Search Results (109)

Background/Objectives: Taste dysfunction is a highly prevalent yet underrecognized complication among patients with head and neck cancer (HNC), significantly impairing nutritional intake, treatment adherence, and quality of life (QoL). This comprehensive review synthesizes current knowledge on the pathophysiological mechanisms and clinical management of taste dysfunction associated with HNC and its treatments, particularly chemotherapy and radiotherapy. Methods: A structured literature search was performed across PubMed, Scopus, and Cochrane Library for articles published between January 2015 and February 2025. Studies were included if they investigated taste dysfunction related to HNC, focusing on pathophysiological mechanisms and therapeutic interventions. A total of 47 original studies were analyzed through a narrative synthesis due to heterogeneity in study designs and outcomes. Results: Taste dysfunction in HNC patients arises from tumor-related inflammation, cytotoxic injury from chemotherapy, and radiation-induced epithelial and neural damage. Chemotherapy and radiotherapy often exert synergistic negative effects on gustatory function. Management strategies identified include dietary counselling, nutritional supplementation (zinc, lactoferrin, monosodium glutamate, miraculin), pharmacological agents targeting salivary function, and non-pharmacological interventions such as acupuncture, photobiomodulation, and reconstructive surgery. However, the evidence is limited by small sample sizes, methodological variability, and the frequent exclusion of HNC patients from broader dysgeusia trials. Reported prevalence of taste dysfunction ranged from 39% to 97.4%, with higher rates observed among patients treated with radiotherapy and chemoradiotherapy. Conclusions: Taste dysfunction remains a critical yet unmet clinical challenge in HNC patients. High-quality, targeted research is urgently needed to develop standardized assessments and evidence-based management strategies to improve patient outcomes. Full article

There has been a growing trend of young people coming out as Lesbian, Gay, Bisexual, Transgender, Queer (LGBTQ) in recent years. Research on the relationship between LGBTQ grandchildren and their grandparents is limited and primarily focuses on the grandchildren’s perspective. This pilot study seeks to understand the relationship between grandparents and their LGBT grandchildren, from the grandparents’ perspective. Six Israeli grandparents were interviewed using a qualitative methodology, guided by a semi-structured interview protocol. Analysis of the interviews revealed three main themes: grandparents’ exposure to the grandchildren’s sexual orientation and their gender identity; the shattering of the grandparents’ dream and concern for the grandchild; and the relations between the grandparents and their LGBT grandchildren. The research findings in this pilot study indicate that the relations remained close and did not change following disclosure of the sexual orientation. However, some grandparents needed time to resume their regular relationship. The insights learned from the research findings regarding the process undergone by the grandparents upon discovering their grandchildren’s sexual orientation can help professionals treat and counsel family members, when necessary, how to bridge the gaps, and rebuild the relations between the grandparent and the grandchild, as these relations are important for the well-being of both. Full article

In higher education, the employability and entrepreneurship services play an essential role in the labor market insertion of graduates. The management of public relations promotes institutional projection, the creation of networks with companies, and the dissemination of initiatives to strengthen professional skills. This research analyzes how the communication strategies of Andalusian public universities improve employability and encourage entrepreneurship. A methodological triangulation is used: literature review, analysis of social networks with Fanpage Karma, and study of corporate websites. The results show a focus on counseling, training, workshops, job fairs, and networking events, strengthening the brand of universities and their commitment to the professional development of students. Full article

Background/Objectives: The aging of workers with intellectual and developmental disabilities is an emerging reality attributed to the rise in life expectancy and improved labor market access. In this study, “workers” is used as an inclusive, neutral term covering all individuals engaged in paid labor—whether employees, self-employed, freelancers, or those performing manual or non-manual tasks. It encompasses every form of work. It is crucial to comprehend the reality of aging workers from the perspectives of the primary individuals involved: the workers, their families, and supporting professionals. Methods: A qualitative study was developed, involving 12 focus groups and 107 participants, using NVivo 12 Pro for analysis; we used a phenomenological methodology and grounded theory. Results: A set of concrete needs was highlighted: among them, 33 were related to declining work ability due to aging and disability (WADAD), and 30 to transition to retirement. These needs were grouped into categories: workplace accommodations, coordination and collaboration, personal and family support, counseling and training, and other types of needs. Conclusions: This study establishes an empirical basis tailored to the needs of this group, enabling the development of prevention and intervention protocols that address WADAD and the transition to retirement. Full article

