Search Results (1,004)

Background: Ageing is accompanied by physical, psychological and social changes that can negatively affect the quality of life of older adults. Loneliness is one of the most important psychosocial problems in later life and is closely related to lower life satisfaction. The aim of this study was to investigate the relationship between subjective loneliness and quality of life in older adults in Primorje-Gorski Kotar County, taking into account gender and living arrangements. Methods: A convenience sample of 153 adults aged 63 years and older participated in the study. Quality of life was assessed using the Personal Well-Being Index-Adult (PWI-A), and loneliness was measured using the short version of the UCLA Loneliness Scale. Statistical analyses included descriptive statistics, Spearman correlation and Mann–Whitney U test, performed in Statistica 14.0. Results: A significant negative correlation was found between loneliness and quality of life (r = −0.448; p < 0.01). A significant negative correlation was found between loneliness and quality of life (r = −0.448; p < 0.01). Women reported significantly higher levels of subjective well-being than men (p < 0.05), while no significant gender difference was observed for loneliness. No significant differences were found based on living arrangement (living alone vs. with others) (p > 0.05). Conclusions: The results confirm that loneliness significantly affects the subjective well-being of older adults. Gender differences were observed in subjective well-being but not in loneliness. Living arrangement did not show a strong influence. These results emphasize the need for targeted strategies and psychosocial interventions aimed at reducing loneliness and improving quality of life in ageing populations. Full article

Background/Objectives: This study examined the prevalence of depression among older adults in Busan—the first metropolitan city in South Korea to become a super-aged society—and identified the social environmental factors associated with depression. Methods: Using data from the 2023 Korea Community Health Survey (KCHS), 5143 individuals aged 65 and older residing in Busan were analyzed. Depressive symptoms were measured using the PHQ-9, and social environmental factors—including unmet medical needs, satisfaction with the community environment, participation in social activities, and frequency of social contact—were derived from KCHS items. Descriptive statistics and logistic regression were performed using SPSS, version 29.0. Results: Participants’ mean age was 73.50 ± 0.11 years, and 54.4% were female. The average depression score was 2.85 ± 0.06, with 3.7% having moderate, 1.2% moderately severe, and 0.4% severe depression. Logistic regression revealed that low healthcare accessibility was significantly associated with higher odds of moderate-to-severe depression (OR = 2.54, 95% CI = 1.78–3.62). Conversely, higher satisfaction with community environment (OR = 0.80, 95% CI = 0.73–0.87) and greater participation in social activities (OR = 0.68, 95% CI = 0.53–0.87) were associated with lower odds of depression. Conclusions: Depression in older adults is a multidimensional phenomenon shaped by the complex interplay of individual, health-related, and socio-environmental factors. Region-specific, community-based programs that enhance living environments, expand social participation, improve healthcare access, and promote positive health perceptions are essential. These findings can inform integrated nursing and policy interventions that support healthy aging and enhance older adults’ well-being. Full article

Background/Objectives: The aging global population has led to a rising prevalence of type 2 diabetes mellitus (T2DM), in which biomedical outcomes alone fail to capture patients’ lived experiences. Patient-Reported Outcome Measures (PROMs) can provide insights into psychological, psychosocial, and quality-of-life (QoL) dimensions, yet their use—particularly among older adults—remains inconsistent. This AI-assisted rapid review aimed to map how PROMs are currently applied in adults with T2DM, with specific attention to studies involving older populations, focusing on their role in assessing well-being, distress, depression, and treatment satisfaction, as well as their implementation in clinical and organizational practice. Methods: A rapid review was conducted using Elicit, an AI tool designed to support systematic evidence synthesis. Studies published between 2015 and 2025 were identified from Semantic Scholar, complemented by manual searches for recent or unindexed papers. Eligibility criteria required inclusion of adults with T2DM and use of validated PROMs in real-world settings. Studies explicitly describing older or elderly subgroups were highlighted separately. After screening 504 records, 167 studies were included. Data extraction covered study design, instruments used, populations, outcomes, and implementation details. Results: The most frequently assessed outcomes were diabetes distress, depression, QoL, treatment satisfaction, and self-efficacy. Common instruments included PAID, DDS, PHQ-9, WHO-5, EQ-5D, SF-36, DTSQ, and GDS. Evidence showed PROMs effectively identified high-risk patients and informed tailored interventions, but integration into routine care remained limited. Barriers included workflow disruption, lack of provider training, heterogeneity of tools, and insufficient cultural validation. Facilitators included brief instruments, digital administration, and linkage with care planning. Conclusions: PROMs are valuable in capturing psychosocial and psychological burdens in adults with T2DM, including but not limited to older populations, but routine implementation is inconsistent. Broader adoption will require digital infrastructure, clinician training, and organizational integration, as well as the development of PROMs that capture experiences with emerging diabetes technologies. Methodologically, this study illustrates the feasibility of AI-assisted rapid reviews to generate timely, evidence-informed syntheses. Full article

