Search Results (1,995)

Introduction. Singapore had previously embraced at least two types of pre-participation questionnaires for those intending to take up or enhance their level of physical activity (PA). Concern over the usefulness of and difficulty in understanding these questions led to the design of a Singapore Physical Activity Readiness Questionnaire (SPARQ). The primary objective of this study was to review the level of difficulty in understanding the seven SPARQ questions. Secondary objectives included the rate of identifying individuals as unfit for PA and to seek public feedback on this tool. Method. A public, cross-sectional survey on the SPARQ was carried out, obtaining participants’ bio-characteristics, having them completing the SPARQ and then providing feedback on the individual questions. Results. Of the 1136 who completed the survey, 35.7% would have required referral to a medical practitioner for further evaluation before the intended PA. Significant difficulty was experienced with one question, moderate difficulty with four and only slight difficulty with the remaining two. The length of the questions and use of technical terms were matters of concern. Suggestions were provided by the participants on possible amendments to the questions. Conclusions. The very high acceptance rate of the SPARQ will need to be tempered with modifications to the questions to enhance ease of understanding and use by members of the public. Full article

Background/Objectives: The objective of this study was to validate a new parent-reported scale for tracking Pediatric Acute-onset Neuropsychiatric Syndrome (PANS). PANS is a condition characterized by a sudden and severe onset of neuropsychiatric symptoms. To meet diagnostic criteria, an individual must present with either obsessive–compulsive disorder (OCD) or severely restricted food intake, accompanied by at least two additional cognitive, behavioral, or emotional symptoms. These may include anxiety, emotional instability, depression, irritability, aggression, oppositional behaviors, developmental or behavioral regression, a decline in academic skills such as handwriting or math, sensory abnormalities, frequent urination, and enuresis. The onset of symptoms is usually triggered by an infection or an abnormal immune/inflammatory response. Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) is a subtype of PANS specifically linked to strep infections. Methods: We developed a 101-item PANS/PANDAS and Related Inflammatory Brain Disorders Treatment Evaluation Checklist (PTEC) designed to assess changes to a patient’s symptoms over time along 10 subscales: Behavior/Mood, OCD, Anxiety, Food intake, Tics, Cognitive/Developmental, Sensory, Other, Sleep, and Health. The psychometric quality of PTEC was tested with 225 participants. Results: The internal reliability of the PTEC was excellent (Cronbach’s alpha = 0.96). PTEC exhibited adequate test–retest reliability (r = 0.6) and excellent construct validity, supported by a strong correlation with the Health subscale of the Autism Treatment Evaluation Checklist (r = 0.8). Conclusions: We hope that PTEC will assist parents and clinicians in the monitoring and treatment of PANS. The PTEC questionnaire is freely available at neuroimmune.org/PTEC. Full article

Background/Objectives. Social and Emotional Education (SEE) interventions during early childhood have shown considerable promise in enhancing children’s emotion understanding, social competence, and behavioural adjustments. However, few studies have examined their long-term impact, especially across the preschool-to-primary school transition. This study evaluated the effectiveness of a manualized SEE program, Timmy’s Trip to Planet Earth, in promoting emotional, behavioural, and social functioning over time. Methods. A quasi-experimental longitudinal design was adopted with pre- and post-test assessments conducted approximately 18 months apart. Participants were 89 typically developing children (aged 59–71 months), assigned to an experimental group (n = 45) or a waiting-list group (n = 44). The program combined teacher training, classroom-based lessons, home activities, and teachers’ ongoing implementation support. The effectiveness of the program was measured via the Test of Emotion Comprehension (TEC), the Strengths and Difficulties Questionnaire (SDQ), and the Social Competence and Behavior Evaluation (SCBE-30). Results. Significant Time × Group interactions were observed for the TEC External and Mental components, indicating greater improvements in emotion recognition and mental state understanding in the intervention group. The SDQ revealed significant reductions in conduct problems and increased prosocial behaviours. In the SCBE-30, a significant interaction effect was found for social competence, with the intervention group showing greater improvement over time compared to the control group. Conclusions. The findings suggest that SEE programs can produce meaningful and lasting improvements in children’s emotional and social skills across key educational transitions. Teacher training and family involvement likely played a critical role in supporting the program’s sustained impact. Full article

