Search Results (859)

The paper contributes to the debate on the holistic sustainability assessment of real estate projects, integrating economic, financial, environmental, and social aspects. A methodological study is presented to support decision-making processes involving the preferability ranking of alternative investment scenarios: new building production vs. retrofitting the existing stock, in the context of urban transformation interventions. The study integrates life cycle approaches by introducing the social components besides the economic and environmental ones. Firstly, a composite unidimensional (monetary) indicator calculation is illustrated. The sustainability components are internalized in the NPV calculation through a Discounted Cash-Flow Analysis (DCFA). Life Cycle Costing (LCC) and Life Cycle Assessment (LCA) are suggested to assess the economic and environmental impacts, and the Social Return on Investment (SROI) to assess the intervention’s extra-financial value. Secondly, a methodology based on multicriteria techniques is proposed. The Hierarchical Analytical Process (AHP) model is suggested to harmonize various performance indicators. Focus is placed on the criticalities emerging in both the methodological approaches, while highlighting the relevance of multidimensional approaches in decision-making processes and for supporting urban policies and urban resilience. Full article

Background/Objectives: Undergoing intensive cancer treatment, such as allogeneic haematopoietic stem cell transplantation, challenges the entire life situation of patients and their family caregivers. A prerequisite for effective care is that interventions are tailored to the unique circumstances of each individual. The aim of this study was to examine the feasibility of a developed person-centred nursing model in this context. Methods: The nursing model involves systematic use of conversation tools with subsequent conversations to assess and address the needs of patients (two tools) and their family caregivers (one tool). Patients, family caregivers and registered nurses from two Swedish stem cell transplantation centres testing the model were included. Data to measure practicality were gathered from the tools and documented conversations, while acceptability was assessed from the interviews. Results: 36 patients, 32 family caregivers and 16 registered nurses participated. 67–94% of the patients and 94% of the family caregivers completed the tools. 78–97% of the subsequent conversations were conducted as planned. 78% of the patients and registered nurses were positive about one of the patient tools, while 41% were positive about the other patient tool. 95% of the family caregivers and registered nurses were positive about the family caregiver tool. Most participants considered that the systematic use of tools helped to structure a holistic needs assessment. Conclusions: This feasibility study indicates that most components of our nursing model are practical, acceptable and support registered nurses when conducting person-centred nursing. With further development, the model has the potential to enhance the quality of care and support within the cancer context. Full article

Background: University students are particularly vulnerable to psychological distress due to the transitional nature of this life phase and increasing academic, social, and financial pressures. Accumulating evidence indicates that lifestyle behaviors—especially nutrition and physical activity—play a critical role in shaping mental health, cognitive functioning, and overall well-being in this population. Methods: The objective of this scoping review was to systematically map the literature on the combined impacts of diet and physical activity on psychological well-being among university students. Following PRISMA-ScR guidelines, an initial search of three major databases (PubMed, Sciencedirect, and Wiley) yielded 718 articles. After a multi-stage screening process, 39 articles of various designs (including cross-sectional, interventional, and review studies) focusing on non-clinical student populations were included. The studies were then thematically analyzed. Results: While most research explored isolated behaviors, a smaller set of integrated studies revealed synergistic effects, reporting enhanced outcomes in mental health and quality of life. Notably, several articles proposed practical strategies—such as app-based tools, structured wellness initiatives, and interdisciplinary educational programs—as effective means to support healthier habits. Conclusions: The evidence strongly suggests that universities should prioritize holistic, multi-component wellness strategies over siloed, single-behavior initiatives. Developing integrated programs that combine nutritional education and physical activity support represents a practical and effective approach to enhance student well-being. Full article

