Search Results (4,310)

Anxiety and depression are common comorbidities in patients with chronic obstructive pulmonary disease (COPD), which can contribute to increased morbidity, reduced quality of life, and worse clinical outcomes. Nevertheless, these psychological conditions remain largely overlooked. This narrative review includes studies published between 1983 and 2025 to synthesise the current evidence on the risk factors, clinical impacts, and therapeutic strategies for these comorbidities. While the exact mechanisms leading to their increased prevalence are not fully understood, growing evidence implicates a combination of biological (e.g., systemic inflammation), social (e.g., isolation and stigma), and behavioural (e.g., smoking and inactivity) factors. Despite current guidelines recommending the identification and management of these comorbidities in COPD, they are not currently included in COPD assessments. Undetected and unmanaged anxiety and depression have serious consequences, including poor self-management, non-adherence to medications, increased risk of exacerbation and hospitalisations, and even mortality; thus, there is a need to incorporate screening as part of COPD assessments. There is robust evidence showing that pulmonary rehabilitation, a core non-pharmacological intervention, can improve mood symptoms, enhance functional capacity, and foster psychosocial resilience. Psychological therapies such as cognitive behavioural therapy (CBT), mindfulness-based approaches, and supportive counselling have also demonstrated value in reducing emotional distress and improving coping mechanisms. Pharmacological therapies, particularly selective serotonin reuptake inhibitors (SSRIs) and serotonin–norepinephrine reuptake inhibitors (SNRIs), are commonly prescribed in moderate to severe cases or when non-pharmacological approaches prove inadequate. However, the evidence for their efficacy in COPD populations is mixed, with concerns about adverse respiratory outcomes and high discontinuation rates due to side effects. There are also barriers to optimal care, including underdiagnosis, a lack of screening protocols, limited provider training, stigma, and fragmented multidisciplinary coordination. A multidisciplinary, biopsychosocial approach is essential to ensure early identification, integrated care, and improved outcomes for patients with COPD. Full article

As people spend extended periods of time indoors, stress and negative emotions caused by work have become increasingly difficult to ignore. Observing window views is widely considered an effective method to alleviate stress and promote mental health. However, the specific visual elements within these views that contribute to stress reduction and the differential restorative benefits across varying compositions remain insufficiently understood. This study focuses on four major visual elements commonly seen through windows: sky, buildings, greenery, and roads. Using a horizontal layering approach, nine window views were created based on different proportions of these elements. Participants were exposed to these views, and their responses were evaluated through the positive and negative affect scale (PANAS), as well as electroencephalographic (EEG) data acquisition. The findings indicate that greenery exhibits the most pronounced positive effect on stress mitigation and the enhancement of positive affect, while the presence of roads is more likely to elicit negative emotional responses. Additionally, the visual richness and structural completeness of the window scenes are found to significantly impact restorative outcomes. These findings provide empirical insights for landscape and architectural design aimed at improving psychological well-being. Full article

Objective: Irritability and reactive aggression are transdiagnostic features that are predictive of adverse long-term outcomes. This investigation examined whether intranasal oxytocin administration impacts the interaction between irritability and reactive aggression, and whether these effects can be detected at a neural level via a facial expression processing task during functional MRI (fMRI). Methods: In this study, 40 children and adolescents with severe irritability and psychiatric diagnoses of disruptive mood and behavioral disorders were assigned to either intranasal oxytocin or placebo administration over a 3-week period in a randomized, double-blind trial (ClinicalTrials, NCT02824627). Clinical measures and fMRI during a facial expression processing task were collected pre- and post-intervention. Brain regions sensitive to oxytocin administration were determined using whole-brain statistical analyses, with post hoc analyses to determine whether changes in the neural activity mediated the relationship between changes in irritability and reactive aggression across the intervention period. Results: Youth who received intranasal oxytocin administration exhibited significant decreases in irritability and reactive aggression compared to their counterparts in the placebo group. Further, oxytocin administration was associated with significant increases in neural activity in the right superior prefrontal cortex, which fully mediated the relationship between improvements in irritability and improvements in reactive aggression. Conclusions: Intranasal oxytocin significantly reduced irritability and reactive aggression in youth, as well as neural activity in the prefrontal cortex, such that increases in the cortical activity fully mediated the relationship between changes in irritability and reactive aggression. Taken together, these findings may reflect oxytocin-related enhancements in emotional regulation in youth with severe irritability, a potential therapeutic mechanism for mitigating reactive aggression. Full article

