Search Results (3,207)

Background/Objectives: Helicobacter pylori (H. pylori) infection remains common globally, yet data on its prevalence and correlates among dental students in Eastern Europe are limited. Dental students may face potential occupational exposure through contact with saliva and aerosols during their clinical training. This study aimed to measure the seroprevalence of H. pylori among Lithuanian dental students and evaluate its associations with academic year, self-perceived oral health and hygiene factors, and gastrointestinal symptoms. Methods: An observational–analytical cross-sectional study was conducted in 2025 among 202 dental students from lower (I–II) and higher (IV–V) academic years at the Lithuanian University of Health Sciences. Participants underwent serological testing for H. pylori IgG antibodies using capillary blood and completed a structured questionnaire on sociodemographic factors, oral health behaviors, clinical exposure, and gastrointestinal symptoms assessed by the Gastrointestinal Symptoms Rating Scale (GSRS). Descriptive and bivariate statistical analyses were performed to assess associations. Results: Overall H. pylori seroprevalence was 12.4% and did not differ significantly in different academic years. Seropositivity was significantly associated with longer toothbrushing duration and a family history of stomach ulcer. No significant associations were found with the number of patients treated, the use of personal protective equipment, or most oral hygiene indicators. Higher-year students reported greater overall gastrointestinal symptom scores than lower-year students; however, GSRS scores did not differ between H. pylori-seropositive and -seronegative participants. Conclusions: H. pylori seroprevalence in this student population was relatively low, and no association was found with clinical exposure or gastrointestinal symptom severity. Household-related factors may be more relevant to transmission than occupational exposure in dental training. Further longitudinal studies are needed to clarify risk factors and transmission pathways. Full article

Background/Objective: Health is a multidimensional construct shaped not only by clinical conditions but also by psychological, social, environmental and cultural factors. In low- and middle-income countries undergoing rapid epidemiological transition, understanding health requires integrated and culturally informed approaches. However, quality of life, perceived health status and lifestyle behaviors are often investigated separately, limiting the interpretation of well-being in specific local contexts. This study aimed to provide an integrated assessment of quality of life, perceived health status and lifestyle behaviours among adults attending a peri-urban public hospital in Kenya, using internationally validated instruments applied within a specific local cultural context. Methods: A cross-sectional observational study was conducted at Tigoni Level 4 Hospital, Kiambu County, Kenya. Adult outpatients (N = 40) were consecutively recruited. Quality of life was assessed using the WHOQOL-BREF, perceived health status using the EQ-5D-5L and EQ-VAS, and lifestyle behaviours using selected modules of the WHO STEPS instrument. Descriptive statistics were performed, and exploratory associations were examined using Spearman’s rank correlation coefficient. Results: Participants had a mean age of 35.9 ± 11.4 years, with a balanced gender distribution. Lifestyle risk factors were prevalent, including insufficient physical activity (40%) and overweight or obesity (>50%). WHOQOL-BREF scores revealed a heterogeneous profile, with relatively preserved social relationships and lower scores in the psychological and environmental domains. Pain/discomfort and anxiety/depression were the most frequently reported EQ-5D-5L problems. The mean EQ-VAS score was 68.2 ± 15.7. Perceived health was positively associated with physical and psychological quality of life, while higher body mass index was associated with lower physical quality of life. Mental health emerged as a cross-cutting factor across instruments. Conclusions: The findings highlight the multidimensional nature of health in a peri-urban Kenyan context and suggest the importance of considering local social and cultural influences when interpreting standardized health measures. Mental health and environmental conditions play a central role in shaping quality of life and perceived health, while lifestyle risk factors are already prevalent in a relatively young outpatient population. Integrating standardized health measures within a cross-cultural framework may support more holistic and person-centred approaches in primary care and public health in similar settings. Full article

