Search Results (1,110)

Background/Objectives: Chronic primary pain (CPP) is a new diagnostic category including chronic pain conditions lacking clinical signs or a clear etiopathogenetic origin. These disorders may share a common neural mechanism known as central sensitization, where nociceptive neurons become hyper-responsive to standard or subthreshold pain stimuli, resulting in pain hyper-sensitivity. In this context, non-invasive brain stimulation (NIBS) appears to be a promising tool for improving CPP symptoms by targeting maladaptive brain activity and connectivity. To date, the effects of NIBS on CPP symptoms remain unexplored. To fill this gap, we conducted a meta-analysis, investigating the effect of NIBS in improving the three core symptoms of CPP, namely pain intensity, emotional distress, and functional disability. Methods: Following PRISMA guidelines, we screened four databases up to February 2025 for English-language, peer-reviewed randomized clinical trials that included CPP patients treated with NIBS and reported pre/post or follow-up scores on validated measures of at least one core symptom. Quality of life was examined as an additional outcome. Results: Fifty-four studies were included, with 1371 participants receiving real stimulation and 1103 sham. Findings highlighted that real stimulation improved CPP symptoms immediately after treatment and at one-month follow-up. Meta-regressions showed that longer CPP duration reduced short-term effects on emotional distress and diminished all outcomes at one-month follow-up. Conclusions: Further research is needed to establish standardized NIBS protocols for CPP management, to investigate the effectiveness at longer follow-up periods, and to test whether combining NIBS with other interventions enhances treatment effectiveness and durability. Full article

Leftover spaces, often associated with neglected urban corners, bear physical and conceptual similarities to ignored parts of designed wholes. This study proposes an analytical approach to develop resilient intervention strategies by analyzing the production of leftover spaces through users’ emotional experiences. An experimental pilot study was conducted along Söğütlüçeşme Street in Kadıköy, Istanbul, where all corner points were typologically classified based on morphological characteristics. To measure the impact of these configurations on spatial emotional characters, a survey was implemented using Plutchik’s wheel of emotions. Following a quantitative analysis of emotion frequencies and intensities, findings were visualized via radar charts and spatialized using QGIS 3.40 to generate an emotional map. The resulting emotional maps were further used to identify spatial vulnerabilities and resilience priorities across the study area. By making the gaps between point-based emotional clusters continuous through the IDW interpolation method, the emotional topography of the study area was modeled, thereby presenting an analytical framework that identifies emotional thresholds, spatial vulnerabilities, and resilience priorities. Results indicate that as the physical boundaries of corner voids expand, influenced by angling and massing decisions, public diversity increases, creating a positive emotional atmosphere. Conversely, compressed voids demonstrate a higher potential for producing leftover spaces. This study reveals that mapping user emotions as a data layer is critical for constructing more inclusive and resilient urban environments. Full article

Background/Objectives: Labor pain is a multidimensional experience associated with physiological, cultural, psychological, and contextual factors. This study aimed to examine the association of personality-related characteristics, cultural beliefs, obstetric characteristics, and proxy indicators of post-disaster context with labor pain perception among women giving birth in Hatay after the 2023 Türkiye earthquakes. Methods: This prospective observational study was conducted with 314 women admitted to Hatay Training and Research Hospital between February and June 2025. Participants were between 38 and 42 gestational weeks, had a singleton healthy fetus, were admitted in active labor, and were expected to give birth vaginally. Data were collected using a researcher-developed questionnaire, the Ten-Item Personality Inventory, and the Visual Analog Scale. Labor pain was assessed at 6 cm, 8 cm, and full cervical dilatation (10 cm). Results: VAS scores increased significantly across cervical dilatation points, from 5.04 ± 0.81 at 6 cm to 7.01 ± 0.82 at 8 cm and 8.06 ± 0.93 at full cervical dilatation (10 cm). Repeated-measures ANOVA showed a significant within-person increase in pain intensity across the three assessment points, F(2, 626) = 996.444, p < 0.001, partial η² = 0.761. Age was not significantly correlated with VAS pain score at full cervical dilatation. In exploratory unadjusted comparisons, VAS scores at full cervical dilatation differed according to education level, official marriage status, previous birth history and mode, attendance at antenatal education, and praying to relieve labor pain. In the multivariable regression model, higher Extraversion and higher education level were associated with lower VAS scores, whereas attendance at antenatal education, greater importance given to traditional rules, previous assisted vaginal/cesarean birth, and current place of residence were independently associated with VAS scores. Conscientiousness was not significantly associated with VAS scores in the adjusted model. Earthquake experience was not significantly associated with VAS scores. Conclusions: Labor pain perception was associated with selected sociodemographic, obstetric, and cultural characteristics. The findings support the importance of individualized, culturally sensitive, and trauma-informed midwifery care in disaster-affected regions. Personality-related findings should be interpreted cautiously because the corrected reliability analysis showed low internal consistency for Agreeableness, Emotional Stability, and Openness to Experience, although Extraversion showed high internal consistency and Conscientiousness showed relatively better but still limited internal consistency. Disaster-related findings should also be interpreted cautiously because post-disaster context was assessed using only limited proxy indicators; current place of residence was independently associated with VAS scores in the adjusted model, whereas earthquake experience was not. Because of the observational design, causal interpretations cannot be made. Full article

