Search Results (7,475)

This study aimed to investigate the levels of resilience and stress coping strategies among Greek secondary education teachers, examining the relationships between these two constructs and identifying the specific coping strategies that predict teachers’ resilience. The sample consisted of 200 teachers who completed the Teachers’ Protective Factors of Resilience Scale and the Ways of Coping with Stress Questionnaire. The results indicated that teachers’ resilience levels ranged from moderate to high, with Emotional/Behavioral adequacy and Values and Beliefs emerging as the predominant protective factors. Additionally, significant positive correlations were found between the protective factors of resilience and active coping strategies such as Positive Approach and Seeking Social Support. Finally, multiple linear regression analysis revealed that stress coping strategies accounted for a significant amount of the variance in the overall resilience and the specific subscales. In almost all cases, Positive Approach and Seeking Social Support emerged as the predominant strategies predicting higher levels of resilience; in a few cases, the Escape/Avoidance strategy significantly predicted lower levels. Full article

Autism spectrum disorder (ASD) has a continuously rising global prevalence, imposing a heavy burden on affected families and society. Emotional and behavioural problems are the most common comorbidities of ASD and severely impair the long-term prognosis of affected children. While mindful parenting represents a validated positive parenting model, the internal mechanisms underlying its association with emotional and behavioural developmental outcomes in children with ASD remain unclear. This study adopted a cross-sectional design. Between April and August 2023, 268 parent–child dyads were recruited via convenience sampling from hospitals and special education settings in Jinan, China. Validated instruments were used to assess mindful parenting, parenting stress, family management, and child emotional and behavioural problems, and data were analysed using path analysis with observed variables. The results showed that the sequential chain mediation pathway was fully consistent with the data for total difficulties, with the total indirect effect accounting for 66.71% of the total association. For prosocial behaviour, the model received only partial support, with a 61.54% total indirect association, as the unique indirect path via parenting stress did not reach statistical significance. These findings indicate that mindful parenting is associated with fewer child difficulties through a sequence involving reduced parenting stress and better family management. For prosocial behaviour, this association appears primarily linked to family management, with no significant unique contribution of parenting stress. The study reveals potential family process mechanisms and can inform the development of family-centred interventions. Full article

Background/Objectives: Supporting families during end-of-life care in intensive care units is clinically, emotionally, and ethically demanding, and nurses’ experiences of this work in Saudi Arabian intensive care settings remain underexplored. This study explored nurses’ experiences of providing psychosocial and emotional support to families during end-of-life care, including their role in treatment-limitation and goals-of-care discussions. Methods: A qualitative descriptive study, analyzed using reflexive thematic analysis from a contextualist position, was conducted with 15 intensive care nurses across three healthcare facilities in Riyadh. Ten were Saudi nationals and five internationally recruited; eleven had Arabic as a first language. Semi-structured interviews were conducted in Arabic (n = 11) or English (n = 4) between December 2025 and February 2026 and coded in the language of collection. Results: Three themes were developed: doing relational work inside a system organized for clinical throughput; carrying what the work leaves behind; and standing between, brokering understanding for families. Nurses described having no formal decision-making authority while shaping what families understood and what the clinical team heard. Conclusions: Nurses positioned themselves as intermediaries between families and clinical teams. This relational work was shaped by staffing, formal preparation, access to palliative care, and physician recognition of the nursing role. Strengthening these organizational conditions may support more consistent family care. Full article

Depression and other mental health problems are increasingly prevalent among university students, highlighting the need to identify psychological resources that support mental well-being and early prevention. Adaptive Insensitivity has recently been proposed as a potentially adaptive psychological resource; however, no validated instrument is currently available to assess this construct. This study developed and validated the Insensitivity Scale (IS) among Chinese university students and further examined the mediating role of rumination in the relationship between insensitivity and depressive symptoms. An initial item pool was generated through word association tasks, open-ended surveys, online text analysis, and semi-structured interviews, and the resulting dimensions were subsequently organized and interpreted within the ABC model. The psychometric properties of the IS were evaluated across multiple independent samples using exploratory and confirmatory factor analyses, reliability analyses, and validity assessments. The final 15-item IS comprised three dimensions, Emotional Cognitive Management, Interpersonal Boundary Management, and Behavioral Response Management, and demonstrated satisfactory structural validity, internal consistency, test–retest reliability, and criterion-related validity. Insensitivity was positively associated with psychological resilience and regulatory emotional self-efficacy and negatively associated with emotional vulnerability, anxiety, and depressive symptoms. Rumination partially mediated the relationship between insensitivity and depressive symptoms, accounting for 52% of the total effect. These findings provide preliminary evidence that insensitivity is associated with better mental health among university students and may represent a potentially complementary perspective on adaptive psychological functioning. The IS demonstrated satisfactory psychometric properties for assessing individual differences in insensitivity and may facilitate further research on its role in psychological adaptation and mental health among university students. Full article

