Search Results (1,039)

Background: Mental health concerns are notably common among students attending universities in Saudi Arabia, and low engagement with psychological services has been widely documented in this population group. Telemental health has emerged as a promising alternative under Vision 2030’s digital transformation agenda, although the determinants of university students’ intentions to use these services have received limited empirical attention in Saudi Arabia. Objective: This study examined attitudes toward telemental health services, perceived barriers to seeking psychological help, and predictors of behavioral intentions to use telemental health services among university students in Saudi Arabia, based on the Technology Acceptance Model and Theory of Planned Behavior. Methods: A cross-sectional design was employed using an online, self-administered questionnaire. A total of 236 undergraduate students from three large universities in Riyadh were recruited using convenience sampling methods. We examined demographic variables, telemental health attitude variables (ease of use, usefulness, subjective norms, trust in telemental health, relative advantage, intentions, and attitudes), and barrier subscales (fear of stigma, trust in mental health professionals, difficulties in self-disclosure, perceived devaluation, and lack of knowledge) among university students. Descriptive statistics, Welch’s t-tests, and multiple linear regression analyses were conducted using SPSS (version 29). Results: Participants demonstrated moderately positive attitudes toward telemental health (M = 74.15, SD = 16.11) and reported moderate overall barriers (M = 50.76, SD = 14.44), with trust in mental health professionals being the most prominent barrier. The regression model explained 58.0% of the variance in behavioral intentions (F(19, 211) = 15.35, p < 0.001). Attitude was the strongest predictor (β = 0.534, p < 0.001), followed by trust in telemental health, sex, and difficulty in self-disclosure. Conclusions: Culturally tailored awareness campaigns, trust-building communication, and gender-sensitive service design are recommended to promote the adoption of telemental health by Saudi university students. These efforts align with Vision 2030’s digital health priorities and may support the equitable expansion of mental healthcare access in this population. Full article

Positive teacher–student relationships in early childhood predict stronger academic and social–emotional outcomes, whereas conflictual or dependent relationships contribute to children’s stress and behavioral and academic difficulties. While prior research emphasizes teachers’ observable relational behaviors, fewer studies explore the internal emotional and cognitive processes that shape these relationships. This mixed-methods study examined how preschool teachers’ emotion socialization practices (i.e., emotion coaching and dismissing) and their classroom expressions of positive and negative emotions relate to their mental representations of their relationships with students. Quantitative analyses tested whether teachers’ emotional expressiveness moderated associations between their emotion socialization practices and relational representations. Complementing these analyses, qualitative narrative interviews with an independent teacher sample explored how educators described their emotional expressiveness, emotion-related practices, and perceived relationships with students. Informed by emotion socialization theory, attachment theory, and the prosocial classroom model, findings highlight the interplay of teachers’ emotional beliefs, regulation, and relational schemas in shaping classroom climate. Our integration of quantitative and qualitative insights provides a more comprehensive understanding of teachers’ emotional functioning and underscores the importance of supporting educators’ relational and emotional competencies to enhance classroom quality and student well-being. Full article