Objective: Marital infidelity significantly impacts both the community and the institution of marriage. This study aims to develop a theoretical framework for analyzing marital infidelity through a game-theoretic lens. Methodology/Design/Approach: This research employs a game-theoretic model to predict the decision-making processes of unfaithful partners. Static game models are utilized to explore the interactions between spouses, focusing on identifying Nash equilibria that encapsulate the complexities and uncertainties inherent in infidelity-related decisions, whether through pure or mixed strategies. Results: The analysis reveals strategic dynamics in marital infidelity, where Nash equilibria indicate scenarios where one or both partners may engage in extramarital affairs. A Nash equilibrium is established when both partners perceive the benefits of infidelity as outweighing the costs, leading to diminished trust and communication. The Mixed-Strategy Nash Equilibrium (MSNE) hypothesis suggests that spouses may oscillate between fidelity and infidelity based on probabilistic strategies. Research Implications: This study provides a game-theoretic perspective on marital infidelity, whose findings may be used to inform legal frameworks and social policies addressing the consequences of infidelity, potentially impacting family counseling and legal services. Value/Originality: This research introduces a game-theoretic approach to understanding trust and transgression in marriages, identifying two primary categories of Nash equilibria. It fills a theoretical gap while providing practical insights into marital behavior. Full article

The efficacy of in vitro fertilization (IVF) is significantly hindered by early embryonic developmental failure and oocyte maturation arrest. Recent findings in reproductive genetics have identified several oocyte-specific genes—TUBB8, KIF11, and CKAP5—as essential regulators of meiotic spindle formation and cytoskeletal dynamics. Mutations in these genes can lead to significant meiotic defects, fertilization failure, and embryo arrest. The links between genotype and phenotype, along with the underlying biological mechanisms, remain inadequately characterized despite the increasing number of identified variations. This systematic review was conducted in accordance with PRISMA 2020 guidelines. Relevant papers were retrieved from the PubMed and Embase databases using combinations of the keywords “TUBB8,” “KIF11,” “CKAP5,” “oocyte maturation arrest,” “embryonic arrest,” and “IVF failure.” Studies were included if they contained clinical, genomic, and functional data on TUBB8, KIF11, or CKAP5 mutations in women undergoing IVF. Molecular data, including gene variant classifications, inheritance models, in vitro tests (such as microtubule network analysis in HeLa cells), and assisted reproductive technology (ART) outcomes, were obtained. Eighteen trials including 35 women with primary infertility were included. Over fifty different variants were identified, the majority of which can be attributed to TUBB8 mutations. TUBB8 disrupted α/β-tubulin heterodimer assembly due to homozygous missense mutations, hence hindering meiotic spindle formation and leading to early embryo fragmentation or the creation of many pronuclei and cleavage failure. KIF11 mutations resulted in spindle disorganization and chromosomal misalignment via disrupting tubulin acetylation and microtubule transport. Mutations in CKAP5 impaired bipolar spindle assembly and microtubule stabilization. In vitro validation studies showed cytoskeletal disturbances, protein instability, and dominant negative effects in transfected animals. Donor egg IVF was the sole effective treatment; however, no viable pregnancies were documented in patients with pathogenic mutations of TUBB8 or KIF11. TUBB8, KIF11, and CKAP5 are essential for safeguarding oocyte meiotic competence and early embryonic development at the molecular level. Genetic differences in these genes disrupt microtubule dynamics and spindle assembly, resulting in various aspects of oocyte maturation and fertilization. Functional validation underscores the necessity of routine genetic screening for women experiencing unresolved IVF failure, as it substantiates their causal role in infertility. Future therapeutic avenues in ART may be enhanced by tailored counseling and innovative rescue methodologies like as gene therapy. Full article

