. Findings suggest that TeacherGen@i facilitates meaningful development of teaching competencies such as instructional decision-making, classroom communication, and student engagement, while also identifying notable design limitations related to cognitive load, user interface design, and instructional scaffolding. This exploratory research offers preliminary insights into the integration of generative AI in teacher simulations and its potential to support responsive and scalable simulation-based learning environments. Full article

The ecological rice–eel co-culture system is not only beneficial for enhancing productivity and sustainability in agriculture but also plays a crucial role in promoting environmental health. In the present study, based on the long-term positioning trial of the rice–eel co-culture system that began in 2016 and was sampled in 2023, the effects of reduced nitrogen fertilizer application on soil physico-chemical properties and the bacterial community were investigated. Treatments included a conventional regular fertilization treatment (RT), rice–eel co-culture system regular fertilization (IT), and nitrogen-reduction 10%, 30%, and 50% fertilization treatments (IT90, IT70, and IT50). Our research demonstrated the following: (1) Compared to RT, IT significantly increased soil water-stable macroaggregates (R0.25), mean weight diameter (MWD), geometric mean diameter (GMD), and available phosphorus content, with the increases of 15.66%, 25.49%, 36.00%, and 18.42%, respectively. Among the nitrogen-reduction fertilization treatments, IT90 showed the most significant effect. Compared to IT, IT90 significantly increased R0.25, MWD, GMD, and available nitrogen content, with increases of 4.4%, 7.81%, 8.82%, and 28.89%, respectively. (2) Compared to RT, at the phylum level, the diversity of Chloroflexi was significantly increased under IT and IT50, and the diversity of Gemmatimonadota was significantly increased under IT90, IT70, and IT50. The diversity of Acidobacteriota was significantly higher in IT90 and IT70 compared to IT. It was shown that the rice–eel co-culture system and nitrogen fertilizer reduction could effectively improve the degradation capacity of organic matter and promote soil nitrogen cycling. In addition, redundancy analysis (RDA) identified total phosphorus, total nitrogen, and available nitrogen (p = 0.007) as the three most important environmental factors driving changes in the bacterial community. (3) The functional prediction analysis of soil microbiota showed that, compared to RT, the diversity of pathways related to biosynthesis (carbohydrate biosynthesis and cell structure biosynthesis) and metabolism (L-glutamate and L-glutamine biosynthesis) was significantly higher under IT70, IT90, IT, and IT50 (in descending order). However, the diversity of pathways associated with degradation/utilization/assimilation (secondary metabolite degradation and amine and polyamine degradation) was significantly lower under all the rice–eel co-culture treatments. In conclusion, the rice–eel co-culture system improved soil physicochemical properties and the soil microbial environment compared with conventional planting, and the best soil improvement was achieved with 10% less N fertilizer application. Full article

Background: School-based tobacco control policies are critical for preventing youth tobacco use. While many districts adopt formal policies to create smoke- and vape-free environments, the degree to which these policies are enforced at the school level may vary, influencing their effectiveness. Little is known about how consistently such policies are implemented across schools within urban school districts. Objectives: This study aimed to examine the existence and enforcement of school-level tobacco control policies in an urban public school system, using Baltimore City schools as a case example. Methods: We conducted a survey of school personnel from 20 high schools in Baltimore City in 2024. The survey instrument assessed the presence and enforcement of policies related to tobacco use prevention, communication, signage, disciplinary actions, and institutional support. Descriptive statistics (frequencies and percentages) were used to summarize responses. Spearman correlations were also used for bivariate correlations. Additional school-level and neighborhood-level contextual data were collected from the internet (neighborhood socioeconomic status and school performance). Results: While many policies existed across the 20 participating schools, their enforcement was widely inconsistent. Most schools reported the existence of policies prohibiting tobacco use in school buildings (60%) and vehicles (55%). However, few schools had visible tobacco-free signage (35%) or offered cessation programs (15%). Communication of policies to students (70%) and staff (65%) was the most commonly enforced aspect of tobacco control policies. Conclusions: Findings suggest that while tobacco control policies may be adopted across urban school systems, their enforcement at the school level remains uneven. Greater attention may be needed to support policy implementation and to reduce variability in school-level practices. Baltimore City serves as a useful case study to understand these challenges and identify opportunities for strengthening school-based tobacco prevention efforts. Full article

X-ray and EUV solar flare emission cause increases in the Earth’s dayside ionospheric electron density. While the response of the lower ionosphere to X-rays is well studied, the delay between EUV flare emission and the response of the ionospheric F-region has not been investigated. Here, we calculate the delays between incident He II 304 Å emission, and the TEC response for 10 powerful solar flares, all of which exhibit delays under 1 min. We assess these delays in relation to multiple solar and geophysical factors, and find a strong negative correlation (∼−0.85) between delay and He II flux change and a moderate negative correlation (∼−0.55) with rate of increase in He II flux. Additionally, flare magnitude and the X-ray-to-He II flux ratio at peak He II emission show strong negative correlations with delay (∼−0.80 and ∼−0.75, respectively). We also identify longer delays for flares occurring closer to the summer solstice. These results may have applications in upper-ionospheric recombination rate calculations, atmospheric modelling, and other solar–terrestrial studies. We highlight the importance of incident EUV and X-ray flux parameters on the response time of the ionospheric electron content, and these findings may also have implications for mitigating disruptions in communication and navigation systems. Full article

