Search Results (510)

Digital game consumption increasingly unfolds across video platforms, comment sections, and community discussions, where platform visibility, creator-mediated information, interaction metrics, and commercialization signals shape users’ expectations. In platform-mediated digital commerce, visible interaction may indicate information use, cultural resonance, payment concern, or consumption-related complaint rather than uniformly positive engagement. Using self-determination theory as a motivational lens within a platform-mediated consumer-behavior framework, this study examines whether platform content cues, public comment responses, and user perceptions provide convergent evidence on differentiated engagement meanings. The empirical setting is Bilibili content related to the Chinese wuxia role-playing game Where Winds Meet. The analysis combines 1164 public videos, 19,919 hot comments, and a content-exposure-anchored survey of 564 valid respondents. The results show differentiated patterns: functional information cues correspond to saving-oriented engagement and useful responses; cultural-aesthetic cues correspond to supportive interaction and cultural responses; and payment-mechanism and experience-problem cues correspond to payment concerns and complaints. The survey further shows that perceived information value, cultural/experiential connection, perceived monetization fairness, consumer autonomy in spending decisions, and perceived monetization risk are associated with continued engagement intention. These findings suggest that engagement quality should be interpreted through platform-mediated consumer relationships rather than interaction volume alone, while recognizing that hot-comment evidence reflects a platform-visible layer of user response rather than the full distribution of comments or player attitudes. Full article

Background/Objectives: As a key health information and communication technology, mobile health information services (MHISs) play a critical role in delivering health information, enabling remote monitoring, and supporting patient well-being. However, widespread resistance among older adults hinders their access to these information services and undermines these benefits. Employing the technology–personal–environment (TPE) framework, this study constructed and verified a comprehensive model to explain older adults’ resistance to MHIS use. Methods: Quantitative data from 430 elderly individuals aged 65 and above from China who participated in the free health check-up basic public health program were analyzed using structural equation modeling. Results: Technology access barriers, technology usage barriers, declining physiological conditions, and resistance to change were positively related to technology anxiety. Declining physiological conditions, resistance to change, social legitimacy power, and perceived institutional effort were negatively related to perceived autonomy. Additionally, technology anxiety was positively related to resistance to MHIS use, while perceived autonomy was negatively related to resistance to MHIS use. Conclusions: The findings clarify the mechanisms linking technological barriers, individual characteristics, and environmental factors to older adults’ resistance to MHIS use. Therefore, relevant health information service providers should adopt systematic actions that simultaneously alleviate technology anxiety through user-centric design and supportive training while fostering perceived autonomy by respecting older adults’ choices and enabling meaningful participation. These findings offer actionable insights for healthcare information system designers and providers to reduce older adults’ exclusion from digital health information ecosystems, thereby enhancing patient well-being among aging populations. Full article

Background/Objectives: Major Depressive Disorder (MDD) is a leading cause of disability, yet physical therapy (PT) is underrepresented in hospital-based psychiatric care. While exercise is a known adjunctive treatment, specific evidence on functional, task-oriented interventions in acute settings remains scarce. This study explored changes in quality of life, depressive symptoms, pain, and self-efficacy in patients with MDD following a specialized hospital-based PT program focused on functional movement and autonomy. Methods: We conducted a prospective pre–post case series in the Short-Stay Psychiatric Unit of the Royo Villanova University Hospital (Zaragoza, Spain). We recruited seven adult patients with MDD via convenience sampling. The intervention consisted of a group-based PT program (two 45 min sessions/week during the hospital stay) utilizing task-oriented functional exercises targeting progressive strength, balance, and motor control designed to enhance self-efficacy through activities of daily living (ADLs), combined with health education. Outcomes included the EQ-5D-3L (quality of life), MADRS (depression), NRS (pain), GSE (self-efficacy), and GCPC-UN-ESU (satisfaction). Results: All seven participants (100%) exhibited a positive upward trend in self-perceived health status via the EQ-VAS (mean increase of 35 points). Six cases (85.7%) showed preliminary positive trends in the anxiety/depression dimension of the EQ-5D-3L, with the mean Single Index Value increasing from 0.310 to 0.683. Reductions in depressive symptom severity were observed in six participants, with several transitioning toward moderate or mild levels. Additionally, four patients reported descriptive reductions in pain intensity and showed favorable shifts in self-efficacy scores. Six participants expressed high satisfaction with the intervention. Conclusions: Integrating a hospital-based functional PT program with standard care may offer preliminary benefits for quality of life and reduce depressive symptoms in MDD patients. These findings suggest that task-oriented PT presents a feasible complementary approach for acute psychiatric admissions, although larger controlled trials are needed to confirm these exploratory results. Full article

