Search Results (43)

Background/Objectives: Colorectal cancer is a leading cause of cancer-related death worldwide, with rising incidence in younger adults. Unhealthy diets high in red and processed meat and low in fiber are key modifiable risk factors, highlighting the need for preventive nutritional strategies targeting CRC through dietary interventions. Methods: A one-day sample diet for colorectal cancer prevention, consisting of fiber-rich meals excluding red meat and incorporating whole grains, legumes, vegetables, fruits, nuts, and lean protein alternatives (such as fish and poultry), was developed. Its acceptability was assessed in a cross-sectional study using an online questionnaire among healthy Romanian adults aged 18–50, with a total of 395 included participants. Results: Of the 395 respondents meeting the inclusion criteria (aged 18–50, no cancer or chronic gastrointestinal disorders), 63.5% were females, predominantly urban (90.1%), and highly educated. Mean age was 32.4 years; mean BMI was 25.07 kg/m². The proposed colorectal cancer-preventive diet was rated as “quite attractive” and “very attractive” by 74.9% of participants. All meals received high ratings, with dinner and the first snack being most favored. Most respondents (77.2%) found the diet satisfying and the satiety level and energy adequate, and 90.4% were willing to adopt it at least a few times per week. Financial accessibility was affirmed by 77.2% of the respondents. However, 61.8% reported difficulty eliminating red meat consumption. Female participants rated the diet significantly more attractive than males did (p = 0.041). Willingness to adopt the diet strongly correlated with higher acceptability (p < 0.0001), while BMI and education level showed no significant effect. Conclusions: The proposed colorectal cancer-preventive diet was well accepted by Romanian adults aged 18–50, with higher receptivity among women and those with higher education; willingness to adopt the diet at least a few days per week was high, especially among those psychologically ready for dietary change, while key barriers included red meat reduction and perceived cost, underscoring the need for gender-sensitive, culturally adapted interventions and further research on long-term adherence and clinical impact. Full article

Background: This review explores the influence of eco-anxiety on sustainable consumption, with a specific focus on the urban context. While the literature on green consumerism continues to expand, the role of emotional and psychological factors, especially eco-anxiety, in shaping sustainable consumption decisions remains underexplored. Most existing studies emphasize cognitive, social, or contextual drivers, often overlooking affective dimensions that may significantly influence consumer behavior. Addressing this gap, the review examines how emotional responses to climate change, such as eco-anxiety, inform and potentially motivate eco-friendly consumption patterns. Understanding these affective pathways offers valuable insights on how individuals and urban communities can effectively adapt to climate change and establish a sustainable consumption culture. Methods: A systematic literature search was conducted in Scopus and Web of Sciences databases, following a predefined keyword strategy, resulting in 56 initial records. We further implemented a supplementary search of gray literature on Google Scholar to search for additional reports. The full-text screening process identified 12 eligible studies based on the following inclusion criteria: quantitative or mixed-methods studies focusing on adult and young adult individuals, including both measures of eco-anxiety and green consumption and assessing their direct or indirect relationship. Results: Findings suggest that eco-anxiety functions as a cognitive–affective motivator for sustainable consumer choices; however, the strength and direction of this influence appear contingent on moderating emotional and psychological variables and cross-cultural and demographic moderators. Discussion: This review highlights the need for urban-focused intervention tailored communication, marketing, and business strategies that address the emotional dimensions of climate change. Policymakers and businesses are encouraged to consider affective drivers as eco-anxiety to promote sustainable consumption stewardship within urban communities. By addressing these psychological responses, urban societies can become more resilient and proactive in confronting climate change challenges. Full article

