Search Results (3,903)

Background/Objectives: Magnetic resonance imaging (MRI) is often supported by structured safety screening and preparation, yet first-time patients may still experience anxiety, claustrophobic distress, loss of control and non-completion. This study aimed to describe the experiences of adults undergoing MRI for the first time and to identify implications for nursing preparation, communication and diagnostic imaging service design. Methods: A descriptive phenomenological study informed by Husserlian philosophy was conducted in the radiology department of a university hospital in Thailand. Eleven adults who underwent first-time MRI were purposively recruited, including eight who completed and three who did not complete the examination; five participants were hospital personnel. Data were generated through in-depth semi-structured interviews, non-participant observation, audio recording and field notes, and were analysed using Colaizzi’s method. Results: Across the four themes, negotiation of control was identified as a descriptive cross-theme pattern grounded in participants’ accounts rather than as a separate interpretive construct. Participants entered MRI seeking diagnostic clarity, encountered a sensory and spatial environment that weakened control, attempted to regain control through coping and communication, and reflected on the support they would need for any future examination. Four interrelated themes were generated: becoming aware of bodily abnormality and accepting MRI; encountering the MRI environment; managing oneself inside the scanner; and reflecting after passing through the experience. Conclusions: The findings suggest that first-time MRI can be experienced as a nursing-relevant care encounter rather than a neutral technical event. Nursing preparation may need to move beyond routine instructions by addressing sensory realities, anxiety and claustrophobia, coping rehearsal, communication options and post-examination reflection. The effects of these strategies on completion and service outcomes require prospective evaluation. Full article

Background/Objectives: Digital transformation is a strategic priority for healthcare systems, requiring nurses to develop competencies that enable the safe, effective, and critical use of digital technologies in clinical practice. Understanding nurses’ digital competence profile is essential to inform leadership, education, and workforce development strategies. This study aimed to assess digital competence among Portuguese nurses, examine its relationship with soft skills, and identify priority areas for professional development. Methods: A quantitative, descriptive-correlational, cross-sectional study was conducted with a nationally recruited convenience sample of Portuguese nurses. Data were collected using a Digital Competence Assessment Questionnaire based on the European Digital Competence Framework for Citizens (DigComp) and Soft Skills Inventory. Associations between digital competence and soft skills were analysed using descriptive, inferential, and multivariable statistical methods with IBM SPSS Statistics version 30.0. Results: Based on the exploratory classification of the knowledge/performance score, 52.0% of participants fell within the Intermediate and 27.2% within the Advanced proficiency intervals. Adapting and Coping, Analyzing and Interpreting, and Interacting and Presenting were positively associated with self-reflected digital competence. Multivariable analysis showed that soft skills accounted for a larger proportion of variance in self-reflected digital competence than in the knowledge/performance test score; however, the explanatory value of the latter model was limited. Conclusions: Participants were predominantly classified within the Intermediate and Advanced proficiency intervals, although comparatively lower descriptive performance was observed in Safety. The findings highlight the potential complementary role of technical competencies and soft skills in digital capability and suggest the value of further investigating targeted educational approaches. These findings may inform nursing leadership, education, and workforce-development strategies aimed at supporting digital competence and sustainable digital transformation. Full article

Cliff habitats are characterized by limited and heterogeneous water availability, requiring plants to develop adaptive strategies to cope with drought stress. Opisthopappus longilobus, a cliff-endemic Asteraceae species restricted to the Taihang Mountains of northern China, has evolved under persistent water-limited conditions and represents a valuable model for investigating the molecular mechanisms underlying drought adaptation. However, the transcriptional regulatory networks involved in its drought response remain largely unexplored. In this study, we performed RNA sequencing of O. longilobus leaves under control and drought conditions to investigate drought-responsive regulatory networks. Six RNA-seq libraries were generated, and a total of 5260 differentially expressed genes (DEGs) were identified in response to drought stress. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses revealed that these DEGs were mainly associated with phytohormone signal transduction, stress-responsive regulation, defense responses, metabolic reprogramming, and transcriptional regulation. Notably, multiple transcription factor families, including MYB, ERF, and ABF, were enriched among drought-responsive genes, suggesting their involvement in drought adaptation. Furthermore, quantitative RT-PCR was used to validate the RNA-seq results. Among the drought-responsive transcription factors, an R2R3-MYB transcription factor, OlMYB35, was identified as a candidate regulator and was further demonstrated to play a positive role in drought response through transient transformation assays. Taken together, this study provides new insights into drought-responsive regulatory mechanisms in O. longilobus and identifies OlMYB35 as a promising candidate gene for further functional validation and potential application in stress-resilient chrysanthemum breeding. Full article