Objective: To analyze the perceived facilitators and barriers promoting and hindering the clinical application of the best evidence of clean intermittent catheterization (CIC) in patients after radical hysterectomy (RH). Methods: This study employed a convergent parallel mixed-methods design. Participants included patients undergoing CIC after RH, medical and nursing practitioners and managers in the gynecological department and outpatient clinics at a tertiary-level women’s and children’s hospital in Chengdu. They were included in both components separately. Interview data were managed using Nvivo 11.0 software and analyzed through directed content analysis. Quantitative data were analyzed using SPSS 29.0 statistical software. Results: A questionnaire survey was conducted among 156 healthcare providers and 300 patients. Qualitative interviews were conducted with 11 healthcare workers and 12 patients. At the evidence itself level, evidence meeting clinical needs and evidence lacking practical applicability, respectively, promoted and hindered clinical implementation of the best evidence. At the potential adopters’ level, healthcare professionals’ insufficient professional competence, low willingness to promote implementation, numerous concerns, and lack of autonomy and awareness regarding the importance of the task were significant barriers, but they maintained an overall positive attitude toward the application. At the practical environment level, patient-related perceived barriers predominantly hindered evidence implementation. Additionally, a supportive practice atmosphere, economic feasibility, and talent development opportunities served as key facilitators. However, existing nursing practice content and workflows directly impacted evidence adoption. Conclusions: The promotion and barriers to the clinical application of the best evidence for CIC in RH postoperative patients are multifaceted. Targeted intervention strategies must be developed to facilitate the effective translation of evidence into clinical practice. Full article

Background: Cancer-related cognitive impairment is a frequent and clinically relevant concern among women with breast cancer, particularly during active oncological treatment, with potential consequences for memory, attention, executive functioning, daily autonomy, emotional well-being, and quality of life. This study aims to evaluate the effectiveness of the Playful Attention and Active Memory intervention (ALMA) on cognitive functioning in women with breast cancer undergoing active oncological treatment. Methods: This single-centre, three-arm, parallel-group randomized controlled trial at the University Healthcare Complex of Salamanca (Spain) will evaluate 63 women with breast cancer undergoing active oncological treatment. Participants will be randomized (1:1:1) into a health education control group, an individual non-tailored cognitive training group, or the ALMA multidimensional group intervention (two 120 min face-to-face sessions/week for four months, combining psychoeducation, targeted cognitive stimulation, and group feedback). Assessments will occur at baseline and post-intervention. The primary outcome is objective global cognitive performance (Montreal Cognitive Assessment). Secondary outcomes include perceived cognitive function, everyday cognition, functional autonomy, anxiety, sleep quality, performance status, and everyday memory failures. Intention-to-treat analysis using linear mixed models will perform prespecified comparisons of ALMA versus both other groups. Expected results: This study is designed to provide evidence on the potential value of a structured, multidimensional cognitive intervention delivered during active breast cancer treatment. By comparing ALMA with both health education and individual cognitive training, the trial may clarify whether the integration of psychoeducation, ecological cognitive stimulation, and group-based support offers additional benefits beyond cognitive practice alone. The inclusion of objective, subjective, and functionally oriented outcomes strengthens the clinical relevance of the protocol and may contribute to the development of more comprehensive supportive care strategies for cancer-related cognitive impairment. Trial registration: This protocol is registered at ClinicalTrials.gov under the identifier NCT07165912. Full article