With the rise in short-term intercultural mobility programs, enhancing students’ adaptive capacity through structured experiential learning has become a key concern. Using constructivist grounded theory, this study draws on extending the situated learning and embodied cognition theories as analytical frameworks to explore international students’ cross-cultural adaptation within the context of study tours. It develops a three-phase framework (pre-departure, on-site immersion, and post-tour reflection) to trace their transition from cultural distance to adaptation. The findings reveal that the process through which international students shift from cross-cultural distance to multidimensional adaptation can be further accelerated by environmental settings, situational behaviors, and short-term emotional responses within study tour contexts. Moreover, culture-led and nature-led environments evoke distinct patterns of participation and emotional responses, facilitating varying degrees and dimensions of adaptation across psychological, social, and cultural domains. The study extends situated and embodied learning perspectives by conceptualizing study tours as dynamic, context-sensitive learning sites. By considering adaptation processes context-dependent, this study deepens the understanding of how learning, emotion, and environment interact to shape intercultural development and offers practical insights for designing responsive, stage-sensitive study tour programs. Full article

Background/Objectives: Despite its well-established health benefits, adherence to the Mediterranean lifestyle (MedLife) has declined globally, including in its region of origin, alongside a significant shift toward ultra-processed food consumption. Understanding the factors associated with MedLife adherence is essential for developing targeted interventions and tailored policy recommendations. As part of the MEDIET4ALL PRIMA project, this cross-sectional study aimed to comprehensively examine geo-demographic, socio-economic, psychological, behavioral, and barrier-related factors associated with and potentially contributing to MedLife adherence. Methods: Data were collected from 4010 participants aged 18 years and above across ten Mediterranean and neighboring countries using the multinational MEDIET4ALL e-survey, which included the validated MedLife index, along with various other questionnaires. Results: Results indicate that only 22% of respondents demonstrated high adherence to the Mediterranean lifestyle (MedLife), with significant variability observed across countries, age groups, education levels, and health statuses. Spain had the highest proportion of participants with high adherence (38%). Factors associated with significantly higher adherence rates include older age, living in the Mediterranean region, higher education levels, a greater awareness of MedLife principles, lower perceived barriers, normal BMI, better health status, and stable economic and marital conditions (p-values ranging from 0.04 to <0.001). Additionally, individuals with high MedLife adherence exhibited more socially and physically active lifestyles and experienced less psychological strain (p < 0.001). Regression analyses identified MedLife awareness as the strongest positive predictor of adherence (β = 0.206), followed by social participation (β = 0.194) and physical activity (β = 0.096). Additional positive contributors include life satisfaction, sleep quality, living in the Mediterranean region, age, and education (β ranging from 0.049 to 0.093). Conversely, factors that are negatively associated with adherence include sedentary behavior, living environment, and barriers such as low motivation, taste dislike, price unaffordability, limited availability, and the time-consuming nature of preparing Mediterranean food (MedFood; β ranging from −0.036 to −0.067). Conclusions: These findings indicate that fewer than one in four adults across Mediterranean and neighboring countries demonstrate high adherence to MedLife, supporting prior evidence of suboptimal adherence even within Mediterranean regions. This study identified a range of behavioral, socio-demographic, and environmental factors—both positive and negative predictors—that can help guide the design of targeted, culturally adapted interventions to promote MedLife behavior. Future research should incorporate objective measurements and longitudinal monitoring to better understand underlying mechanisms, establish causality, and develop sustainable strategies for enhancing MedLife adherence in diverse populations. Full article

Background: Physical inactivity among adolescents, particularly females in conservative societies like Saudi Arabia, poses significant risks to both physical and psychological health. Cultural norms, environmental constraints, and limited access to gender-appropriate sports facilities further exacerbate the problem. Understanding these factors is essential for developing effective, context-sensitive interventions. Aim: This study aimed to examine the relationship between daily physical activity behaviours and health outcomes, both physical and psychological, among adolescent females in Saudi Arabia. This paper also explores the impact of socio-environmental variables such as income, household size, and urban/rural residence on activity levels and wellbeing. Methods: A cross-sectional survey of 636 adolescent females aged 13–21 was conducted using validated instruments. The Physical Activity Questionnaire for Adolescents (PAQ-A) measured physical activity levels, and the Self-Rated Health (SRH) assessed psychological wellbeing and health-related quality of life. The analysis employed an Ordinal Logistic Model (OLM) guided by the Social Ecological Model (SEM) to assess predictors of physical activity participation. Results: The OLM results indicated that higher income levels, smaller household size, urban residence, and older age categories were significantly associated with higher levels of physical activity (p < 0.05). Participants with higher PAQ-A scores reported better psychological health and quality of life. The model showed a good fit, with a pseudo-R² of 0.36. Cultural and environmental barriers, particularly in rural areas, were identified as significant deterrents to participation. Conclusions: The findings highlight the urgent need for culturally adapted, gender-sensitive health promotion programs that target both individual and structural barriers to physical activity among adolescent girls in Saudi Arabia. Enhanced societal support and accessible sports infrastructure could significantly improve health outcomes and quality of life. Full article

