Search Results (191)

The primary objective of this research is to identify the most influential factors in the digital platforms used by cancer patients and their environments for accessing oncopaediatric information. This is a PRISMA-guided systematic review that synthesises studies published between 2004 and January 2023 and does not report new primary data. We explore the drivers and barriers of web-based platforms, health apps and social media. We conducted a literature review guided by the PICOS strategy: (P) children and adolescents; (I) factors affecting the use of health apps and social media; (C) without a specific comparison; (O) measuring impact, understanding and success factors; (S) using a conceptual approach. Our study reveals a dual dynamic in paediatric oncology science communication, in which drivers (information, collaborative efforts, comprehensive education) and barriers (age-appropriate content, misinformation) shape the complex communication landscape. The reality is that a healthcare application is needed that focuses on extensive education and the paediatric patient’s involvement in understanding and improving their well-being. It requires adapting communication strategies. Additionally, we explore the theory of online health communication and identify several promising avenues for research. Full article

Vulvodynia is a chronic vulvar pain condition that can interfere with women’s developmental processes and overall well-being. Adopting a broader perspective of women’s health informed by lifespan developmental and biopsychosocial frameworks, this study examined psychosocial factors related to the psychological well-being of Italian women with vulvodynia. Between December 2023 and December 2024, a total of 533 women diagnosed with vulvodynia completed an online survey. The survey included questions about sociodemographics and the illness, as well as validated measures of dyadic adjustment, social support, self-efficacy, perceived stress, and psychological well-being. Descriptive statistics, group comparisons, Pearson correlations, and hierarchical multiple regressions were performed. Nearly two-thirds of the women reported symptoms lasting over five years, and 44% experienced severe pain. Those with more intense pain, longer symptom duration, or delayed diagnosis reported lower well-being and higher stress. Satisfaction with treatment was linked to greater well-being. Psychological well-being was strongly correlated with social support, dyadic adjustment, and psychological resources. Regression analyses identified younger age, higher pain intensity, lower treatment satisfaction, reduced social support, lower self-efficacy, and greater stress as predictors of poorer psychological well-being. Vulvodynia should be considered a psychosocial and developmental challenge as well as a medical condition. These findings underscore the importance of viewing vulvodynia as not only a medical condition, but also a psychosocial and developmental challenge within women’s broader health trajectories, highlighting the need for interventions that address pain and provide structured emotional support to strengthen psychological and relational resources. Full article

This study presents a comprehensive carrying capacity assessment for Gunung Gede Pangrango National Park (GGPNP), a key biodiversity hotspot in Java, Indonesia, integrating Physical Carrying Capacity (PCC), Real Carrying Capacity (RCC), and social-ecological correction factors. Using a PCC-RCC framework that combines GIS-based slope and land-cover analysis with an online visitor survey (camping n = 34; recreation n = 31) and 2020–2024 visitation statistics, we evaluated sustainable limits for hiking, camping, and recreation. Ecological and social constraints, primarily steep topography (>25% slope) and preferences for uncrowded conditions, reduce effective capacity by 96–99% from theoretical physical limits. The resulting daily RCC thresholds are 210–282 persons for hiking across three main trails, 131–204 for camping, and 803 for recreation, demonstrating that spatial availability is a poor predictor of sustainable capacity. Comparison with 2020–2024 visitation data reveals systemic overuse of the recreation zone on non-working days and pinpoints October as the most critical month. Given the park’s financial constraints, we recommend adopting dynamic visitor limits, developing a fee structure that reflects ecological value and demand, and diversifying revenue streams to mitigate degradation and ensure long-term financial and environmental sustainability. Full article