Purpose: To investigate the impact of mental fatigue on the shooting accuracy and movement timing in the instep kick of Asian high-level soccer players. Methods: Eight male collegiate soccer players (age 22.00 ± 0.93 years) were tested before and after mental fatigue induction. Mental fatigue was induced via a 30 min Stroop task. The effectiveness of fatigue induction was assessed using heart rate variability (HRV), a visual analog scale (VAS), rating of perceived exertion (RPE), and the Athlete Burnout Questionnaire (ABQ). Shooting performance was evaluated before and after mental fatigue using the Loughborough Soccer Shooting Test (LSST) and by evaluating timing by means of high-speed imaging. Results: Following mental fatigue induction, HRV decreased. Subjects’ motivation (VAS) to exercise significantly decreased (p < 0.001), while VAS mental fatigue level (p < 0.001) and mental effort level (p < 0.002) significantly increased. Significant differences were observed after completing the Stroop task for ABQ Emotional/Physical Exhaustion (p < 0.007), Reduced Sense of Accomplishment (p < 0.007), Sport Devaluation (p < 0.006), and overall burnout level (p < 0.002). LSST showed that the subjects’ left foot test scores (−4.13, p < 0.013), right foot test scores (−3, p < 0.001), and total scores (−3.16, p < 0.001) significantly decreased. Although movement times increased slightly after fatigue, they did not reach statistical significance. Conclusions: Mental fatigue significantly impairs the shooting accuracy of collegiate soccer players, as evidenced by decreased LSST scores. However, it has no significant effect on event duration during shooting execution. Mental fatigue affected decision-making but not shooting movement timing. More cognitively challenging tasks are more affected by mental fatigue. Full article

Employee turnover remains a critical challenge for organizations, prompting an examination of how leadership approaches influence employees’ intentions to leave. This study investigates the impact of transformational leadership on turnover intention, focusing on emotional exhaustion and creativity as potential mediators. The study employs a quantitative design grounded in leadership and organizational psychology theory and surveys 182 professionals working in the information technology sector across Bosnia and Herzegovina, Croatia, Serbia, and Montenegro. Structural equation modeling reveals that transformational leadership reduces turnover intention by alleviating emotional exhaustion, highlighting the importance of psychological well-being in employee retention. While transformational leadership enhances employee creativity, creativity did not significantly mediate turnover intention in this context. These findings suggest that strategies that foster engagement and reduce burnout in knowledge-intensive industries can strengthen organizational commitment and improve retention. This study contributes to the understanding of behavioral mechanisms linking leadership to employee outcomes and offers actionable insights for modern organizations aiming to address turnover through supportive, empowering leadership practices. Additional mediators and contextual variables should be explored in further research. Full article

Background/Objectives: Dry eye (DE) can cause persistent eye rubbing, contributing to keratoconus (KC) development and progression. Both keratoconus (KC) and dry eye (DE) significantly impact patients’ functional and emotional well-being, with KC patients exhibiting a higher prevalence of DE symptoms and signs. This study examined whether functional (KEPAQ-F) and emotional (KEPAQ-E) quality of life, assessed by the Keratoconus End-Points Assessment Questionnaire, differ when influenced by symptoms and clinical signs of general DE versus meibomian gland dysfunction (MGD) in KC patients. Methods: Volunteers with KC (ages 18–70) underwent DE and MGD assessments, completing OSDI, MGD (MGDQ), and KEPAQ questionnaires. Clinical measures included NITBUT, Schirmer, and meibography. Pearson correlations and path analysis assessed relationships between DE and MGD symptoms and KEPAQ-F/E. Results: Forty-five KC participants (mean age: 45 ± 13, range: 20–69 years, 25 males) were enrolled; 22 (49%) had DE, and 15 (33%) had MGD. Significant correlations were observed between KEPAQ-E (2.9 ± 3.0 Logit) and KEPAQ-F (1.7 ± 3.0 Logit) scores with OSDI (26.5 ± 26.7) and MGDQ (3.3 ± 2.2) scores, and all Belin outcome measures A-D for all participants. In participants with diagnosed dry eye, KEPAQ E and F were also significantly correlated with loss of meibomian glands in the lower eyelids (R = −0.44, p = 0.04). Path analysis showed both DE and MGD were negatively correlated with lower KEPAQ-E and KEPAQ-F scores, with DE symptoms were more influential (p < 0.05). The model explained 42% of the KEPAQ-E variance and 41% of the KEPAQ-F variance. Conclusions: Emotional and functional quality of life in KC is significantly and negatively related to DE and MGD symptoms, with DE symptoms exhibiting a greater impact. Furthermore, greater loss of meibomian glands in the lower eyelids is significantly associated with reduced emotional and functional KEPAQ scores in DE patients. These results underscore the critical importance of evaluating DE in KC to improve patient-reported outcomes. Full article

