Search Results (4,357)

Learning from feedback depends not only on the feedback provided but also on how learners interpret, evaluate, and respond to it. This descriptive phenomenological study explored how preclinical medical students experienced receiving peer evaluation in a team-based learning (TBL) course. Forty-one reflective journals written by first-year medical students (27 men, 14 women) after receiving anonymous peer feedback were analyzed using Colaizzi’s seven-step descriptive phenomenological method. Five interrelated themes emerged: preparing to contribute, encountering oneself through peers’ eyes, making sense of emotional responses, transforming feedback into future practice, and becoming a responsible evaluator. Students described peer feedback as a social mirror that revealed differences between their self-perceptions and those of their peers. They reported a range of emotional responses and also reflected on the credibility and relevance of the feedback they received. Many students expressed intentions for future participation, and some reflected on their own responsibilities as evaluators. Taken together, the accounts described self-reflection, emotional appraisal, and intentions for future participation after peer evaluation. The findings suggest that peer evaluation accompanied by open-ended reflection may provide a useful context for examining how students experience and make sense of feedback. Whether such reflection contributes to subsequent changes in behavior, feedback literacy, self-regulated learning, or professionalism requires further study. Full article

The Fei Qian (飞箝) Argumentation Scheme, one of the core rhetorical schemes of the School of Diplomacy (Zonghengjia, 纵横家) aimed at controlling others, has yet to receive systematic theoretical analysis, and its significance within the history of Chinese logic remains underexplored. Drawing primarily on the Guiguzi (《鬼谷子》) and related pre-Qin period sources, this article examines the Fei Qian Argumentation Scheme across three dimensions: its structural logic, its intended targets, and its practical application. The analysis reveals that the Fei Qian Argumentation Scheme exhibits a fundamental asymmetry in evaluative standards—it demands factual reliability of the premises while judging the conclusion solely by the criterion of audience acceptability. Operationally, the scheme proceeds by deploying external flattery (fei, 飞) to draw upon captivating words (Gou Qian zhi ci, 钩箝之辞), supplemented where necessary by inward emotional manipulation (Gou Qian, 钩箝). Its application is further stratified by social hierarchy: the scheme is directed upward at rulers (zhi tian xia, 制天下) and laterally at peers (zhi ren, 制人), while subordinates may be directed without recourse to it. In practice, the Fei Qian Scheme presupposes a careful assessment of power and capacity (duo quan liang neng, 度权量能), pursues the goal of winning willing compliance (cong hua, 从化), and resorts to the compound strategy of “encumber responsibilities and reveal weaknesses” (chong lei–zi hui, 重累—訾毁) when the primary scheme fails. The emergence of the Fei Qian scheme form and the broader rise in the School of Diplomacy were inseparable from the specific socio-cultural and historical context of the Spring and Autumn and Warring States periods. To a significant degree, the argumentation theories and practices of the School of Diplomacy advanced the development of bianxue (辩学, the art of disputation) and of Chinese logic as a whole. Full article

With increasing interest in nature-based and biophilic built environments, understanding how users perceive natural characteristics embedded in sports venues and how these perceptions are associated with psychological experiences and behavioural intentions has become an important research topic. However, limited studies have examined the psychological mechanisms through which perceived nature-based characteristics of sports venue design are related to users’ revisit intention. Based on restorative environment theory and place attachment theory, this study investigates the relationship between nature-based sports venue design and revisit intention from a user-perceived built environment perspective, with a particular focus on the mediating roles of perceived restorativeness and place attachment. A questionnaire survey was conducted among university students in Shandong Province, China, and 623 valid responses were obtained. Structural equation modelling and bootstrap analysis were employed to examine the proposed relationships. The results showed that perceived nature-based sports venue design characteristics were positively associated with revisit intention, perceived restorativeness, and place attachment. Perceived restorativeness was positively associated with both place attachment and revisit intention, while place attachment was positively associated with revisit intention. Furthermore, mediation analysis indicated that perceived restorativeness and place attachment separately mediated the relationship between perceived nature-based sports venue design characteristics and revisit intention, and together formed a sequential mediation pathway. These findings suggest that nature-based characteristics embedded within sports venues may support users’ restorative experiences and emotional connections with places, which are associated with continued engagement with sports spaces. This study provides user-centred evidence for built environment design and sports venue planning by highlighting the potential importance of natural lighting, spatial openness, visual connections with nature, and restorative spatial experiences. Full article