Background and Objectives: Access to medicines is a fundamental determinant of health equity and a core pillar of universal health coverage, encompassing the timely availability, affordability, and appropriate use of essential medicines. Socioeconomic disparities may limit actual and timely access to pharmacological treatment, particularly in healthcare systems characterized by mixed public–private financing and significant out-of-pocket expenditures. This study aimed to evaluate socioeconomic determinants of access to medicines among Romanian patients with chronic diseases, focusing on income level, prescription reimbursement, perceived affordability, and substitution behavior during medicine shortages. Materials and Methods: A cross-sectional study was conducted between October and December 2024 using a structured online questionnaire administered to 200 adult patients diagnosed with cardiovascular diseases, diabetes mellitus, chronic hepatitis B and C, or oncological conditions, recruited at the “Prof. Dr. D. Hociotă” Institute of Phonoaudiology and Functional ENT Surgery, Bucharest, Romania. Associations between income and access-related variables were assessed using Spearman’s rank correlation coefficients with 95% confidence intervals. Binary logistic regression identified independent predictors of perceived difficulty in accessing medicines (p < 0.05). Results: Lower income was significantly associated with greater reliance on reimbursed prescriptions (r_s = −0.241, 95% CI: −0.37 to −0.10, p = 0.001) and fully reimbursed prescriptions (r_s = −0.305, 95% CI: −0.43 to −0.17, p < 0.001). Income was strongly correlated with perceived affordability of treatment (r_s = 0.601, 95% CI: 0.50–0.69, p < 0.001). In multivariate logistic regression analysis, income below 3000 RON/month (adjusted OR = 1.94, 95% CI: 1.05–3.58, p = 0.034) and insufficient affordability (adjusted OR = 4.12, 95% CI: 2.15–7.89, p < 0.001) were independently associated with perceived difficult access to treatment. Additionally, 80% of respondents reported purchasing substitute medicines when prescribed medicines were unavailable. Conclusions: This cross-sectional study indicates that socioeconomic status and perceived affordability are significant determinants of access to medicines among Romanian patients with chronic diseases attending a tertiary ENT centre. Financial vulnerability remains a major barrier despite existing reimbursement mechanisms. Policy interventions aimed at strengthening income-sensitive reimbursement strategies and ensuring consistent pharmaceutical availability may improve equitable access and therapeutic continuity. Full article

Children in difficulty are at heightened risk of developing personality-related problems, partly due to gaps in family care and social protection. This study examines whether (a) the availability of an individual study desk at home—a basic family educational resource—is associated with borderline personality features (BPFs) in this population and (b) perceived social support and school life shape this association. Using survey data from 14,993 children in difficulty in Hubei Province, China, and applying propensity score matching (PSM), we find that children with their own desk report significantly lower levels of BPFs. The protective association between desk ownership and children’s perceptions of social support is stronger when children perceive higher social support, whereas indicators of school life do not significantly moderate this relationship. Heterogeneity analyses further show that the benefit of having a desk is greater for children without siblings. These findings highlight the protective role of physical learning environments and suggest that targeted provision of basic educational resources could serve as a practical entry point for early-intervention programs aimed at reducing the risk of developing BPFs. Full article

Generative AI tools are increasingly used in higher education, yet most available systems lack pedagogical grounding, course alignment, and insight into student learning. This paper presents the development, implementation, and evaluation of the bioTutor, an open-source, course-specific AI chatbot designed to support constructivist learning in large university classrooms. The system integrates a curated knowledge base, a didactically structured interaction design, and a learning analytics dashboard for instructors that summarizes anonymized student-chatbot conversations. To assess students’ perceptions of usefulness, ease of use, learning relevance, output quality, and result demonstrability, we developed an education-adapted extension of the Technology Acceptance Model (edTAM) and applied it in an introductory biology course with 407 enrolled students. During a 23-week deployment, students generated more than 10,000 interactions across over 1000 conversations. Questionnaire data indicate high usability, strong perceived usefulness, and broad interest in adopting similar tools. Usage patterns show that the bioTutor was employed both for learning and exam preparation. These findings suggest that students perceived pedagogically structured, course-grounded AI chatbots as useful for learning and exam preparation, while the lecturer dashboard provided aggregated insights into students’ questions and recurring difficulties. The open-source framework enables adaptation to other disciplines and provides a scalable foundation for further research on didactically informed AI systems in higher education. Full article

Period poverty, defined as difficulty affording menstrual products, is increasingly recognized as a basic needs issue among students in the United States. However, evidence on the prevalence and awareness of this phenomenon among both undergraduate and graduate populations remains limited. Therefore, the aim of this descriptive cross-sectional study is to describe period poverty experiences and awareness levels among menstruating college students at a public university in South Florida. An online survey was administered to menstruating undergraduate and graduate students (n = 151). Period poverty was assessed using a past-year affordability question, while awareness of period poverty was measured descriptively through seven items derived from a previous study on period poverty in U.S. college students. Overall, 13.9% of respondents reported past-year period poverty. Awareness of period poverty was limited, despite high support for policies providing free menstrual products. Only 16.67% perceived period poverty to be highly prevalent in developed countries, and only 8% believed that it existed in their local area. Three fourths (75.00%) of the sample strongly supported policies to provide free menstrual products. Finally, over half of the respondents felt “not at all embarrassed” (55.07%) towards buying menstrual products, while just over one fourth reported being “fairly embarrassed” (28.26%). The discrepancy between the number of students experiencing period poverty and the levels of awareness of the issue shows a clear need for evidence-based educational interventions and menstrual resources on college campuses to improve overall menstrual well-being. Full article

