Search Results (3,779)

Background: T-cell redirecting therapies (TCRTs), including CAR T-cell therapies and bispecific antibodies, have transformed treatment for relapsed/refractory multiple myeloma (MM), yet real-world adoption remains limited by awareness and access barriers across patients, caregivers, and physicians. Methods: We conducted a cross-sectional study (June–September 2025) using IRB-approved REDCap surveys distributed to patients with MM (via MyChart), caregivers of TCRT recipients (via email), and community physicians (via email). Surveys assessed TCRT familiarity, perceived barriers, and access challenges. The primary objective was to compare TCRT utilization across racial groups among previously treated patients. Results: A total of 428 respondents participated (346 patients, 51 caregivers, 31 physicians). Among patients, 18% were Black. Overall, 26% were unfamiliar with TCRT, with higher unawareness among Black patients (32% vs. 25%) and those with ≤high school education (42% vs. 23%). Higher education was associated with twice the odds of TCRT utilization (p = 0.05). Among patients reporting prior MM treatment, TCRT utilization was similar across racial groups (39% Black vs. 38% non-Black). Among patients reporting TCRT receipt, Black patients more frequently reported receiving therapy through clinical trials compared with non-Black patients (44% vs. 34%). Among caregivers, 53% reported effects on mental/emotional wellness, 61% moderate-to-high stress during treatment, and 33% provided >40 h/week of care during month one. Among physicians, 71% referred patients for TCRT, but 48% reported <25% of referrals resulted in treatment. Patient hesitancy was the most cited referral barrier. Conclusions: Awareness gaps disproportionately affect Black patients and those with lower education. Caregivers experience substantial emotional and time burden. Patient hesitancy remains the primary barrier to TCRT referrals. Clinical trials may serve as an alternative access pathway for some patients. Multi-level interventions targeting education, caregiver support, and care coordination are needed to improve equitable TCRT access. Full article

Early childhood education (ECE) professionals’ reflections on mental states have been associated with staff–child interaction quality and child development. However, experimental evidence from mentalization training in ECE teacher education is limited. Fifteen Finnish student teachers with a caregiver background, enrolled in a higher education program, participated in a Video Enhanced Reflective Practice (VERP) intervention. The training was integrated in two blended learning study modules, where the focus was to support children’s language, cognitive, and social–emotional development. The student teachers’ observed mental state talk increased during trainer-guided peer discussions as well as student-guided discussions with two children during picture book reading interactions. The student teachers’ self-reported general interaction skills also improved. In the pilot study, growth was observed in mentalization and interaction skills, following a higher education program that combined VERP with evidence-based content. The preliminary data suggest that future interventions should focus on the transfer of training and on improving ECE student teachers’ talk about emotional states during interactions with children. Full article

Background/Objectives: Empathy is a fundamental component of pediatric oncology nursing. This study aims to examine in depth how nurses working in pediatric oncology define empathy, experience it in clinical practice, and manage emotional and professional boundaries in the empathetic care process. Methods: A qualitative research design was used. Semi-structured individual interviews were conducted with 17 nurses with at least 2 years of experience in pediatric hematology-oncology units. The interviews were conducted via Zoom. Data were analyzed using Braun and Clarke’s thematic analysis, and data collection continued until thematic saturation was achieved. Results: Three main themes were identified: Understanding Empathy, The Journey of Empathy, and The Cost of Empathy. Nurses defined empathy as an indispensable part of high-quality pediatric oncology care; however, they reported conceptual uncertainty in distinguishing empathy from sympathy and indecision regarding appropriate emotional boundaries. Empathy was perceived as a dynamic process shaped more by clinical experience than formal education. Early professional experiences were often characterized by emotional distress, while increasing experience enabled nurses to regulate their emotions and adopt more sustainable empathic practices. Despite this adaptation, prolonged exposure to children’s suffering and death was associated with compassion fatigue and emotional exhaustion. The absence of structured empathy training and formal emotional support systems further intensified these challenges. Conclusions: In pediatric oncology nursing, empathy is a complex, evolving professional competency that demands continuous emotional regulation and boundary management. Structured empathy training, reflective supervision, and strengthening institutional support mechanisms are essential to promote sustainable empathic care while protecting nurses’ emotional well-being. Full article