Background/Objectives: Sexuality is a frequently overlooked but clinically significant dimension in patients with obsessive–compulsive disorder (OCD). Beyond comorbid anxiety and depressive symptoms, OCD can substantially affect sexual functioning and include obsessions and compulsions relating to sexual content. This review aims to synthesize current evidence on sexual dysfunction in OCD and the role of sexuality in OCD symptom dimensions, as well as associated neurobiological, cognitive, and clinical outcomes. Methods: We conducted a review of the literature including studies published in the last 20 years using the PubMed and Cochrane databases. Our search strategy used the terms “sexual AND (Obsessive-compulsive disorder OR OCD)”, retrieving a total of 582 articles. After a screening and eligibility assessment based on predefined inclusion and exclusion criteria, 200 studies were included. Additional papers were retrieved through citation tracking. Results: Sexual dysfunction is highly prevalent in OCD patients, particularly among women, ranging from low desire and arousal to anorgasmia and pain during intercourse. Sexual obsessions affect a large proportion of OCD patients and are associated with an early onset, male sex, greater symptom severity, poorer insight, and suicidality. These obsessions often co-occur with aggressive or religious themes. Neuroimaging studies indicate distinct patterns of brain activation in patients with sexual obsessions. Treatment with SSRIs and CBT is often less effective in this subgroup, suggesting the need for targeted interventions. Conclusions: Sexuality-related symptoms in OCD patients constitute a distinct and clinically relevant domain that affects functioning, prognosis, and treatment response. Recognizing and addressing these symptoms is essential for the holistic and effective care of patients with OCD. Full article

Background: While survival outcomes for breast and cervical cancer have improved in Saudi Arabia, little is known about the long-term sexual and psychosocial well-being of survivors. This study aimed to assess sexual satisfaction, emotional health, and social relationship quality among Saudi women diagnosed with cervical and breast cancers and to identify sociodemographic predictors of quality of life (QoL) across these domains. Methods: A cross-sectional survey was administered to 129 women with a history of breast or cervical cancer during May–July 2021. The instrument combined validated tools measuring three core QoL domains: sexual function and satisfaction, psychological and emotional well-being, and social and relationship qualities. Multivariable ordinal logistic regression was used. Results: A total of 129 women with cervical and breast cancers (51.2% cervical, 48.8% breast) participated. Most were aged 31–45 years (45.7%), married (83.0%), with 48.1% holding a bachelor’s degree. Overall, 74.4% of participants reported high to moderate emotional well-being; 48.8% reported satisfactory sexual function, and only 41.1% perceived high quality in social relationships. Younger age (21–30 years), higher education, and having more children were significantly associated with lower emotional well-being (p < 0.05). Conversely, current treatment status and higher parity were associated with better sexual function. Social and relationship quality was significantly higher among younger and employed women. Perceived importance of domains varied, with emotional well-being rating the highest (82.9%). Conclusions: Sexual and social QoL are underserved yet critical components of survivorship care. Cultural, familial, and educational contexts play significant roles in shaping post-treatment experiences. Interventions tailored to age, family dynamics, and treatment stage are needed to improve the holistic well-being of survivors in Saudi Arabia. Full article

This study presents a case study of a holistic, psychosocial hazard management intervention program in a project-based, remote workforce in the Australian construction industry. There is a dearth of research on targeted, integrative, multi-level wellbeing interventions, and we seek to address this gap. Given the high rates of psychological distress and suicide in construction, understanding these hazards and the responses needed to manage them is critical for prevention. Data were collected from workers before and after the implementation of an intervention using an empirically validated measure of the work environment underpinned by the job demands–resources framework to evaluate exposure to psychosocial hazards, and mental health indicators, including psychological distress and suicidal ideation. Results revealed that job demands and resources improved following the change initiative, and workers reported significantly lower levels of psychological distress compared to workers on similarly diverse remote sites. The findings highlight the need for targeted mental health interventions addressing specific workplace psychosocial risks that adopt a holistic approach to change across all levels of an organisation. The study contributes to a nuanced understanding of psychosocial risks in construction and informs strategies to mitigate mental health harms in high-risk occupational settings. Full article