Background/Objectives: Individuals with listening difficulties (LiD) report problems understanding speech despite normal hearing sensitivity. This study investigated how speech characteristics (clarity, speaking rate, and loudness) influence subjective speech understanding in adults with LiD under quiet and noisy conditions, compared with individuals with normal hearing (NH) and those who are hard of hearing (HH). Methods: A questionnaire-based survey assessed perceived speech intelligibility across 12 listening conditions created by combining two environments (quiet and noisy) and six speaking styles. Participants included 77 adults with LiD (50 LiD without developmental disorders [DD] and 27 LiD and DD), 30 adults with NH, and 26 individuals with HH. Ratings were analyzed using analysis of variance and correlation analyses. Results: Both the LiD and HH groups demonstrated significantly reduced speech understanding in noisy environments when the speaking style was suboptimal, compared with the NH group. In contrast, the LiD group uniquely reported difficulties even under quiet conditions with clear, slow, and loud speech. Loud speech in quiet conditions was not consistently beneficial, particularly in the LiD and DD group, possibly reflecting auditory hypersensitivity. Conclusions: Listening difficulties in the LiD group are influenced by environmental and speaker-related factors and cannot be addressed solely by conventional strategies used for hearing loss. Although individualized communication approaches may be required, further investigation, including experimental studies, is necessary to validate this interpretation. Full article

Background/Objectives: Given that post-traumatic stress disorder (PTSD) and post-traumatic growth (PTG) are separate constructs that can co-occur following adversity, we examined how prior adversity and current functioning difficulties may relate to the likelihood of meeting criteria for PTSD and scoring above the cutoff for PTG among individuals who reported being impacted by their prior adversity. Methods: Participants (n = 2112) in this international sample completed online measures assessing their adversity history, current functioning difficulties (i.e., negative world assumptions and autonomic reactivity), PTSD symptomatology, and PTG. Results: Chi square analyses suggested a trend toward an association between meeting criteria for PTSD and scoring above the cutoff for PTG, although not statistically significant (p = 0.061). Multivariable logistic regression analysis found that individuals most impacted by caregiver abuse and certain specific adversities (i.e., parent with a mental health problem, caregiver and non-caregiver sexual abuse, and being held captive) were more likely to meet the criteria for PTSD. Whereas those most impacted by life-threatening situations and the specific adversities of being impacted by a life-threatening illnesses or injury, were more likely to meet the criteria for PTG. However, the strongest predictor of the likelihood of PTSD was increased autonomic reactivity, and the strongest predictor of the likelihood of PTG was fewer negative world assumptions. Conclusions: Our research suggests the need to assess the perceived impact of adversity history, as well as the potential negative consequences of autonomic reactivity and negative world assumptions, as these may be associated with PTSD symptomatology and PTG. Full article

Experiential avoidance, defined as unwillingness to deal with personal experiences such as thoughts, emotions, and memories, is closely related to difficulties in emotion regulation. This is because emotional awareness and acceptance are crucial for regulating distressing feelings. Somatic symptoms, referring to bodily sensations such as headaches, nausea, and fatigue with or without any underlying medical condition, are frequently reported among individuals with avoided or dysregulated emotional burden. This cross-sectional correlational study aimed to examine the mediating role of emotion regulation difficulties in the relationship between experiential avoidance and somatic symptoms; we used a sample size of 397 individuals recruited from a non-clinical population with the convenience sampling technique. The measurement instruments were the Brief Experiential Avoidance Questionnaire (BEAQ), Somatic Symptom Scale (SSS-8), and Difficulties in Emotion Regulation Scale (DERS-16). Statistical analysis was conducted using the IBM SPSS 29 statistical program and the SPSS Process Macro 4.2 extension. The results indicate that difficulties in emotion regulation mediated the relationship between experiential avoidance and somatic symptoms controlling for age, education, gender and perceived income and all variables were significantly correlated with each other, including subscales of difficulties in emotion regulation. Limited access to emotion regulation strategies was subscale with an indirect effect on the association between experiential avoidance and somatic symptoms. These findings are expected to guide mental health professionals in consulting clients with somatic symptoms and emotion regulation difficulties. Full article