Background/Objectives: Poor oral health, which is often overlooked in nursing homes (NHs), is associated with aspiration pneumonia. This analysis assesses the cost effectiveness of an oral hygiene intervention, “Mouth Care Without a Battle©” (MCWB), which trains NH staff to provide daily mouth care. The first year of a pragmatic cluster randomized effectiveness trial conducted in 14 NHs demonstrated a significant reduction in pneumonia incidence in intervention NHs. Methods: Because the two-year primary outcome was not statistically significant, the first-year analysis is post hoc. The incremental cost-effectiveness ratio (ICER) of costs (staff training, time spent providing mouth care, and pneumonia-related hospitalizations) to effects (reductions in pneumonia cases) over one year was estimated using bootstrapping. Results: Analyses for 1605 residents with clustering by NH show that the likelihood that MCWB is cost-saving ranges from 6.5% to 61.1% depending on whether staff are paid benefits and various levels of estimated hospital costs. Similarly, the likelihood that MCWB results in reduced pneumonia cases but with higher costs ranges from 32.0% to 86.6%. Whether MCWB is cost-effective depends on society’s willingness to pay for reduced pneumonia cases and related unmeasured benefits. These estimates may represent a lower bound of potential cost savings because analyses did not include costs of treating pneumonia if not hospitalized, ambulance transport, or the emotional costs of illness. However, other excluded costs (e.g., dental restorations) and resources required to improve fidelity could reduce the likelihood of cost savings. Conclusions: MCWB and similar interventions that improve oral health care in NHs may yield cost savings or produce benefits from the reduction in pneumonia that justify net increases in costs incurred. It is also important to consider who bears the costs (e.g., the NH) versus who reaps the benefits (e.g., healthier residents and reduced Medicare payments). Full article

Immersive Virtual Reality (VR) environments are increasingly adopted in clinical psychology and stress-management contexts; however, their therapeutic effectiveness depends on the system’s ability to understand and dynamically respond to users’ affective states. Emotional regulation plays a key role in psychological resilience, directly influencing stress coping mechanisms, cognitive performance, and overall mental well-being. Despite recent advances, automatic recognition of scenario-associated affective conditions in VR remains challenging because head-mounted displays occlude facial features. This study proposes a VR-based serious game for affective training and regulation, in which users interact with goal-oriented scenarios targeting fear, anger, and joy. We introduce a multimodal affective computing model to objectively assess users’ emotional responses by integrating electrocardiogram (ECG) signals and posture-based features extracted through computer vision. An early-fusion architecture combined with a Long Short-Term Memory (LSTM) network captures temporal dependencies in synchronized multimodal data. We established a controlled experimental framework using immersive VR scenarios, enabling the collection of synchronized physiological and behavioral data from a cohort of 20 healthy adult participants. The proposed model was evaluated under a strict Leave-One-Subject-Out (LOSO) cross-validation scheme across independent subjects, achieving a robust inter-subject accuracy of $78.94\%\pm 10.77\%$ and a global macro F1-score of 0.635, demonstrating strong generalization to entirely unseen users without data leakage. Furthermore, the system maintained an outstanding balance in detecting active emotional states (recall > 80.0% for fear, anger, and joy). Additionally, subjective evaluations using the PANAS and SGU questionnaires confirmed the coherence between detected and perceived emotional states, as well as the system’s high usability. The results suggest the potential viability of combining immersive environments and multimodal affective computing to explore the technical feasibility of adaptive frameworks that could eventually translate into healthcare contexts. This work may contribute to the development of intelligent digital health technologies by providing a foundation for responsive VR systems that can monitor emotional regulation and are fully aligned with sustainable well-being ecosystems (SDG 3: Good Health and Well-being and SDG 10: Reduced Inequalities). Full article