Simulation-based learning (SBL) is recognized as a transformative methodology in teacher education, yet the social–emotional processes through which pre- and in-service teachers navigate role dissonance remain underexplored. Drawing on the Social–Emotional Learning (SEL) framework proposed by CASEL, this study conceptualizes simulation as a cyclical SEL loop across three phases, pre-briefing, simulation, and debriefing, each activating distinct competencies: self-awareness, self-management, social awareness, relationship skills, and responsible decision-making. This qualitative phenomenological inquiry examines the lived social–emotional experiences of pre- and in-service teachers participating in The School of Valtance, a large-scale, multi-role international simulation embedded in a postgraduate teacher qualification program. Participants from 9 international faculties were deliberately assigned to roles, such as pedagogue, head of studies, and parent, divergent from their professional backgrounds, generating the cognitive–emotional disruption known as the “valley of despair”. Data were gathered through semi-structured interviews, reflective journals, and facilitator field notes across all three simulation phases and subjected to thematic analysis. The findings reveal that role dissonance disrupts participants’ emotional equilibrium, activating self-awareness and social awareness competencies that precede and enable metacognitive growth. The debriefing phase emerges as the space in which the SEL loop closes, as participants articulate and consolidate both the emotional turbulence and relational learning generated during the simulation, transforming affective experience into transferable social–emotional competence. These findings offer practical guidance for simulation designers seeking to embed SEL intentionally across all phases of the pedagogical cycle in intercultural teacher training contexts. Full article

Background/Objectives: Tinnitus is often a distressing and disabling condition that negatively affects individuals’ emotional well-being and quality of life. The aim of this study was to evaluate the relationship between perceived tinnitus handicap and sociodemographic and clinical characteristics, personality traits, and symptoms of depression, anxiety, and stress. Methods: Tinnitus patients with hearing loss (N = 127) underwent audiologic testing and completed the Tinnitus Handicap Inventory (THI), Depression Anxiety Stress Scales (DASS), and Eysenck Personality Questionnaire—Revised Short Form (EPQ-RS). Patient sociodemographic data (age, sex, and education level) and descriptive tinnitus characteristics were collected. The control group (N = 119) comprised tinnitus-free patients with hearing loss. Results: Patients experiencing catastrophic tinnitus reported significantly higher depression, anxiety, and stress scores compared to those with slight, mild, or moderate tinnitus grades. Education level was weakly negatively associated with THI scores. Conversely, weak-to-moderate positive relationships were observed for tinnitus loudness, pure tone average, the three DASS subscales, and the neuroticism subscale. Hierarchical multiple regression identified subjective tinnitus loudness, neuroticism, and total emotional distress (the total DASS score) as statistically significant predictors of the total THI score. Patients with tinnitus showed statistically significantly higher depression, anxiety, and stress subscale scores compared to tinnitus-free controls. Conclusions: The severity of tinnitus handicap is strongly correlated with subjective loudness, underlying neuroticism, and emotional distress. Patients with catastrophic tinnitus exhibit markedly higher levels of depression, anxiety, and stress. Consequently, clinical management of tinnitus must move beyond standard audiologic testing to include comprehensive psychological screening and targeted distress-reduction therapies. Full article

Free generative AI (GenAI) services appear to democratize access, but freemium platform models can create post-access stratification after basic connectivity and initial use have been achieved. This article conceptualizes paid commitment to GenAI as an emergent outcome of a socio-technical system composed of platform tiers, user capabilities, task environments, economic constraints, affective feedback, and institutional access. Using a cross-sectional 2025 survey of 2000 South Korean adults aged 18–69, the study models the observed states of non-use, free use, and paid commitment through sequential logit models. Descriptive results show that 70.6% of respondents used GenAI in the previous year, yet only 20.6% of users, or 14.6% of the total sample, paid for access. Practical AI literacy is positively associated with both initial use and paid commitment, whereas critical AI awareness is associated with initial use but not payment. Negative emotions are negatively associated with initial use but positively associated with paid commitment among users, a pattern consistent with vigilant and intensive engagement. The premium digital divide is defined not as a fourth level of the digital divide, but as a tier-mediated extension of second-level inequality that may condition access to later educational, occupational, or civic benefits. Because the data are cross-sectional and combine different GenAI platforms, the estimates are ecosystem-level associations and do not establish causal direction or platform-specific effects. Full article