This study examines the relationships between intrinsic motivation factors—task autonomy, personal growth and development opportunities, self-actualization, and decision-making participation—and employee retention, as well as the mediating role of perceived organizational pride. Using a quantitative cross-sectional survey, data were collected from 154 academic staff members at Taif University, Saudi Arabia. CFA supported the measurement model, and the hypotheses were tested using Hayes’ PROCESS macro. The findings show that all intrinsic motivation factors are positively associated with employee retention. Perceived organizational pride also mediates these relationships, suggesting that intrinsically motivating work conditions may support retention by strengthening employees’ pride in institutional membership. The results further indicate that developmental and participative factors show stronger associations with retention than task autonomy. This study contributes to employee retention research by integrating intrinsic motivation and identity-based explanations in the context of Saudi higher education. However, given the cross-sectional design and single-university sample, causal interpretation and generalizability should be treated with caution. The findings highlight the importance of growth-oriented, participative, and pride-enhancing work environments for supporting academic staff retention. Full article

The purpose of the current research was to investigate novelty as a potential basic psychological need (BPN) by investigating whether novelty met the essentiality (essential for overall growth and well-being) and universality (fulfillment or frustration can predict humans’ well-being across all demographics and cultures) criteria of a BPN. To this end, we tested a path model of relations between perceived novelty, the established BPNs (autonomy, competence, relatedness), and two growth and well-being outcomes: intrinsic motivation and transformative experience. We tested this model with a U.S. university student sample, representing an individualistic culture (Study 1), and a Kuwaiti university student sample, representing a collectivist culture (Study 2). In both studies, we found evidence for novelty meeting the essentiality criteria in that the direct paths from perceived novelty to the growth and well-being outcomes were statistically significant. The consistency of this finding across the two samples provides preliminary support for the universality of novelty. However, we could not directly compare U.S. and Kuwaiti results in a single model due to a lack of measurement invariance. Thus, the universality claims are tentative. These results suggest that novelty may function like a BPN for university students, and supporting novelty needs may foster beneficial educational outcomes. Full article

This paper explores how children perceive and use outdoor spaces in their everyday urban environment, and which spatial characteristics encourage engagement, autonomy, and diverse play. This study was conducted using child-led sensory walks—an exploratory qualitative method in which children acted as active research guides—with ten children aged 6 to 11 in residential areas of Zagreb. Verbal comments, movement patterns, and play behaviours were recorded and analysed through thematic analysis. Following the walks, eleven public playgrounds were assessed from a landscape architecture perspective, integrating children’s observations with an expert evaluation of spatial organisation, shade provision, connectivity with surrounding green spaces, and potential for unstructured play. The results reveal a pronounced preference for natural and semi-natural spaces, where children exhibited longer stays, more diverse physical and symbolic play, and a greater sense of autonomy. These findings affirm the relevance of affordance theory and multisensory experience in understanding children’s spatial behaviour and demonstrate the potential of the sensory walk as a transferable research and design tool in landscape architecture practice. At a broader scale, they point to the untapped role that playgrounds—redesigned as genuine green infrastructure nodes—could play in advancing urban climate adaptation goals at the neighbourhood scale. Full article

Doctoral student wellbeing refers to the perceived state of psychological, physical, and social health experienced by a person during the process of completing a doctoral thesis. From a eudaimonic and salutogenic perspective, this construct goes beyond the mere absence of distress and incorporates dimensions such as meaning and purpose in life, personal growth, autonomy, feelings of mattering, and the quality of academic and personal relationships. It is a multidimensional construct shaped by the interaction between personal variables, including prior psychological history, personality traits, and task motivation, among others, and contextual variables, such as funding conditions, quality of supervision, departmental culture, family and personal circumstances, and social and institutional support networks. Doctoral wellbeing is therefore dynamic: it evolves throughout the different phases of the doctoral process and is influenced by conditions specific to this population that distinguish it from other groups of students or workers. It has emerged as a critical concern in higher education research, driven by evidence of high rates of psychological difficulties among this population. This entry paper offers a narrative and conceptual review of the current state of knowledge on doctoral student wellbeing, identifying the main challenges facing this group, the factors that influence their wellbeing, and the pathways forward in terms of intervention and future research. Full article