Affective computing has become increasingly relevant in child–robot interaction (CRI), particularly in social robotics, emotion recognition, engagement assessment, and autism-related interventions. This systematic review with a critical and integrative synthesis analyzes 105 included studies to examine how affect is sensed, represented, processed, expressed, and evaluated in CRI. The literature search was conducted in IEEE Xplore, Web of Science, Scopus, and PubMed, following a systematic screening process guided by the review objectives. A descriptive and structured narrative synthesis was conducted considering publication characteristics, robot platform and morphology, target population, sensing modalities and observed affect-relevant features, affective constructs and representation models, computational and control mechanisms, robot affective expression, evaluation strategies, and remaining research gaps. The findings show a strong emphasis on ASD-related contexts, visually observable and behavioral features, facial emotion recognition, body movement analysis, and engagement assessment. The review also identifies important limitations, including reliance on camera-based affect recognition, comparatively limited use of physiological and other complementary sensing modalities, unclear alignment between robot roles and interaction strategies, insufficient reporting of robot emotional expressiveness and control mechanisms, and limited attention to explainability, data governance, and long-term ethical implications. Based on these findings, an integrative taxonomy of affective computing in CRI is proposed, comprising six interconnected dimensions: interaction context; sensing modalities and observed features; affective constructs and representation models; computational and control mechanisms; robot affective expression; and evaluation and adaptation strategies. Rather than treating these dimensions as entirely novel categories, the taxonomy consolidates and extends previously fragmented classifications into a child-centered representation of the affective interaction process. Overall, this review argues that affective CRI should move beyond automatic emotion recognition toward multimodal, embodied, developmentally appropriate, explainable, and ethically grounded robot interaction. Full article

Research on social commerce, influencer marketing, consumer–brand engagement, and CEO social media communication has rapidly expanded. However, less is known regarding how entrepreneurial leaders’ personal short-video accounts operate as platformized interfaces that organize consumer interaction. This study examines how CEO short-video communication produces an observable, collectively sustained commercial persona and connects executive visibility with fan labor, consumer–brand engagement, and consumption imagination. Using the Douyin account of a leading Chinese technology entrepreneur as a case, this study analyzes 372 short videos posted up to 15 August 2024, and 185,561 valid first-level comments. It combines structured content analysis, intercoder reliability testing, BERTopic-assisted topic location, manual thematic validation, and text-based emotional intensity analysis. Work footage, scenes of everyday life, casual presentations, and product props translate entrepreneurial authority into an approachable, platformized commercial persona. In comment sections, users perform informational, relational, affective, memetic, mobilizing, and defensive labor through product requests, familiar address, emotional identification, memes, consumption mobilization, and brand defense. These practices stabilize CEO personas, circulate product meanings, and create consumption imagination, understood as public projections of saving for, ordering, using, or affiliating with products rather than evidence of actual purchases. Emotional identification, consumption mobilization, and brand defense display higher observable emotional intensity than product requests. This study contributes a case-derived conceptual framework demonstrating how CEO identity capital, platform affordances, fan labor, and product-centered imagination are assembled in short-video social commerce. Full article

A series of documented deaths by suicide following prolonged interactions with chatbots based on large language models (LLMs) has exposed the clinical risks of delegating emotional support to conversational artificial intelligence. This paper proposes a psychodynamic account of these events, integrating the bi-logical theory of Ignacio Matte Blanco, the Freudian theory of primary hallucination, and the analysis of demand elaborated by Carli and Paniccia. Two theoretical moves ground the account. First, the suicidal crisis is conceptualized not as a continuous state but as a pathological prevalence of symmetric logic that recurs and consolidates across acute moments, marked by the generalization, maximization, and irradiation of psychic pain and by the collapse of temporality; LLM-based chatbots, conversely, are conceptualized as systems of pure formal asymmetry lacking any symmetric, emotional, and embodied base. Second, their encounter generates what we call relational hallucination: an unconscious, structurally determined process, homologous to primary hallucination, through which the subject in crisis invests the chatbot with relational qualities perceived as real. Because the process obeys the laws of symmetric logic, it is resistant to correction by information alone, and it can consolidate cumulatively even across interactions that also contain deliberative, asymmetric elements such as planning. The chatbot, responding to the explicit request rather than to the unconscious demand it conveys, produces an amplificatory collusion that reinforces the premises of the crisis. The failure of algorithmic support in acute suicidal states is therefore ontological rather than technical. Implications for clinical training, regulation, and research are discussed, including testable hypotheses linking markers of symmetric prevalence to the intensity of chatbot attachment. Full article