The inspiration and main goal for creating smart cities is to improve the quality of urban life. However, this ambitious task is not always successful as urban stakeholders are not homogeneous. Their experiences and expectations can vary significantly, which ultimately affects their level of satisfaction with life in the city. This article assesses the quality of life in 19 cities with county rights located in the Silesian province of Poland. The assessment takes into account stakeholders’ age, gender, education, and household size. The study also assesses the geographical variation in the quality of life in individual cities in the region with a view to individualizing the management approach. The research methodology is based on a survey conducted in a representative sample of 1863 residents of Silesian cities. The results are analyzed using descriptive statistics and nonparametric tests. The conclusions indicate a lower quality of life for women, residents aged 31 to 40, and people with primary education and a bachelor’s degree. The quality of life is significantly worse in post-mining towns where economic transformation has not been successfully implemented. The quality of urban life is rated highest by men, older people, and residents with basic and secondary education. Communities living in cities with modern industry and a stable economic situation are very satisfied with their standard of living. The results of the study imply the need for an individualized approach to shaping living conditions in cities and the implementation of remedial measures for groups and cities at risk of a lower quality of life. This will help to balance the quality of urban life and prevent various forms of exclusion. Full article

Background: This study characterizes the current representation of sociodemographic groups within Canadian radiation oncology training programs and trainees’ lived experiences. Methods: A 59-item ethics-approved, bilingual survey assessed sociodemographics, training perceptions, mentorship, discrimination/harassment experienced, and open-ended questions. Electronic surveys were distributed to all Canadian radiation oncology residents/fellows. Descriptive statistics summarized survey responses. Categorical groups were compared using chi-squared/Fisher’s exact tests. Thematic analysis was performed on open-ended responses. Results: Between July and December 2023, 98 of 177 (56%) trainees participated: 70% were residents, 52% identified as male, 62% as a racialized minority, and 10% as a sexual minority. Most respondents reported training program satisfaction (83%) and a respectful workplace culture (69%); however, discrimination during training was reported by 38%. Less than half (45%) felt comfortable reporting discrimination/harassment within their workplace. Women were more likely to feel under-represented in-training (46% vs. 13%, p = 0.001) and perceived more discrimination events (64% vs. 19%, p < 0.001). Three themes emerged as follows: importance of offering EDI education, ensuring pathways for reporting learner mistreatment, and creating appropriately diverse selection committees. Conclusions: Although most Canadian radiation oncology trainees reported satisfaction and a respectful culture, key differences between groups were observed. Targeted strategies and stronger institutional policies to improve representation and reduce rates of discrimination/harassment are needed. Full article

This research situates urban planning as a social well-being determinant, highlighting that cities function as social habitats that shape individuals’ quality of life, as well as being physical spaces. The study emphasises the dangers of inadequate urban management, particularly when it is based on biased or incomplete information. This has the potential to exacerbate inequality and undermine the benefits of urbanisation. The present study focuses on the intersection of gender, social roles, and access to basic infrastructure, including childcare centres, elderly facilities, healthcare services, pedestrian paths, street lighting, and green areas. By addressing this critical urban issue, namely the uneven distribution of opportunities for well-being, the study contributes to the existing body of knowledge in this field. The Capability Approach, developed primarily by Amartya Sen and Martha Nussbaum, provides a theoretical framework for evaluating individuals’ freedom to pursue the lives they value. Theories of subjective well-being (SWB) are rooted in psychological and economic traditions that assess individuals’ life satisfaction, happiness, and emotional equilibrium The present study proposes a methodological framework that integrates the Capability Approach with Subjective Well-Being theory. This approach facilitates a more comprehensive measurement of citizens’ well-being, transcending the limitations of traditional gender dichotomies. The study identifies the manner in which infrastructural design affects individual capabilities and demonstrates the manner in which urban policies can foster gender equality and inclusive socio-economic development. It is therefore evident that the research provides urban planners and policymakers with actionable insights by demonstrating that equitable infrastructure provision is a cornerstone of sustainable, socially just urban development. Full article