Background/Objectives: Mental health conditions represent a growing global health concern, disproportionately impacting populations in low- and middle-income countries like Pakistan. Limited epidemiological data, coupled with recent socioeconomic and environmental disruptions, has intensified the need for current insights into psychological burden and coping capacities in the Pakistani population. Methods: A descriptive, cross-sectional survey was conducted from January to May 2023 among 400 community-dwelling adults attending outpatient departments in Islamabad and Rawalpindi. A structured 75-item questionnaire incorporating validated tools (PHQ-9, GAD-7, WHO-5, CSES, and SRQ-20) was used to assess depression, anxiety, well-being, coping self-efficacy, and mental distress. Descriptive statistics, χ² and Fisher’s exact tests, and Spearman’s rank correlation (r_s) analyses were performed using IBM SPSS 22.0. Results: Most respondents were male (73.0%), aged 25–34 (60.0%), and urban-dwelling (80.0%). Clinically relevant depression and anxiety were observed in 57.0% and 19.5% of participants, respectively; 38.0% reported mental distress. Conversely, 76.5% demonstrated fair-to-good coping efficacy and 51.0% had high well-being scores. Younger age (≤34 years), higher income, urban residence, and male gender were associated with significantly better mental health outcomes. Strong positive correlation was found between PHQ-9 and GAD-7 scores (r_s = 0.672), and moderate negative correlations were found between GAD-7 and WHO-5 (r_s = −0.496), and PHQ-9 and WHO-5 (r_s = −0.310). Conclusions: Our findings highlight the significant psychological burden among urban Pakistani adults, alongside promising levels of resilience and coping self-efficacy. These results emphasize the urgent need for early, culturally adapted mental health screening and intervention programs in outpatient settings. Integrating such strategies into primary care, particularly for vulnerable subgroups like women, older adults, and those with lower income could facilitate timely diagnosis, improve outcomes, and reduce stigma surrounding mental health. Full article

Strong emotional bonds within families are foundational to children’s academic, psychological, and social development. While family cohesion is widely recognized as a protective factor across these domains, there remains a need to understand the specific mechanisms and interventions that foster such cohesion, particularly in diverse socioeconomic and cultural contexts. This systematic review examines global evidence on factors influencing family cohesion and evaluates intervention strategies designed to strengthen familial relationships. Drawing on 41 peer-reviewed studies published between 2015 and 2023, this review adheres to PRISMA guidelines and applies the Mixed Methods Appraisal Tool (MMAT) to assess methodological quality. The findings are organized around four core dimensions of family cohesion—emotional bonding, adaptability, communication, and support—and highlight both common patterns and culturally specific mechanisms. Studies were drawn from a range of settings including North America, sub-Saharan Africa, Latin America, East and Southeast Asia, and Europe, enabling a cross-cultural analysis of how family cohesion operates under different social, cultural, and economic conditions. Intervention strategies are reviewed separately following the synthesis of correlations, with attention to their effectiveness, cultural relevance, and contextual adaptability. Community-based programs, trauma-informed therapies, and parenting interventions emerge as key approaches, though their success has varied by regional and structural context. Studies consistently demonstrate that higher family cohesion correlates with improved academic outcomes, as supportive home environments promote motivation, reduce stress, and enhance learning. Mental health benefits are also evident, with cohesive and adaptable families mitigating risks of anxiety and depression through open communication and emotional availability. Social competence is fostered through observed and practiced interpersonal skills within family settings. Socioeconomic status emerges as both a challenge and a moderating factor, with lower-SES families facing greater barriers to cohesion but also displaying notable resilience when supported through external interventions. Effective strategies identified include family therapy, parenting education, community-based programs, culturally sensitive approaches, and socioeconomic policy supports. Family cohesion and adaptability are critical to nurturing children’s academic success, emotional well-being, and social development. This review contributes to a more culturally nuanced and policy-relevant understanding of family cohesion by integrating empirical findings across global contexts and identifying both shared and differentiated pathways to resilience. The results inform future program design and suggest priorities for cross-cultural family research and intervention development. Full article