Service robots have the potential to support cognitive and social well-being in long-term care facilities, yet their widespread adoption depends on intuitive interaction modalities that minimize user learning effort and the need for a technical expert on-ground. Spoken dialogue is a natural interface, and recent advances in large language models (LLMs) promise more flexible and engaging exchanges than traditional scripted systems. In this study, we implemented a modular speech-based architecture combining automatic speech recognition, text-to-speech synthesis, and a conversational agent capable of switching between a fully scripted and LLM-driven dialogue. The implemented architecture was embodied in a TIAGo robot (PAL Robotics) and tested to compare three conversational strategies: (1) scripted, pre-defined dialogue, (2) LLM-based free-form conversation, and (3) LLM-based conversation augmented with personal information provided through the prompt. Eighteen younger adults and eighteen older adults engaged in a five-minute interaction with the robot under all three conditions in a within-subject design, and subsequently completed the Almere model questionnaire. Across all subscales and both participant groups, differences between dialogue strategies were small and statistically non-significant, despite informal comments from several older participants indicating a perceived increase in intelligence or naturalness for the LLM conditions. The findings suggest that generative dialogue and basic personalization alone do not meaningfully shift perceived acceptance in brief, task-neutral encounters, underscoring the importance of longer-term deployment and functionally meaningful robot roles in future evaluations. Full article

Background: Breast cancer poses not only a physical health threat but also significant emotional and identity challenges for women, particularly regarding femininity and body image. Understanding how patients adapt psychologically can guide effective psychosocial interventions. Objective: This study aimed to evaluate psychological adaptation, coping strategies, illness acceptance, and body image in women with breast cancer and identify factors associated with better adjustment. Methods: A cross-sectional study was conducted among 30 women aged 22–66 undergoing treatment at the Wielkopolskie Centrum Onkologii, Poland. Standardized tools included the Mini-MAC scale (coping strategies), Acceptance of Illness Scale (AIS), and Body Image Scale (BIS). Descriptive statistics and correlations were analyzed. Results: Most participants exhibited a constructive coping style, with positive redefinition and fighting spirit being predominant. Some women simultaneously showed elements of a destructive coping style, including helplessness and hopelessness, indicating complex emotional reactions. Overall, participants demonstrated high illness acceptance, despite notable body image-related discomfort, particularly shame, reduced perceived attractiveness, and appearance-related anxiety. While age did not correlate significantly with coping or body image, a significant negative association was found between age and illness acceptance, with younger women showing better adjustment. Conclusions: Psychological adaptation to breast cancer is multidimensional and individualized, dependent on personality traits, internal resources, and social support. Findings highlight the need for holistic, patient-centered psychosocial care, addressing both emotional adaptation and body image-related distress, including support for intimacy and prosthetic interventions. Individualized strategies can improve quality of life and functional outcomes during and after cancer treatment. Full article

In competitive sport, an athlete’s success is often linked to their physical strength, skill, and overall athletic ability. However, physical talent alone does not fully account for sporting success, as psychological and other personal factors also play a crucial role in achieving high performance. Thus, the present cross-sectional study aimed to examine the relationships between perfectionistic personality characteristics, achievement goal orientations, and trait anxiety among young football players using correlation and regression analyses. Participants consisted of 152 male U16 football players (M = 15.67, SD = 0.54) competing in the official league organized by the Cyprus Turkish Football Federation (CTFF). Data were collected using the Sport Multidimensional Perfectionism Scale (SMPS), the 2 × 2 Achievement Goals Questionnaire for Sport (AGQ-S), and the State Trait Anxiety Inventory (STAI). Pearson’s correlation analyses and simple linear regression models were conducted to examine relationships among variables and to identify significant predictors of trait anxiety. Correlation analyses revealed that trait anxiety was positively associated with concern over mistakes (r = 0.28, p < 0.01), perceived parental pressure (r = 0.17, p < 0.05), and mastery-avoidance goals (r = 0.37, p < 0.01), whereas it was negatively associated with mastery-approach goals (r = −0.18, p < 0.05). Regression analyses indicated that concern over mistakes significantly predicted trait anxiety (β = 0.25, p = 0.003), while perceived parental pressure was not a significant direct predictor (β = 0.10, p = 0.21). In addition, mastery-avoidance goals significantly predicted trait anxiety (β = 0.43, p < 0.001), whereas mastery-approach goals were negatively associated with trait anxiety (β = −0.28, p < 0.001). In conclusion, the findings indicate that perfectionistic concerns and mastery-avoidance goals are key factors associated with higher trait anxiety, whereas mastery-approach orientations may serve as a protective factor among young football players. Full article