Background/Objectives: Several randomized controlled trials have found that dietary interventions promoting self-guided shifts away from ultra-processed foods (UPFs) and toward minimally processed, nutrient-dense foods may alleviate depressive symptoms. However, translating these interventions into scalable and sustainable real-world approaches remains a key challenge. Adopting a minimally processed dietary pattern requires sustained effort (e.g., meal planning, shopping, and preparation) within environments where UPFs are pervasive and convenient. These demands may be especially burdensome for individuals experiencing depressive symptoms. Consequently, interventions that rely heavily on individual effort may be difficult to maintain. Commercial meal delivery services may offer a structural solution by reducing logistical and cognitive barriers to dietary change, yet little is known about how individuals with depressive symptoms experience this approach. Methods: In a parent study, we conducted a randomized pilot study of a meal delivery service designed to provide minimally processed meals to adults with moderate to moderately severe depressive symptoms; here we report qualitative findings from post-intervention interviews with participants assigned to the meal delivery condition (n = 20). Results: Participants appreciated reductions in preparatory effort and mental load, which supported adherence. Dietary changes were also linked to improved mood through increased energy, mood stability, and more positive self-evaluation. However, social settings were a near-universal barrier, and acceptability depended on palatability, compatibility with personal preferences, and perceived autonomy. Several participants also described a temporal adjustment process (early cravings/withdrawal followed by adaptation). Conclusions: Overall, these findings suggest participant-informed priorities for future testing and refinement of scalable meal delivery interventions for depression, including personalization and choice, quality control, and support for social and withdrawal-related challenges. Full article

Introduction: Dietary habits adopted during young adulthood play a critical role in physical, emotional, and cognitive health. University students represent a particularly vulnerable group due to academic stress, lifestyle transitions, and increased autonomy, factors that may influence eating behaviors, body weight perception, and psychological well-being. This study aims to examine dietary habits among students and their associations with self-perceived body weight, lifestyle characteristics, and psychological factors within a biopsychosocial framework. Materials and Methods: A cross-sectional observational study was conducted using a structured, self-administered online questionnaire distributed to university students aged 18–30 years in Romania. The questionnaire assessed dietary habits, nutritional knowledge, lifestyle behaviors, and psychological variables, including perceived stress and body weight perception. Body mass index was calculated based on self-reported anthropometric data. Results: The findings indicated substantial variability in dietary behaviors, with a high prevalence of irregular meal patterns, frequent snacking, and engagement in weight-control practices. Irregular meal patterns were reported by approximately 62% of participants, while 47% had engaged in at least one weight-loss diet. Discrepancies between self-reported BMI and perceived body weight were observed in roughly 38% of cases, and 83% of respondents reported at least one psychological symptom (stress, anxiety, or low mood) related to eating behaviors. A positive correlation was observed between sleep duration and perceived rest quality (r = 0.364, p < 0.001). High frequencies of caffeinated beverage consumption were also observed. Additionally, 204 participants reported no alcohol consumption, while the variety of alcoholic beverages consumed was strongly correlated with alcohol intake frequency (r = 0.734, p < 0.001). Conclusions: Dietary habits among university students are closely interconnected with body weight perception, lifestyle behaviors, and psychological well-being. These findings emphasize the need for integrative health promotion strategies that address nutrition, emotional regulation, and lifestyle balance to support mental and cognitive health during young adulthood. Full article

Artificial intelligence systems increasingly mediate high-stakes human activities, yet urban navigation remains highly challenging for blind and visually impaired individuals. Although digital navigation technologies have significantly improved route planning and accessibility, many existing systems still rely on generic interaction paradigms that insufficiently account for cognitive load, contextual uncertainty, and the adaptive needs of vulnerable users. This challenge highlights the importance of Human-Centred AI approaches capable of supporting not only functional accessibility, but also cognitively sustainable and trustworthy interaction. This paper introduces LAZAR, a human-centred adaptive AI framework for accessible urban mobility grounded in a user-centred design methodology and formalised through a structured Software Requirements Specification. Rather than focusing exclusively on route optimisation, LAZAR approaches assistive navigation as an adaptive human–AI interaction problem in which instructional granularity, interaction frequency, and feedback mechanisms are designed to support user autonomy and situational awareness whilst limiting unnecessary cognitive burden. The proposed framework integrates high-fidelity prototyping, accessibility-oriented interaction modelling, and a modular multi-agent architecture intended to support adaptive and personalised guidance. Central to the approach is a cognitive load-aware interaction layer designed to regulate the presentation and timing of navigational assistance according to user needs and contextual conditions. The proposed multi-agent architecture is presented as a modular design framework whose interaction principles and interface logic were partially operationalised in the evaluated prototype. The complete integration of all adaptive coordination mechanisms, together with large-scale real-world validation, remains part of ongoing and future development work. This work contributes a structured methodology for the design of adaptive assistive AI systems that integrates accessibility requirements, human-centred interaction principles, and cognitively informed guidance strategies. A formative usability evaluation involving eleven visually impaired participants provides preliminary empirical evidence regarding usability, accessibility, and perceived usefulness of the proposed interaction model. The framework establishes a foundation for future research on inclusive and adaptive AI-based navigation systems in urban environments. Full article

