Search Results (5,125)

Background and Objectives: Oral health is an important component of overall health, including in children, since dental caries is the most frequent oral health condition in this demographic. It affects children’s daily performance and can lead to complications ranging from moderate discomfort to highly disabling problems, which are reflected in their quality of life. Validating instruments that provide reliable information to measure how oral health impacts children’s quality of life will help prioritize the management of these problems through personalized treatments. The aim of this study was to perform transcultural adaptation and Spanish validation of a POQL instrument in children aged 6 to 12 years who attended the Pediatric Dentistry Clinic at the Universidad Autónoma de Ciudad Juárez (UACJ), and to establish an association between the presence of carious lesions and the quality of life of children. Materials and Methods: We conducted a validation study involving a sample of 379 children aged 6 to 12 years who were attending the Pediatric Dentistry Clinic at the Universidad Autónoma de Ciudad Juárez. The instrument, adapted into Spanish, was applied to measure oral health-related quality of life, and the clinical diagnosis of caries was established using the ICDAS II system. Results: The mean age of the children was 8.51 years ± 1.64; 50.4% were boys and 49.6% girls. A total of 45.9% of the children presented caries with ICDAS II codes 5 and 6, corresponding to a severe stage with advanced tooth destruction, and 52% of the children reported their perception of their oral health-related quality of life as good. In the bivariate statistical analysis, the chi-square test showed no relationship between moderate and severe ICDAS II stages and the children’s perception of their quality of life, resulting in a very low Spearman correlation. Conclusions: The findings suggest that this instrument may represent a reliable and valid tool for use in children aged 6 to 12 years. The observed association between different degrees of carious lesions and children’s quality of life may reflect the close relationship between oral health and important psychosocial domains, including physical, emotional, and social development, which constitute the core dimensions evaluated by the POQL instrument. Full article

Introduction: Problematic internet use has been increasingly associated with depression, anxiety and other psychiatric symptoms; however, its impact on attentional functioning has not been thoroughly researched. This cross-sectional study was conducted in Târgu Mureș, Romania, and aimed to examine the associations between problematic internet use, attentional control, and symptoms of depression and anxiety in adults, and to determine whether problematic internet use independently predicts attentional control after accounting for emotional symptoms. Methods: A cross-sectional study was conducted on 224 adults who completed an anonymous online survey between 1 January 2026 and 1 April 2026. Problematic internet use was assessed using the Compulsive Internet Use Scale-14 (CIUS-14), attentional control using the Attentional Control Scale (ACS), depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9), anxiety symptoms using the Generalized Anxiety Disorder-7 scale (GAD-7), and eating disorder risk using the SCOFF questionnaire. Descriptive statistics, internal consistency analyses, Pearson correlations, group comparisons according to the CIUS-14 screening threshold, and multiple linear regression analyses were performed. Results: Problematic internet use was significantly associated with lower attentional control (r = −0.493, p < 0.001), higher depressive symptoms (r = 0.408, p < 0.001), and higher anxiety symptoms (r = 0.467, p < 0.001). In the regression model, problematic internet use remained the only significant independent predictor of attentional control (B = −0.597, p < 0.001), whereas depressive and anxiety symptoms were not significant after adjustment. Participants above the CIUS-14 screening threshold reported significantly lower attentional control and higher depression and anxiety scores than those below the threshold. Conclusions: Problematic internet use was associated with poorer attentional control and greater emotional symptom severity in Romanian adults. These findings suggest that problematic internet use may be linked to a broader cognitive–emotional vulnerability profile. However, because of the cross-sectional design, self-report measures, convenience sampling, and lack of detailed information on specific online activities, the findings should be interpreted cautiously. Longitudinal studies using objective cognitive measures and more detailed assessment of digital behaviors are needed. Full article

This study investigates how chromatic manipulation of cinematic content modulates emotional engagement, with specific attention to sex-differentiated responses. We used a mixed factorial design with chromatic condition as a within-subject factor and biological sex as a between-subject factor, counterbalanced across scenes through a 3 × 3 Latin square that renders scene identity orthogonal to chromatic condition by construction. Thirty adult viewers were recorded with synchronised facial-expression analysis (AFFDEX 5.1), blink detection, and galvanic skin response (Shimmer GSR). The primary inferential target was the Condition × Sex interaction on automated positive facial valence. This interaction was statistically reliable under three converging tests: a mixed-effects model (${\beta }_{\mathrm{Mod}\times \mathrm{F}}=-4.48$, $SE=2.16$, 95% CI $[-8.81,-0.14]$, $p=0.043$), a participant-level cluster bootstrap (2000 resamples; 95% percentile CI $[-9.78,-0.63]$; $p_{\mathrm{boot}}=0.011$), and a label-permutation test. The effect was stable under leave-one-subject-out resampling (100% sign-stability) and persisted after introducing scene as a fixed factor. Blink rate and electrodermal activation showed directionally consistent but weaker interaction patterns. A multidimensional engagement framework that separates attentional-autonomic intensity from expressive valence supports interpretation of the finding as specific to expressive affective behavior rather than to overall activation. The results provide empirical evidence that chromatic manipulation in realistic cinematic stimuli modulates expressive affective responses in a sex-dependent manner, and they establish a reproducible multimodal biometric framework for chromatic impact assessment. Full article