Background/Objectives: Patient dignity is one of the central values in nursing, equivalent to justice, freedom, and individuality. The purpose of this study was to investigate the psychometric properties of the Greek version of the Inpatient Dignity Scale (IPDS). Methods: In this descriptive, cross-sectional study, 280 patients from three Hemodialysis Units (HD) completed the IPDS, a self-completed questionnaire assessing patients’ expectations regarding dignity and patients’ satisfaction with dignity. Items are categorized into four dimensions, both for expectations and satisfaction: Respect as a Human Being, Respect for Personal Feeling and Time, Respect for Privacy, and Respect for Autonomy. For the translation into Greek, a double forward-backward translation process was followed, and subsequently, cultural adaptation was carried out. Construct validity was tested using the Confirmatory Factor Analysis (CFA) conducted in AMOS 26.0. Convergent validity was assessed through correlations with the Caring Behaviors Inventory-16 (CBI-16) and correlations between the dimensions of the IPDS. Repeatability was assessed using the Intraclass Correlation Coefficient (ICC), and internal consistency using Cronbach’s alpha. The SPSS 26.0 statistical program was used for the descriptive and correlational analyses (p < 0.05). Results: The mean age of participants was 64.8 years old. CFA revealed an acceptable fit for the questionnaire (CFI 0.92–0.93, TLI 0.91–0.94, and RMSEA < 0.08 for both expectations and satisfaction). The IPDS was significantly and positively correlated with the CΒΙ-16, indicating good convergent validity. Cronbach’s alpha was >0.70 in all dimensions of the IPDS, indicating good internal consistency. Conclusions: The Greek version of IPDS is a valid and reliable tool to measure patients’ perceived dignity. Full article

Background: Artificial intelligence (AI) is poised to fundamentally reshape healthcare delivery, offering unprecedented advancements in diagnostics, treatment personalization, and operational efficiency. However, a growing body of international research reveals a critical “optimism–knowledge gap”: healthcare professionals are enthusiastic about AI’s potential but possess limited technical knowledge and practical experience. This gap compromises the safe and effective implementation of AI tools. The Italian healthcare context presents a unique and amplifying challenge, as it is defined by the stringent “human-in-the-loop” oversight mandated by the Garante per la protezione dei dati personali (Italy’s Data Protection Authority). This legal framework makes clinician competence not just a goal, but a prerequisite for regulatory compliance. Objective: This study aimed to provide an exploratory quantitative assessment of AI awareness, practical application, and understanding of its limitations among a sample of clinicians in Italy. It specifically sought to compare the preparedness of hospital-based clinicians and general practitioners (GPs) and to identify the workforce’s perceived educational needs within this unique legal environment. Methods: A descriptive, cross-sectional survey was conducted from February to August 2025. Using a non-probability convenience sampling method via professional networks, the survey yielded 362 total responses. Data were analyzed descriptively and inferentially using Chi-square (${\chi }^2$) tests to compare cohort responses on familiarity, practical exposure, knowledge of limitations, and interest in further training. Results: A universal and high demand for education was found, with 89.9% of all respondents being “Moderately” or “Very” interested in learning more about AI. This optimism coexists with dangerously low practical exposure. The gap was most profound among GPs, 44.1% of whom have “Never” used an AI tool—a rate significantly higher than hospital clinicians (34.9%; ${\chi }^2=3.14$, p = 0.045). Furthermore, 32.6% of GPs admitted that they “understand some benefits but not the limitations.” Conclusions: Italian clinicians mirror the global optimism–knowledge gap. These findings underscore the urgent need for structured, continuous education in AI literacy to address ethical and regulatory imperatives within the Italian healthcare system. Full article