Social media has become a central element in the daily lives of adolescents, shaping not only their communication patterns but also their self-perception, identity construction, and relationships with others. While these platforms provide opportunities for connection and self-expression, they also entail significant risks. This paper presents a scoping review of the literature, following principles of transparency and rigor inspired by the PRISMA framework, on the impact of social media on adolescent identity, with particular attention to self-concept, self-esteem, and body image. It also examines cyberbullying as a prevalent form of digital violence during adolescence, analyzing its causes, consequences, and variations according to gender, age, and social context. The findings indicate that adolescents build their identities both offline and online, where constant comparison, the use of filters, and the pursuit of social validation can generate emotional distress, insecurity, humiliation, and even social exclusion. Gender differences are also observed: girls are more exposed to aesthetic pressure, whereas boys tend to reproduce ideals of strength and leadership. Finally, the review highlights the importance of social work interventions focused on prevention, digital education, and emotional support in order to foster safe online environments and promote the development of authentic, stereotype-free identities. Full article

The COVID-19 pandemic was responsible for an unprecedented increase in psychological problems among post-secondary students worldwide. Drawing on data from a repeated cross-sectional (RCS) project, this study investigated changes in psychological symptoms, emotional regulation (cognitive reappraisal and emotional suppression), and academic, social, and personal–emotional college adjustment, and associations between these variables among students in two countries during the phases of lockdown (2021), lifting of restrictions (2022), and the endemic phase (2023). University students in Canada (n = 1014) and Spain (n = 447) completed online surveys during these periods. Students in both countries reported significant declines in perceived COVID-19 stress across the pandemic phases. In comparison with pre-pandemic rates, elevated psychological symptoms remained constant. There were some country differences, but sex differences were consistent. Psychological symptoms mediated the association between cognitive reappraisal and the adjustment measures among Canadian students during each pandemic period. Alternatively, they mediated the linkages of maladaptive emotional suppression with academic, social, and personal–emotional functioning of Spanish students at every phase, but only during the lifting of restrictions and the endemic phase for Canadian students. The results indicate the complexity of country and context in the role of emotional regulation during uncontrollable conditions and provide directions for intervention in stressful situations, including adjustment to university and future disastrous environmental events. Full article

Background: Population ageing is a global challenge, prompting ageing-in-place policies in Hong Kong to support community-dwelling older adults while reducing healthcare costs. Yet, their impact on health-related quality of life (HRQoL) remains underexplored amid Hong Kong’s long life expectancy and growing older population. Traditional surveys are costly and time-consuming, while routinely collected registration data offers a large, efficient source for health insights. This study uses enhanced administrative data to track HRQoL trajectories and inform policy. Methods: This is a prospective, open-ended longitudinal study, enrolling adults aged 50 or older from a collaborating non-governmental organization in Hong Kong’s Southern District. Data collection, started in February 2021, occurs annually via phone and face-to-face interviews by trained social workers and volunteers using a standardized questionnaire to assess individual (e.g., socio-demographics), environmental (e.g., social support via Lubben Social Network Scale-6), biological (e.g., chronic illnesses), functional (e.g., cognition via Montreal Cognitive Assessment), and HRQoL (e.g., EQ-5D-5L) factors. A secure online system links health and service use data (e.g., service utilization like community care visits). Analysis employs descriptive statistics, group comparisons, correlations, growth modelling to identify health trajectories, and structural equation modelling to test a revised quality-of-life framework. Sample size (projected 470–580 after two follow-ups from a 2321 baseline) is based on power calculations: 300–500 for latent class growth analysis (LCGA) class detection and 200–400 for structural equation modelling (SEM) fit (e.g., RMSEA < 0.06) at 80% power/α = 0.05, simulated via Monte Carlo with a 50–55% attrition. Discussion: This is the first longitudinal HRQoL study in Hong Kong using enhanced non-governmental organization (NGO) administrative data, integrating social–ecological and HRQoL models to predict trajectories (e.g., stable vs. declining mobility) and project care demands (e.g., increase in in-home care for frailty). Unlike prior cross-sectional or inpatient studies, it offers a scalable model for NGOs, informing ageing-in-place policy effectiveness and equitable geriatric care. Full article