This article presents the “When a Parent is Born” project, focused on early identification and intervention for psychological distress during pregnancy and postpartum. It addresses the perinatal vulnerability to depression, and psychological distress, providing psychological support for high-risk cases within a clinical setting. The sample included 997 pregnant women (Mean_age = 32.75; SD = 5.33). The protocol encompassed psychological distress (EPDS, PAMA), social support (MSSS), couples’ relationship (DAS), childhood maltreatment (CTQ-SF), and prenatal attachment (MAAS). Univariate and multivariate linear regression models were employed for the analyses. This study highlighted the prevalence of depressive symptoms in 24.7% of the sample, a non-clinical population, and suicidal risk in 2.4%. All predictors were associated with EPDS and PAMA scores in univariate regressions (p < 0.005). In the multivariate model of childhood trauma predictors, emotional abuse and neglect were significant for EPDS (F = 19.584, p < 0.001) and PAMA (F = 17.876, p < 0.001). In the multivariate regression models, the main significant associations (EPDS; F = 17.708, p < 0.001) (PAMA; F = 19.346, p < 0.001) remained for DAS (p < 0.001) and emotional abuse (EPDS p = 0.005; PAMA p < 0.001). These findings revealed factors associated with perinatal psychological distress and highlighted the importance of psychological screening during pregnancy to support holistic care through a multidisciplinary team. However, the study presents limitations, including the use of self-report measures, the cross-sectional nature of the data, and the limited generalizability of the findings, as the sample is restricted to Southern Italy. Full article

Background: Themanagement of occupational respiratory diseases (ORDs) requires a multidisciplinary approach, yet collaboration between pulmonologists and occupational physicians is often fragmented, potentially compromising patient outcomes. This study aimed to systematically compare the management strategies for ORDs between these two specialties in Italy to identify gaps and opportunities for integration. Methods: A cross-sectional survey was conducted using a structured 12-item questionnaire distributed to board-certified pulmonologists and occupational physicians across Italy. The questionnaire assessed diagnostic pathways, therapeutic strategies, preventive measures, and patterns of interdisciplinary collaboration. A total of 102 specialists (51 pulmonologists and 51 occupational physicians) completed the survey. Comparative analyses were performed using Pearson’s ${\chi }^2$ tests. Results: Significant divergences in practice were identified. Pulmonologists primarily focused on clinical diagnosis, utilizing pulmonary function tests (34.3%) and imaging (11.8%), and favored pharmacotherapy (27.5%) as the first-line treatment, in alignment with clinical guidelines. Conversely, occupational physicians prioritized detailed occupational and exposure histories (15.7%) and preventive interventions aimed at exposure reduction (15.7%). While both groups acknowledged the importance of collaboration, a substantial number reported that it occurred only occasionally (17.6% of pulmonologists and 12.7% of occupational physicians), indicating a significant gap in integrated care. Shared barriers included poor patient adherence and limited access to advanced diagnostic tools. Conclusions: While sharing a common foundation in diagnostic and preventive principles, pulmonologists and occupational physicians in Italy operate with distinct, complementary approaches that remain insufficiently integrated. The observed fragmentation in diagnostic and therapeutic pathways underscores an urgent need for shared national guidelines, structured interdisciplinary training, and formalized communication protocols. Bridging this disciplinary divide is essential to delivering holistic care, optimizing worker health, and preserving work ability. Full article

Heart transplantation represents a pivotal intervention for end-stage heart failure, extending survival. However, it imposes profound physical, psychological, and social challenges that often undermine recipients’ quality of life (QoL). These challenges are especially pronounced in collectivist cultural contexts like China, where familial obligations and stigma surrounding chronic illness intensify existential burdens. Grounded in theoretical frameworks including Coping Theory, Self-Determination Theory, Socioemotional Selectivity Theory, and Terror Management Theory, this cross-sectional study explored the interplay between social support and QoL among Chinese heart transplant recipients, elucidating the mediating roles of self-esteem and death anxiety, as well as their sequential chain-mediating pathway. Employing validated psychometric instruments, including the Social Support Rating Scale (SSRS), Rosenberg Self-Esteem Scale (RSES), Templer Death Anxiety Scale (T-DAS) and SF-36 Health Survey, along with chain-mediation modeling, the analysis revealed that social support exerts a direct positive influence on QoL, supplemented by indirect effects through enhanced self-esteem, reduced death anxiety, and a chained cognitive-existential mechanism linking these factors. These insights highlight the complex psychosocial dynamics of post-transplant adaptation, advocating for targeted and culturally attuned interventions. These interventions include family-based support programs, self-esteem enhancement strategies, and death anxiety counseling. The aim is to promote holistic rehabilitation and sustained well-being among heart transplant recipients in China’s context. Full article