Higher mathematics is a core component of STEM and engineering education; however, many students encounter difficulties in developing conceptual understanding and problem-solving skills. This study examines students’ use of artificial intelligence-based chatbots to support learning in higher mathematics within a personalized learning framework. The empirical basis of the study consists of a cross-sectional anonymous online survey conducted at Saken Seifullin Kazakh Agrotechnical University (Kazakhstan) (n = 154). The results of the descriptive analysis indicate that 72% of respondents reported an understanding of chatbot operating principles, 49% used chatbots “as needed,” and 7% reported very frequent use. The most common areas of chatbot application were the computation of derivatives and integrals (44%) and graph plotting (28%). Among the most frequently perceived benefits, respondents highlighted explanations of complex topics (45%) and rapid access to problem solutions (28%). At the same time, the main perceived limitations included insufficient accuracy of responses (42%) and difficulties in entering mathematical expressions (35%). Overall, the findings suggest that students primarily perceive chatbots as on-demand support tools for computational tasks and conceptual explanations, while concerns related to accuracy and usability remain significant barriers to their broader adoption in the educational process. Full article

Gender-based violence in public transportation is a global phenomenon that restricts women’s rights and autonomy. Most of the documentation relies on harassment and physical aggression, but the subtle internalized mechanisms that reproduce gender inequities remain insufficiently analyzed. This study involves the concept of symbolic violence as an analytical category to unveil how resignation and normalization of violence perpetuate gender power relations and limit women’s mobility. A cross-sectional survey of 263 women aged 15–60 was conducted in Querétaro, Mexico, a rapidly growing city with significant mobility challenges. The questionnaire included items on perceptions of safety, violent experiences, responses to acts of violence, and prevention strategies. An inductive–abductive analysis was implemented to construct empirical indicators derived from Bordieu’s concept of symbolic violence and habitus. Findings reveal that fear, avoidance, and self-regulation are normalized responses to violence in public transport. Women implement strategies such as changing routes, limiting night travel, or increasing their expenses to access safer options. Six empirical indicators were identified: perceived insecurity as normality, resignation to harassment, bodily and emotional self-regulation, preventive reorganization of mobility, personal costs of safety, and collective inaction. In conclusion, the study demonstrates how symbolic violence operates through behaviors, actions, perceptions, and thoughts that reproduce inequities. Operationalizing symbolic violence provides a methodological and conceptual tool to advance gender equality and inform gender-sensitive mobility policies. Full article

Chatbots have spurred keen academic interest in the last decade, with researchers focusing primarily on the factors impacting chatbot adoption by consumers. Based on a systematic literature review (SLR) of 202 selected peer-reviewed papers published from 2015 to 2025, this article aims to achieve the following objectives: (1) describe publication trends, including relevant journals and highly-cited papers; (2) analyze the methodological approaches and theoretical models employed in the field; (3) investigate the drivers and barriers to consumers’ adoption of chatbots; and (4) outline directions for future research. Among the findings, the review reveals that perceived usefulness, perceived ease of use, anthropomorphic characteristics, consumer trust in chatbot applications, and the ability of chatbots to emulate a human-like personality are key drivers of chatbot adoption, whereas perceived risks and anxiety are the most reported barriers. This study offers several future research avenues and highlights the importance of considering the role of emotions and personality traits. Full article