Olfactory detection of essential oils (EOs), natural plant-derived mixtures of odorous volatile compounds, stimulates neural pathways involved in emotion, cognitive function, and memory in humans and significantly influences insect behavior (inducing attractiveness or repellency). In this study, the olfactory perception of rose (EO 1, a synthetic mixture with rose aroma), eucalyptus (EO 2), lemon (EO 3), clove (EO 4), rosemary (EO 5), and caraway (EO 6) EOs in untrained human participants was compared to the behavioral responses induced in Tenebrio molitor (adult insects) by EO exposure. Significant differences emerged in the perception of EO odor dimensions (pleasantness, intensity, and familiarity) using a Likert-type scale in untrained participants. The tested EOs elicited different behavioral responses in T. molitor insects, as assessed by repellency, escape, and choice tests. A positive correlation (r = 0.7861, p < 0.05) emerged between EO odor intensity perceived by participants and escape induction in T. molitor adults. GC–MS analysis revealed citronellol, 1,8-cineole, limonene, eugenol, α-pinene, and carvone as the most abundant volatile compounds in EO 1, EO 2, EO 3, EO 4, EO 5, and EO 6, respectively. The EO odor dimensions in participants and insect behavioral responses were also related to the in silico physicochemical/pharmacokinetic properties of the main EO components. Our results provide new insights into the chemical basis of olfactory preferences both in T. molitor adults and humans. Full article

Background/Objectives: Postoperative monitoring of microvascular free flaps is critical for early detection of vascular complications and flap survival. Nurses play a central role in this process; however, qualitative evidence on their experiences and challenges remains limited. This study explored nurses’ experiences in free tissue flap care to identify clinical practices, challenges, and improvement needs. Methods: A phenomenological qualitative design was used. Data were collected through semi-structured interviews with nine nurses experienced in free tissue flap care, recruited via purposive and snowball sampling. Interviews were conducted online and lasted 30–45 min. Data were analyzed using content analysis with MAXQDA 2025. Inter-researcher reliability was 97%. Results: The findings were categorized into four main themes and seventeen subthemes: (1) clinical monitoring and evaluation in the care process, (2) challenges and difficulties, (3) emotional and professional reflections, and (4) suggestions for improving care. Nurses reported that flap care requires intensive monitoring, rapid decision-making, and close collaboration with physicians, especially within the first 24–48 h. Monitoring was largely based on observation and experience due to the lack of standardized protocols. Major challenges included high workload, frequent assessments, and donor site management. Emotional burden, stress, and responsibility were also prominent. Conclusions: Free flap care is a complex and demanding process for nurses. The lack of standardized monitoring tools and protocols is a key gap. Developing structured tools, improving training, and strengthening multidisciplinary collaboration may enhance patient safety and care quality. Full article

Background: Pain during orthodontic debonding is a common clinical concern. Although previous studies have mainly focused on mechanical approaches to reduce discomfort, the influence of emotional characteristics of patients on pain perception remains insufficiently explored. In this study, we aimed to evaluate the association between pain perception, emotional affect, and anxiety during orthodontic bracket removal using different clinical protocols. Methods: A prospective observational comparative study was conducted at Rey Juan Carlos University (Madrid, Spain). A total of 140 orthodontic patients underwent bracket removal according to four routine clinical protocols determined by clinical scheduling: ligated with interocclusal cotton rolls (used for tooth stabilization), non-ligated with cotton rolls, ligated without cotton rolls, and non-ligated without cotton rolls. Pain intensity was assessed using a Visual Analog Scale (VAS) immediately before (T0) and after (T1) bracket removal. Baseline pain (T0) was recorded to control for pre-existing discomfort. Anxiety and emotional affect were measured using the State–Trait Anxiety Inventory (STAI) and the Positive and Negative Affect Schedule (PANAS), respectively. Statistical analyses included ANOVA, factorial ANCOVA adjusted for baseline pain, and multivariable regression models. Results: No significant baseline differences were observed among groups. The highest post-debonding pain scores were found in the group without cotton rolls and without ligatures. ANCOVA revealed a significant main effect of cotton roll use, with lower adjusted pain scores in patients treated with cotton rolls, whereas ligation showed no statistically significant independent effect. In multivariable regression analyses, baseline pain, age, and negative affect were independently associated with higher post-debonding pain. Conclusions: Within the limitations of a non-randomized design, cotton roll use was associated with lower post-debonding pain, whereas ligation appeared to have a limited influence. Patient-related factors—particularly negative affect, age, and baseline pain—were also associated with pain perception, supporting a biopsychosocial perspective. These findings should be interpreted as exploratory evidence rather than causal effects. Full article