The search for antioxidant compounds from aquatic or marine environments to cope with the harmful effects of reactive oxygen species (ROS) is one of the major challenges in contemporary blue biotechnology. Among marine microorganisms, microalgae have emerged as promising candidates for the discovery and production of natural bioactive molecules with antioxidant properties. This review highlights the potential of microalgae and cyanobacteria as a sustainable source of antioxidant compounds and examines their growing relevance in biotechnology and pharmaceutical applications. A broad range of antioxidant metabolites produced by microalgae, including carotenoids, fatty acids, vitamins, polyphenols, and flavonoids, has also been discussed, with particular emphasis on their antioxidant mechanisms and bioactive properties. This review also integrates antioxidant mechanisms with the physiological and metabolic responses, underlying antioxidant production and sustainable strategies used to enhance their accumulation. Furthermore, microalgae offer the advantage of sustainable production systems, with the potential to enhance the biosynthesis and accumulation of valuable compounds through optimized cultivation strategies. Thus, different sustainable approaches aimed at increasing antioxidant compound production or reducing operational costs in microalgae cultivation are discussed to identify efficient and economically viable processes that maximize the biotechnological potential of these microorganisms for future industrial applications. Full article

Background: Worldwide, around 400,000 children are diagnosed with cancer every year. Understanding survivors’ social and stigma-related experiences may help address their needs and improve their outcomes. Objectives: To explore the social and stigma-related experiences, coping strategies, and support needs of pediatric cancer survivors in Newfoundland and Labrador, a province of Canada. Methods: This is a qualitative, cross-sectional study focusing on retrospective participant experiences. Eligibility criteria included being diagnosed with cancer before the age of 18 and being diagnosed or treated in the province. Extensive recruitment activities were employed. Data collection occurred through semi-structured virtual interviews and completion of a sociodemographic survey. Participant interviews were transcribed verbatim, and themes were identified iteratively through inductive thematic analysis. Descriptive statistics were used to define the participants’ sociodemographic characteristics. Results: Seven participants were recruited. Thematic analysis identified five major themes: (i) isolation and being treated differently; (ii) support received, coping mechanisms, and support needs; (iii) resilience and interest to give back; (iv) workplace and disability related experiences; and (v) additional impacts of cancer. Our results showed that participants received substantial social support in various ways but inadequate professional mental health support. School was a significant setting for cancer-related stigmatization. Discrimination in the workplace was rare and was disability-related rather than cancer-related. Conclusions: Our results show that there are significant issues to address, such as stigma and isolation experienced by pediatric cancer survivors as well as the need to improve the psychosocial support programs offered to them. Our results also show that the participants had distinct lived experiences compared to adult-onset cancer populations. Overall, the findings presented are expected to inform further studies and healthcare-education policies to help address these issues and improve the experiences of pediatric cancer survivors. Full article

Background/Objectives: Dietary supplements (DSs) and over-the-counter (OTC) medications for mood improvement and stress relief are widely used, but little is known about how their use relates to coping preferences, trust in physicians, and communication with doctors. This exploratory cross-sectional study compared users and non-users of such products in Poland. Methods: Data were collected between October 2024 and May 2025 and included 798 adults recruited through a mixed-mode convenience sampling strategy (636 online and 162 in person). Participants were classified as current users (CUs; n = 184), past users (PUs; n = 297), or never-users (NUs; n = 317). The outcomes included hypothetical future coping strategies (under an assumption of unlimited resources), trust in physicians using an author-translated adaptation of the Trust in Doctors in General (T-DiG) scale and three-category communication-related attitudes. Multivariable models were adjusted for age, gender, education, medical or health science background, and recruitment mode. Results: Overall, 60.3% of respondents reported current or past use. Compared with NUs, both CUs and PUs had higher adjusted odds of selecting future DS/OTC use (CUs: aOR = 5.60, 95% CI 3.44–9.14, p < 0.001; PUs: aOR = 2.44, 95% CI 1.52–3.93, p < 0.001). PUs also had higher adjusted odds of selecting psychotherapy (aOR = 1.50, 95% CI 1.04–2.17, p = 0.031; overall p = 0.018). Product-use status was associated with selected items of T-DiG: communication competency (overall p = 0.031) and global trust (overall p < 0.001). Compared with NUs, CUs had lower adjusted scores on both subscales (aMD = −0.19, 95% CI −0.33 to −0.04, p = 0.010 and aMD = −0.40, 95% CI −0.59 to −0.21, p < 0.001, respectively). Overall product-group effects were also observed for the first two communication items: CUs had lower relative risk ratios than NUs for discussing product-related doubts first with their physician (RRR = 0.52, 95% CI 0.35–0.78, p = 0.001) and for feeling free to raise such doubts (RRR = 0.57, 95% CI 0.36–0.92, p = 0.022). Conclusions: Product-use status showed selective associations with hypothetical coping preferences, physician trust, and communication-related attitudes rather than a uniform pattern of reluctance to seek professional support. Current use was most strongly associated with lower trust and less favorable product-related communication attitudes. Given the cross-sectional design and hypothetical nature of the coping outcomes, these findings do not establish causality, temporal ordering, or actual healthcare-seeking behavior. Full article