The research was initiated by the Plečnik House gallery (Ljubljana, Slovenia) and focuses on the 3D architectural reconstruction of the unrealised monument of the Czech military leader Jan Žižka, designed by the Slovenian architect Jože Plečnik. In addition, the experience with the 3D reconstructed monument in the exhibition “Plečnik and the Sacred” was analysed. Using the available references and interpretative approaches, a digital and 3D-printed reconstruction was created that retains Plečnik’s architectural style. The experimental phase included a detailed interpretation of the studied references, 3D modelling, 3D printing, exhibition and experience analysis. The dimensions of the finished 3D-printed model are 52.80 × 55.21 × 44.60 cm. It was produced using stereolithography (SLA) for figurative elements and fused deposition modelling (FDM) for architectural components. The reconstruction was evaluated using participant testing, including semantic differential analysis, comparative studies, and knowledge-based questionnaires. The results showed that architectural elements were reconstructed with an average similarity score of 1.97 out of 5. Statues followed with a score of 1.81, and props, though detailed, met audience expectations, scoring 1.61. Clothing received the lowest score of 1.40. This research emphasises the importance of a hypothetical digital 3D reconstruction of never constructed monument for broader understanding of Plečnik’s legacy. Full article

Background/Objectives: Fibromyalgia syndrome (FMS) is a chronic pain condition in which executive function (EF) alterations have been reported, though strikingly, relationships between simple executive functions (EFs) (updating, inhibition, and mental flexibility) and high-order ones, such as planning and problem-solving, have not been addressed yet in this population. This research aimed to firstly explore how low-level EFs play a role in planning and problem-solving performances. Methods: Thirty FMS patients and thirty healthy participants completed a series of neuropsychological tests evaluating low- and high-order EFs. Clinical and emotional symptoms were assessed with self-report questionnaires, while pain and fatigue levels were measured with numerical scales. Importantly, specific drug restrictions were accounted for. Results: Patients scored lower in most neurocognitive tests, with statistical significance noted only for visuospatial working memory (WM) and two planning and problem-solving tests. Pain, fatigue, and sleep disturbances showed important effects on most of the cognitive outcomes. Multiple regression analyses reflected that planning and problem-solving were successfully and partially predicted by updating, inhibition, and mental flexibility (though differences emerged between tasks). Conclusions: Our study confirms the presence of cognitive impairments in FMS, especially in high-order EFs, supporting patients’ complaints. Clinical symptoms play a role in FMS dyscognition but do not explain it completely. For the first time, as far as the authors know, simple EF influences on planning and problem-solving tests have been described for FMS patients. These results might help in unraveling the dysexecutive profile in FMS to design more adjusted treatment options. Full article

Background: As population aging accelerates, the demand for professionals in older adult care continues to rise. Traditional teaching methods often fail to improve students’ willingness to serve older adults or foster teamwork. This study evaluated the effects of integrating a flipped classroom with project-based learning (PBL) and a hands-on clinical practicum into a health internship course. Methods: A mixed-methods design was adopted. Participants included 88 interdisciplinary university students enrolled in an 18-week, two-credit geriatric health internship course offered at a university in central Taiwan from August 2023 to July 2024. The course combined flipped classroom and PBL approaches, as well as clinical practicum activities. Data on willingness to serve older adults, teamwork skills, and learning outcomes were collected using structured questionnaires and analyzed with paired t-tests. Results: Significant improvements were found in willingness (from 68.93 to 73.15), teamwork (67.33 to 71.45), and learning outcomes (89.84 to 102.14) (p = 0.001). Qualitative findings further revealed increased empathy, improved teamwork, and enhanced ability to apply knowledge in real-world contexts. Conclusions: A teaching approach that integrates a flipped classroom, PBL, and a clinical practicum can effectively enhance students’ competencies in older adult care. Future research should explore long-term and cross-cultural impacts. Full article