The 15-minute city (15MC) model has gained increasing attention as a framework for promoting sustainable urban living by ensuring that essential services, including urban green spaces (UGSs), are accessible within short walking or cycling distances. UGSs play a vital role in public health, social interaction, and environmental resilience, yet questions remain about how equitably they are distributed and accessed in cities. This study assesses proximity and accessibility to UGSs in Porto, Portugal, through the lens of the 15MC. The methodology combined a GIS-based spatial analysis of walking and cycling catchments with a complementary questionnaire to capture user perceptions and travel behaviors. Results show that, while 84% and 100% of residents live within a 15-minute walking and cycling distance of a UGS, respectively, accessibility remains uneven, particularly for walking. Large peripheral parks contribute significantly to provision but remain less accessible to central neighborhoods, and cycling to UGSs is marginal due to fragmented and insufficient infrastructure, and residual cycling use. Subjective findings mirrored the spatial analysis, highlighting dissatisfaction with cycling conditions and only moderate satisfaction with pedestrian environments. The study emphasizes the need for integrated planning that improves local connectivity, infrastructure quality, and spatial equity to fully realize the 15MC vision. Full article

Background: Depression, anxiety, and stress are increasingly prevalent among university students, raising concerns about the role of video gaming behaviors, social support, and academic factors in mental health. Internet Gaming Disorder (IGD), recognized in international classifications, has been linked to psychological distress but remains underexplored in Portuguese higher education students. Objective: This study aimed to examine the relationships between IGD, social support, academic performance, and mental health outcomes. Methods: A cross-sectional survey was conducted with Portuguese university students, collecting sociodemographic information, gaming habits, academic performance, social support, and mental health indicators. Data analyses included non-parametric tests, Spearman correlations, and multiple linear regression models to explore group differences, associations, and predictors of mental health outcomes. Results: No significant gender or age differences were observed in social support or mental health. Students living with parents, engaging in multiplayer gaming, and exercising regularly reported higher social support. Social support correlated negatively with depression, anxiety, and stress, whereas IGD correlated positively with these symptoms. Regression analyses identified academic performance, IGD, and intimacy as predictors of depression; family satisfaction as a predictor of anxiety; and family satisfaction and academic performance as protective factors against stress. Conclusions: Findings highlight the interplay of behavioral, social, and academic factors influencing students’ mental health. Effective interventions should reinforce family support and students’ academic self-efficacy, alongside fostering responsible gaming practices. Limitations include cross-sectional design and self-reported measures, indicating the need for longitudinal studies. Full article

Background: This study examined the clustering of unhealthy lifestyle behaviours and their determinants among adolescents across Europe, Central Asia, and North America. Methods: The study included 210,713 adolescents aged 11 to 15 years from 45 countries who participated in the 2018 Health Behaviour in School-aged Children (HBSC) study. Lifestyle behaviours, including physical inactivity, inadequate fruit and vegetable consumption, frequent soft drink consumption, alcohol use, and smoking, were used to examine the clustering of unhealthy behaviours. Multilevel mixed-effects logistic regression was employed to assess the associations between unhealthy behaviour clustering (≥3 unhealthy behaviours) and contextual factors at the individual, family, and school levels. Results: A high prevalence of clustered unhealthy behaviours was observed among adolescents, with 51.5% engaging in three or more unhealthy lifestyle behaviours. The odds increased with age (AOR: 1.79, 95% CI: 1.75, 1.84 for those aged ≥ 15 years), among males (AOR: 1.26, 95% CI: 123, 1.28), and among those experiencing higher academic pressure (AOR: 1.13, 95% CI: 1.09, 1.17 for very high academic pressure). In contrast, the odds were lower among adolescents from a higher family affluence background (AOR: 0.62 95% CI: 0.60, 0.65 for high), among adolescents living with both parents (AOR: 0.83, 95 CI: 0.81, 0.85), those reporting higher family support (AOR: 0.62, 95% CI: 0.60, 0.63 for high), higher peer support at school (AOR: 0.87, 95% CI: 0.84, 0.89 for high), and those reporting higher school satisfaction (AOR: 0.50, 95% CI: 0.48, 0.52 for very high). Conclusions: The study reveals that one in two adolescents engages in three or more unhealthy lifestyle behaviours. It emphasises the need to tackle this public health challenge through multisectoral interventions targeting individual-level and contextual factors at the family and school levels. Full article