Forgiveness is a multidimensional phenomenon that often functions as a disposition; it is closely linked to psychological well-being and religion/spirituality. However, no validated instruments have been available to assess forgiveness in the Georgian context. This study aimed to adapt the Toussaint Forgiveness Scale (TFS) for use in Georgia and to examine cross-cultural patterns of forgiveness and mental health among Georgian Orthodox Christians and Polish Roman Catholics. Methods: Study 1 (N = 321) validated the Georgian TFS using confirmatory factor analysis and assessed its convergent validity with perceived stress and religiosity. Study 2 applied structural equation modeling to analyze associations between forgiveness dimensions and mental health indicators in Georgian (n = 110) and Polish (n = 111) samples. Results: The Georgian TFS showed good psychometric properties. In both groups, self-forgiveness was associated with lower depressive symptoms; in Georgia, it also predicted higher quality of life. Forgiveness by God predicted reduced anxiety and depression in Georgia but not in Poland. Although path patterns varied, overlapping confidence intervals suggest no significant between-group differences. Conclusions: Forgiveness supports mental health across cultures, especially self-forgiveness. Its expression may show subtle, culturally nuanced patterns, though these require cautious interpretation. Full article

Background and Objectives: Stress urinary incontinence (SUI) impacts 4–50% of adult women, frequently resulting in embarrassment, diminished self-esteem, and social withdrawal, significantly affecting quality of life. The aim of our study is to cross-culturally adapt and validate the Urinary Incontinence Outcome Questionnaire (IOQ) for the Serbian population and to assess the multifaceted impact of SUI on the quality of life among women. Materials and Methods: A cross-sectional study involved a total of 150 women: 100 undergoing surgical management for SUI (ST group) and 50 receiving non-surgical treatments, including vaginal estrogen, pessaries, electrical stimulation, or collagen fillers (NST group). The participants completed questionnaires on demographics, fatigue (MFI), anxiety and depression (HADS), and quality of life (SF-36), as well as the IOQ. Results: The ST group had a mean age of 60.0 ± 10.0 years, with 65% married, 65% with secondary education, 62% non-smokers, and 78% with comorbid conditions, primarily cardiovascular disease (59%). The NST group showed similar characteristics, with a significant difference in cardiovascular comorbidity (p = 0.049). All IOQ subscales demonstrated good internal consistency (Cronbach alpha > 0.7), except for the subscale Complications (Cronbach alpha = 0.440). The IOQ score for “Symptoms pre-operative” had the highest mean value (62.8 ± 18.6), while “Hospital Re-admission” had the lowest (303 ± 17.1). A comparison of the SF-36 scores showed significant differences in the Energy (p = 0.025) and Emotional well-being (p = 0.015) domains between the ST and NST groups. Conclusions: The Serbian version of the IOQ has been validated, demonstrating psychometric features that endorse its application in clinical and research contexts. This study highlights the significant impact of SUI on quality of life and the need for a comprehensive approach to treatment. The results emphasize the importance of addressing both the physical and psychological aspects of SUI to improve the lives of affected women. Full article