Background/Objectives: Substance use disorders remain a significant public health concern, particularly when vulnerability emerges during adolescence and young adulthood. Although much of the literature has focused on treatment and recovery, prevention-oriented scholarship increasingly points to the value of strengths-based approaches that reduce risk by cultivating protective processes. This narrative review examines resilience as a protective factor in substance use prevention across adolescence and young adulthood, with particular attention to health promotion, developmental context, and multilevel prevention systems. Methods: A narrative review approach was used to synthesize interdisciplinary literature from psychology, public health, education, addiction studies, and prevention science. The review focused on peer-reviewed scholarship addressing resilience, protective factors, and prevention-related processes relevant to adolescent and young adult substance use. Literature was analyzed thematically across major domains including conceptualizations of resilience, developmental relevance, protective factors, prevention strategies, diverse and at-risk populations, and conceptual and methodological challenges. Results: The literature suggests that resilience is most useful for substance use prevention when conceptualized as a dynamic and ecological process rather than a fixed individual trait. Protective processes associated with lower substance use risk include emotional regulation, adaptive coping, family support, peer connectedness, school engagement, community cohesion, and culturally meaningful sources of identity and belonging. Prevention strategies appear most promising when they are multilevel, relational, developmentally responsive, and integrated with broader mental health and health promotion efforts. At the same time, the literature remains limited by definitional inconsistency, measurement variability, heterogeneous outcome indicators, a predominance of cross-sectional evidence, inconsistent or null protective effects for some factors and outcomes, and insufficiently contextualized uses of resilience. Conclusions: Resilience offers a valuable framework for substance use prevention across adolescence and young adulthood when it is grounded in developmental, ecological, and equity-aware perspectives. Prevention may be strengthened by moving beyond deficit-focused models and intentionally cultivating the supportive conditions under which young people can adapt, connect, and thrive without turning to substances as a means of coping. Full article

Background/Objectives: Hispanic adults in the United States seek and access professional mental health services at a disproportionately lower rate than non-Hispanic White adults, despite having similar rates of mental health challenges. Community focus groups held in El Paso, Texas, in 2022 revealed both systemic and individual-level factors that serve as barriers to help-seeking and access. Participant recommendations for overcoming these barriers included increasing mental health education and improving the cultural responsiveness and navigability of mental health services. Stemming from these findings and informed by the literature on trauma-informed practice, culturally responsive interventions, and evidence-informed practices, we developed and pilot-tested a 4-week closed group community-grounded mental health engagement program called Pensamientos y Pláticas. Methods: The program was offered to 82 participants. Paired-sample t-tests were used to analyze differences between pre- and post-intervention data for the outcome variables assessed: stigma and emotional well-being. Analysis was limited to the 39 participants who completed at least half of the modules and had intact pre- and post-intervention data. Results: Data analysis revealed a statistically significant reduction in stigma related to help-seeking with a small-to-moderate effect size, while no statistically significant increase in emotional well-being was supported by the data. Conclusions: Findings from this pilot study reflect preliminary evidence of feasibility, acceptability, and potential benefit at reducing stigma related to seeking help in Hispanic communities and support Pensamientos y Pláticas as a promising culturally responsive stigma-reduction intervention. Full article

Professional online communities increasingly function as digital social infrastructures during societal disruption, yet less is known about how their support practices reorganize during prolonged crises. This study examined how social support, engagement patterns, and support-seeking behavior changed in a large Hebrew-language professional Facebook group for Israeli educators across routine and crisis periods. Quantitative content analysis was conducted on an analytic sample of 1008 posts published between January 2022 and July 2025, covering the pre-war period and the wartime period following October 2023. Posts were coded for informational, emotional, and instrumental support and for support-seeking, and negative binomial and logistic regression models examined engagement and predictors of support-seeking. Informational support was dominant (69.3%), followed by support-seeking (30.7%), emotional support (12.8%), and instrumental support (4.4%). During wartime, support-seeking and instrumental support were less frequent, whereas informational and emotional support were more frequent. Informational posts received approximately three times more likes, while support-seeking posts received fewer likes but sustained comment activity. Anonymous authors were more likely to seek support, but posts by anonymous authors received fewer comments. The findings suggest an aggregate pattern of support flexibility in the analytic sample, reflected in a relative shift from reactive support-seeking toward proactive informational sharing and emotional processing as part of collective resilience-building during sustained societal crisis. Full article

