Search Results (2,888)

Rural communities have a close-knit social structure, hindering the disclosure of mental disorders due to fear of negative societal perception. The study aimed to explore the experiences of both clubhouse members and staff with stigma and to examine how the Clubhouse addresses stigma in rural Wyoming through semi-structured interviews. Semi-structured interviews were conducted with 16 participants (12 clubhouse members and 4 staff members). The data analysis was performed in NVivo using reflexive thematic analysis. Three main themes were generated: “mental health prejudices,” where participants reported being perceived as dangerous, unintelligent, incompetent, and attention seekers. The second main theme, “the root causes of mental health stigma,” has three subthemes: “mental health illiteracy”, “the media,” and “personal struggles and background.” The third main theme, “clubhouse effort to address stigma,” encompasses two subthemes: “the unique clubhouse environment for self-stigma recovery” and “advocacy and community outreach.” The study findings highlight the emotional challenges individuals with mental illness face due to stigma from the media and the public. However, the clubhouse provides a non-judgmental environment that addresses both self- and public stigma. The findings also support expanding clubhouses, especially in rural areas, to improve mental health outcomes. Full article

This study evaluates the feasibility of using a lightweight, off-the-shelf sensing system for short-term stress detection during exergaming. Most existing studies in stress detection compare rest and task conditions, providing limited insight into continuous stress dynamics, and there is no agreement on optimal sensor configurations. To address these limitations, we investigated dynamic stress responses induced by a cognitive–motor task designed to simulate rehabilitation-like scenarios. Twenty-three participants completed the experiment, providing electrodermal activity (EDA), blood volume pulse (BVP), self-report, and in-game data. Features extracted from physiological signals were analyzed statistically, and shallow machine learning classifiers were applied to discriminate among stress levels. EDA-based features reliably differentiated stress conditions, while BVP features showed less consistent behavior. The classification achieved an overall accuracy of 0.70 across four stress levels, with most errors between adjacent levels. Correlations between EDA dynamics and perceived stress scores suggested individual variability possibly linked to chronic stress. These results demonstrate the feasibility of low-cost, unobtrusive stress monitoring in interactive environments, supporting future applications of dynamic stress detection in rehabilitation and personalized health technologies. Full article

Against the backdrop of inclusive development and modernization of employment governance, the limitations of traditional approaches to promoting employment for persons with disabilities—such as information asymmetries and inefficient resource allocation—have become increasingly salient. Building a systematic promotion framework for disability employment has therefore emerged as a critical agenda for advancing modern social governance. Drawing on bounded rationality and information asymmetry theories, this study develops a tripartite evolutionary game model encompassing government, employers, and persons with disabilities. By incorporating key elements such as initial intentions, skill matching, and policy signal transmission, the model analyzes the strategic choices and dynamic interactions among stakeholders. We conduct numerical simulations using delay differential equations (DDEs), perform stability and sensitivity analyses in MATLAB R2024b, and triangulate findings with a practice-based case from Shanghai. The results indicate that persons with disabilities exhibit the highest policy responsiveness within the employment ecosystem and act as the core driver of convergence toward desirable equilibria through four mechanisms: skill-matching effects, policy signal diffusion, perceived institutional fairness, and system-level synergy gains. Although employer subsidies and penalties directly target firms, they exert the strongest psychological incentive effects on persons with disabilities, revealing a “misaligned incentives” feature in policy signaling. Systemic synergy gains activate market network effects, facilitating a pivotal shift from “policy transfusion” to “market self-sustenance.” Based on these findings, we propose a diversified policy toolkit, enhanced policy signaling mechanisms, and innovations in concentrated employment models to support the modernization of disability employment governance. Full article

Charitable giving plays a vital role in advancing sustainable development, yet little is known about its determinants in transitional economies. This study addresses this gap by examining the socioeconomic and psychological drivers of prosocial financial behavior in Uzbekistan, integrating the Theory of Planned Behavior (TPB), Norm Activation Theory (NAT), and Well-Being Theory. Data from a sample of 348 individuals reveal two distinct pathways of giving: one shaped by resources (income, age) and another by subjective well-being (happiness). While income, age, and happiness emerged as significant positive predictors of charitable behavior, traditional TPB factors such as attitude, subjective norms, and perceived behavioral control were not supported in this context. A surprising finding was the negative association between personal norms and charitable giving, challenging assumptions of Western-centric models and pointing to the importance of cultural and institutional conditions, such as trust in charities and informal giving practices. The study contributes to sustainability research by showing that fostering well-being and targeting specific demographic groups can enhance philanthropy, while also emphasizing the need for culturally sensitive approaches in understanding prosocial behavior within emerging economies. Full article