Background: Rapid urbanization has intensified the challenges of freight transport, particularly in last-mile (LM) delivery, leading to rising costs and environmental externalities. Autonomous vehicles (AVs) have emerged as a promising innovation to address these issues. While much of the existing literature emphasizes business and operational perspectives, this study focuses on the acceptance of AVs from the standpoint of e-consumers—individuals who make purchases via digital platforms—in an emerging market context. Methods: Grounded in an extended Unified Theory of Acceptance and Use of Technology 2 (UTAUT2), which is specifically suited to consumer-focused technology adoption research, this study incorporates five constructs tailored to AV adoption. Structural Equation Modeling (SEM) was applied to survey data collected from 304 e-consumers in Northeast Brazil. Results: The findings reveal that performance expectancy, hedonic motivation, and environmental awareness exert significant positive effects on acceptance and intention to use AVs for LM delivery. Social influence shows a weaker, yet still positive, impact. Importantly, price sensitivity exhibits a minimal effect, suggesting that while consumers are generally cost-conscious, perceived value may outweigh price concerns in early adoption stages. Conclusions: These results offer valuable insights for policymakers and logistics providers aiming to implement consumer-oriented, cost-effective AV solutions in LM delivery, particularly in emerging economies. The findings emphasize the need for strategies that highlight the practical, emotional, and environmental benefits of AVs to foster market acceptance. Full article

Objective: Considering the absence of research testing the entire sequence of passion, behavioral regulation, and subjective well-being (SWB), this study aimed to analyze the hypothetical causal relationships between the variables of a model that integrates the Dualistic Passion Model (DMP) and Self-Determination Theory (SDT) in order to understand the impact of harmonious passion (HP) and obsessive passion (OP) and the regulation of motivation on the SWB of elite athletes with disability. Method: This study includes 143 elite athletes from national adapted sports (36 female; 107 male) aged between 15 and 59 (M = 29.21; SD = 10.45). Weekly training sessions ranged from 1 to 12 (M = 4.52; SD = 2.71), and the years of competitive practice ranged from 1 to 28 (M = 5.55; SD = 6.98). Data were collected using valid and reliable questionnaires for the study population and analyzed using structural equation analysis. The following results were identified: a positive and a significant effect between OP and self-determination motivation (SDM); a positive but not a significant effect between OP and non-self-determination motivation (NSDM); a significant effect between SDM and SWL and SDM and positive affect (PA); and, finally, a positive but non-significant effect between SDM and negative affect (NA). In contrast, there is a positive and significant effect between HP and SDM; a negative and significant effect between HP and NSDM; a positive but non-significant effect between NSDM and SWL; a negative and significant effect between NSDM and PA; and, finally, a positive and significant effect between NSDM and NA. Conclusions: The perception of passion regarding sport can be a positive predictor of SDM, which, in turn, can influence levels of SWB, both from a cognitive point of view (SWL) and from an emotional point of view (PA). This reinforces the positive effect of the self-determination behavior in adapted sport on SWB and its contribution to health and quality of life in people with disabilities. Full article