B-cell precursor acute lymphoblastic leukemia (B-ALL) is characterized by a constellation of somatic pathogenic variants associated with malignant transformation. These variants have implications for clinical management by providing clinical biomarkers. Most B-ALL cases have a sporadic presentation. However, some patients may present the disease as the neoplastic manifestation of cancer predisposition syndromes caused by germline pathogenic variants. In these cases, genetic counseling and personalized oncologic management is mandatory, considering the patient’s sensitivity to conventional therapies. In this review, we have summarized current knowledge on the biological role and clinical relevance of somatic and germline pathogenic variants associated with B-ALL, and discuss three aspects of their application as biomarkers: (1) their usefulness to determine specific molecular subtypes, predicting prognosis and response to specific therapies, (2) their influence in genetic counseling and therapy adaptation for B-ALL in the context of underlying cancer predisposition syndromes, and (3) their detection and interpretation through methodologies. We also included a brief discussion on the need to reclassify variants of uncertain significance to clarify their clinical relevance. Finally, we discuss cases illustrating the impact of somatic and germline pathogenic variants in personalized medicine. Full article

Background/Objectives: Breastfeeding is a cornerstone of infant nutrition, promoting optimal development and health benefits for both mother and child. Despite high initiation rates in Poland (97%), exclusive breastfeeding (EBF) drops sharply, reaching only 4% by six months postpartum. The aim of this study is to identify factors associated with breastfeeding practices and barriers to exclusive breastfeeding (EBF) among Polish women during the postpartum period, with particular emphasis on the role of medical personnel support and maternal stress levels. Methods: A cross-sectional observational study, adhering to STROBE guidelines, was conducted from January to May 2023. The study included 1092 Polish women, surveyed using the Computer-Assisted Web Interview (CAWI) methodology. The women exclusively breastfeeding accounted for 79% (n = 863) of the study group. The remaining women supplemented their child with modified milk (n = 229; 21%). Statistical analyses were performed using IBM SPSS Statistics (Version 26.0), and logistic regression to assess associations between variables and breastfeeding outcomes. Results: Logistic regression analysis indicated that in the women experiencing low or medium stress, none of the analysed support factors significantly influenced the likelihood of exclusive breastfeeding discontinuation. However, women experiencing high stress, receiving counselling for effective breastfeeding (OR = 0.467; 95% CI: 0.232–0.941; p = 0.033) and assistance with proper breastfeeding (OR = 0.424; 95% CI: 0.220–0.819; p = 0.011) were associated with a lower likelihood of introducing formula feeding. The main reported reasons for early breastfeeding cessation included breast health issues, mental exhaustion, lack of medical support and infant-related difficulties. Conclusions: The findings allow us to underscore the urgent need for targeted interventions to improve breastfeeding rates in Poland. New evidence indicates that women experiencing higher levels of stress require increased support from medical personnel in order to breastfeed exclusively. Full article

Background/Objectives: Alcohol consumption in young persons is a growing phenomenon, with significant implications for physical and mental health. This behavior exposes adolescents and young adults to multiple risks, such as affecting cognitive functions, the development of emotional disorders, and social integration difficulties. The present study sets out to investigate the way alcohol consumption influences emotionality in young people, focusing on the emotional changes (anxiety and irritability), cognitive changes (attention deficit and memory disorder), and behavioral changes (impulsivity and aggressiveness). Methods: The methodology involved collecting quantitative data from a sample of young people who consume and do not consume alcohol, using standardized questionnaires and advanced statistical software (processed in MATLAB version 9.11_R2021b). We analyzed variables such as consumption frequency and intensity, affective scores, and demographic factors to highlight the correlations between consumption level and the intensity of affective modifications. Results: The results revealed a significant association between alcohol consumption and the rise in anxiety and depression symptoms or a tendency toward impulsive behaviors. Additionally, we observed that psychosocial factors, including group pressure, family climate, and stressful contexts, can exacerbate emotional vulnerability. Conclusions: This study suggests the need for early psychological interventions and prevention programs to approach emotional and cognitive dimensions and the social influences associated with consumption. Implementing support and counseling strategies, as well as education and awareness campaigns, can contribute to reducing risky behavior and promoting young people’s harmonious development. Full article