Driving with assistive devices creates complex cognitive and emotional demands that require systematic investigation. This study uses a multivariate approach based on subjective and objective measures to evaluate mental workload (MWL), stress and emotional state during simulated driving with an assistive device. Thirty healthy adults ($42\pm 13$ years of age, 7 females) completed four driving tasks combining two levels of difficulty (Easy vs. Hard) and two steering tools (wheel vs. single-pin aid). Subjective measures from NASA Task Load Index and Self-Assessment Manikin were collected, as well as physiological parameters from electroencephalographic, electrocardiographic, and electrodermal activity signals. The results revealed that the assistive device significantly induced increases in perceived physical demand, frustration, loss of emotional control and stress, yet reducing intrinsic sympathetic response represented by electrodermal activity parameters. Multivariate analyses highlighted that combining different physiological predictors improved MWL estimation. This study marks an initial step towards understanding the impact of assistive devices on MWL and stress in post-acute individuals returning to driving. Full article

Background/Objectives: This longitudinal study examined the association between sleep duration, sleep difficulties, and sleeping place at one year (t1) and corresponding characteristics at 4/5 years of age (t2). Methods: Data were collected from 2018 to 2021 (t1) and from 2021 to 2024 (t2) in the LIFE Child cohort study conducted in Leipzig, Germany. Parents completed the Brief Infant Sleep Questionnaire at t1 and the Child Sleep Habits Questionnaire at t2. Associations between sleep characteristics at t1 and t2 were estimated using linear and logistic regression models. All associations were adjusted for child sex, age at t2, and maternal education. Results: The analyses showed significant associations between shorter sleep durations, later sleep onset times, more frequent nightly awakenings and bed sharing and room sharing at t1 and more sleep difficulties at t2. A shorter sleep duration at t2 was predicted by shorter sleep and more parent-perceived sleep difficulties at t1. Bed sharing and room sharing at t1 were significantly associated with a lower probability of sleeping alone at t2. Conclusions: These results indicate that sleep duration, sleep difficulties, and sleeping places are already stable in early childhood. Full article

Background: Full pulpotomy has gained increasing attention as a conservative treatment option for managing complicated crown fractures and pulp exposures in mature permanent teeth. However, little is known about how undergraduate dental students perceive this treatment approach and which factors influence their willingness to adopt it in clinical practice. Objective: This study aimed to evaluate undergraduate dental students’ knowledge, attitudes, and preferences regarding full pulpotomy and to identify factors associated with willingness to use full pulpotomy as a definitive treatment option. Materials and Methods: A cross-sectional questionnaire-based study was conducted among fourth- and fifth-year dental students. The questionnaire evaluated participants’ treatment preferences, perceived procedural difficulties, preferred pulp capping materials, attitudes toward rubber dam use, perceived barriers to full pulpotomy adoption, and willingness to use full pulpotomy as a definitive treatment. Associations between variables were assessed using chi-square tests and multivariable binary logistic regression analysis. Results: In total, 255 undergraduate dental students participated in the study. Spontaneous pain (69.4%), prolonged pain to heat (50.6%), percussion sensitivity (46.7%), and radiographic findings (43.9%) were the most frequently reported diagnostic criteria for symptomatic irreversible pulpitis. In the standardized clinical scenario, a pulpotomy-based approach was the most preferred treatment strategy (45.1%), followed by single-visit pulpectomy with obturation (28.6%) and pulpectomy with calcium hydroxide dressing (24.7%). MTA was the most preferred pulp capping material (57.3%), followed by Biodentin (12.9%) and calcium hydroxide (8.2%). Overall, 55.7% of participants reported willingness to use full pulpotomy as a definitive treatment option. Clinical year, previous exposure to pulpotomy cases, and confidence in bleeding control were independently associated with willingness to use full pulpotomy. Previous performance of pulpotomy procedures and attitude toward mandatory rubber dam use were independently associated with greater willingness to use full pulpotomy, whereas perceived barriers and uncertainty regarding implementation were negatively associated. Conclusions: In this single-center, questionnaire-based study, undergraduate dental students generally showed a positive attitude toward full pulpotomy; however, acceptance was strongly influenced by practical experience, confidence in procedural protocols, and perceived implementation barriers. These findings may help inform future educational strategies aimed at improving confidence and supporting evidence-based adoption of conservative pulp-preserving approaches. Full article