Background: Live music, understood as real-time musical performance delivered in the physical presence of patients or other participants, is increasingly incorporated into healthcare settings as an arts-based, non-pharmacological practice intended to support well-being and humanize care. While previous reviews have examined a broad range of music-based interventions in healthcare, limited attention has been given specifically to live music, its contextual characteristics, and the values attributed to its use within hospital environments. Objectives: This scoping review aims to map and synthesize the literature on live music in healthcare settings, focusing on clinical contexts, populations involved, and the therapeutic, psychosocial, and environmental values reported. Methods: A scoping review was conducted following the framework of Arksey and O’Malley. Searches were performed in Web of Science, Scopus and Pubmed using terms related to live music and healthcare settings. Studies published in English or Spanish over the past 20 years were considered. After screening titles, abstracts, and full texts, 81 studies met the inclusion criteria. Results: The studies covered diverse hospital units and patient groups, particularly oncology, neonatal and intensive care, palliative care, and haemodialysis. Reported outcomes were mainly psychological and emotional, including reductions in anxiety, stress, and distress, alongside improvements in mood, well-being, and quality of life. Cognitive, physiological, and environmental benefits were also identified, emphasizing the role of live music in creating supportive and humanized care environments. Most studies were conducted in Europe and North America. Conclusions: Live music is widely implemented in healthcare settings and is associated with benefits extending beyond symptom reduction to experiential and humanizing dimensions of care. This scoping review provides an overview of the existing evidence base and identifies directions for future research in arts and health. Full article

Background: In the context of population aging and the growing burden of chronic conditions, promoting exercise participation has become an important strategy for supporting healthy aging. However, older adults with chronic conditions often face multiple constraints related to symptom burden, risk perception, and everyday life. A theory-informed understanding of the determinants of exercise participation in this population is therefore needed. Methods: This study adopted a theory-informed qualitative descriptive design and conducted face-to-face semi-structured interviews with 30 community-dwelling older adults with chronic conditions. Purposive sampling was used to ensure variation in age, sex, chronic condition type, and exercise participation. Data were analyzed using the framework method guided by the Theoretical Domains Framework (TDF), and the resulting themes were subsequently mapped onto the Capability, Opportunity, Motivation–Behavior (COM-B) model. Results: Participants were aged 60–86 years, and most were women, had low educational attainment, came from rural backgrounds, and lived with multimorbidity. Participants described exercise participation as a day-to-day process of negotiating symptoms, risk, functional boundaries, and everyday responsibilities rather than as a simple matter of willingness. Although most participants recognized the value of exercise, many lacked disease-specific knowledge about suitable exercise types, safe intensity, progression, and warning signs. Symptom burden and functional limitations constrained exercise, but many participants used symptom-based self-regulation strategies, such as resting, slowing down, or modifying activity when discomfort occurred. Family members, peers, health professionals, and community resources could either facilitate exercise or restrict it, depending on their accessibility, continuity, specificity, and practical relevance. Continued participation was closely linked to perceived benefits, controllable risk, self-efficacy, positive emotional experience, and immediate bodily feedback. Conclusions: Exercise promotion for older adults with chronic conditions should move beyond general advice and provide disease-adapted exercise education, symptom-based self-regulation strategies, family and peer support, professional guidance, age-friendly community resources, and feedback mechanisms that support long-term maintenance. Full article