Background/Objectives: With the development of the silver economy, older adults have shown increasing interest in digital technologies, such as electronic fitness games (Exergames). This study explores the impact of commercial exergames on the emotional experience of older adults in order to provide novel ideas and applications for healthy aging. Methods: This was a prospective, single-center, unblinded, repeated-measures randomized controlled trial comparing an exergame intervention with traditional indoor exercise. This study included 30 older adults (aged 60–89 years) who were able to move independently. The intervention group performed exergame training using Ring Fit Adventure, whereas the comparison group performed traditional indoor exercise. The intervention lasted four weeks, with two sessions per week (eight sessions). Mood states were assessed using the Brunel Mood Scale, and data were analyzed using a linear mixed-effects model to examine group, time, and interaction effects. Results: Significant group × time interaction effects were observed for confusion, depression, fatigue, tension, and vigor (p < 0.05). No significant interaction effect was found for anger (p = 0.942). Conclusions: This study examined commercial exergames from the perspectives of emotional experience and mental health. Both commercial exergames and traditional indoor exercise were associated with improvements in immediate mood states. The exergame-based training approach was associated with lower levels of confusion, depression, and fatigue, as well as higher vigor scores. The results provide preliminary evidence regarding the role of digital exercise in mood regulation among older adults. Full article

This study addresses second-home ownership not merely as a form of tourism accommodation or real estate investment, but as a home-building process intersecting with local life, belonging, daily practices, and sustainable destination governance. While the economic, environmental, and community impacts of second-homes have been extensively discussed in the literature, how individuals perceive their primary and secondary homes differently in terms of the bodily, material, vibrant, imaginary, and emotional dimensions of home has been examined in a limited number of studies. This research analyzes paired data obtained through a two-stage online questionnaire from 223 British participants who own a secondary home in the Mugla–Ortaca region and a primary home in the United Kingdom. The 18-item Home Scale was used as the measurement tool. Confirmatory factor analysis, reliability–validity analyses, measurement invariance, and paired-samples t-tests were applied. The findings show that the bodily home difference was not statistically significant at the conventional 0.05 threshold, whereas primary-home scores were significantly higher in the material, vibrant, imaginary, and emotional home dimensions. The small to small-medium effect sizes suggest that the results should be interpreted cautiously as an asymmetrical home-building process rather than as evidence of a hierarchical superiority of the primary home. The study proposes a planning approach that does not view second home owners as merely transient consumers in sustainable coastal–rural destinations, but rather considers social sustainability, service planning, seasonality management, and local community engagement channels together. Full article

Introduction: The work-related quality of life affects employee satisfaction and organizational effectiveness, with a direct impact on the quality of healthcare. This study aims to investigate the work-related quality of life (WRQoL) among nurses in tertiary healthcare, as perceived by the nurses themselves, in relation to their demographic and professional characteristics. At the same time, it seeks to highlight the way in which the individual dimensions of WRQoL influence their sexual and mental health. Materials and Methods: A descriptive cross-sectional study was conducted in 2023 in a General Hospital in Greece. Data were collected using structured questionnaires assessing sociodemo-graphic and occupational characteristics, WRQoL, mental health (Depression, Anxiety and Stress Scale—DASS-21), and female sexual function (Female Sexual Function Index—FSFI-19). Pearson correlation analysis and multiple linear regression analysis were performed. The regression model was adjusted for age, marital status, number of children, and work experience. Results: The results demonstrated a significant negative association between depression and sexual function (β = −0.388, p = 0.029), while stress was positively associated with sexual function (β = 0.371, p = 0.038). The overall regression model was statistically significant (p = 0.001), explaining 18.6% of the variance in sexual function. Conclusions: The findings highlight the close interrelationship between work-related quality of life, mental health, and sexual function among nurses. Poorer psychological well-being was associated with reduced sexual function, emphasizing the impact of occupational and emotional burden on nurses’ overall health. These results underline the importance of supportive workplace environments and targeted interventions to promote mental and sexual well-being among healthcare professionals. Full article