Implementing nature-based solutions (NbSs) for wildfire risk management and other hazards has been challenging in emerging economies due to the high costs, the lack of immediate returns on investment, and stringent inclusion criteria set by organizations like the IUCN and domain experts. To address these challenges, this exploratory study proposes a new concept: green/blue initiatives. These initiatives represent intermediate steps, encompassing small-scale, community-driven activities that can evolve into recognized NbSs over time. To explore this concept, experiences related to wildfire prevention in the Biobío region of Chile were analyzed through primary and secondary source reviews. The analysis identified three initiatives qualifying as green/blue initiatives: (1) goat grazing in Santa Juana to reduce fuel loads, (2) a restoration prevention farm model in Florida called Faro de Restauración Mahuidanche and (3) the Conservation Landscape Strategy in Nonguén. They were examined in detail using data collected from site visits and interviews. In contrast to Chile’s prevailing wildfire policies, which focus on costly, large-scale fire suppression efforts, these initiatives emphasize the importance of reframing wildfire as a manageable ecological process. Lastly, the challenges and enabling factors for adopting green/blue initiatives are discussed, highlighting their potential to pave the way for future NbS implementation in central Chile. Full article

Fertilization is a critical measure for vegetation restoration and ecological reconstruction in degraded grasslands. However, little is known about the long-term effects of different combinations of nitrogen (N), phosphorus (P), potassium (K) on plant and microbial communities in degraded grasslands. This study conducted a four-year (2017–2020) N, P, K addition experiment in the Khorchin Grassland, a degraded typical grassland located in Zhalute Banner, Tongliao City, Inner Mongolia, to investigate the effects of fertilization treatment on plant functional groups and microbial communities after grazing exclusion. Our results showed that the addition of P, NP, and NPK compound fertilizers significantly increased aboveground biomass of the plant community, which is mainly related to the improvement of nutrient availability to promote the growth of specific plant functional groups, especially annual and biennial plants and perennial bunchgrasses. However, the addition of N, P, and NP fertilizers significantly reduced the species diversity of the plant community. At the same time, the addition of N, P, and NP fertilizers and the application of N and NP significantly reduced fungal species diversity but had no significant effect on soil bacteria. Our study provides new insights into the relationships between different types of fertilization and plant community productivity and biodiversity in degraded grasslands over four years of fertilization, which is critical for evaluating the effect of fertilization on the restoration of degraded grassland. Full article

Objective: This study aimed to improve the understanding of the lives of patients with chronic neuropathic pain planned for invasive motor cortex stimulation (iMCS) and assess their expectations towards this intervention and its impact. Methods: Semi-structured face-to-face interviews were conducted until saturation of data was reached. Patients were recruited from one university medical center in the Netherlands. All interviews were audio-recorded, transcribed verbatim, and subjected to thematic analysis using iterative and inductive coding by two researchers independently. Results: Fifteen patients were included (11 females; mean age 63 ± 9.4 yrs). Analysis of the coded interviews revealed seven themes: (1) the consequences of living with chronic neuropathic pain; (2) loss of autonomy and performing usual activities; (3) balancing energy and mood; (4) intimacy; (5) feeling understood and accepted; (6) meaning of life; and (7) the expectations of iMCS treatment. Conclusions: This is the first qualitative study that describes the suffering of patients with chronic neuropathic pain, and their expectations prior to invasive brain stimulation. Significant themes in the lives of patients with chronic pain have been brought to light. The findings strengthen communication between physicians, caregivers, and patients. Practice Implications: The insights gathered from the interviews create a structured framework for comprehending the values and expectations of patients living with central pain and reveal the impact of symptoms due to the central pain. This knowledge improves the communication between physicians and caregivers on one side and the patient on the other side. Furthermore, the framework enhances the capacity for shared decision-making, particularly in managing expectations related to iMCS. Full article

This research addresses urban inequality by focusing on the rehabilitation of communal rooftops in Ciutat Vella, Barcelona, the city’s historic district, where residential vulnerability is concentrated in a particularly dense heritage urban environment with a shortage of outdoor spaces. Using participatory methodologies, this research develops low-cost, removable, and recyclable prototypes aimed at improving social interaction, technical performance, and environmental conditions. The focus is on vulnerable populations, particularly the elderly. The approach integrates a bottom–up process and scalable solutions presented as a Toolkit of micro-projects. These micro-projects are designed to improve issues related to health, safety, durability, accessibility, energy savings, and acoustics. In addition, several possible material solutions for micro-projects are examined in terms of sustainability and cost. These plug-in interventions are designed for adaptability and replication throughout similar urban contexts and can significantly improve the quality of life for people, especially the elderly, in dense historic environments. Full article