Assessment of the placental cord insertion (PCI) is a vital component of antenatal ultrasound examinations. PCI can be complex, particularly in cases of abnormal PCI, and requires proficient sonographer spatial perception. The current literature describes the increasing potential of three-dimensional (3D) modelling to enhance spatial awareness and understanding of complex anatomical structures. This study aimed to evaluate sonographers’ confidence in ultrasound assessment of the PCI and the potential benefit of novel 3D-printed models (3DPMs) of the PCI in ultrasound education. Sonographers employed at a large private medical imaging practice in Western Australia were invited to participate in a face-to-face presentation of two-dimensional (2D) ultrasound images, ultrasound videos, and 3DPMs of normal cord insertion (NCI), marginal cord insertion (MCI), and velamentous cord insertion (VCI). Our objective was to determine the benefit of 3DPMs in improving sonographers’ confidence and ability to spatially visualise the PCI. Thirty-three participants completed questionnaires designed to compare their confidence in assessing the PCI and their ability to spatially visualise the anatomical relationship between the placenta and PCI, before and after the presentation. There was a significant association between a participant’s year of experience and their confidence levels and spatial awareness of the PCI prior to the demonstration. The results showed the 3DPMs increased participant confidence and their spatial awareness of the PCI, with no significant association with years of experience. Additionally, participating sonographers were asked to rate the 3DPMs as an educational device. The 3DPMs were ranked as being a more useful educational tool for spatially visualising the NCI, MCI, and VCI than 2D ultrasound images and videos. Most participants responded favourably when asked whether the 3DPMs would be useful in ultrasound education, with 75.8%, 84.8%, and 97% indicating the models of NCI, MCI, and VCI, respectively, would be extremely useful. Our study has demonstrated a potential role for 3DPMs of the PCI in ultrasound education, supplementing traditional 2D educational resources. Full article

Background and Objectives: Orthodontic treatment aims to enhance dental aesthetics and function, yet many patients report dissatisfaction. This study was designed with the following objectives: To assess overall patient satisfaction during active orthodontic treatment; to identify key psychosocial and clinical predictors of satisfaction, including self-confidence, social experiences, and cost perception; to evaluate the impact of orthodontist–patient communication on satisfaction and perceived treatment outcomes; to explore the relationship between aesthetic improvement and willingness to undergo treatment again. Materials and Methods: A cross-sectional survey was conducted using structured questionnaires to assess satisfaction, pain perception, treatment expectations, and communication quality. Statistical analyses, including correlations and regression models, were used to identify predictors of satisfaction. The study included 450 orthodontic patients from the north-eastern region of Romania, undergoing active treatment at the time of data collection. Results: The strongest predictor of satisfaction was improved self-confidence and smile aesthetics (r = 0.62). Effective communication with orthodontists significantly increased satisfaction (r = 0.58, p = 0.002), while perceived high costs had a negative impact (r = −0.41). Pain and discomfort were common, with 90% of patients experiencing treatment-related pain, leading to reduced compliance. Social embarrassment due to braces also contributed to dissatisfaction (r = −0.47). Conclusions: Patient satisfaction with orthodontic treatment is primarily influenced by aesthetic improvements and effective communication. While enhanced smile perception boosts confidence, financial concerns and social discomfort may negatively affect the overall experience. Improving accessibility to treatment and providing comprehensive patient support are essential for optimizing patient satisfaction. Full article

Introduction: Overactive bladder (OAB) and urinary incontinence (UI) are prevalent, particularly in older adults, and affect quality of life. OAB involves urgency, frequency, nocturia, and urgency incontinence, often linked to involuntary detrusor contractions. Treatment guidelines recommend a stepwise approach, starting with pelvic floor muscle training (PFMT), followed by pharmacological or minimally invasive therapies, such as neuromodulation. However, the combined effects of PFMT and neuromodulation have not been well established. This study aimed to evaluate the impact of combining pelvic floor exercises with neuromodulation versus PFMT with sham neuromodulation or standard physiotherapy after a 12-week intervention in individuals with OAB and UI. Methods/Materials: A double-blind, randomized controlled trial was designed with three groups: PFMT + neuromodulation, PFMT + sham, and conventional physiotherapy (control) in a 1:1:1 ratio. This study followed the CONSORT guidelines and was registered at ClinicalTrials.gov (NCT06783374). The sample size was calculated using GPower^® software, assuming a Cohen’s effect size of 1.04, a power of 0.80, an alpha of 0.05, and a 15% dropout rate, totaling 63 participants (21 per group). Participants attended 24 sessions over 12 weeks (2 sessions per week). The interventions were based on previously validated protocols. Outcomes: The primary outcomes included health-related quality of life, pelvic floor muscle function, pain, adherence, and general health. The secondary outcomes included Incontinence Quality of Life questionnaire, 3-day bladder diary, International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form, kinesiophobia, and electromyographic data. Full article