Background: Fear of falling (FOF) is a significant concern among older adults, especially after total knee arthroplasty (TKA). FOF can limit daily activities, reduce quality of life, and hinder recovery. This study aimed to investigate the prevalence, severity, and impacts of FOF in patients undergoing TKA and identify factors contributing to increased FOF. Methods: A prospective observational study was conducted at King Abdulaziz Medical City in Riyadh, Saudi Arabia, from April 2024 to December 2024. This study included 52 participants aged 20 to 75 years who had undergone primary TKA. Data were collected at two time points: after TKA and at three months post-surgery. The Short Falls Efficacy Scale-International (SFES-I) was used to assess the severity of FOF, and the Short Form 36 (SF-36) was used to measure the quality of life. Descriptive statistics, t-tests, and logistic regression were used for analysis. Results: This study included 52 participants (mean age: 63.77 ± 6.65 years; 82.7% female). Post-TKA, all participants exhibited high FOF (mean SFES-I score: 56.75 ± 8.30). After three months, the mean SFES-I score decreased significantly to 49.04 ± 12.45 (t = 4.408, p < 0.05). Post-TKA, SF-36 showed significant improvements in the physical function, role of physical limitations, bodily pain, vitality, social function, role of emotional limitations, and mental health subdomains. Bilateral total knee arthroplasty, body mass index, and some SF-36 subcomponents—such as general health, vitality, and role of emotional limitations—were identified as factors leading to increased FOF. Conclusions: FOF remains prevalent and severe in TKA patients, even at three months post-surgery, affecting rehabilitation outcomes. Early identification and tailored interventions for FOF should be considered essential components of comprehensive TKA recovery programs. Full article

Background: Workplace mobbing is a widespread phenomenon with serious psychological and emotional consequences on employees’ emotional well-being. Psychological resilience has been identified as a potential protective factor against such adverse outcomes. Aim: This study investigates the relationship between workplace mobbing and emotional well-being, as expressed through positive and negative affect, and examines the mediating role of psychological resilience in this association. Methods: Ninety nurses participated in this cross-sectional study. Data were collected using the Connor–Davidson Resilience Scale (CD-RISC), the Workplace Psychologically Violent Behaviors (WPVB) scale, and the Positive and Negative Affect Schedule (PANAS). Statistical analyses included correlation, multiple regression, and mediation using bootstrapped confidence intervals. Results: Resilience was strongly associated with positive affect (r = 0.74, p < 0.001) and inversely with negative affect (r = −0.46, p < 0.001). Mobbing was significantly related to increased negative affect (β = 0.12, p < 0.001) but not to positive affect. Resilience emerged as the strongest predictor of emotional outcomes and partially mediated the relationship between “Attack on professional role” and negative affect. Conclusions: Psychological resilience plays a key protective role in moderating the emotional impact of workplace mobbing. Enhancing resilience in healthcare professionals may mitigate the negative emotional effects of mobbing, although it does not fully buffer against all its consequences. Full article

Early-career teachers (ECTs) entered the profession during the COVID-19 pandemic, a period that introduced unique stressors to an already-demanding career phase. This systematic review examines empirical studies published between 2020 and February 2025 to explore how the pandemic influenced ECT wellbeing, with particular attention to stressors and protective factors impacting long-term retention and professional sustainability. Guided by PRISMA protocols, databases including Web of Science, ERIC, Google Scholar, and Scopus were searched, screening 470 records and identifying 30 studies that met inclusion criteria: peer-reviewed, empirical, focused on early-career teachers (within the first five years), and situated in or explicitly addressing the pandemic and its ongoing impacts. The results of Braun and Clarke’s thematic analysis (2006) revealed that pandemic-related challenges such as increased workload, professional isolation, disrupted induction processes, and emotional strain have persisted into the post-pandemic era, contributing to sustained risks of burnout and attrition. Regardless, protective factors identified during the pandemic—including high-quality mentoring, structured induction programmes, collegial support, professional autonomy, and effective individual coping strategies—continue to offer essential support, enhancing resilience and professional wellbeing. These findings underscore the necessity of institutionalising targeted supports to address the enduring effects of pandemic-related stressors on ECT wellbeing. By prioritising sustained mental health initiatives and structural supports, education systems can effectively mitigate long-term impacts and improve retention outcomes for early-career teachers in a post-pandemic educational landscape. Full article