Background/Objectives: Celiac disease is a chronic autoimmune disorder triggered by gluten ingestion in genetically predisposed individuals. In children and adolescents, it presents heterogeneously and may negatively affect physical, psychological, and social well-being. Although a strict gluten-free diet is the only effective treatment, it may also impose important dietary, social, and economic burdens. This systematic review aimed to evaluate the impact of celiac disease on the quality of life of affected children and adolescents and their families. Methods: This systematic review was conducted according to PRISMA, AMSTAR 2, and Cochrane Handbook recommendations. Searches were performed in PubMed, Scopus, CINAHL, Web of Science, and PsycINFO for studies published between 2019 and 2026 in English or Spanish. Quantitative, qualitative, and mixed-methods studies on pediatric celiac disease and quality of life were included. Two reviewers independently conducted study selection, data extraction, and risk-of-bias assessment. Due to study heterogeneity, a narrative synthesis was performed. Results: Thirteen studies were included. Children and adolescents with celiac disease generally reported lower quality of life, particularly in emotional, social, and school-related domains. Adherence to a gluten-free diet was an important factor associated with quality of life. Although it improved symptoms, it was also linked to social restrictions, nutritional imbalances, and financial burden. Families also reported stress, lifestyle changes, and reduced well-being. Findings should be interpreted cautiously due to heterogeneity and variability in methodological quality across studies. Conclusions: Current evidence suggests that celiac disease may have a multidimensional impact on the quality of life of pediatric patients and their families. These findings support the need for a comprehensive multidisciplinary approach addressing dietary, psychosocial, and family-related factors. Full article

Background/Objectives: Rare diseases have a substantial impact not only on affected individuals but also on their families, particularly parents who assume primary caregiving roles. Despite increasing attention to rare conditions, parents’ experiences remain fragmented across the literature. This integrative review aimed to synthesise existing evidence on the experiences and multidimensional impact of caring for a child with a rare disease on parents. Methods: An integrative review was conducted following Whittemore and Knafl’s methodology and reported according to PRISMA 2020 guidelines. A systematic search was performed across MEDLINE, CINAHL, PsycINFO, PsycARTICLES, and Scopus from 1 November 2025 to 31 January 2026. Twenty-two studies (qualitative, quantitative, mixed-methods, and reviews) were included. Data were analysed using thematic synthesis. Results: Three interrelated themes were identified: (1) the diagnostic journey, characterised by prolonged uncertainty, fragmented care, and the pivotal role of communication; (2) multidimensional caregiving burden, encompassing emotional, social, economic, and physical impacts, with notable gender differences; and (3) adaptive trajectories, involving dynamic coping processes, parental upskilling, and meaning-making. Across studies, caregiving burden emerged as a cumulative and system-influenced phenomenon, while adaptation was found to coexist with ongoing uncertainty rather than representing a linear resolution. Conclusions: Caring for a child with a rare disease profoundly affects parents across multiple domains. The findings highlight the need for integrated, family-centred care models, improved diagnostic communication, and sustained psychosocial support. Implications for nursing practice: Nurses play a key role in recognising caregiver burden, supporting adaptive processes, and promoting effective communication throughout the diagnostic and care trajectory. Full article

Although generative artificial intelligence (GenAI) feedback shows promise for educational applications, its actual impact on learning outcomes and the factors influencing its effectiveness remain unclear. This study conducted a systematic review and meta-analysis to evaluate the effectiveness of GenAI feedback and identify key moderating factors. Following the PRISMA 2020 guidelines, we reviewed 36 experimental and quasi-experimental studies published between 2023 and 2025, yielding 72 effect sizes. The results revealed that GenAI feedback had a moderate positive effect on academic achievement (g = 0.61), with significant moderation by contextual factors. Subgroup analysis revealed that teaching methods significantly moderated the effectiveness of GenAI feedback, with stronger effects observed in learner-centered environments promoting active construction than in teacher-centered, receptive instruction; whereas educational level, disciplines, intervention duration, and GenAI role showed no significant moderation. A three-level random-effects model was employed to account for effect size dependencies, correcting for the underestimation of standard errors typical of conventional two-level models. Outcome dimension analysis showed that GenAI feedback had the strongest impact on cognitive outcomes, with promising but less established benefits for metacognitive development, and modest effects on non-cognitive outcomes. Future research should further clarify the roles of metacognitive and non-cognitive outcomes in GenAI feedback. In practice, GenAI feedback should serve as complementary scaffolding within constructivist pedagogies to support metacognitive development, while teacher emotional support should be preserved to foster students’ non-cognitive development. Full article