Background/Objectives: Assistive technologies are commonly used as a compensatory strategy for individuals with neurological conditions. However, several negative factors have been associated with their use, leading to their non-use or interruption. Therefore, the aim of the present study was to examine the potential of the Assistive Technology Device Predisposition Assessment (ATD-PA) as an outcome measure to identify psychosocial and user-perceived factors associated with the non-use or interruption of assistive technology, particularly mobility devices. Methods: A descriptive, cross-sectional and non-experimental design was employed, as no variables were manipulated. The sample was selected using non-probability convenience sampling and consisted of 80 participants, of which 14 participants discontinued or interrupted the use of assistive technology. An ad hoc sociodemographic questionnaire was administered, along with the Assistive Technology Device Predisposition Assessment, based on the Matching Person and Technology (MPT) model. Results: Factors related to non-use or interruption appeared to be associated with higher perceived levels of global health, self-care, and physical well-being. Findings from the ATD-PA, used as an indicator of subjective satisfaction, showed strong associations between the perceived level of loss and the need for assistive technologies in domains such as comfort, self-care, and general health (r = 0.72–0.90). The perceived benefit of the device was closely linked to knowledge of its use, safety, fit with personal habits, and perceived capability and stamina (r = 0.69–0.94). Comfort using the device was mainly reported in familiar environments such as with family and friends. In contrast, comfort in broader community contexts did not demonstrate meaningful associations. Conclusions: Findings are consistent with Lauer’s model of non-use and highlight the importance of psychosocial determinants such as perceived health, safety, support, and contextual comfort in understanding the interruption or non-use of assistive technology, in line with the International Classification of Functioning, Disability and Health framework. The ATD-PA shows potential as an outcome-oriented tool to support follow-up and the early identification of risk factors for non-use. Longitudinal studies are needed to better understand usage patterns over time. In Spain, the lack of standardized outcome evaluation protocols and systematic follow-up processes underscore the need for structured monitoring strategies in assistive technology provision. Full article

Objective: This exploratory study presents an international, multi-stakeholder snapshot of perceptions regarding real-world data and real-world evidence in health technology assessment. The aim is to identify perceived opportunities, barriers, and enabling conditions rather than to generate generalizable conclusions. Methods: A 21-item, expert-validated questionnaire was distributed via LimeSurvey to diverse health technology assessment stakeholders, including academia, industry, health technology assessment agencies, healthcare providers, policymakers, patients, and payers. The survey explored perceptions of value, methodological and regulatory challenges, and future outlooks for RWD/RWE use in HTA. Ethical approval was obtained by the University of West Attica Ethics Committee, and pilot testing was conducted prior to dissemination. Data were analyzed using descriptive statistics, consistent with the study’s exploratory intent and acknowledging that results are preliminary and not statistically generalizable. Results: Thirty-two completed responses demonstrated preliminary stakeholder support for integrating real-world data and real-world evidence into health technology assessment. Respondents represented academia, industry, HTA agencies, healthcare providers, policymakers, and patient/advocacy groups; however, no payer responses were obtained. Respondents emphasized the value of real-world data in complementing clinical trials by capturing real-world effectiveness, patient diversity, and long-term outcomes, especially in rare diseases and cancer. Key challenges included poor data quality, confounding biases, and regulatory barriers. Stakeholders highlighted the importance of standardization, transparency, and international collaboration. Opportunities included better decision-making, personalized healthcare, and improved post-market monitoring, with strong calls for robust infrastructure, clear methodologies, patient involvement, and supportive health policy frameworks. Conclusions: Real-world data and evidence enhance health technology assessment by supporting better decisions and personalized care. However, issues like data quality, methods, and trust must be addressed through standardization, strong infrastructure, and collaboration to ensure effective and impactful implementation in healthcare, while acknowledging these insights are based on a small exploratory sample. Full article