Background/Objectives: Eating disorders (EDs) in adolescents are increasingly prevalent. In South Tyrol, a bilingual region in Northern Italy, not only actual gender and age prevalences can be compared to screening rates, but even the comparability of screening tools across languages can be examined. Methods: A cross-sectional analysis integrated clinical registry data with representative, online school-recruited adolescents (11 to 17) self-reports. 166 clinically diagnosed cases and 1465 screened adolescents (1246 German, 219 Italian), were examined. The SCOFF questionnaire (cutoff ≥ 2 for German and ≥3 for Italian), body mass index, body image perception, psychosocial and lifestyle indicators in proxy and self-reports were examined using descriptive statistics and logistic regression. Results: The clinical dataset for 2024 has a prevalence rate of 0.4%. The SCOFF screening tool identified symptomatic cases in 10.6%, and an age-increasing trend among females. The overall SCOFF-prevalence did not differ between language versions, although responses to individual items varied significantly. Predictors of ED included body image, psychosomatic complaints, problematic social media use, and low social support, with differences between genders. Parents tended to underestimate their children’s perception of being “too thick.” Conclusions: In early adolescence, preventive strategies are needed and targeted interventions in late adolescence. For early detection and intervention, gender-sensitive prevention and active parental involvement is needed. The SCOFF questionnaire demonstrates utility across both languages, but bilingual comparison highlights the need for culturally adapted tools and cross-language validation. Full article

Background/Objectives: Engaging patients, caregivers, and community groups in health research priority-setting ensures that research agendas reflect genuine needs and enhance patient-centered care. Regions with cultural and linguistic diversity, such as South Tyrol in northern Italy, face challenges in achieving fair representation. This study aimed to identify health services research priorities in South Tyrol, a culturally and linguistically diverse region in Italy, through a bilingual participatory survey involving general practitioners (GPs) and patient and social interest organizations (PSIOs). Methods: A cross-sectional online survey (August–September 2025) was conducted among invited PSIOs (n = 64) and regional GPs (n = 290). A bilingual, self-developed questionnaire assessed organizational characteristics, priority ratings for predefined topics, experiences with research participation, and preferred participation modes. The data were analyzed descriptively. Group comparisons were performed using the Mann–Whitney U and chi-square tests with effect size calculation. Associations were examined using Spearman’s correlation. Free-text responses were thematically content-coded. Results: Ninety-five responses were analyzed, including nine general practitioners (9.5%) and 86 participants (90.5%) from patient and social interest organizations, of whom 27 (28.4%) held leadership or board positions. Across all groups, the highest-rated research priorities included children and adolescent mental health, palliative and end-of-life care, and continuity of primary care. Willingness to participate in future research was expressed by 38% of the respondents, with an additional 52% indicating conditional interest. Online surveys were the most preferred mode of participation, followed by workshops and board meetings. Conclusions: Participatory bilingual approaches are feasible in South Tyrol and highlight priorities that are highly relevant for patient-centered health services. Future initiatives should strengthen the structures for research participation, enhance GP engagement, and link identified priorities to research funding and policy action. Full article

Aims: To ask UK women with diabetes whether they have discussed sexual health with healthcare professionals (HCPs) during diabetes care, and to explore communication barriers. Methods: An online questionnaire was developed, based on a published HCP communication survey, piloted by six women with diabetes. A total of 163 participants, recruited via social media and HCP network, completed Part 1 by selecting Likert or narrative response options, providing descriptive data. We report proportions with 95% confidence intervals (Wilson); percentages are calculated using the number responding to each item. Item-level missingness is retained as a non-analysed category, and the n is reported per question. No inferential comparisons were planned a priori. After Part 1 completion, participants could choose to finish, or to continue to Part 2 questions regarding vulval anatomy, function, and vocabulary (77 completed 2A: 80 completed 2B). Part 2 data was analysed thematically. Results: During diabetes care, a minority of participants, 44/163 (27%), said they had ever discussed sexual health, or had been advised how to access sexual health support, 28/163 (17%). If an HCP discussed sexual health, many women said they expected to feel surprised, 114/163 (70%), or pleased, 88/163 (54%). Some participants said they expected HCPs would find the topic inappropriate, 56/163 (36%), or annoying, 44/163 (27%). Some participants expressed HCP gender preference (75/163 [46%] female and 4/163 [3%] male) for such discussion. Part 2 findings revealed unmet sexual health literacy needs with potential to impact on communication with HCPs. Conclusions: Women reported infrequent communication about sexual health and diabetes during diabetes care. Findings highlight potential communication barriers for some participants including the following: unmet educational needs regarding diabetes and sexual health, lack of confidence about available support, fear of a negative HCP response, and preference for the gender of the HCP. Whereas in previous research, HCPs feared upsetting women by discussing sexual health, many participants said they expected to respond positively. Full article