Background/Objectives: Survival rates after pediatric liver transplantation have improved substantially over recent decades, yet the psychiatric consequences for recipients remain a concern that warrants closer attention. We sought to map the psychiatric symptom burden across multiple domains in this population and to determine which symptom clusters carry the greatest impact on health-related quality of life (HRQOL). Materials and Methods: Fifty liver transplant recipients between the ages of 8 and 18 were enrolled at a single center. Children and their parents completed four psychiatric measures—the CBCL, CDI, SCARED, and CRIES-13—alongside the parent-proxy PedsQL to capture HRQOL across physical, emotional, social, and school functioning domains. Correlations between instruments were calculated, and linear regression was used to determine which psychiatric variables independently predicted PedsQL Total scores. Results: Across all psychiatric measures, higher symptom scores were associated with lower HRQOL, with school functioning recording the lowest absolute PedsQL domain score, while emotional functioning demonstrated the strongest and most consistent inverse correlations with all psychiatric symptom measures across instruments. CBCL Total (r = −0.607), SCARED Total (r = −0.557), and CRIES-13 Total (r = −0.548) scores all correlated meaningfully with overall HRQOL. When entered into multivariable analysis, anxiety symptoms measured by the SCARED (β = −0.295, p = 0.032) and post-traumatic stress symptoms measured by the CRIES-13 (β = −0.400, p = 0.004) stood out as the two independent predictors of worse PedsQL Total scores. Conclusions: Even in medically stable recipients, anxiety and post-traumatic stress symptoms were independently associated with lower daily functioning scores and overall quality of life. These findings suggest that routine psychosocial screening and trauma-informed approaches may warrant integration into post-transplant care protocols, and that prospective, adequately powered studies are needed to confirm and extend these associations. Full article

Background/Objectives: Intermittent fasting (IF) has been widely investigated for its metabolic effects, including improvements in insulin sensitivity, lipid metabolism, and inflammatory markers. However, its psychological and experiential dimensions remain comparatively underexplored. The present narrative review examines IF within a psychobiological framework, integrating evidence from metabolic science, neuroendocrinology, and affective neuroscience to explore its potential impact on emotional regulation and interoceptive processes. Methods: A structured narrative literature search was conducted across PubMed, Scopus, and Google Scholar, focusing on studies published between 2010 and 2025. Eligible studies included human and relevant animal research addressing metabolic, hormonal, interoceptive, and psychological responses to IF. Evidence was synthesized thematically to identify convergent mechanisms linking metabolic adaptations to emotional and regulatory outcomes. Results: Available literature suggests that IF is associated with a metabolic shift toward lipid utilization, characterized by increased ketone body production, particularly β-hydroxybutyrate. These adaptations appear to be accompanied by modulation of neuroendocrine pathways and may influence central nervous system functioning through mechanisms potentially related to neuroinflammation, mitochondrial efficiency, and synaptic plasticity. Emerging evidence further suggests that IF may modulate BDNF signaling and gut–brain axis activity, although direct causal pathways in humans remain to be established. At the psychological level, IF is associated with heterogeneous emotional outcomes: structured fasting protocols have been linked to modest improvements in perceived stress and mood in metabolically healthy individuals, whereas irritability, anxiety, or behavioral rigidity may emerge in those with pre-existing psychological vulnerabilities. Individual differences in interoceptive sensitivity, emotion regulation strategies, and moderating biological factors—including sex, circadian timing, and habitual physical activity—appear to influence these responses. Conclusions: Overall, IF may be conceptualized as a context-dependent psychobiological stressor whose effects extend beyond metabolic regulation to include interoceptive and emotional processes. These effects appear bidirectional, potentially promoting psychological resilience in some individuals while increasing the risk of affective destabilization or maladaptive behaviors in others. Current evidence remains limited by a lack of integrative and longitudinal studies combining metabolic and psychological measures. Future research adopting multidisciplinary approaches is needed to clarify the mechanisms underlying individual variability and to better define the potential benefits and risks of IF in both clinical and non-clinical populations. Full article