Background/Objectives: The aim of this study was to apply data-driven clustering techniques for the subtyping of tinnitus severity to a retrospective cross-sectional cohort of 564 subjects. Additionally, the response of the resulting phenotypes to an enriched acoustic environment (EAE) treatment was investigated. Methods: A hierarchical decision cascade was applied to classify the measured audiograms of participants into six hearing loss (HL) patterns. K-clustering techniques were applied to demographic (gender), hearing (average audiometric threshold, HL pattern), tinnitus (tinnitus onset age, duration, severity, lateralisation, type of sound, aetiology) and emotional variables. Subjects received customised EAE stimulus to be listened to for one hour daily over four months. Results: Five phenotypes were found by applying K-clustering techniques to numerical and categorical variables. EAE provided an average tinnitus severity reduction of 24.3 points, which was clinically relevant and statistically significant, in 78% of subjects who completed the four-month treatment. Conclusions: Analysis of the performance of EAE treatment in the different phenotypes afforded clear differences in the composition of excluded, dropped out, and not improved subjects. Absolute mean improvement of both severity and emotional scores was larger in phenotypes PH3 and PH4, as they had higher tinnitus distress and emotional symptoms at baseline. Nevertheless, relative change of severity score was notably smaller in PH4. Full article

Mothers of preterm infants (PT; <37 weeks gestational age) face economic barriers to mother’s own milk (MOM) provision, including lack of paid maternity leave and unpaid workload that may prevent sustained MOM provision. The objective of this study was to understand how mothers of PT infants navigate decisions about MOM provision and paid and unpaid work. Semi-structured interviews were conducted with mothers of PT infants between 5 days and 10 weeks postpartum. Interviews included questions about responsibilities in the home, pre-delivery work experience and plans to provide MOM, and postpartum work experience and MOM provision. Data were analyzed using reflexive thematic analysis, following Braun and Clarke’s method. This study included 18 mothers, who were predominantly non-White (79%) and covered by Medicaid (72%) with infants born at a median gestational age of 32 weeks. Three themes emerged: (1) unexpected prenatal events create postpartum job uncertainty; (2) breastfeeding intentions are often derailed after PT delivery; and (3) the unpredictable reality of having a PT infant shifts maternal priorities and obligations related to paid and unpaid workload. PT delivery creates emotional and financial stress and uncertainty for new mothers. Although federal and employment-based paid leave may alleviate some financial stress for mothers employed prior to delivery in the United States, mothers who leave the workforce before delivery will not benefit from these policies. Policies are needed to support all mothers of PT infants in facilitating long-duration MOM provision, independent of employment status. Full article

Background: Delirium management remains inconsistently implemented in intensive care units (ICUs), and existing studies provide limited insight into how assessment capability, organisational opportunity, and emotional motivation interact in Chinese tertiary care settings. Aim: To explore ICU nurses’ perceived barriers and facilitators to delirium assessment and management using the Capability, Opportunity and Motivation model of Behaviour (COM-B). Methods: A qualitative descriptive exploratory study was conducted with 14 registered ICU nurses from two tertiary hospitals in Chongqing, China, between December 2025 and February 2026. Purposive sampling captured variation in clinical experience, educational background, and ICU type. The first author conducted face-to-face interviews in Mandarin Chinese and completed the initial coding. COM-B informed both the interview guide and the deductive organisation of the analysis, while six themes and 33 lowest-level factors were developed within the three domains. During revision, the fixed analytic structure was audited against all 14 Mandarin transcripts, and the second author independently applied the fixed codebook to five complete transcripts selected for maximum variation; disagreements were resolved by returning to the original Mandarin context and predefined coding boundaries. Results: Eighteen barriers and fifteen facilitators were identified across six themes within the COM-B domains. Capability was strengthened by clinical experience, senior nurses’ intuitive pattern recognition, and conversational assessment, but constrained by difficulty recognising hypoactive delirium, uncertainty when assessing older adults, inconsistent use of CAM-ICU, and insufficient targeted training. Opportunity was enhanced by staffing, environmental control, peer support, family engagement, and physician collaboration, but restricted by fragmented visibility, sensory overstimulation, workload, restrictive visiting, and delayed medical responses. Motivation reflected the tension between professional duty and accountability for safety on one hand and emotional burden, verbal abuse, and violence on the other. Cross-domain accounts showed that opportunity constraints could amplify anxiety and safety-first motivation, narrowing feasible behaviour toward containment, whereas social support could sustain relational care. Conclusions: Delirium management was shaped by interacting behavioural, organisational, and emotional conditions. Strengthening assessment capability alone is unlikely to produce consistent practice without staffing, workflow, environmental, and interprofessional support. Mapping the findings to Behaviour Change Wheel intervention functions highlighted training, environmental restructuring, enablement, and modelling as priority candidate functions for prospective evaluation; education alone was unlikely to be sufficient. Reporting Method: This study was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research checklist. Patient or Public Contribution: No patient or public contribution was involved in the design, conduct or reporting of this study. Participants were registered intensive care unit nurses. Full article