As intelligent systems become decision-support tools in the architecture, engineering, and construction (AEC) industry, establishing human–AI trust is critical. However, in engineering consulting, the psychological mechanisms underlying trust formation remain unclear. Grounded in Self-Determination Theory and the Stereotype Content Model, this study utilized multi-wave survey data from Chinese engineering consulting employees to investigate these mechanisms. We examined how perceived autonomy influences human–AI trust through the competitive dual-mediation of warmth perception and competence perception, alongside the asymmetric moderating role of critical thinking. Results reveal that perceived autonomy directly enhances trust. However, social cognition acts as a competitive mechanism: autonomy positively impacts trust via warmth perception but generates a negative indirect effect via competence perception. Furthermore, critical thinking exerts an asymmetric boundary effect; it does not interfere with the intuitive warmth pathway but significantly intensifies the negative indirect effect through the competence pathway. Ultimately, these findings highlight that perceived autonomy exerts a double-edged sword effect in the context of human–AI collaboration. To mitigate professional defensive rejection and calibrate trust, AEC firms should prioritize human-in-the-loop deployment strategies, objective interface designs, and the cultivation of AI collaborative literacy. Full article

This study examines how methodological openness is associated with the social sustainability of learning in secondary education. A comparative, non-experimental, exploratory mixed-methods study was conducted with two secondary school classroom groups that completed the same technological task—the construction of a functional drawbridge—through two project-based learning configurations: a highly structured Guided Project and a more open STEM-PBL configuration. Data were collected through a sociometric questionnaire, a perceived group functioning scale, and open-ended student responses, yielding structural, perceptual, and qualitative evidence on classroom interaction. The results indicate that the open STEM-PBL configuration appeared to be associated with a more cohesive and integrated relational structure, reflected in higher reciprocity, lower isolation, and more distributed peer connections. Conversely, the more structured approach appeared to be associated with more positive and stable student perceptions of cooperative work, particularly in relation to responsibility, participation, peer support, and organizational stability. The central finding is a dissociation between the structural pattern of peer choices and students’ perceived experience of cooperative group functioning. These exploratory findings suggest that socially sustainable learning environments depend not simply on expanding student autonomy, but on balancing openness, structure, and teacher mediation in ways that support relational inclusion, equitable participation, and group cohesion. Full article

Psychosocial factors are associated with the well-being of university students, influencing their academic demands, degree of autonomy and control, and perceived support within their learning environment. Based on the demand–control–support model, the Questionnaire of Psychosocial Factors in University Environments (CFPAU, for its acronym in Spanish) was developed. This newly created instrument was designed to assess risk and protective factors in university students. This study included a total sample of 1221 Mexican students from two public universities in Mexico. The samples were randomly divided into two equivalent groups. Exploratory factor analysis (EFA) was performed on the first group (n₁ = 611), and confirmatory factor analysis (CFA) was performed on the second group (n₂ = 610) via the diagonally weighted least squares (DWLS) method. The final structure consisted of 5 global dimensions and 13 specific subscales, including psychological demands, active study and professional development opportunities, institutional quality and social relationships, recognition and career certainty, and school–life conflict. The CFA results showed adequate fit across the five dimensional models (CFI range = 0.921–1.00; TLI range = 0.910–1.00; RMSEA range = 0.000–0.065; SRMR range = 0.003–0.072). Factorial invariance by sex showed stability in the configural, metric, and scalar models, and subscale reliability was adequate (α and ω = 0.71–0.90). Furthermore, convergent and divergent validity were verified through correlations in the expected direction via the WHO-5 and DASS-21. These findings support the structural validity and internal consistency of the CFPAU, confirming its usefulness in identifying psychosocial risk and protective factors in university students. Full article