Background/Objectives: Children with cerebral palsy (CP) commonly present impairments in gross motor function and limitations in activities of daily living (ADLs), which negatively impact independence and quality of life. Identifying effective rehabilitation strategies is essential to promote functional development. To evaluate the effectiveness of occupational therapy (OT) interventions on gross motor function and independence in ADLs among children with CP. Methods: Seven electronic databases were searched through August 2025. The review protocol was registered in PROSPERO (CRD42025634706) and conducted in accordance with PRISMA guidelines. Methodological quality and certainty of evidence were assessed using the Oxford Centre for Evidence-Based Medicine scale, the Risk of Bias 2 (RoB 2) tool, and GRADEpro. Randomized controlled trials reporting OT interventions targeting gross motor and ADL outcomes were included. Results: Of 594 identified records, 14 studies met the inclusion criteria. Meta-analysis indicated that OT interventions significantly improved gross motor function (GMFM-66; ES = 0.32 [0.01–0.63], p = 0.04), mobility (PEDI-Mobility; ES = 0.46 [0.05–0.87], p = 0.02), and occupational performance (COPM-Performance; ES = 2.63 [1.14–4.11], p = 0.001) and satisfaction (COPM-Satisfaction; ES = 2.17 [0.82–3.51], p = 0.002). No significant changes were observed in self-care (PEDI-Self-Care; ES = 0.19 [−0.14–0.53], p = 0.26). Conclusions: Evidence suggests that OT interventions effectively enhance gross motor function, mobility, and occupational performance in children with CP. These results support the integration of OT within pediatric rehabilitation programs to optimize functional outcomes. Full article

This paper investigates the advantages and challenges associated with synchronous and asynchronous activities in intercultural virtual collaboration (IVC) projects, particularly in relation to student satisfaction and learning outcomes. This study draws parallels between two distinct IVC projects. The first facilitated real-time interaction among students, lecturers, and peers from partner universities in the Netherlands and Japan. In contrast, the second project involved separate live classes led by local instructors in the Netherlands and Spain and featured asynchronous interactions among peers. This latter arrangement required students to exercise a greater degree of autonomy in their collaborative efforts. In both IVC projects, students developed a business case study that explored the influence of cultural factors on international marketing strategies. They participated in discussions and reflective exercises concerning the issue of greenwashing within the selected company. Our research employs data derived from students’ final business case reports and satisfaction surveys. The surveys include both closed and open-ended questions to assess the effectiveness of the distinct IVC formats. Our research provides insights into the impact of the IVC formats on the student experience and learning. Findings indicate no substantial differences in the quality of work produced between the two formats; however, student satisfaction was notably higher in the synchronous model, highlighting that the way interactions are structured impacts the collaborative experience, even when final outputs are similar. This study offers important insights for educators navigating the challenges of virtual teaching and for policymakers looking to use digital technologies to foster a globally aware and responsible generation in an increasingly digital world. Full article

Student disengagement remains a major barrier to effective learning in synchronous online classrooms, where lack of interaction, limited feedback, and screen fatigue often contribute to passive participation. Despite the growing use of generative AI, there is a notable lack of empirical research investigating the application of generative AI in addressing engagement challenges in synchronous online sessions. This study introduces VClass Engager, a novel experimental system that utilizes generative AI to foster student participation and deliver instant, personalized feedback during live virtual sessions. The system integrates several features, including instant analysis of student answers to chat questions, real-time AI-generated feedback, and a leaderboard that displays students’ cumulative scores to promote sustained engagement. To assess its effectiveness, the system was evaluated across multiple courses. Engagement was measured by tracking participation in three in-class formative questions, and response quality was analyzed using a cumulative link mixed model (CLMM). In addition, a post-session survey captured students’ perceptions regarding usability, motivational impact, and feedback quality. Results demonstrated statistically significant increases in student participation and response quality in sessions using VClass Engager compared to baseline sessions. Survey responses revealed high levels of satisfaction with the system’s ease of use and motivational aspects. By combining AI and gamification, this study provides early empirical evidence for a promising approach to enhancing engagement in synchronous online learning. Full article