This article analyzes how novice investors emotionally experience a stock market simulation conducted with virtual money. Financial simulations are sometimes criticized because they do not reproduce the real financial consequences of investment decisions. However, the fifteen semi-structured interviews conducted after the simulation show that the absence of monetary loss does not eliminate the emotional intensity of the experience. Participants report stress, fear, frustration, disgust, disappointment, satisfaction, and pride. This article argues that virtual money shifts emotional responses toward other forms of issues. Virtual losses are often interpreted as signs of poor decision-making, a lack of competence, or personal failure. Conversely, virtual gains may produce feelings of satisfaction or validation of one’s choices. Ranking also plays a central role: it transforms the exercise into a competitive situation and gives social value to individual performance. The academic bonus constitutes another form of stake because it situates the simulation within a framework aimed at improving academic performance. Based on a thematic analysis of the interviews, this article identifies five dimensions: virtual money as partial protection against financial loss; ranking as a symbolic substitute for financial stakes, the academic bonus as a real consequence of performance, virtual loss as a perceived loss of competence and frustration as a driver of recovery attempts, withdrawal, or disengagement. These findings show that stock market simulations are useful tools for observing how novices assign emotional meaning to gains, losses, ranking and their own competence. This article contributes to the literature on emotions and experimental simulations by demonstrating that emotional intensity does not depend exclusively on exposure to financial loss. Even when virtual, money becomes emotionally significant when it is associated with stakes related to performance, social comparison, academic success, and decision-making identity. Full article

This study employed a mixed-methods design combining a survey of 167 social workers in Seoul and in-depth interviews with three social welfare experts to explore strategies for integrating forest welfare services into the social service system. The survey results showed a high willingness to participate in forest welfare services. Demand was high for psychological and emotional stability (29.3%) and recreation and leisure enhancement (26.0%). Among the expected benefits, stress relief and improvement of psychological health showed the highest response rate (38.9%), while guaranteed participation during working hours was identified as the most important support needed (51.5%). Expert interviews indicated that a legal and institutional foundation, evidence of service effectiveness, professional program development, and cooperation among relevant organizations are necessary for sustained service operation and integration into the social service system. Based on these findings, this study proposes four major strategies for service revitalization: establishing a legal and institutional foundation, securing policy and academic evidence, developing tailored service models reflecting target characteristics, and establishing inter-organizational cooperation. These findings provide baseline information for future pilot implementation, effectiveness evaluation, and institutionalization of forest welfare services for social workers. Full article

Background: Executive functions (EFs) are cognitive and emotional abilities that underpin goal-directed behavior, decision-making, and problem-solving. EFs can be categorized into two broad types, Hot EFs and Cool EFs, distinguished by their relation to emotional processing. Cool EFs are associated with cognitive control, while Hot EFs involve emotional regulation and decision-making in emotionally charged contexts. EFs contribute to self-regulation, including the ability to adjust behavior in response to feedback. Methods: The aim of this study is to investigate the relationship between Hot (decision-making under uncertainty) and Cool (cognitive flexibility) EFs in middle childhood. To assess these dimensions of EFs, we used two tasks, the Iowa Gambling Task (IGT) and the Wisconsin Card Sorting Test (WCST), completed by children (N = 90) aged 6–12 years. Results: Traditional WCST indices of cognitive flexibility were not associated with IGT performance. Using hierarchical linear regression models, the most significant overlap concerns the negative relationship between post-loss adjustment in the WCST (post-loss reaction time—plRT) and learning across the IGT (learning index—LI). Children who responded faster after negative feedback (plRT ↓) showed greater improvement in advantageous choice over the course of the task (LI ↑). Conclusions: The findings suggest that decision-making in the IGT is more closely linked to dynamic, process-based aspects of self-regulation than to static measures of cognitive flexibility. It can be concluded that the relationship between WCST and IGT during middle childhood is best described as weak, process-specific, and developmentally modulated, indicating that Cool and Hot EFs are partially distinct yet interconnected systems. Full article