The Method for the Empowerment of Trauma Survivors (METS) is a recovery-oriented group intervention tailored to refugees and asylum seekers who experienced traumatic events. This study explores how undocumented migrants in the Netherlands experience participation in METS, how these experiences relate to changes in their mental well-being, and which aspects of the intervention participants find most valuable. A qualitative case study was conducted involving in-depth, individual interviews with undocumented migrants who participated in METS. Interviews focused on participants’ experiences with the intervention and perceived changes in mental well-being. Five main themes emerged: connectedness, group dynamics, personal development, emotional well-being, and practical aspects. Changes in mental well-being were often subtle, difficult to articulate, and in some cases temporary. While some participants reported positive developments, many continued to face significant challenges and did not experience notable improvement. No participants reported negative outcomes as a result of participation. METS appears suitable for a heterogeneous population with diverse cultural, religious, and educational backgrounds. Reported benefits often related to group participation rather than METS-specific characteristics. Future research is warranted to further explore whether METS is a valuable addition to existing transdiagnostic psychosocial group interventions. Full article

Background and Objectives: This study examined associations between physical activity, body perception, and self-rated health (SRH) in a nationally representative sample of Korean adults. Materials and Methods: This study analyzed data from the 2023 Korea Community Health Survey (n = 228,249 adults aged ≥19). Variables included Body Mass Index (BMI), body perception, and participation in walking and stretching. Complex sample t-tests and one-way ANOVA were used to examine group differences in BMI, body perception, and self-rated health (SRH). Comparisons were made across gender, age groups, residential environment (metropolitan vs. non-metropolitan), and household size. Results: Mean BMI was highest in individuals in their 30s and was lowest in those aged 80 and above (p < 0.001). Females reported lower BMIs and more positive SRH than males (p < 0.001). Metropolitan residents and individuals in larger households showed higher physical activity rates and more favorable SRH (p < 0.001). SRH and physical activity declined with age, while exercise participation was higher among individuals with higher BMI or self-perceived overweight status (p < 0.001). Although the direction of this association should be interpreted with caution. Conclusions: Age, gender, residence, and household composition significantly influenced physical activity and SRH. These findings highlight the need to prioritize interventions for older adults, single-person households, and non-metropolitan populations. Full article

Objective: To evaluate a 30 h educational program delivered to community health care workers (CHWs) involved in geriatric care within a primary care clinic, measure increase in knowledge, likelihood of using the education, and baseline results of geriatric screenings for patients 65 and older conducted by CHWs in their clinics. Methods: Design, Setting and Participants: This is an evaluation with a two-center, pre–post design study of a 30 h in-person educational program. The program used the Kirkpatrick model to evaluate the educational program. The study used quantitative and qualitative data collection with surveys measuring knowledge, feedback, content, and demographics of the participants and chart reviews to measure clinical implementation of 4Ms discussion. Qualitative data collection included a focus group and open-ended questions in the survey. Thematic analysis from focus groups explored the feedback from the educational program. Results: Twelve community health care workers (average age 40, 90% female) from two federally qualified health centers (FQHC) participated in the 30 h training program. Perceived knowledge improved after the completion of the training. Final exam scores after the training were also significant, indicating an improvement in content retention. Overall, 98% of participants described the training as “Excellent” and 96% rated excellent for the speakers who provided the training. Additionally, 83% suggested they would apply the training in their practice. Approximately 40% of chart reviews indicated the completion of the 4Ms (What Matters, Mentation, Medication, and Mobility) discussion with patients. Thematic analysis yielded two new practice dimensions: care provision and clinical documentation. The training resulted in organizational adaptation with the development of an intake form in the Electronic Health Record (EHR) to document the 4Ms. Conclusion: Results indicate improvement in all dimensions of the training with an emphasis on level 4, indicating wider organization adaptation of 4Ms discussion. Full article

Background: Diagnosing facial melanoma, specifically lentigo maligna (LM) and lentigo maligna melanoma (LMM), is a daily clinical challenge, particularly for small or traumatized lesions. LM and LMM are part of the broader group of atypical pigmented facial lesions (aPFLs), which also includes benign look-alikes such as solar lentigo (SL), atypical nevi (AN), seborrheic keratosis (SK), and seborrheic-lichenoid keratosis (SLK), as well as pigmented actinic keratosis (PAK), a potentially premalignant keratinocytic lesion. Standard dermoscopy with handheld devices is the most widely used diagnostic tool in dermatology, but its accuracy heavily depends on the clinician’s experience and the perceived difficulty of the case. As a result, many benign aPFLs are excised for histological analysis, often leading to aesthetic concerns. Reflectance confocal microscopy (RCM) can reduce the need for biopsies, but it is limited to specialized centers and requires skilled operators. Aims: This study aimed to assess the impact of personal skill, diagnostic confidence, and perceived difficulty on the diagnostic accuracy and management in the differential dermoscopic diagnosis of aPFLs. Methods: A total of 1197 aPFLs dermoscopic images were examined on a teledermoscopic web platform by 155 dermatologists and residents with 4 skill levels (<1, 1–4, 5–8, >8 years). They were asked to give a diagnosis, to estimate their confidence and rate the case, and choose a management strategy: “follow-up”, “RCM” or “biopsy”. Diagnostic accuracy was examined according to the personal skill level, confidence level, and rating in three settings: (I) all seven diagnoses, (II) LM vs. PAK vs. fully benign aPFLs, (III) malignant vs benign aPFLs. The same analyses were performed for management decisions. Results: The diagnostic confidence has a certain impact on the diagnostic accuracy, both in terms of multi-class diagnosis of six aPFLs in diagnostic (setting 1) and in benign vs malignant (setting 3) or benign vs. malignant/premalignant discrimination (setting 2). The perceived difficulty influences the management of benign lesions, with easy ratings predominantly matching with “follow-up” decision in benign cases, but not that of malignant lesions assigned to “biopsy”. The experience level had an impact on the perception of the number of real easy cases and had no to minimal impact on the average diagnostic accuracy of aPFLs. It, however, has an impact on the management strategy and specifically in terms of error reduction, namely the lowest rates of missed malignant cases after 8 years of experience and the lowest rates of inappropriate biopsies of benign lesions after 1 year of experience. Conclusions: The noninvasive diagnosis and management of aPFLs rest on a daily challenge. Highlighting which specific subgroups of lesions need attention and second-level examination (RCM) or biopsy can help detect early malignant cases, and, in parallel, reduce the rate of unnecessary removal of benign lesions. Full article