Postpartum body image is a critical aspect of maternal well-being, influenced by sociocultural, psychological, and relational factors. Theoretical models offer a broader framework for understanding these influences, whereas regression analyses identify specific associations. This systematic review aimed to identify theoretical models assessing postpartum body image and to examine its association with relevant constructs using regression analysis. A search was conducted of four databases (PubMed, EMBASE, Web of Science, and American Psychological Association) between August 2022 and March 2024. Studies including mothers over 18 years old, within 0–24 months postpartum, that applied theoretical models and/or regression analyses were included. Of 169 articles retrieved from databases and 1 identified through backward snowballing, 18 studies met the inclusion criteria. Three theoretical models were identified, and highlighted sociocultural influences, social support, and breastfeeding as key determinants of body dissatisfaction. Regression analysis identified association between postpartum body image and maternal weight, depression, mode of delivery, sexual function, breastfeeding, and social support. Given these influences, the review emphasizes the importance of adopting holistic approaches to support maternal well-being. Interventions addressing postpartum body image should integrate strategies that consider cultural expectations, promote adequate social support, and address physical and emotional health challenges, such as weight management and mental health care. PROSPERO (CRD42022352992). Full article

This study investigates the gendered effects of political violence on women (and children) from a church leader perspective. This paper critically examines the role of church leadership in protecting vulnerable groups in society (particularly women and children) and interrogates how church leadership has incorporated women and children into peacebuilding programmes. Using qualitative methods, in-depth interviews were conducted with church leaders affected by political violence in Zimbabwe. The results of this study show that women and children are disproportionately affected by political violence. The women and children are affected socially, economically, and psychologically as a result of political violence, which results in severe trauma, disruption, and loss of livelihoods, and, in severe cases, loss of lives. The results further indicate that the Church plays a crucial role in providing safe havens for the victims, offering spiritual guidance and counselling for the victims. However, the findings show that the Church continues to lack gender sensitivity and inclusivity in peacebuilding programmes. Women and children continue to be underrepresented in leadership roles in churches, as well as in driving the peacebuilding agenda. This paper argues for a transformative and gender-sensitive framework in church-led peace interventions, which prioritises the needs of women and children and incorporates them in the process. This paper argues that by adopting this approach, the Church harnesses its transformative capacity as a change agent for building sustainable peace and addressing political violence in a holistic manner. This interdisciplinary study contributes to the evolving scholarly debates on the intersections of gender, religion, and peacebuilding. Full article

Background: In response to the high prevalence of burnout in nursing, a hospital research team developed, studied, and implemented RISE (Resilience, Insight, Self-Compassion, Empowerment), a novel psychoeducational group program designed to reduce distress and promote well-being among professional caregivers, specifically nurses and nurse leaders. Pilot studies and randomized controlled trials showed positive results, and thus, the program was operationalized. Methods: This quality improvement/quality assurance (QI/QA) project involved scaling the program and gathering data to evaluate implementation and impact on well-being indicators. The intervention involves structured weekly (8–9 weeks) 90-min group sessions integrating mindfulness, cognitive-behavioral techniques, and acceptance and commitment therapy. Eight licensed mental health providers were trained and delivered the program. Implementation outcomes included adoption/stakeholder engagement, fidelity, provider satisfaction, participant engagement, and sustainability. Participant outcomes were measured through validated scales and participant feedback forms. The implementation process was examined at the participant, provider, and organizational levels to identify barriers and enabling factors. Results: The program was implemented in seven acute care hospitals. From January 2023 to December 2024, 160 participants completed the program. Effective implementation strategies included intensive training and supervision of qualified providers, multi-departmental collaborations, and rigorous fidelity monitoring. Quality improvement processes addressed challenges such as early attrition and administrative burden. Evaluation data from pre- and post-intervention surveys demonstrated statistically significant improvements in psychological outcomes, with high satisfaction reported by both participants and providers. Conclusion: The findings support the effective implementation of the program as part of a broader organizational strategy to address nurse burnout and workforce mental health. Lessons, implications, and future directions for healthcare leaders are discussed. Full article