Stereo vision leverages binocular imagery to emulate the human visual system in perceiving three-dimensional (3D) structures by estimating disparity from rectified image pairs and converting it to depth via geometric triangulation. In recent years, deep learning-based stereo matching has significantly advanced in accuracy, efficiency, and generalization, surpassing traditional methods and demonstrating great potential in remote sensing applications. However, stereo matching in remote sensing faces unique challenges not commonly seen in terrestrial datasets. These include limited access to satellite imagery, seasonal differences between image pairs, difficulty in identifying small objects, and widespread regions with repetitive textures, such as lakes and forests. Unlike prior surveys that primarily address ground-level scenes, this paper presents a comprehensive review of stereo matching techniques tailored for remote sensing. It synthesizes the progress and limitations of representative models, analyzes the characteristics and domain-specific constraints of remote sensing stereo datasets, and outlines future research directions and application prospects in this field. Full article

The rapid emergence of virtual assets, blockchain-based transactions, and immersive digital economies presents major challenges to financial reporting processes (recognition, measurement, disclosure, and assurance). This study aims to investigate stakeholder readiness for digital financial reporting in the context of virtual assets, focusing on the human capital dimension, which was often overlooked in prior research. A mixed-methods design was employed to obtain comprehensive insights from both experts and students. Qualitative interviews with 16 academics and practitioners were conducted to capture expert perspectives on the inclusion of metaverse-related courses in accounting curricula. Furthermore, a survey of 438 accounting students was analyzed to examine the determinants of Digital Financial Reporting Readiness (DFRR) using the Stimulus–Organism–Response (S-O-R) framework. Experts highlighted opportunities for enhanced professional judgment but raised concerns about automation risks and institutional capacity. Quantitative results indicated that perceived importance and usefulness significantly increased student interest, which strongly predicted DFRR, while perceived difficulty reduced student interest. By interpreting the findings through the lens of Experiential Learning Theory (ELT), this study provides a process-oriented explanation of how cognitive evaluations translate into professional preparedness. This study contributes by conceptualizing DFRR as a human capital construct and offering a multi-stakeholder perspective by integrating student readiness with expert insights to inform the adoption of the metaverse in accounting education. Full article

This study explores experiences of spending time in immersive virtual reality with a natural environment among individuals with type 2 diabetes, aiming to enhance perceived wellbeing and reduce perceived stress. Seventeen participants with type 2 diabetes took part in a multimodal lifestyle education program and used immersive virtual reality with natural environment over a six-month period, selecting from a number of 30 min serene natural environments. Semi-structured interviews were conducted and analyzed using qualitative content analysis. Participants described immersive virtual reality with a natural environment experience as providing tranquility, inspiration, and a sense of transcending time and space (A). Feelings of calm and mental withdrawal from everyday demands were often reported (A2), and memories were evoked (A2). Some participants experienced these effects as extending beyond the immersive virtual reality with natural environment sessions themselves (A3–4). At the same time, several factors were identified that could disrupt the restorative experience (A5), including technical issues, individual preferences for specific environments, health- or situation-related constraints, and difficulties establishing a regular routine for headset use. Immersive virtual reality with natural environment was generally viewed as a valuable complement to real-world nature experiences, particularly for individuals with limited access to outdoor environments (B1–2). Overall, the findings suggest that immersive virtual reality with natural environment experiences may offer a supportive resource for enhancing emotional wellbeing and managing stress in people with type 2 diabetes, while not replacing the benefits of actual nature exposure. Full article