Objective: Depressive symptoms exist on a continuum in the general population, yet the underlying neurobiological mechanisms, particularly the interplay between resting-state networks and task-evoked social cognitive responses, remain elusive. Methods: Leveraging the Human Connectome Project (HCP) dataset, we included 867 participants. With depression scores as the independent variable and age/sex as covariates, we systematically examined associations with sleep quality, negative emotions, sensory scores, gray matter volume (GMV), fractional amplitude of low-frequency fluctuations (fALFF), multi-seed resting-state functional connectivity (rsFC), as well as brain activation and behavioral performance during working memory, emotion recognition, social cognition, relational reasoning, language comprehension, and gambling tasks. The statistical threshold was set at voxel-level p < 0.001 (uncorrected) combined with cluster-level FWE correction at p < 0.05. Results: (1) Depression scores were positively correlated with sleep disturbances, negative emotions (anger/fear), and pain. (2) In resting-state, depression scores negatively correlated with ventral striatum (VS)–cerebellum/parahippocampal gyrus/fusiform rsFC, yet positively correlated with pregenual anterior cingulate cortex (preACC)–supplementary motor area (SMA) rsFC. (3) In task-fMRI, only the social task showed a positive association with task accuracy and regional activation in bilateral pre/postcentral gyri, superior temporal gyri, left middle frontal gyrus, and SMA/paracentral lobule. Conclusions: Elevated depression scores are linked to a pattern that may reflect relative decoupling between reward and perceptual systems, along with enhanced connectivity in cognitive control circuits. Socially, high scorers exhibit a pattern suggestive of compensatory hypervigilance, accompanied by enhanced behavioral performance. This study provides multidimensional evidence for the dimensional neural representation of depressive symptoms. Full article

Large language model-enabled virtual patients may expand access to clinical skills practice by supporting explicitly defined practice tasks. This program evaluation examined medical students’ awareness, use, and perceptions of the McMaster Virtual SP Tool, a custom generative artificial intelligence tool developed to supplement clinical skills practice. We conducted an anonymous, single-institution cross-sectional survey of students across three cohorts at McMaster University. Quantitative responses were summarized descriptively, and free-text responses were analyzed using qualitative content analysis informed by task-aligned fidelity, deliberate practice, learner-centred feedback, and simulation instructional design. Thirty-five students responded; 23 (65.7%) were aware of the tool and 16 (45.7%) had used it. Among the 16 users, 15/16 (93.8%) found the tool at least somewhat easy to navigate; 13 (81.3%) would use it again; and 13 (81.3%) would recommend it. Across all respondents, 14/35 (40.0%) reported using AI-enabled virtual patients for OSCE preparation. Users valued its accessibility, independent low-stakes rehearsal, and usefulness for focused history-taking, question wording, and clinical reasoning. Perceived limitations included reduced human connection, nonverbal and emotional realism, physical examination practice, and feedback specificity. AI-enabled virtual patients may therefore be considered as adjuncts for selected cognitive and structural rehearsal tasks. Objective educational outcomes were not assessed. Full article

Background: Mental health issues among university students are a growing global concern, including in Malaysia. This exploratory study aims to examine mental health support systems in Malaysian universities using a dyadic perspective, capturing both students’ and counsellors’ experiences. This addresses a key gap in the literature, which has largely relied on single-perspective accounts. Methods: A qualitative exploratory design was employed using purposive sampling. Semi-structured interviews were conducted with 15 students receiving mental health support and 10 university counsellors. The data were analysed using hybrid deductive–inductive thematic analysis. Results: Three themes emerged from the findings. The first theme showed that students sought support once distress affected their daily functioning, valuing trust, safety, and emotional guidance, while counsellors described a parallel process of assessing student needs and facilitating longer term recovery. The second theme identified barriers shared by both groups, namely limited awareness of services and stigma, alongside additional constraints reported only by counsellors, including staffing shortages, unclear referral pathways, and limited institutional support. The third theme centred on strategies for improvement, including early assessment, awareness campaigns, digital accessibility, resilience building, and stronger collaboration among students, counsellors, and university stakeholders. Conclusions: This study contributes to the literature by integrating three complementary theoretical perspectives to explain university students’ mental health support experiences, support networks, and help-seeking behaviour. The findings also provide practical guidance for university administrators, counsellors, and policymakers seeking to develop more accessible, proactive, and student-centred mental health support systems. As the study is based on qualitative, cross-sectional data, the findings should be interpreted as indicative rather than causal. Nonetheless, they suggest that strengthening such initiatives may contribute to more supportive and responsive mental health provision within higher education institutions. Full article