Tourist satisfaction of nighttime urban lakes as scenic areas, such as the Daming Lake, is influenced by multiple factors, which are crucial for tourists’ experiences and the sustainable development of these areas. This paper explores the factors impacting nighttime visitor satisfaction at the Daming Lake Scenic Area. Basing our studies on analysis of the literature and questionnaire surveys, the study constructs a visitor satisfaction evaluation index system based on the Expectancy-Disconfirmation Theory. Utilizing the revised importance-performance analysis method, the study identifies several significant influencing factors including the distinctive features of nighttime shopping products, the rich variety of nighttime tourscape and entertainment products, the aesthetically pleasing design of nighttime lighting products, the affordable price of nighttime dining products, and the diverse methods, reasonable pricing, and multimodal transit options of nighttime transportation. Furthermore, it finds the main factors that reduce tourists’ satisfaction in nighttime urban lakes include: premium pricing of nighttime shopping and dining products, transport infrastructure deficiencies, the cultural connotation of tourism products, and the safety of nighttime tourscape and entertainment products. This research provides insights to enhance satisfaction in urban lake scenic areas and expands the application of the tourist satisfaction theory. Full article

The aim of this study was to compare IC and CSR and to examine ICr as a mediating variable. The study employed a relational survey design and involved participants drawn from industrial organizations based in Tehran. To evaluate participants’ perceptions of innovation climate, corporate social responsibility, and Individual Creativity, standardized questionnaires were used. In analyzing the findings, the structural equation modeling (SEM) approach was adopted, and the analyses were conducted using SPSS AMOS version 26. The analysis revealed that an Innovative Climate exerts a positive and statistically significant influence on CSR. In addition, a positive and significant association was identified between Innovative Climate and Individual Creativity. The results further demonstrated a meaningful relationship between Individual Creativity and CSR. Finally, to test the hypothesis of partial mediation, the study confirmed that Individual Creativity functions as a mediating mechanism between IC and CSR. Overall, these findings highlight the critical role of an innovative environment in enhancing CSR efforts from the perspective of Individual Creativity, and they provide insight for future studies aimed at developing strategies to strengthen creativity as a strategic means of achieving more effective CSR outcomes. The study advocates the development of an innovation-oriented mindset as a pathway to promoting socially responsible practices within Tehran’s industrial sector. Full article

Objective: The mother’s birth experience is crucial in identifying her care needs. The “Questionnaire for Assessing the Childbirth Experience” (QACE) consists of four subscales designed to assess a mother’s childbirth experience. However, psychometric evaluations of the QACE have not been conducted in Turkey. This study aims to adapt and assess the validity and reliability of the “Questionnaire for Assessing the Childbirth Experience” short version for the Turkish maternal population. Methods: This methodological study included 205 mothers who gave birth in a public hospital. Data were collected using an Introductory Information Form and the Questionnaire for Assessing the Childbirth Experience (QACE). Results: The content validity index (CVI) for Item 9 was calculated as 0.875, while the remaining 12 items obtained a CVI of 1.00. The internal consistency of the scale, as measured by Cronbach’s alpha coefficient (α = 0.758), indicated an acceptable level of reliability across all items. During the Exploratory Factor Analysis (EFA), one item (Item 13) was excluded due to cross-loading. The remaining 12 items were grouped into four distinct subscales. Conclusions: The short version of the QACE demonstrates acceptable psychometric properties and serves as a valid and reliable instrument for assessing childbirth experiences among Turkish women. Full article