Patient embarrassment represents a significant yet often underrecognized barrier to effective gynecological care. This review integrates multidisciplinary evidence from Embase, PubMed, PsycINFO, and the Cochrane Library (2000–2025) to examine the relationship between embarrassment, shame, and modesty and their impact on care-seeking behaviors, clinical outcomes, and healthcare utilization. Available data indicate that embarrassment is consistently associated with reduced participation in preventive screening, with up to one-third of non-attenders citing modesty-related concerns. In symptomatic patients, these emotional barriers contribute to clinically meaningful diagnostic delays, particularly in conditions such as cervical cancer, vulvar cancer, and endometriosis. Embarrassment also affects in-consultation behavior, with a substantial proportion of patients reporting withheld concerns or incomplete disclosure of medically relevant information. The consequences extend beyond delayed diagnosis to include reduced treatment adherence, increased disease severity at presentation, and higher healthcare costs due to more complex and resource-intensive interventions. Contributing factors include cultural stigma, prior negative clinical experiences, fear of judgment, and aspects of the clinical environment that may heighten patient vulnerability. Full article

This study examines punctuation as a paralinguistic resource in digital political discourse, focusing on its role in encoding stance in a corpus of tweets produced by Donald Trump. Drawing on a dataset of 1000 tweets, the analysis combines quantitative and qualitative approaches to identify patterns in the use of exclamatory, interrogative, and mixed punctuation forms. The findings suggest that punctuation functions systematically as a mechanism of textual amplification, shaping the expression of evaluation, emotional intensity, and interactional meaning. Repeated exclamation marks are closely associated with heightened stance and emphasis, while interrogative forms frequently function rhetorically to signal doubt and challenge rather than to request information. Mixed forms further demonstrate the flexibility of punctuation in encoding multiple layers of meaning within a single utterance. The analysis also shows that punctuation operates in close interaction with lexical intensifiers and capitalization, forming clusters of meaning that reinforce communicative force. By foregrounding punctuation as a meaningful semiotic resource, the study contributes to a more nuanced understanding of how written discourse adapts to the constraints of digitally mediated communication. It argues that punctuation should be treated as an integral component of pragmatic and discourse-analytic inquiry and highlights its role in the construction of stance in contemporary digital political discourse. Full article

Background and Objectives: Anxiety can influence the intensity of postoperative pain, anesthesia and the need for analgesia. Likewise, proper anxiety management can reduce hospital stays. Therefore, it is important to review the actions of nursing professionals and estimate the effect size of nursing interventions to reduce anxiety in pre- and postsurgical processes. Therefore, the objective of this study was to analyze the effectiveness of preoperative motivational interviews by nursing to reduce pre- and postoperative anxiety and postoperative pain after surgery. Materials and Methods: A systematic review was carried out according to the PRISMA guidelines, with a record in PROSPERO using DeCS and Boolean operators OR and AND to increase the specificity of the search. In the EBSCOhost, Pubmed, Cochrane Library and Scopus databases, 104 studies were obtained. Patients ≥ 18 years of age with scheduled surgeries, communication skills, clinical trials or quasi-experimental studies were included. The risk of bias 2 (RoB2) tool was used to assess the risk of bias in the studies. A random effects meta-analysis was performed to analyze pre- and postoperative anxiety and postoperative pain. Results: A total of 6 studies were included (4 clinical trials and 2 quasi-experimental studies). All the studies analyzed preoperative anxiety, which was significantly lower (SMD = −1.53; 95% CI: −4.01 to −0.95; I² = 40%). Postoperative pain (SMD = −0.74; 95% CI: −0.94 to −0.54; I² = 35%) and postoperative anxiety (SMD = −0.48; 95% CI: −0.78 to −0.19; I² = 0%) also decreased. Conclusions: Motivational interviews by nurses may help provide clearer information and emotional support and allow patients to express doubts, reducing their fear of anesthesia, pain and the recovery process. Emotional control improved adaptation to the surgical environment, reducing postoperative pain. With respect to implications for clinical practice, it is necessary to use the same scales to measure anxiety to better compare the studies. Full article