Physics concepts are considered an essential component of STEM (science, technology, engineering, and mathematics) education and fundamental for economic and technological development in the world. However, there can be student academic underperformance, such as the school environment, learning media and infrastructure, student interest and emotions, as well as social and economic development factors in communities. These problems are even more acute in rural areas of developing countries, where poverty is high and teachers often lack the necessary technological skills. The aim of this study was to evaluate the impact of a low-cost STEM tool focused on motivation in learning, in terms of five variables of interest in physics in rural areas, as well as the durability of the tools used to learn 12 physics concepts. A quasi-experimental study was conducted with the participation of 78 high school students, with an average age of 15.82 years, in a rural area of Guerrero, Mexico. The results showed that using the STEM tool significantly increased students’ interest in learning methodology, active participation, and attitude towards physics, facilitating the teacher’s work. In addition, the 3D construction kit used in the experimentation, besides being low-cost, proved to be affordable and durable, making it ideal for use in rural areas. Full article

During the transition of culture-featured district planning from static conservation to innovation-driven models, existing research remains constrained by mechanistic paradigms, reducing districts to functional containers and neglecting human perceptual interactions and meaning-production mechanisms. This study explores and quantifies the generative mechanisms of spatial communicability and cultural dissemination efficacy within human-centered frameworks. Grounded in humanistic urbanism, we analyze Harbin Central Street as a case study integrating historical heritage with contemporary vitality, developing a tripartite communicability assessment framework comprising perceptual experience, infrastructure utility, and behavioral dynamics. Machine learning-based threshold analysis reveals that spatial encoding elements govern communicability through significant nonlinear mechanisms. The conclusion shows synergies between street view-quantified greenery visibility and pedestrian accessibility establish critical human-centered design thresholds. Spatial data analysis integrating physiologically sensed emotional experiences and topologically analyzed spatial morphology resolves metric fragmentation while examining spatial encoding’s impact on interaction efficacy. This research provides data-driven decision support for sustainable urban renewal and enhanced cultural dissemination, advancing heritage sustainability. Full article

Advances in neuroscience have improved the understanding of cognitive, emotional, and social processes involved in learning. Simultaneously, technologies such as artificial intelligence, augmented reality, and gamification are transforming educational practices. However, their integration into formal education remains limited and often misapplied. This study aims to evaluate the impact of technology-supported neuroeducational models on student learning and well-being. A systematic review was conducted using PubMed, the Web of Science, ScienceDirect, and LILACS, including open-access studies published between 2020 and 2025. Selection and methodological assessment followed PRISMA 2020 guidelines. Out of 386 identified articles, 22 met the inclusion criteria. Most studies showed that neuroeducational interventions incorporating interactive and adaptive technologies enhanced academic performance, intrinsic motivation, emotional self-regulation, and psychological well-being in various educational contexts. Technology-supported neuroeducational models are effective in fostering both cognitive and emotional development. The findings support integrating neuroscience and educational technology into teaching practices and teacher training, promoting personalized, inclusive, and evidence-based education. Full article

This article examines training itineraries for early childhood education professionals in Portugal, focusing on promoting social and human development through music and the arts for infants. The training models discussed are categorized as short-term and long-term, encompassing both theory and practice through a transdisciplinary approach. Based on initiatives promoted by the Companhia de Música Teatral (CMT) and the Education and Human Development Group of the Centre for the Study of Sociology and Musical Aesthetics (CESEM) at NOVA University Lisbon, the article highlights projects such as: (i) Opus Tutti and GermInArte, developed between 2011 and 2018; (ii) the Postgraduate Course Music in Childhood: Intervention and Research, offered at the University since 2020/21, which integrates art, health, and education, promoting collaborative work between professionals; and (iii) Mil Pássaros (Thousand Birds), developed since 2020, which exemplifies the integration of environmental education and artistic practices. The theoretical basis of these training programs combines neuroscientific and educational evidence, emphasizing the importance of the first years of life for integral development. Studies, such as those by Heckman, reinforce the impact of early investment in children’s development. Edwin Gordon’s Music Learning Theory and Malloch and Trevarthen’s concept of ‘communicative musicality’ structure the design of these courses, recognizing music as a catalyst for cognitive, emotional, and social skills. The transformative role of music and the arts in educational and social contexts is emphasized, in line with the Sustainable Development Goals of the 2030 Agenda, by proposing approaches that articulate creation, intervention, and research to promote human development from childhood onwards. Full article