This study aims to develop and examine Lazarus and Folkman’s psychological stress and coping theory, utilizing scales that measure problem-focused and emotion-focused coping in the context of environmental issues, as defined by Homburg and colleagues, to predict adaptation behavior in agriculture. The goal is to analyze Iranian farmers’ problem-focused and emotion-focused coping styles in response to climate change stress. Using structural equation modeling (SEM), we examined the effects of cognitive appraisals, including demand appraisal and self-efficacy, along with collective efficacy, on problem- and emotion-focused coping. The data for this study were collected through paper-based questionnaires from 250 farmers in Iran. Our results indicate that the perception of increased threat and harm posed by water scarcity to agricultural income and health (demand appraisal), the belief in one’s ability to adapt (self-efficacy), and the perception of the effectiveness of collaborative efforts among farmers in enhancing adaptation (collective efficacy) are associated with both problem- and emotion-focused coping responses. Notably, the Cognitive Theory of Stress model was a stronger predictor of problem-focused coping, accounting for 91% of the variance, compared to just 15% for emotion-focused coping. The results from this study shed light on the cognitive processes most associated with particular types of coping styles. Our findings may inform and guide climate change policy and programs that aim to target and enhance farmers’ climate change adaptation and resilience. Full article

Background: Family caregivers play a central role in supporting people with colorectal cancer (CRC) and often manage complex physical, emotional, and practical demands. However, evidence regarding their experiences and supportive care needs in Kazakhstan remains limited. This qualitative study explored caregiving experiences, caregiving burden, caregivers’ needs, and coping strategies. Methods: A qualitative descriptive design was used, involving semi-structured interviews with 21 family caregivers caring for patients with CRC. Participants were recruited purposively from the Medical Center of West Kazakhstan Marat Ospanov Medical University and outpatient clinics in Aktobe between December 2025 and March 2026. Interviews were audio-recorded, transcribed verbatim, and analyzed using inductive reflexive thematic analysis. Results: Most family caregivers of patients with colorectal cancer were women (95.2%). Five main themes developed: emotional challenges, transformation of daily life, caregiving tasks, caregivers’ needs and support gaps, and coping strategies and resilience. Diagnosis was described as a distressing experience characterized by shock, fear, and uncertainty. Caregiving substantially disrupted employment, financial stability, and family roles, often requiring work adjustment or leaving the workforce. Caregivers reported insufficient preparation for stoma care and expressed a strong need for structured training. Social isolation was common, as both caregivers and patients experienced a shrinking of their social support networks. Despite substantial burden, caregivers described adaptive responses to ongoing emotional and practical demands, and resilience was a prominent theme. Conclusions: Family caregivers of patients with colorectal cancer in Kazakhstan face interconnected emotional, informational, physical, and system-level challenges, while also drawing on resilience. The findings highlight priorities for support, including structured stoma care education, psychological services, recognition of caregivers’ roles, and improved discharge and transitional care. Full article

Empathy is essential to humanized nursing care, yet its relationship with emotional competence before professional entry remains insufficiently specified. This single-school cross-sectional study examined whether distinct dimensions of emotional competence were differentially associated with emotional empathy among 337 secondary-level vocational nursing students enrolled in a five-year Croatian program for general care nurses/medical technicians. Students completed the Emotional Skills and Competence Questionnaire (ESCQ-45) and the Emotional Empathy Scale from the E-Questionnaire, which primarily captures affective responsiveness to others’ distress and other negative-valence states. Spearman correlations, Kruskal–Wallis tests with Dunn–Holm post hoc comparisons, Welch tests, and hierarchical linear regression with heteroscedasticity-consistent type 3 robust standard errors were used. Emotional empathy correlated with emotion perception and understanding (ρ = 0.35, p < 0.001) and emotion management (ρ = 0.28, p < 0.001), but not with emotion expression and naming (ρ = 0.10, p = 0.070). In the fully adjusted regression model, emotion perception and understanding (β = 0.254, p < 0.001), emotion management (β = 0.254, p = 0.003), and female versus male reported sex (β = 0.277, p < 0.001) were statistically significant predictors, whereas clinical exposure was not (p = 0.429). Emotion expression and naming had a negative adjusted coefficient (β = −0.158, p = 0.040) after simultaneous control for the remaining predictors. The findings support a dimensional interpretation of emotional competence and indicate that negative-valence emotional empathy is more closely associated with recognizing, understanding, and managing emotions than with expressive emotional skills considered in isolation. Full article