Background and objectives: Social media use has become pervasive among the general population, with growing concern regarding its potential effects on mental health and sleep. While existing studies report associations between social media engagement and psychological outcomes, limited attention has been given to users’ self-perceived impact. To assess the self-perceived impact of social media use on mental health and sleep-related outcomes among healthy adolescents and adults aged 16–50 years old, and to identify associated demographic and behavioral factors. Methods: A cross-sectional survey was conducted among residents of Jeddah, Saudi Arabia, aged 16–50 years without a history of psychiatric or chronic sleep disorders, using a structured online questionnaire. Perceived mental health impact was assessed using a six-item study-specific questionnaire evaluating participants’ subjective perceptions regarding emotional and psychological responses to social media exposure. Higher perceived impact was defined as a composite score of 12–24 points on the study-specific scale. Data included sociodemographic characteristics, patterns of social media use, perceived mental health impact assessed through a 6-item Likert scale, and sleep-related outcomes. Associations were evaluated using chi-square tests and logistic regression analysis. Results: Most participants reported daily social media use exceeding 3 h, with 44.9% engaging in late-night use and 87.6% using devices within 30 min before sleep. Overall, 18.6% exhibited higher perceived mental health impact. Higher odds were observed among younger participants, students, and single individuals. Snapchat and YouTube use, and late-night engagement were independently associated with increased perceived impact. Approximately one-third reported insomnia after social media use, and 44.3% perceived improved sleep with reduced usage. Conclusions: Social media use is widely prevalent and commonly perceived to negatively affect mental well-being and sleep, particularly with intensive and late-night use. Self-awareness of these effects may represent a valuable leverage point for prevention, supporting the need for targeted digital wellness strategies and public health interventions. Full article

Russia’s invasion of Ukraine has exposed millions of individuals to traumatic experiences, displaced them under temporary protection, and caused psychological distress. This exploratory study examined resilience, emotional experiences, and psychosocial profiles among displaced and non-displaced Ukrainian women affected by the war. A total of 249 adult women participated, including 122 displaced women under temporary protection residing in Spain and 127 women living in Ukraine. Participants completed the Brief Resilient Coping Scale (BRCS) and the Scale of Positive and Negative Experience (SPANE). Group comparisons and cluster analyses were conducted to identify distinct psychosocial patterns. Displaced women showed slightly higher resilience scores than non-displaced women, although differences were not statistically significant. Non-displaced women reported significantly higher levels of both positive and negative emotional experiences, suggesting greater emotional intensity among those remaining in Ukraine. Cluster analyses identified three psychosocial profiles: an adaptive profile characterized by high positive affect, low negative affect, stronger social support, and higher resilience; a vulnerable profile marked by low social support, elevated negative affect, and lower resilience; and an intermediate profile showing high negative affect despite moderate-to-high social support. Although displaced women under temporary protection were more represented in the vulnerable profile, this association was not statistically significant. The findings highlight the heterogeneity of psychological adaptation during war and displacement and emphasize the protective role of resilience and social support. Full article

With the widespread use of social media and online platforms in the dissemination of public opinion within universities, the multi-class classification of risk-related texts has become a critical component of online public opinion analysis in higher education institutions. Existing multi-class risk classification methods often focus on static semantic representations, making it difficult to effectively capture the emotional evolution within texts and the differences between samples, which in turn affects the accuracy of risk classification. To address this, this paper proposes a multi-class risk classification model for university online public opinion that integrates contextual semantic modeling, emotional evolution detection, and adaptive confidence-based feature fusion. The model employs pre-trained BERT for context encoding and, while preserving high-level semantic information, enhances the model’s adaptability to domain-specific features through a selective unfreezing strategy. First, a Bidirectional Gated Recurrent Unit (BiGRU) is introduced to model the emotional evolution trajectory within text sequences, and an emotional transition intensity metric is constructed by calculating the difference between adjacent hidden states, thereby explicitly capturing the magnitude of emotional changes. Additionally, a convolutional feature branch is designed to capture local emotional patterns, enhancing the model’s ability to perceive local risk cues and fine-grained emotional fluctuations. Finally, the Emotion-Adaptive Feature Mixer (EAFM) is introduced. This module adaptively weights global emotional evolution features and local emotional pattern features based on sample confidence to adjust the contributions of different feature branches in risk classification. Experimental results demonstrate that the proposed model exhibits good convergence characteristics in the university online public opinion scenario represented by the CUOPO dataset and demonstrates strong interpretability through attention visualization and confidence coefficient analysis. Full article

This article aims to explore human emotions in selected texts of Joseph’s narrative through the lens of affect theory. Jacob’s gift of a famous coat to Joseph evokes in the brothers an intense emotion that involves a negative feeling toward him. The narrator’s articulations in Gen 37:3–11; 18–35; 42:21–25, 43:29–30; 44:18–34 and 45:1–5; 14–15 are emotionally persuasive and stimulate reader’s emotion. Judah’s utterance in 44 contains an inspiring flame of persuasive eloquence and affect accretion that accompanies mental feelings. This speech made Joseph emotionally charged and unable to control himself, cried out aloud and let loose his concealment before his brothers in Gen 45. Full article