Objective: To analyse the rhetorical strategies employed in formal complaints regarding adult Attention Deficit Hyperactivity Disorder and Autism assessments, specifically where no service failure was identified. Methods: A rhetorical analysis was conducted on 48 complaints determined to be not upheld overall, submitted to a UK NHS Trust between 2024 and 2025. Results: Complainants demonstrated high rhetorical sophistication, frequently deploying a “Triple Core” strategy: Causal Attribution (blaming the service for life failures), Emotional Impact Description (framing dissatisfaction as medical trauma), and Procedural Challenge (alleging administrative breach). A minority (18.8%) employed economic arguments, whilst 81.2% included specific outcome demands, such as a prescription or a specific diagnosis. Conclusions: Complaints in this area of clinical practice demonstrate sophisticated rhetorical construction, functioning as instruments of organisational pressure. The “Triple Core” strategy creates an epistemic conflict where clinical judgement is contested by the patient’s lived experience narrative. These findings suggest that high complaint volumes may reflect a systemic gap between public expectation and clinical criteria rather than safety failures. Full article

Background/Objectives: This study aims to compare the oral health-related quality of life (OHRQoL) of children with molar incisor hypomineralisation (MIH) and their parents with that of an age- and caries-matched control group, and to evaluate the long-term impact of dental rehabilitation on OHRQoL. Methods: A total of 30 children aged 8–12 years were included, with 15 participants in the MIH group and 15 in the control group. OHRQoL was assessed using the Pediatric Oral Health-Related Quality of Life (POQL) scale. Data were obtained at baseline and at 3, 6, and 12 months after treatment. Statistical analyses included a chi-square test, independent samples t-test, Mann–Whitney U test and Friedman test, according to data distribution. Results: Baseline POQL scores were significantly higher in the MIH group compared with the control group for both children and parents (p = 0.020 and p = 0.036, respectively). Among subscales, emotional functioning scores in children and role and physical functioning scores in parents were significantly higher in the MIH group (p = 0.027 and p = 0.032, respectively). Following dental rehabilitation, POQL scores significantly decreased in both groups (p < 0.001), and this improvement was maintained throughout the 12-month follow-up period. Conclusions: MIH has a negative impact on the OHRQoL of both children and parents, regardless of caries experience. Comprehensive dental rehabilitation results in significant and sustained improvements in OHRQoL, indicating the importance of early and comprehensive management in children with MIH. Full article

This study aims to explore the relationship between negative meta-stereotypes, intergroup anxiety, doctor–patient trust, and doctor–patient relationships and investigate the intervention impact of imagined intergroup contact through two experiments. Study 1 examined whether intergroup anxiety and doctor–patient trust sequentially mediate the effect of negative meta-stereotypes on the doctor–patient relationship. Two hundred participants were randomly assigned to a negative meta-stereotype activation or control group, and completed measures of intergroup anxiety, doctor–patient trust, and doctor–patient relationship quality. Study 2 built on these findings by testing imagined intergroup contact as a potential intervention. Following negative meta-stereotype activation, 184 participants were randomly assigned to one of four conditions: no imagination, imagined landscape, imagined contact with a professionalism-focused physician, or imagined contact with a care-focused physician. Study 1 revealed that negative meta-stereotype activation significantly increased intergroup anxiety, decreased doctor–patient trust, and impaired the doctor–patient relationship. Importantly, intergroup anxiety and doctor–patient trust played a chain mediating role in this relationship. Study 2 demonstrated that only imagined contact with a caring physician (but not a purely professional one) significantly reduced intergroup anxiety, enhanced doctor–patient trust, and improved the doctor–patient relationship. These findings provide evidence consistent with a serial emotional-cognitive pathway from intergroup anxiety to doctor–patient trust through which negative meta-stereotypes may impair the doctor–patient relationship, and by pinpointing emotional care as the core component that makes imagined intergroup contact effective in this context. Full article

This study examines the relationship between Sudanese audiences’ exposure to digital media coverage of the civil war and their psychological immunity and post-traumatic stress disorder (PTSD) symptoms while also investigating the mediating role of psychological immunity. Data were collected through an online survey from a sample of 774 Sudanese respondents residing both inside and outside Sudan. The findings indicate a relatively high level of exposure to digital news coverage, particularly through social media platforms such as Facebook, reflecting the growing centrality of digitally mediated news environments in conflict reporting. The results also reveal moderate levels of psychological immunity and relatively high levels of PTSD symptoms, especially in the hyperarousal dimension. Statistical analysis shows a negative association between media exposure and psychological immunity, and a positive association between exposure and PTSD symptoms, with psychological immunity partially mediating this relationship. Beyond these findings, this study highlights important implications for journalism practice and media responsibility. The intensity and emotional nature of digital war coverage raise critical concerns regarding ethical news production, the circulation of distressing content, and the potential psychological impact on audiences. These findings underscore the need for more responsible digital journalism practices, including content moderation, trauma-sensitive reporting, and the promotion of media literacy, in order to mitigate the potential harm associated with repeated exposure to crisis-related news content. Full article