The external servicescapes surrounding tourist attractions influence visitor emotions and contribute to the sustainable development of urban tourism destinations. However, the relationship between objective streetscape visual elements and subjective emotions from a big data perspective remains unclear. This study examines their predictive capacity, relative model-based importance, and nonlinear association patterns using 14,968 street-view images from 178 tourist-attraction AOIs in Shanghai and UGC-derived emotion scores. Drawing on servicescape theory and a data-driven sustainability perspective, semantic segmentation was used to classify streetscape visual elements into three dimensions (environmental conditions, spatial layout and signage or symbols). Among the evaluated models, the MLP ensemble achieved the strongest out-of-sample performance, but its test-set R² was only 0.026, indicating limited out-of-sample predictive capacity. SHAP analysis revealed that environmental conditions and spatial layout and functionality jointly accounted for 89.3% of the total absolute SHAP attribution, although the model’s overall predictive power remained low. PDP analysis further identified distinct nonlinear response patterns across streetscape features. This study extends servicescape research to open tourism environments and provides exploratory evidence for sustainable streetscape management around tourist attractions. Full article

Criminal behavior has been explained through multiple theoretical frameworks developed independently, including general personality models (FPI, Big Five, HEXACO), maladaptive configurations (Dark Triad/Tetrad, psychopathy), and criminogenic cognitions. However, integrated analysis of this literature suggests the existence of a multilevel architecture of antisocial vulnerability rather than entirely distinct, non-communicating mechanisms. This narrative integrative review synthesizes empirical evidence regarding these frameworks in incarcerated populations, drawing predominantly on literature indexed in Web of Science and Scopus, supplemented by Google Scholar and snowballing searches, as detailed in the Methods section. The analysis identifies a convergent dispositional core—characterized by elevated aggression, emotional excitability, and psychological strain, alongside reduced conscientiousness, agreeableness, honesty–humility, and social integration—that may exert its influence on behavior partly through dynamic mechanisms such as self-efficacy and self-control, together with the more proximal influence of criminogenic cognitions, expressed differentially through maladaptive personality configurations. The persistent heterogeneity of offender profiles and conceptual convergences across models support this same multilevel structure. The findings propose a three-level integrative conceptual model that explicitly links these previously fragmented studies, with implications for directing correctional interventions toward dynamic mechanisms rather than solely toward stable personality traits. Full article

Social and emotional skills can be addressed within ordinary mathematics activities, but the teacher-level conditions associated with such emphasis remain unclear. This study examined whether mathematics teachers’ perceived instructional autonomy was associated with their reported emphasis on students’ social and emotional skill development and whether overall teacher self-efficacy statistically carried part of that association. Data came from 863 teachers in 352 schools in TALIS 2024 Türkiye. Analyses retained the teacher weight, school clustering, and the 100 official Fay-BRR replicate weights for the separately calibrated ISCED 2 and ISCED 3 populations. Instructional autonomy was positively associated with self-efficacy and with reported social–emotional emphasis, and self-efficacy was positively associated with the outcome. The statistical indirect association was positive (B = 0.140, 95% CI [0.100, 0.179]); all four primary hypotheses were supported. The association was positive at both educational levels, and no statistically reliable difference from teachers of other subjects was detected. The findings identify a design-sensitive association pattern in a substantively meaningful mathematics-teaching context, but they do not establish temporal or causal mediation and should not be interpreted as evidence about observed practice or student outcomes. Full article