This study explores mothers’ subjective perceptions of self-worth in relation to their children’s achievements using Q methodology. A Q population was constructed based on previous studies and interviews. Forty Q sample statements were selected. Thirty-three mothers raising children were purposefully sampled to ensure representativeness in the P sample. The Q sorting procedure was conducted, followed by a principal component analysis using the Ken-Q Analysis Desktop Edition. The findings identified four distinct types of maternal self-worth perception: Type 1, Achievement-Independent, perceives self-worth independently from their children’s achievements and accepts their failures without attempting to control them. Type 2, Achievement-Dependent, considers children’s achievements crucial in their own life satisfaction and exhibits a strong tendency to control their children. Type 3, Ambivalent-Fusion, believes that children’s achievements do not directly affect their self-worth but shows an overprotective attitude to prevent their children’s failure. Type 4, Maternal-Obligation, perceives children’s achievements as a validation of their role as a mother and strongly internalizes the expectations and responsibilities associated with motherhood. This study categorizes mothers’ perceptions of self-worth and highlights the need for tailored support. The findings provide foundational data for the development of counseling services aimed at addressing mothers’ self-worth in relation to their children’s achievements. Full article

Background: Cochlear implants (CIs) have become a widely used intervention for Deaf and hard-of-hearing (DHH) children, particularly for developing spoken language. However, parental decision-making regarding CIs is influenced by a range of factors, including socio-economic status, healthcare accessibility, cultural beliefs, and societal attitudes. While extensive research on parental perceptions of CIs exists in high-income countries (HICs), there is limited research on these perspectives in low- and middle-income countries (LMICs), like South Africa, where disparities in healthcare access significantly impact CI uptake. Objectives: This study aimed to explore the views and perceptions of South African parents regarding CIs for their DHH children, with a specific focus on how financial, cultural, and informational barriers influence decision-making. Methods: A mixed-methods approach was used, combining Q-methodology for quantitative data and thematic analysis for qualitative insights. Nine parents of DHH children participated. The Q-set survey ranked parental attitudes toward CI risks, benefits, and accessibility, while semi-structured interviews provided deeper insights into decision-making processes. Factor analysis grouped participants into clusters based on their perceptions, and qualitative data were analysed using a thematic framework approach. Results: Findings revealed two distinct parental clusters: (a) Cluster 1 parents viewed CIs as essential for speech development and strongly supported implantation, and (b) Cluster 2 parents recognized CI benefits but emphasized that outcomes vary based on individual circumstances. Three overarching themes emerged from thematic analysis: (1) financial barriers restricting CI access, (2) parental reliance on medical professionals for decision-making, and (3) persistent stigma and cultural beliefs influencing CI perceptions. Conclusions: This study highlights critical barriers to CI access in South Africa, including socio-economic inequities, limited healthcare infrastructure, and persistent stigma. While parents largely recognized the benefits of CIs, their decisions were shaped by financial constraints and concerns about Deaf identity and societal acceptance. This study calls for the expansion of publicly funded CI programmes, the development of culturally tailored parental counselling protocols, and targeted public awareness campaigns to reduce stigma surrounding hearing restoration devices. These interventions can help mitigate financial and cultural barriers to CI adoption in South Africa. Full article

This study aimed to evaluate Romanian university students’ perceptions of career counseling and guidance (CCG) services provided in 2022–2023. A quantitative methodology was employed, analyzing survey data (n = 7402 respondents from 18 universities) to explore awareness of, utilization of, and satisfaction with such services. Data analysis via SPSS included descriptive statistics (mean, median, standard deviation), bivariate correlations (Pearson, Spearman), and Chi-Square tests to identify significant relationships between variables, such as academic year, knowledge of CCG staff/services, and overall service evaluation. Preliminary results suggest low rates of CCG awareness and use, highlighting a disparity between student needs and available resources. This study contributes to understanding the Romanian CCG context by integrating theoretical perspectives from the international literature on dropout prevention, workforce adaptability in the digital age, and higher education quality assurance models. Limitations regarding reliance on secondary data and subjective response biases are discussed, and directions for future research aimed at improving CCG efficacy and student career transition support are proposed. Complete findings will be presented in the full work, providing an empirical foundation for CCG policy and strategy development aimed at enhancing career guidance services in Romanian higher education. Full article