Compassion fatigue is a widely recognized phenomenon in human care settings, but it has been little explored in the veterinary field, despite sharing many of the same determinants. This study aimed to (1) identify distinct emotional risk profiles in veterinarians based on their levels of compassion fatigue and satisfaction; (2) estimate the relative prevalence of compassion fatigue in each of these profiles; and (3) analyze the predictive value of sociodemographic variables (gender, age, cohabitation) on belonging to these profiles. A cross-sectional study was conducted with 135 practising veterinarians. An abbreviated version of the ProQOL scale, adapted to the animal context, was used. Its two-dimensional structure (compassion fatigue and satisfaction) was validated using confirmatory factor analysis. Hierarchical cluster and k-means analyses were performed on the factor scores, which identified four emotional profiles: (1) intense emotional involvement, (2) emotional detachment, (3) functional distancing, and (4) high emotional risk. The latter grouped 23% of the sample, while 50.4% presented significant levels of emotional exhaustion. Finally, an ordinal regression was applied, which showed that being over 44 years of age (OR = 2.11) and living with a partner (OR = 1.94) increase perceived emotional risk, with no significant effects of gender. The findings highlight the need for training initiatives that enhance emotional regulation and communication with animal guardians or owners, while promoting sustainable, ethically responsible, and emotionally healthy professional practice. Full article

Family caregivers provide most daily care for people living with chronic illness or frailty, yet they remain under-recognized in health and social care systems. To address this gap, we co-designed the Caregiver-Centered Care Champions Education Program, which equips frontline providers with the competencies needed to lead caregiver-inclusive change. Guided by the Kirkpatrick-Barr Health Workforce Education Framework, we conducted a mixed methods interpretive description evaluation of learner satisfaction, knowledge and confidence gains, and self-reported behaviour change. Sixty-seven interdisciplinary participants completed three online modules. Quantitative results from pre/post surveys (Wilcoxon signed rank tests) showed significant improvements across all competencies (p < 0.001; large effect sizes) alongside high satisfaction (means 6.56–6.96/7). Qualitative findings revealed that 94% of participants applied program content within three months, and 61% implemented five or more distinct behaviour changes (e.g., collaborative care planning, system navigation support). The analysis illuminated how learners integrated caregiver-centred principles with change leadership strategies. Time constraints and staffing shortages emerged as key barriers. Our co-designed, theory-informed approach effectively bridged individual learning and system change, demonstrating the potential to transform caregiver inclusion practices when supported by organizational policies. Full article

With an aging population and the widespread adoption of smart technologies, elderly residents’ perceived safety in smart apartments has become a critical determinant of their quality of life and their acceptance of technology. However, much of the current research remains confined to either technical or psychological dimensions, with insufficient attention to the systematic interactions among multiple factors as experienced by elderly populations. This study aims to systematically evaluate and optimize the living environments of older adults, with the goal of enhancing their overall quality of life and subjective well-being. This study employs the DANP–mV model to empirically analyze the safety perception of older adults in smart apartments, integrating case-based investigation and evaluation to propose targeted optimization strategies and improvement pathways. Unlike traditional approaches that treat criteria as independent, this hybrid model reveals the interdependencies among factors and establishes a more realistic prioritization of improvement actions. The study found that, compared with merely reinforcing physical security measures, factors such as enhanced remote security support, a stronger sense of control and coping confidence, and higher satisfaction with the protective system exert a more fundamental influence on the overall safety perception. These results demonstrate that adopting a systems-thinking approach shifts the focus of decision-making from superficial safety risks to underlying causal drivers, thereby mitigating resource allocation imbalances and enhancing the effectiveness and sustainability of safety improvement measures. Full article