Background/Objectives: Supporting everyday self-management is a central component of person-centered neurological nursing for young adults living with epilepsy. However, little is known about how young adults experience and negotiate everyday life with epilepsy during a developmental stage characterized by increasing independence and major life transitions. This study aimed to explore how young adults experience and negotiate everyday life with epilepsy. Methods: A qualitative exploratory study informed by a hermeneutic approach was conducted to explore participants’ experiences. Twelve young adults aged 18–29 years participated in individual virtual interviews. Interviews followed a semi-structured guide and were analyzed using reflexive thematic analysis to identify patterns across participants’ experiences. The study was reported according to the Standards for Reporting Qualitative Research (SRQR). Results: The analysis identified a main theme, Keeping balance on a moving platform, which captured how young adults experienced living with epilepsy as a continuous balancing act within an unpredictable condition. Participants described continuously balancing independence with vulnerability while managing seizures, cognitive challenges, and concerns related to safety and social participation. Familiar digital and non-digital tools supported everyday self-management by helping participants structure daily routines, compensate for cognitive difficulties, and maintain a sense of normality. Conclusions: Living with epilepsy in young adulthood requires continuous adaptation to cognitive, emotional, and practical challenges that extend beyond seizure control. This study extends current knowledge by showing that self-management involves continuous negotiation between independence, vulnerability, and everyday participation rather than symptom control alone. The findings provide insights into person-centered neurological nursing by highlighting the importance of individualized support for managing cognitive challenges, everyday self-management, and transitions into education, employment, and family life. Full article

Parents of infants in the Neonatal Intensive Care Unit (NICU) frequently experience significant emotional distress, yet neonatology fellows receive limited training in psychosocial support. This study evaluates the use of online standardized-patient simulation to improve fellows’ communication skills addressing parent concerns. Fellows (n = 13) completed two virtual interactions with standardized parents, with feedback from a neonatal mental health professional (NMHP), a former NICU parent, and a neonatologist using narrative comments and the Gap–Kalamazoo Communication Skills Assessment Scale. Narrative data underwent thematic analysis, and a within-subjects, repeated measures ANOVA examined communication ratings; knowledge and self-efficacy scores were analyzed using descriptive statistics and paired t-tests. Communication scores differed significantly across raters (F(2, 24) = 6.2, p < 0.007). Fellow and faculty ratings were comparable (p = 0.37), whereas parent ratings exceeded fellow self-ratings (p = 0.005). NMHPs and parents identified more thematic codes than fellows (22/26 and 25/26 vs. 15/26), highlighting information delivery, mental health, relationship building, and communication. Fellows’ self-efficacy decreased after participation, (t(12) = 2.88, p = 0.02, d = 0.83). This decline, alongside positive feedback on the simulation’s relevance, reflects increased recognition of the complexity of addressing parental distress and underscores the need for ongoing training and real-world application. This study provides preliminary evidence for the feasibility of using online simulation to train neonatology fellows in communication strategies that support the psychosocial needs of NICU parents. Full article

Background: Acute cardiac events trigger multifaceted psychological responses captured by the construct of cardiac distress, a persistent negative emotional state involving multiple psychosocial domains. The Cardiac Distress Inventory (CDI) assesses this construct, but no Italian version exists. This study aimed to translate the CDI and assess its psychometric properties. Methods: After translation and back-translation, face validity was assessed with five patients and content validity with healthcare professionals. The CDI was administered to 293 patients who experienced a recent cardiac event from two Italian centers. Missing data were handled with multiple imputations. Exploratory factor analysis (EFA; principal axis factoring, oblimin rotation) assessed factorial structure. Criterion validity was assessed using correlations with Emotion Thermometers, Patient Health Questionnaire-4 (PHQ-4) and Kessler-6 (K6); ROC analysis assessed discriminative accuracy and the optimal cut-off. Results: The questionnaire demonstrated good face validity and suboptimal content validity (CVI-S/Ave = 0.72). EFA revealed a five-factor structure explaining 54% of the variance: “Role Change and Adaptation to Disease”, “Emotional Overwhelm, “Cognitive Challenges”, “Social Disconnection”, and “Health System Challenges”. The final 46-item version showed good internal consistency (ω = 0.857–0.926) and discriminative accuracy (AUC = 0.84), with an optimal cut-off of 36 (sensitivity 71%, specificity 84%). Conclusions: The current study provides preliminary evidence for the validity of the Italian CDI. Additional studies are needed to confirm the proposed structures and clinical cut-offs. Full article