Learning Analytics Dashboards (LADs) are increasingly deployed to support self-regulated learning on online courses. Yet many existing dashboards lack strong theoretical grounding, contextual alignment, or actionable feedback, and some designs have been shown to inadvertently discourage learners through excessive social comparison or high inference costs. In this study, we designed and evaluated a LAD grounded in the COPES model of self-regulated learning and tailored to a credit-bearing Massive Open Online Course (MOOC) using a data-driven approach. We conducted a randomized controlled trial with 8745 learners, comparing a control group, a dashboard without feedback, and a dashboard with ARCS-framed actionable feedback. The results showed that the dashboard with feedback significantly increased learners’ likelihood of verification (i.e., paying for the certification track), with mixed effects on engagement and no measurable impact on final grades. These findings suggest that dashboards are not uniformly beneficial: while feedback-supported LADs can enhance motivation and persistence, dashboards that lack interpretive support may impose cognitive burdens without improving outcomes. This study contributes to the literature on learning analytics by (1) articulating the design principles for theoretically and contextually grounded LADs and (2) providing experimental evidence on their impact in authentic MOOC settings. Full article

Background/Objectives: Social media use has become ubiquitous, with governmental bodies and researchers expressing a growing concern about its impact on mental health. This review aims to examine the relationship between social media use and disordered eating in individuals aged 18–30. Specifically, we aim to identify specific patterns of use (including addictive use) that are associated with increased risk for disordered eating. Methods: A search was conducted in March 2025 using PubMed and PsycINFO. Keywords were based on social media platforms and eating behaviors. Inclusion criteria were published studies in peer-reviewed journals from 2015–2025, written in English, with participants aged 18–30, whose disordered eating outcomes were assessed using validated measures. Conclusions: 637 articles were screened, with 28 studies meeting the inclusion criteria. Most studies assessed general social media use, without specifying the platform type. The EAT-26 and EDE-Q scales were used in most research to assess disordered eating. Data were narratively synthesized based on the type of social media variables assessed. Our findings demonstrate a complex relationship between social media use and disordered eating, with more consistent associations being found when the type of content (fitspiration and thinspiration) was the independent variable. These findings align with qualitative findings, which highlighted ambivalence in relation to the effect of social media: it is viewed as both a source of support and social comparison. Avenues for future research include longitudinal studies to understand the interaction between individual factors and social media patterns of use, as well as the utilization of platform-generated data on online engagement patterns. Full article

This study aims to explore the relationship and underlying mechanisms between social appearance anxiety (SAA) and restrained eating (RE) among female college students. Although previous studies have shown a correlation between SAA and RE, the internal pathways remain unclear. Based on social comparison theory and objectification theory, this study constructs a model that includes self-objectification (SO) as a mediating variable and physical exercise (PE) as a moderating variable to analyze the impact mechanisms of SAA on RE. Adopting a cross-sectional online survey design, this study collected data from 2161 female college students in China. The results showed that SAA was significantly positively related to SO (β = 0.37, p < 0.001) and RE (β = 0.34, p < 0.001). SO partially mediated the relationship between SAA and RE (β = 0.125, 95% CI [0.104, 0.149]). Moreover, PE moderates the relationship between SAA and RE (β = −0.15, p < 0.001). However, PE’s moderating effect is insignificant in the relationship between SO and RE. These findings offer valuable insights and suggest that interventions targeting SAA and SO, as well as promoting PE, may help improve RE among female college students. Full article