Background: Children growing up in alcohol-affected families are exposed to chronic stress, adverse childhood experiences (ACEs), emotional insecurity, and environmental instability, all of which may influence neurodevelopmental processes. Numerous EEG markers have been proposed as indicators of attentional regulation, emotional functioning, and stress responsivity; however, their relative diagnostic and practical value remains unclear. The aim of the present study was to verify whether commonly reported EEG markers remain valid indicators of neurofunctional difficulties in children from alcohol-affected families, to establish their hierarchy of importance, and to determine how identified neurofunctional profiles may inform the sequencing of educational interventions and the development of individualized support plans used by educators and social workers. Methods: The study included children aged 6–10 years from alcohol-affected families (n = 20) and a control group from non-dysfunctional family environments (n = 25). Resting-state EEG recordings were conducted under eyes-open and eyes-closed conditions, with analyses focused on the eyes-open condition. Quantitative EEG (qEEG) indices included global, frontal, prefrontal, and midline Theta–Beta Ratio (TBR), frontal alpha asymmetry (FAA), temporal beta stress and parietal beta2 tension. EEG preprocessing was performed using EEGLAB and included artifact rejection, filtering, epoch segmentation, and spectral power analysis. Group differences were analyzed using Welch’s t-tests with Benjamini–Hochberg correction for multiple comparisons. Results: The analyzed EEG markers differed in their ability to distinguish children from alcohol-affected families and controls. The strongest effects were observed for Theta–Beta Ratio (TBR) measures, particularly in frontal and prefrontal regions, indicating impairments in attention regulation, executive functioning, and self-control. Elevated temporal beta stress and parietal beta2 tension reflected increased physiological arousal and chronic stress. In contrast, frontal alpha asymmetry (FAA), commonly associated with depressive emotional processing, was not significant after correction for multiple comparisons. The obtained findings enabled the establishment of a hierarchy of neurofunctional markers, with attentional and executive-function indicators demonstrating greater importance than markers related to depressive symptomatology. Conclusions: The EEG profile of children from alcohol-affected families is characterized primarily by chronic stress, heightened physiological activation, and impaired attention regulation rather than by neurophysiological patterns associated with depression. The results suggest that educational difficulties in this group may stem mainly from deficits in attention control, inhibitory processes, and cognitive flexibility. Consequently, educational interventions should prioritize learning strategies, attentional training, and self-regulated learning skills. The identified hierarchy of EEG markers may also support the development of individualized educational plans and social-support programs, including participation in structured extracurricular activities and interventions aimed at strengthening executive and learning-related competencies. However, given the pilot nature of the present study and the relatively small sample size, these findings should be considered preliminary. Replication in larger, more diverse, and independent cohorts is necessary to confirm the stability, reliability, and generalizability of the identified neurofunctional profile and the proposed hierarchy of qEEG markers before they can be recommended for broader educational and social applications. Full article

As generative AI technologies become increasingly embedded in educational cloud platforms, understanding their impact on teacher professional development is essential. Grounded in the stimulus–organism–response (S–O–R) framework, this study investigates how AI-driven stimuli—hedonicity, interactivity, and immersion—influence teachers’ self-regulation and resilience. Using structural equation modeling, data were collected from in-service teachers in Taiwan who actively utilize educational cloud platforms. The results reveal that all three AI-driven stimuli significantly enhance teachers’ self-regulation and resilience, which in turn are significantly associated with perceived value co-creation intentions. Specifically, self-regulation enables teachers to manage goals effectively, while resilience supports their recovery from technical setbacks. The findings indicate that self-regulation positively influences resilience, and both appear to mediate the relationship between perceived AI-driven stimuli and teachers’ value co-creation intentions. This study highlights the potential role of teachers’ psychological adaptability in AI-enhanced environments. Practical implications suggest that platform developers and administrators should prioritize AI features that foster self-directed learning and emotional engagement to promote collaborative willingness and professional alignment within modern educational ecosystems rather than implying proven macro-level transformation. Full article

Interactions with people who are highly engaged in sustainability (e.g., zookeepers, environmental educators) can have a significant impact on motivating less-engaged individuals to adopt more pro-environmental beliefs and to act on them. The current work examined two groups, graduate students mainly in conservation careers (n = 35) and an undergraduate comparison group (n = 237), to observe how they differed on sustainability beliefs (e.g., reports of willingness to sacrifice for the environment, anthropogenic global warming beliefs), reports of emotional experiences, reflections on nature, and nature–self–humanity cognitive representations. In comparison to undergraduate students, a frequently studied population in sustainability research, the graduate students reported greater willingness to sacrifice for the environment, stronger belief in anthropogenic global warming, and weaker self-interested emotions. When spontaneously reflecting on nature, the graduate students expressed greater connection with nature and stronger negative feelings about how humanity treats the environment. Finally, the graduate students showed more sustainable nature–self representations (e.g., greater inclusion of nature in self, viewing nature as larger than the self). We discuss the implications of these findings for understanding groups that may vary in environmental engagement, for developing measures to assess qualitative and quantitative assessments of nature–self–humanity knowledge, and for providing observations that may spur future work on encouraging people to care more strongly about nature and for supporting people engaged in sustainability fields. Full article