As artificial intelligence (AI) drives significant challenges in education, understanding and addressing the training needs of in-service teachers has become a critical issue for ensuring a responsible and long-term technological transition. Framed within Sustainable Development Goal 4 (SDG 4) and the principles of Education for Sustainable Development (ESD), teacher preparation in AI is increasingly recognized as a key mechanism for promoting ethical, equitable, and inclusive educational transformation. This study explores the influence of several key variables on intention and learning behaviors in relation to AI among a sample of 704 Spanish in-service teachers (71% women) from all compulsory educational levels. Using a validated questionnaire, this study assessed teachers’ anxiety towards AI, basic AI knowledge, personal relevance of AI, AI for social good, perceived self-efficacy, social pressure, and perceived usefulness of AI. Structural equation modeling (SEM) was employed to analyze the direct and indirect relationships among these variables. The results indicate that the perceived usefulness of AI and self-efficacy directly and positively influence the behavioral intention to learn about AI. Furthermore, social pressure and basic AI knowledge indirectly influence this intention. In turn, both behavioral intention and social pressure significantly predicted AI learning behaviors. The model demonstrates strong explanatory power, accounting for 91% of the variance in the behavioral intention to learn about AI. These findings provide evidence to inform the design of teacher training initiatives and policies that promote responsible, ethical, and inclusive integration of AI in educational settings, contributing to sustainable development through education. Full article

As robotaxis transition from technological validation to commercial operation, converting first-time tryers into long-term users becomes pivotal for achieving sustainable development. Existing research mainly examines factors affecting initial adoption intention for robotaxis from a net-effect perspective, yet little is known about the factors affecting continuance intention and their nonlinear causal mechanisms. This study integrates the Expectation–Confirmation Model (ECM) and the Unified Theory of Acceptance and Use of Technology (UTAUT) to construct a systematic analytical framework and employs fuzzy-set Qualitative Comparative Analysis (fsQCA) for configurational analysis. Using survey data from 327 users in China with actual robotaxi experiences, the findings unveil four factor configurations driving high continuance intention and two causing non-high continuance intention. Regarding the interplay of factors driving high continuance intention, post-usage usefulness, satisfaction, and perceived safety constitute a complementary mechanism, whereas expectation confirmation and personal innovativeness form a substitutive mechanism that depends on the specific patterns of factor configurations. This study contributes to the robotaxi adoption literature by extending the research context to the post-adoption phase, developing a tailored theoretical framework, and applying a configurational approach rooted in complex systems analysis paradigms. The findings offer implications for governments to formulate synergistic policy mixes and for robotaxi companies to design user retention strategies. Full article

Adolescents increasingly engage with digital technologies, yet understanding patterns of smartphone use and fostering reflective awareness remain challenging. Traditional assessments in clinical or school settings may limit participation and self-reflection. This study evaluated the feasibility and impact of a Computer-Assisted Web Interviewing (CAWI) approach to monitor smartphone use, provide immediate individualized feedback, and support peer-mediated dissemination in a public science engagement context. Across three editions of the European Researchers’ Night in Rome (2023–2025), 807 adolescents aged 10–19 completed the SAS-SV questionnaire via on-site tablets or personal devices using QR codes. Smartphone use was categorized into Low Involvement, At-Risk, or Problematic. Participants were encouraged to share the survey link with peers, enabling snowball-mediated recruitment. Participant acceptance was assessed through the Net Promoter Score (NPS). Snowball participation accounted for the majority of responses, highlighting the effectiveness of peer-mediated diffusion. SAS-SV categorization indicated 46% Low Involvement, 39% At-Risk, and 15% Problematic use, with minimal gender differences. NPS values ranged from +69 to +79, with snowball participants reporting slightly higher satisfaction than on-site attendees. These results underscore high engagement, perceived value, and the role of peer networks in promoting reflective digital behavior. Integrating CAWI assessment, immediate feedback, and peer-mediated diffusion created a socially situated environment supporting self-reflection and voluntary dissemination. Peer networks extended both the temporal and social reach of the initiative beyond the public event, demonstrating a scalable and non-stigmatizing model. CAWI-based monitoring combined with feedback and peer-driven diffusion is feasible and effective for adolescent digital wellbeing interventions. This approach fosters reflective digital citizenship, supports self-awareness, and leverages social networks to enhance the reach and impact of youth-centered health promotion initiatives. Full article