The COVID-19 pandemic significantly impacted the mental health of workers. This study aimed to assess the prevalence of psychological distress among Brazilian workers during the early months of the pandemic and explore its associated factors. A cross-sectional study was conducted using an online questionnaire administered to 2903 Brazilian workers, including 1752 non-healthcare workers (NHCWs) and 1151 healthcare workers (HCWs), between April and May 2020. Snowball sampling was employed for participant recruitment, and the research questionnaire was adapted for use with the Brazilian population through a process of translation and cultural adaptation, based on an instrument initially created and validated for use in Spain. Differences between NHCWs and HCWs were tested using the chi-square or Fisher’s Exact test and Mann–Whitney test followed by effect size measurement. Multiple linear regression models were used to analyze the association between psychological distress and the predictor variables. Psychological distress was observed in 72.6% (95% CI 70.1–74.2%) of the participants, with no significant difference observed between NHCWs and HCWs. Although 32 variables showed statistically significant differences between NHCWs and HCWs, only 7 demonstrated clinical–epidemiological relevance, primarily related to occupational factors. Work-related stress was positively associated with psychological distress, but this relationship diminished in the absence of family members infected with COVID-19. Conversely, a higher sense of coherence was protective against psychological distress, although this effect weakened in the absence of family members infected with COVID-19. The study highlights the high prevalence of psychological distress among Brazilian workers during the pandemic’s early months. Work stress played a significant role, while sense of coherence appeared to mitigate mental health challenges. These findings highlight the need for targeted mental health interventions, particularly for workers facing both professional and family-related stressors during crises. Full article

In this paper, we investigated the role of generative AI in education in academic publications extracted from Web of Science (3506 records; 2019–2024). The proposed methodology included three main streams: (1) Monthly analysis trends; top-ranking research areas, keywords and universities; frequency of keywords over time; a keyword co-occurrence map; collaboration networks; and a Sankey diagram illustrating the relationship between AI-related terms, publication years and research areas; (2) Sentiment analysis using a custom list of words, VADER and TextBlob; (3) Topic modeling using Latent Dirichlet Allocation (LDA). Terms such as “artificial intelligence” and “generative artificial intelligence” were predominant, but they diverged and evolved over time. By 2024, AI applications had branched into specialized fields, including education and educational research, computer science, engineering, psychology, medical informatics, healthcare sciences, general medicine and surgery. The sentiment analysis reveals a growing optimism in academic publications regarding generative AI in education, with a steady increase in positive sentiment from 2023 to 2024, while maintaining a predominantly neutral tone. Five main topics were derived from AI applications in education, based on an analysis of the most relevant terms extracted by LDA: (1) Gen-AI’s impact in education and research; (2) ChatGPT as a tool for university students and teachers; (3) Large language models (LLMs) and prompting in computing education; (4) Applications of ChatGPT in patient education; (5) ChatGPT’s performance in medical examinations. The research identified several emerging topics: discipline-specific application of LLMs, multimodal gen-AI, personalized learning, AI as a peer or tutor and cross-cultural and multilingual tools aimed at developing culturally relevant educational content and supporting the teaching of lesser-known languages. Further, gamification with generative AI involves designing interactive storytelling and adaptive educational games to enhance engagement and hybrid human–AI classrooms explore co-teaching dynamics, teacher–student relationships and the impact on classroom authority. Full article

This study investigates the psychological factors influencing remote work acceptance during the COVID-19 pandemic using a Bayesian network and probabilistic structural equation modeling (PSEM) approach. The research specifically explores the impact of stress factors induced by the pandemic, including compulsive checking, socio-economic consequences, danger, and contamination, on individuals’ willingness to adopt remote work arrangements. Data were collected from 586 participants with remote work experience, and the Bayesian analysis revealed that compulsive checking had the most significant positive influence on remote work acceptance, followed by socio-economic consequences, while danger and contamination showed no statistically significant effects. The findings suggest that psychological stress factors related to excessive information seeking and economic instability play a stronger role in influencing remote work decisions than direct health-related concerns. These results provide theoretical contributions by extending technology acceptance models to crisis situations and offer practical insights for organizations aiming to implement effective remote work policies. Specifically, strategies such as psychological support programs, financial stability measures, and clear communication regarding workplace safety can enhance employee well-being and productivity in remote settings. Future research should explore long-term effects of stress factors on remote work sustainability and cross-cultural comparisons in pandemic-related work adaptations. Full article