Prenatal and postnatal health guidance, along with women’s individual experiences, greatly influences mothers’ breastfeeding decisions and duration. To understand this better, a methodology combining quantitative and qualitative data is essential. Objective: To map the scientific production on the promotion, protection, and support of breastfeeding developed from mixed methods research. Method: A scoping review that followed the JBI and PRISMA-ScR methodology. The search was carried out in the following databases: Medline/PubMed, EMBASE, Cochrane, BVS, CINAHL, Web of Science, and BDTD. The guiding question was: Which studies on the promotion, protection, and support of breastfeeding were developed using mixed methods? The research took place from December 2023 to June 2024. Results: Of the 3569 studies found, 36 studies using mixed methods were included, with a prevalence of explanatory sequential approaches. Breastfeeding rates in the selected studies remain lower than global recommendations. The barriers to breastfeeding reported by mothers include biological; emotional; cultural; unfavorable social and hospital environment; difficulties in clinical management; lack of support from family, friends, health professionals, and employers; and skepticism about the benefits of breastfeeding. On the other hand, the main facilitators of breastfeeding reported were education and counseling during prenatal, childbirth, and postpartum periods; women’s intention to breastfeed; support from family, employer, spouse, and health professionals. Conclusions: The studies highlighted various issues related to breastfeeding rates, barriers, and facilitators across different contexts and cultures worldwide. The findings demonstrate that employing mixed methods enables a comprehensive and nuanced assessment of breastfeeding practices and the evaluation of relevant interventions. Full article

Background/Objectives: With advancements in Large Language Models (LLMs), counseling chatbots are becoming essential tools for delivering scalable and accessible mental health support. Traditional evaluation scales, however, fail to adequately capture the sophisticated capabilities of these systems, such as personalized interactions, empathetic responses, and memory retention. This study aims to design a robust and comprehensive evaluation scale, the Comprehensive Evaluation Scale for LLM-Powered Counseling Chatbots (CES-LCC), using the eDelphi method to address this gap. Methods: A panel of 16 experts in psychology, artificial intelligence, human-computer interaction, and digital therapeutics participated in two iterative eDelphi rounds. The process focused on refining dimensions and items based on qualitative and quantitative feedback. Initial validation, conducted after assembling the final version of the scale, involved 49 participants using the CES-LCC to evaluate an LLM-powered chatbot delivering Self-Help Plus (SH+), an Acceptance and Commitment Therapy-based intervention for stress management. Results: The final version of the CES-LCC features 27 items grouped into nine dimensions: Understanding Requests, Providing Helpful Information, Clarity and Relevance of Responses, Language Quality, Trust, Emotional Support, Guidance and Direction, Memory, and Overall Satisfaction. Initial real-world validation revealed high internal consistency (Cronbach’s alpha = 0.94), although minor adjustments are required for specific dimensions, such as Clarity and Relevance of Responses. Conclusions: The CES-LCC fills a critical gap in the evaluation of LLM-powered counseling chatbots, offering a standardized tool for assessing their multifaceted capabilities. While preliminary results are promising, further research is needed to validate the scale across diverse populations and settings. Full article

High blood pressure in older adults poses significant risks, including cardiovascular disease, stroke, and renal failure; yet, its management is often overlooked. Nurse-led personalised interventions provide essential guidance, helping patients adhere to treatment plans and adopt lifestyle changes, improving outcomes and quality of life. A scoping review of the literature was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR). Six electronic databases were searched systematically (CINAHL, MEDLINE, PsycINFO, EMBASE, Web of Science, and Scopus). Five research studies were included in this review, from five countries (India, Korea, China, Turkey and Thailand). Primary data were synthesised using descriptive and thematic analysis methodology. The five main themes from this review relate to nurse-led empowerment strategies for hypertension management, variability in blood pressure outcomes, the importance of tailored education and counselling, the role of regular follow-ups and support, and environmental support. Overall, nurse-led personalised interventions improve blood pressure management and patient engagement in older adults, highlighting the need for research into their long-term effectiveness and broader applicability. Full article