Background and aims: Pneumococcal infections, primarily caused by Streptococcus pneumoniae, pose significant global public health challenges, particularly in vulnerable populations. In Saudi Arabia, the introduction of pneumococcal vaccination has been a crucial step towards its prevention. However, gaps in public knowledge and attitudes toward the vaccine may hinder its effectiveness. Recent studies indicate a lack of awareness about the benefits of pneumococcal vaccination, suggesting a need for further investigation. This study determined the knowledge, attitudes, and practices (KAP) of Saudi residents regarding pneumococcal infection and vaccination. Study design and Methods: This observational cross-sectional study was conducted across Saudi Arabia from November 2024 to March 2025. Data were collected through a self-administered online questionnaire designed to evaluate KAP towards pneumococcal infection and vaccination. The sample size was calculated to be 385 participants. The questionnaire underwent expert validation and a pilot study to ensure clarity and reliability. The questionnaire was distributed via social media platforms to collect the data. Data management was conducted using Microsoft Excel, and statistical analysis was performed using Statistical Package for Social Sciences (SPSS) software version 26. Results: This study included 1230 participants of whom 630 (51.2%) were females and 1075 (87.4%) were Saudi citizens. Almost half of the participants (50.2%) were aged 18–30 years, and 498 (40.5%) were married. The average knowledge score was 58.6%, indicating a moderate level of understanding among the participants regarding pneumococcal infection. Also, the average attitudes score was 70.6%, reflecting a generally positive outlook towards the importance of pneumococcal vaccination and its potential to limit infection spread. In addition, the average practices score was 68%, indicating a fairly good level of behaviors regarding vaccination practices. Statistical analyses showed that demographic factors and clinical characteristics significantly shape individuals’ KAP towards pneumococcal infection and vaccination. Conclusions: This study highlights the critical need to improve KAP regarding pneumococcal infections and vaccinations among Saudi residents and could help in developing more targeted and effective public health interventions to protect Saudi residents from pneumococcal infections. Full article

Background: This longitudinal study aims to explore the stability and changes in child temperament dimensions between the ages of three and six, analyzing their relationship with emotional and behavioral problems, differentiated by gender. Method: This study involved 24 boys and 25 girls from various early childhood education centers in Málaga, Spain. To assess temperament, the Spanish adaptation of the Children’s Behavior Questionnaire was used, while emotional and behavioral problems were evaluated using the SPECI Screening for Emotional and Behavioral Problems in Children. Results: Findings indicate that 9 out of the 15 temperament dimensions remained stable, while 4—anger/frustration, attentional focusing, perceptual sensitivity, and sadness—showed significant changes in the total sample. The gender-specific analysis revealed different developmental patterns for boys and girls. Girls exhibited changes in attentional focusing, fear, and perceptual sensitivity, while boys showed changes in anger/frustration and attentional focusing. In addition, girls scored higher in discomfort and fear, whereas boys stood out in activity levels. Regarding behavioral problems, girls’ externalizing symptoms were significantly associated with attentional focusing and smiling/laughter, while internalizing symptoms were linked to low-intensity pleasure and perceptual sensitivity. Conclusions: These findings highlight the importance of addressing temperament from a gender-differentiated perspective when designing educational and family interventions aimed at promoting socioemotional development. Full article

Objectives: Shoulder injury prevalence appears to be the highest among all injuries in CrossFit (CF) athletes. Nevertheless, there is no evidence deriving from prospective studies to explain this phenomenon. The purpose of this study was to document shoulder injury incidence in CF participants over a 12-month period and prospectively investigate the risk factors associated with their demographic, epidemiological, and functional characteristics. Methods: The sample comprised 109 CF athletes in various levels. Participants’ data were collected during the baseline assessment, using a specially designed questionnaire, as well as active range of motion, muscle strength, muscle endurance, and sport-specific tests. Non-parametric statistical tests and inferential statistics were employed, and in addition, linear and regression models were created. Logistic regression models incorporating the study’s continuous predictors to classify injury occurrence in CF athletes were developed and evaluated using the Area Under the ROC Curve (AUC) as the performance metric. Results: A shoulder injury incidence rate of 0.79 per 1000 training hours was recorded. Olympic weightlifting (45%) and gymnastics (35%) exercises were associated with shoulder injury occurrence. The most frequent injury concerned rotator cuff tendons (45%), including lesions and tendinopathies, exhibiting various severity levels. None of the examined variables individually showed a statistically significant correlation with shoulder injuries. Conclusions: This is the first study that has investigated prospectively shoulder injuries in CrossFit, creating a realistic profile of these athletes. Despite the broad spectrum of collected data, the traditional statistical approach failed to identify shoulder injury predictors. This indicates the necessity to explore this topic using more sophisticated techniques, such as advanced machine learning approaches. Full article