The psychological readiness of athletes and its connection to their functional status in returning to sport after a musculoskeletal injury has been previously studied. The “Psychological Readiness of Injured Athlete to Return to Sport” (PRIA-RS) questionnaire is a widely used tool designed to assess an athlete’s psychological readiness to return to sport. The purpose of the present study is to investigate the validity and reliability of the PRIA-RS questionnaire in Greek football athletes. The questionnaire was administered to 113 football athletes, and its face validity, content validity, concurrent validity, construct validity, test–retest reliability, and internal consistency were assessed. The face and content validity of the PRIA-RS were supported, and an exploratory factor analysis confirmed the instrument’s original two-factor structure. Its concurrent validity was demonstrated by examining correlations between the PRIA-RS and three other measures: the Causes of Re-Injury Worry Questionnaire, the Sport Confidence Questionnaire for Rehabilitated Athletes Returning to Competition, and the Attention Questionnaire for Rehabilitated Athletes Returning to Competition. The PRIA-RS exhibited a good internal consistency (Cronbach’s α = 0.82). The intraclass correlation coefficients (ICCs) for the test–retest reliability of each factor were excellent (ICC = 0.97−0.99). Overall, the PRIA-RS appears to be a valid and reliable tool that rehabilitation professionals can utilize in both clinical practice and research by realizing the athletes’ psychological needs and helping them to return safer with no future musculoskeletal injuries. Full article

This study explores the strategic implementation of social support enablers to address expatriate turnover and the shortage of skilled labour in Thailand’s hospitality industry, particularly in the post-COVID-19 context. By integrating Social Support Theory, Cultural Intelligence Theory, and Social Capital Theory, this research identifies and prioritises key enablers essential for expatriate success. We employed a novel three-phase methodology, which included a literature review, a hybrid Best–Worst Method (BWM), Grey Relational Analysis (GRA), and semi-structured interviews with experts. The findings reveal a hierarchical framework of social support enablers, with health and psychological adjustment support, work–life balance initiatives, career development opportunities, and national support for the host country emerging as top priorities. Implementing these enablers effectively addresses expatriates’ adaptation challenges and significantly enhances their performance, well-being, and retention. This study contributes to the literature by providing the first empirically derived, prioritised approach to social support enablers implementation and practical guidance for developing holistic support systems in multicultural hospitality environments. Focusing on Thailand, the methodology and framework offer a robust foundation for future cross-cultural comparisons in expatriate management research. Full article

Aim: We aimed to explore whether there is an association between maternal perceived infant discomfort due to suggestive gastrointestinal alterations and oral-health-related quality of life (OHRQoL) through a survey. Materials and Methods: The present study included two main phases involving Portuguese-speaking parents with full-term infants aged 2–12 weeks old who were not previously hospitalized in a neonatal nursery. First, the original French Infant Colic Questionnaire (ColiQ) was translated, cross-culturally adapted and validated to Portuguese (ColiQ-PT). Then, a survey was distributed, and included sociodemographics, the ColiQ-PT, an oral health value scale, OHRQoL, self-perceived periodontal status, and smoking and oral health habits. Data were analyzed through inferential, correlation and multivariate logistic models in this cross-sectional study. Results: The ColiQ-PT revealed reliability and validity. From a total of 421 responses, higher infant discomfort was correlated with less maternal professional dental care prioritization (ρ = −0.096, p < 0.05). Self-perceived periodontitis correlated with all items of OHRQoL (p < 0.001), all seven OHIP-14 domains, and with the physical (p < 0.001), psychological (p = 0.006), and social (p = 0.011) super-domains. While the infant-related score was associated with baby age (p = 0.023) and physical pain (p = 0.040) related to OHRQoL, the parent score was associated with education (p = 0.005), unemployment (p = 0.035), and physical pain (p = 0.017). The total ColiQ-PT score was significantly associated with more deteriorated social disability related to maternal OHRQoL (ρ = −0.130, p < 0.05). Conclusions: Perceived infant discomfort seems to be linked to maternal deteriorated OHRQoL. This finding highlights the importance of prioritizing oral health in postpartum care. Further research is needed to explore the mechanisms underlying this association and to develop targeted interventions. Full article