This article examines the role of digital communication, social media, and peer influence in Generation Z’s transition from fast fashion to more sustainable consumption practices. Building on sustainability and social influence theories, this study applies a mixed-methods design that combines qualitative content analysis of social media discourse with a quantitative online survey (n = 202). The survey instrument, validated by a panel of experts, measured four dimensions—digital communication, peer influence, sustainable attitudes, and sustainable behaviors—using Likert-type scales with adequate reliability (Cronbach’s α ≥ 0.70). The statistical analyses included descriptive statistics, Pearson correlations, and mean comparison tests (t-test, ANOVA). The results show that digital platforms not only raise awareness but also normalize sustainable choices through peer validation and community engagement. Strong correlations confirm that peer influence mediates the relationship between exposure to sustainability content and the adoption of responsible behaviors, while perceptions of brand sustainability show weaker associations with purchase intention. This study highlights a persistent attitude–behavior gap and identifies opportunities for more effective digital engagement. The findings contribute to the literature on sustainable fashion consumption by clarifying the communicative mechanisms shaping Gen Z’s decisions. Practical implications are offered for brands, policymakers, and educators seeking to foster authentic and inclusive sustainability strategies, particularly in addressing gender differences in sustainable adoption. Full article

To promote the sustainable development of urban smart transportation systems, this study constructs a structural equation model (SEM) based on the Technology Acceptance Model (TAM), incorporating extended variables including social influence, environmental awareness, privacy concerns, and service similarity to investigate users’ behavioral intentions toward Mobility as a Service (MaaS). The research systematically examines key factors influencing user adoption behavior and their underlying mechanisms, providing theoretical foundations and practical guidance for optimizing MaaS system design and policy making. Using SEM as the core analytical framework, this study employs mediation analysis, moderation analysis, and multigroup comparison to empirically examine the direct and indirect effects among variables, as well as group heterogeneity. Data were collected through an online questionnaire survey, with Analysis of Variance (ANOVA) applied to identify the differential impacts of demographic and travel behavior characteristics on users’ intentions and related psychological constructs, thereby supporting precise user segmentation and evidence-based policy interventions. Key findings include the following: (1) Social influence, ease of use, and environmental awareness boost MaaS adoption, while privacy concerns hinder it. (2) Freelancers/self-employed weaken the positive effects of usefulness, ease of use, and social influence on adoption. (3) Service similarity and ease of use effects vary significantly between single-mode and multimodal commuters. The findings extend the theoretical boundaries of TAM and provide both theoretical and practical support for the development of sustainable urban transportation systems. Full article

As environmental conservation and community development gain importance, ecotourism has emerged as a significant segment of the global tourism industry. However, the cultural factors that drive tourist behavior in this domain remain underexplored. This research examined how power distance belief (PDB), interacts with the type of tourism content shared on social media (conspicuous versus experiential) to influence travelers’ ecotourism intentions. To test our hypotheses, we conducted two experimental studies using a 2 (PDB: high vs. low) × 2 (tourism content type: conspicuous vs. experiential) between-subjects design. Participants for both experiments (N = 480) were recruited through an online survey platform. In the experiments, participants’ PDB was situationally primed, and tourism content type was manipulated using specifically created fictitious posts adapted from a real social media platform. Other key variables were measured using validated multi-item scales. Data were analyzed using analysis of variance (ANOVA) and moderated mediation analysis (PROCESS Model 15). The findings reveal that travelers with high PDB show higher ecotourism intentions when exposed to conspicuous content, whereas travelers with low PDB exhibit higher intentions when exposed to experiential content. This interactive effect is mediated by travelers’ social comparison motives. These findings offer novel insights into the motivations underlying ecotourism behavior by identifying distinct pathways through which social media can promote sustainable tourism behaviors, and provide practical guidance for eco-destination managers to design targeted marketing strategies that encourage sustainable tourism practices across different consumer segments. Full article