Background: Food insecurity continues to pose a significant public health challenge in urban low-income communities, where limited resources and unstable food systems may negatively relate to children’s nutrition. Although prior studies have linked food insecurity with inadequate dietary intake, the role of coping strategies in this relationship remains insufficiently understood. This study investigated the associations between household food insecurity, coping strategies, and children’s dietary intake in densely populated urban areas of Surabaya, Indonesia. Methods: A cross-sectional study was conducted among 55 mother–child pairs in Simolawang and Bulak Banteng from September 2025 to February 2026. We used the Household Food Insecurity Access Scale (HFIAS) and the Short Food Literacy Questionnaire (SFLQ), and coping behaviors were assessed using the Reduced Coping Strategy Index (r-CSI). Children’s dietary intake was obtained through a Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ). Pearson correlation and multivariate regression analyses were applied to examine relationships among variables. Results: Most households were classified as food secure (61.82%), although varying degrees of food insecurity were observed. Household food insecurity was not significantly associated with children’s energy or macronutrient intake. In contrast, coping strategy scores were positively associated with household food insecurity (β = 0.26–0.27), indicating greater use of coping strategies among households experiencing greater food insecurity. Conclusions: Food insecurity was linked to increased coping behaviors but not directly to children’s macronutrient intake. Coping mechanisms may help sustain short-term intake but do not guarantee adequate nutrition. Interventions should address both food access and dietary quality in urban poor settings. Full article

The study of loneliness and academic stress is a priority area in university research, given their impact on student well-being, retention in higher education, and academic performance. In Chile, with respect to Social Work education, these phenomena acquire relevance, given that students simultaneously face high curricular demands and professional training practices in contexts of social vulnerability. In this context, a lack of academic organization may contribute to the perception of overload and limit students’ academic coping strategies. The objective of this study was to examine the relationships between loneliness, lack of academic organization, and academic stress among Social Work students in Chile. A total of 298 students from nine public and private universities participated, with an average age of 21.74 years (SD = 3.47). The results, obtained through a structural equation model, confirmed that the relationship between loneliness and academic stress was partially mediated by a lack of academic organization; however, the direct association between loneliness and academic stress represented the strongest effect within the model. Likewise, positive direct effects were observed among the three variables. Taken together, these findings reinforce the need to design educational and institutional strategies oriented at promoting student well-being, thereby strengthening the perception of professional preparedness among future social workers. Full article

Excessive short-video consumption is a global concern, yet its association with mental health among vocational high school students in China remains under-researched. Among many candidate individual, psychological, and behavioral factors, it remains unclear which are the most robust predictors of mental health. This study develops a comprehensive framework to identify core predictors and examine potential pathways linking short-video use to mental health. A survey was administered to 8346 vocational high school students recruited from vocational high schools in Tianjin, China, yielding 6096 valid responses for multi-stage analysis. First, Random Forest (RF) and linear Support Vector Regression (SVR) screened 13 individual, psychological, and behavioral features to identify core predictors. Subsequently, a Path Analysis (PA) with the Bootstrap method was used to examine statistical mediating pathways involving these core features. Across RF and SVR, social support, excessive short-video use, positive coping, and negative coping emerged as the four most important predictors of mental health. PA showed generally good fit (χ²/df = 5.86, CFI = 0.998, TLI = 0.99, RMSEA = 0.03, SRMR = 0.01). Excessive short-video use was significantly and directly associated with mental health problems (effect = 0.221, 95% CI = [0.189, 0.253], 76.7% of the total association) and showed small indirect associations through three statistical pathways: (1) lower social support (effect = 0.023, 8.1%); (2) higher negative coping (effect = 0.035, 12.0%); and (3) a small serial indirect association from reduced social support to decreased positive coping (effect = 0.007, 2.6%). Findings suggest that potential intervention efforts may consider regulating short-video use while simultaneously enhancing social support and adaptive coping mechanisms as part of strategies to reduce psychological risks. Full article