Promoting active lifestyles among adolescents is essential due to their short-, medium-, and long-term contributions to young people’s holistic development and overall health. Beyond physical well-being, Physical Education foster physical activity, autonomy, social connectedness, motivation and emotional well-being, thus constituting a key dimension of quality education. Background/Objectives: The “Estilos de Vida Activos (EVA)” project is a school-based intervention designed to foster adolescent agency and motivation in adopting active habits. Grounded in the salutogenic model, self-determination theory, and the health-based Physical Education pedagogical model, this protocol describes the design and implementation strategies of a participatory intervention in secondary schools. Methods: A variety of research methods will be used to collect quantitative and qualitative data before, during, and after the intervention. Validated questionnaires will assess active commuting, socioeconomic status, satisfaction of basic psychological needs, motivation, levels and intention to engage in physical activity. Qualitative data include interviews with teachers, Photovoice sessions with students, observation notes, and programme materials. Intervention: The EVA intervention is collaboratively developed by students, teachers, and researchers using participatory action research. It includes needs analysis, participatory activities, and co-design of tailored physical activity programmes. The intervention is described using the Template for Intervention Description and Replication checklist (TIDieR) to enhance transparency and replicability. Conclusions: This protocol presents a theoretically grounded and participatory approach to school-based health promotion. By integrating educational and collaborative strategies, it offers a replicable model that promotes adolescent active lifestyles, from contextual relevance, and pedagogical coherence, serving as a guide for inclusive and sustainable interventions in school settings. Full article

The Mediterranean Sea, a biodiversity hotspot with over 8500 marine species, faces escalating threats from climate change, pollution, overfishing, and habitat degradation. This study introduces a novel Decision Support System (DSS) integrating a modified PESTEL framework (BESTEL: Biological, Economic, Social, Technological, Environmental, Legal) with Fuzzy Cognitive Mapping (FCM) to assess and mitigate risks to marine species. Leveraging expert knowledge from 34 specialists, we identified 30 key factors influencing extinction risk, analyzed through Principal Component Analysis (PCA) to reduce dimensionality. The resulting FCM model simulated four policy scenarios, evaluating the impacts of climate change and dam proliferation on biodiversity. Findings reveal that mitigating both drivers significantly reduces extinction risk (−0.14), while unchecked climate change offsets gain from dam removal. The DSS highlights the dominance of climate stressors, with pollution and temperature shifts (−0.45, −0.42) as critical variables. Biological traits like reproductive frequency and longevity respond strongly to environmental improvements. This integrative approach bridges qualitative expertise and quantitative modeling, offering actionable insights for conservation planning. The study underscores the need for holistic strategies combining climate mitigation and habitat restoration to safeguard Mediterranean marine ecosystems. The FCM-based DSS provides a scalable tool for policymakers to prioritize interventions and assess trade-offs in complex socio-ecological systems. Full article

Background: This study aims to examine the relationship between Kinesiophobia and Rumination in athletes, and to reveal the mediating roles of Coping Responses and Psychological Flexibility in this relationship. Methods: Three hundred ninety licensed athletes, including 225 females and 165 males, voluntarily participated in the study. Participants were selected through simple random sampling from various sports clubs across Turkey. During the data collection, participants were contacted online. They completed the personal ınformation form, the Tampa Scale of Kinesiophobia, the Sport Competition Rumination Scale, the Psychological Flexibility Scale, and the Coping Responses Inventory. IBM SPSS 26 and PROCESS Macro Model 4.0 were used for data analysis. In addition to descriptive statistics, Pearson correlation, linear regression, and mediation analyses were conducted. The adequacy of the sample size was evaluated using G*Power (v 3.1). The Bootstrap method with 5000 resamples and a 95% confidence interval was applied in the mediation analysis. Results: The study’s findings indicated that kinesiophobia significantly predicted levels of rumination among athletes, and that both psychological flexibility and coping responses partially mediated this relationship. Although both variables were functional in reducing ruminative thinking, coping responses demonstrated a more potent effect. The results suggest that the tendency to avoid movement affects physical and cognitive processes. Conclusions: It was concluded that psychological flexibility and coping responses are protective factors in reducing repetitive negative thought patterns in athletes. In this regard, it is recommended that holistic intervention programs aimed at enhancing psychological resilience be developed to support mental health and athletic performance. Full article