This study examines the challenges facing intercultural competence education in higher education during times of intense conflict. Most of the intercultural competence programs in higher education are based on Western liberal multicultural logic that strives to build trust between groups in conflict to promote peacemaking. The common conception of trust is described as a developmental cognitive–emotional effort that is anchored in a reflective and multi-perspective calculation of events and procedures that require a willingness to give up parts of positions and standpoints. The process is supposed to be mediated by a professional and unbiased facilitator who creates a “dialogic space” based on self-reflection and perspective-taking of the “other”. Previous findings suggest that these programs were relatively efficient before the 7 October war broke out in Israel. Thus, a joint Palestinian and Jewish program that was conducted at a teacher training college after 7 October challenged these findings. Examining the discursive practices used by the participants during the meetings revealed that the basic liberal multicultural assumptions of the intercultural competence model were rejected by students from both groups. The students interpreted the model as a way to contextualize the term peace in a specific ideological–political context. Understanding peace as a concept with a layered meaning contradicts the intercultural competence model’s perception of it as a universal–humanistic–independent position. Thus, the findings further problematize the universal perception of intercultural competence models in order to adjust them to teacher trainees working outside the West during difficult times. Full article

Sexual and reproductive behaviors and mental health among indigenous peoples are influenced by structural, cultural, and territorial determinants. In Latin America, indigenous populations face inequities related to health service access, sexual education, and mental health care. We assessed the association between sexual and reproductive factors and the presence of mental health symptoms in Wayúu indigenous communities. A cross-sectional study was conducted between 2024 and 2025 in Wayúu communities in Manaure, La Guajira, Colombia. A structured survey including sociodemographic variables, sexual and reproductive history, and mental health symptoms was applied to adult Wayúu indigenous people. A composite score of mental health symptoms was constructed, and the presence of ≥3 symptoms was defined as a “high burden of mental health symptoms.” Descriptive analyses and multivariate logistic regression were performed to estimate adjusted odds ratios (OR). In total, 245 (203 women and 42 men) people participated in the study. The median age was 30 years (IQR 24–38). Forty-nine percent did not receive sex education, and 65% did not use family planning methods. Between 28% and 33% reported persistent symptoms of emotional distress. In multivariable analyses, female sex showed a non-significant association with a higher burden of mental health symptoms (aOR 2.20; 95% CI 0.91–6.19). No statistically significant associations were observed for age, lack of sex education, non-use of family planning methods, or number of children. These findings highlight the high frequency of poor sexual and reproductive health indicators and emotional distress symptoms in Wayúu communities, underscoring the need for integrated, culturally relevant approaches to sexual, reproductive, and mental health care in this population. Full article

This qualitative study, grounded in a phenomenological-interpretive design, aimed to explore university students’ experiences regarding digital hyperconnectivity, emotional well-being, and the balance between academic and personal life at a private university in Viña del Mar, Chile. The sample consisted of 18 Occupational Therapy students (mean age: 22.4 years; 61.1% female, 27.8% male, 5.6% non-binary; representing a diverse range of undergraduate academic years from second to fifth). Data were collected through individual semi-structured interviews and analyzed using open, axial, and selective coding following grounded theory guidelines, with the assistance of Atlas.ti v25 software, to identify emerging categories and establish conceptual relationships. Findings were organized into two analytical categories. The first, Experiences and perceptions of digital hyperconnectivity, portrays hyperconnectivity as a taken-for-granted everyday condition shaped by intensive device use and the predominance of social media, streaming platforms, and artificial intelligence tools; within this category, a tension emerges between recognized practical/pedagogical usefulness and distracting or compulsive patterns of use. The second, Emotional well-being and balance in academic life, highlights the impact on emotions, time management, sleep, and relationships, as well as disconnection strategies to restore balance (time limits, mental breaks, and offline activities). In conclusion, digital hyperconnectivity is significantly associated with emotional well-being and the academic-personal life balance. Students’ narratives suggest that technology can enrich learning when accompanied by regulation, media literacy, and deliberate disconnection practices. Therefore, context-sensitive institutional interventions are needed to promote conscious disconnection, digital identity education, and a pedagogical design that integrates digital tools through a critical and ethical approach. Full article