Background: Family caregivers play a central role in supporting people with colorectal cancer (CRC) and often manage complex physical, emotional, and practical demands. However, evidence regarding their experiences and supportive care needs in Kazakhstan remains limited. This qualitative study explored caregiving experiences, caregiving burden, caregivers’ needs, and coping strategies. Methods: A qualitative descriptive design was used, involving semi-structured interviews with 21 family caregivers caring for patients with CRC. Participants were recruited purposively from the Medical Center of West Kazakhstan Marat Ospanov Medical University and outpatient clinics in Aktobe between December 2025 and March 2026. Interviews were audio-recorded, transcribed verbatim, and analyzed using inductive reflexive thematic analysis. Results: Most family caregivers of patients with colorectal cancer were women (95.2%). Five main themes developed: emotional challenges, transformation of daily life, caregiving tasks, caregivers’ needs and support gaps, and coping strategies and resilience. Diagnosis was described as a distressing experience characterized by shock, fear, and uncertainty. Caregiving substantially disrupted employment, financial stability, and family roles, often requiring work adjustment or leaving the workforce. Caregivers reported insufficient preparation for stoma care and expressed a strong need for structured training. Social isolation was common, as both caregivers and patients experienced a shrinking of their social support networks. Despite substantial burden, caregivers described adaptive responses to ongoing emotional and practical demands, and resilience was a prominent theme. Conclusions: Family caregivers of patients with colorectal cancer in Kazakhstan face interconnected emotional, informational, physical, and system-level challenges, while also drawing on resilience. The findings highlight priorities for support, including structured stoma care education, psychological services, recognition of caregivers’ roles, and improved discharge and transitional care. Full article

Background: Small-scale illegal gold mining, or “Galamsey”, is an important livelihood in Ghana but exposes workers to serious occupational health risks. This study aimed to explore the lived experiences, perceptions of health hazards, and coping strategies of workers from illegal small-scale gold mines in the Atwima Mponua District to inform context-specific interventions and policies. Methods: This qualitative study employed a phenomenological design to explore the occupational health experiences of workers from illegal small-scale gold mines in the Atwima Mponua District. A total of 16 purposively selected workers, ten men and six women, aged 27 to 44 years, with mining experience ranging from 3 to 12 years, working across roles including excavators, washers/panners, chemical processors, ore grinders, and support workers, were interviewed in depth, using a semi-structured interview guide. Thematic analysis was used to analyse the data according to Braun and Clarke’s model. Findings: There were four dominant themes: (1) normalization of risk and fatalistic attitudes about mining risks; (2) Respiratory Manifestations and Dust-Related Ailments; (3) chemical exposures and dermatological conditions; and (4) traumatic injuries from pit collapses, mining equipment accidents, and heavy physical labour. Participants demonstrated low levels of knowledge about long-term health outcomes and reported substantial obstacles to accessing healthcare, including fear of legal action, financial constraints, and geographic isolation. Conclusions: Workers from illegal small-scale gold mines in the Atwima Mponua District bear a serious, hidden occupational health burden normalized by poverty and criminalization. Urgent, comprehensive interventions are needed that address legal protection, economic alternatives, accessible healthcare, and harm reduction. Full article

Background/Objectives: Our aim was to evaluate sleep quality and excessive daytime sleepiness in complex regional pain syndrome (CRPS) and explore their associations with pain characteristics, functional impairment, depressive symptoms, and pain coping strategies. Methods: This pilot exploratory, cross-sectional observational study was conducted at a single tertiary rehabilitation center using a convenience sample of 21 adults with CRPS Type I (n = 17) or Type II (n = 4). Sleep quality and daytime sleepiness were evaluated using the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Pain was assessed with the Numeric Rating Scale (NRS), Short-Form McGill Pain Questionnaire (SF-MPQ), and PainDETECT Questionnaire (PDQ). Limb-specific disability was measured using the Disability of the Arm, Shoulder and Hand (DASH) questionnaire for upper-extremity CRPS (n = 10) and the Lower Extremity Functional Scale (LEFS) for lower-extremity CRPS (n = 11). Psychological factors and central sensitization were assessed via BDI-II, CSQ, and CSI. Results: Poor sleep quality (PSQI > 5) occurred in 81.0% (17/21) of participants (mean PSQI: 10.1 ± 4.1). ESS-defined excessive daytime sleepiness was identified in 47.6% (10/21) of patients (mean ESS: 9.6 ± 5.8). In unadjusted bivariate correlation analyses of the full cohort (n = 21), global PSQI score significantly correlated with NRS pain intensity (ρ = 0.445, p = 0.0431), SF-MPQ sensory pain (ρ = 0.468, p = 0.0325), SF-MPQ affective pain (ρ = 0.461, p = 0.0354), and SF-MPQ total score (ρ = 0.504, p = 0.0199. Conclusions: Sleep disturbances and excessive daytime sleepiness are highly prevalent in CRPS patients in tertiary care. Exploratory unadjusted analyses link sleep quality with pain severity, particularly sensory and affective dimensions. Given the exploratory design and small subgroup sample sizes, larger prospective studies are needed to confirm these findings. Full article

Acne vulgaris is a chronic inflammatory skin disease associated with a substantial psychological burden that may extend beyond visible lesions and objective disease severity. Psychological factors such as stress, coping strategies, quality-of-life impairment, self-esteem, psychiatric symptoms, and treatment adherence are associated with disease perception, self-reported exacerbation, and treatment-related outcomes. This narrative review examines psychological stress and proposed biological mechanisms, coping strategies, treatment adherence, quality of life, self-esteem, sleep disturbance, and psychiatric comorbidity in people with acne. Relevant literature was identified through MEDLINE/PubMed, Scopus, Web of Science, and PsycINFO; the final literature search was conducted on 29 May 2026. Acne-specific studies were prioritized, with broader psychodermatology evidence used where acne-specific data were limited. The psychosocial burden of acne is individualized and only partly aligned with clinician-rated severity, supporting person-centered assessment. For each domain, the review outlines brief, commonly used screening instruments that may be feasible in routine dermatology. Incorporating psychological assessment and targeted supportive strategies into acne care may contribute to quality of life, adherence to therapy, and patient-centered care. The evidence is predominantly cross-sectional and derives from heterogeneous populations, instruments, and study designs, limiting causal inference. Full article

This study investigates how the integration of artificial intelligence reshapes the professional identity of university English teachers within higher education. Against the backdrop of global digital transformation, AI presents both disruptive potential and a significant ‘adaptation crises’ for educators. Using Bronfenbrenner’s Ecological Systems Theory as an analytical framework, this research systematically reviews the existing literature to address three objectives: (1) identify directions and typologies of teacher identity transformation; (2) analyse multilayered ecological influential factors; and (3) examine core challenges teachers face and their corresponding coping strategies. The findings indicate that professional identity is dynamically reconstructed across nested ecosystems, from micro-level classroom interactions to chronological level sociocultural contexts. This study advances an integrative perspective on the complex technology–teacher relationship, highlighting that successful identity transformation requires coordinated support across all ecological levels. Theoretical and practical implications are discussed to facilitate sustainable teacher development in the face of AI. Full article

Wildfires are increasingly recognized as environmental disturbances associated with socio-economic transformations in agrarian systems. This study examines the associations between reported wildfire exposure, land-market outcomes, and agrarian inequality in the Malakand Division of northern Pakistan, a region characterized by forest–agriculture interfaces and livelihood dependence on land. The study aims to analyze how different levels of wildfire exposure are associated with land values, ownership patterns, market transactions, inequality, and coping strategies among farming households. A quantitative cross-sectional design was employed using a sample of 400 households selected through multistage sampling. Data were collected through structured questionnaires and analyzed using ANOVA, chi-square tests, multiple and logistic regression, hierarchical regression, and principal component analysis. Results show that reported land values differed significantly across wildfire-exposure categories (F = 48.72, p < 0.001), with directly exposed households reporting the lowest values. Regression analysis identified direct wildfire exposure as the strongest negative statistical predictor of reported land value (β = −0.468, p < 0.001), while directly exposed households had substantially higher odds of reporting land sales (Exp(B) = 6.35). Chi-square results indicate a significant association between wildfire exposure and land transactions (χ² = 64.82, p < 0.001). Retrospectively reported landholding data show an increase in the Gini coefficient from 0.41 before the reported fire period to 0.53 afterward. The addition of land-transaction variables increased the explained variance in agrarian inequality to 72%, which is consistent with a potential land-market pathway but does not constitute evidence of causal mediation. Coping strategies such as land sale, migration, and borrowing emerged as dominant reported responses among affected households. The study concludes that wildfire exposure is strongly associated with land devaluation, land sales, and greater agrarian inequality. Because the study is cross-sectional and lacks an independently observed pre-fire baseline or causal identification strategy, these findings should not be interpreted as definitive causal effects. Full article