The home-building industry is crucial to Thailand’s economic growth but unfortunately it is plagued by persistent sustainability problems stemming from fierce competition, cost fluctuations, and evolving consumer expectations. Therefore, this study sought to identify the main drivers of sustainable customer loyalty (CL) in the high-end home-building industry by integrating marketing communications strategy (MCS), service quality (SQ), and company management system (CMS) into a unified structural equation model (SEM). Data were collected from 680 customers registered with Thailand’s Home Builders Association through online and in-person surveys. Path analysis of latent variables using LISREL 9.10 showed that the model had strong explanatory power, explaining 72% of the variance of CL (R² = 0.72). MCS had the greatest total effect (β = 0.82), followed by SQ (β = 0.54) and CMS (β = 0.24). The results also showed how transparent communication interventions add to perceived quality while increasing management efficiency which jointly sustains long-term CL. These findings confirm that strategic communication, service excellence, and good corporate management provide the basis for the sustainable competitive advantage and economic resilience of Thailand’s home-building firms. The validated framework provides theoretical and managerial implications for incorporating sustainability into customer relationship strategies. Full article

During medical school, students in Germany acquire knowledge, abilities, competencies, and skills in social medicine. The aim of this study was to investigate how human medicine students perceive the relevance of selected social medical issues and their knowledge gain depending on different teaching formats. The study was designed as a retrospective trend study. Included were four semester cohorts (n = 597 students). Five topics were selected as seminar subjects: work incapacity, rehabilitation, (long-term) care level, graded return to work, and assistive technology for activities of daily living. A new teaching format based on problem-based learning (PBL) and peer teaching (PT) was implemented. In the seminars, each student worked on one topic by him/herself (PBL; for this topic, the student is counted within group PBL in the statistical analysis). Through the presentations of fellow students, a student received information regarding other topics (PT; for these topics, the student is counted within group PT in the statistical comparison with group PBL). 550 students completed a standardized questionnaire at the end of the seminar, rating (a) their perceived relevance of these social medical topics with regard to clinical practice and (b) the personal knowledge gain regarding all topics. The results in group PBL tended to be better than those in group PT, indicating that active engagement with socio-medical topics increases the perception of their relevance. The students benefit more from working on topics themselves than from oral presentations or lectures: the probability of stating a notable knowledge gain regarding the respective topic was significantly higher for all topics in group PBL compared with in group PT (Work incapacity: OR: 1.3 (95%-CI: 1.07; 1.58), Rehabilitation: OR 1.8 (95%-CI: 1.41; 2.20), (Long-term) care level: OR: 1.6 (95%-CI: 1.25; 1.94); Graded return to work: OR: 1.95 (95%-CI: 1.57; 2.42), Assistive technology for activities of daily living: OR: 1.8 (95%-CI: 1.45; 2.31)). Medical students can be sensitized to the clinical relevance of social medicine, particularly when they experience its practical implications via appropriate activating teaching formats. The results suggest that PBL formats are preferable for increasing awareness of socio-medical issues. Full article

Character strengths are the positive personality traits essential for a meaningful life. Recognising and applying character strengths is crucial to becoming high-quality learners. This study explores the role of character strengths in enhancing the quality of education within Hungarian Higher Education, an area often neglected in discussing quality education. Using purposive sampling, semi-structured interviews were conducted with ten international students enrolled in BA and MA Teacher Education programs. The study explored how students perceive and apply character strengths to support learning and academic engagement. Data were analyzed using qualitative content analysis with ATLAS.ti software. The findings highlight several key strengths—such as creativity, hope, curiosity, teamwork, and self-regulation—as essential to fostering effective learning environments. Four predominant thematic areas emerged: the importance of positive personality traits, the pivotal role of the teacher–student relationship in fostering a conducive learning environment, the integration of character strengths in education, and personal development and character strengths, elucidating the integral role of character strengths in promoting quality education, advocating for a harmonious equilibrium between academic knowledge and personal growth. The study also contributes to the limited literature on character strengths in Hungarian Higher Education and suggests directions for future research. Full article

This study conceptualizes how artificial intelligence (AI)-based customer engagement strategies can shape consumers’ green purchasing intentions, focusing on the theorized roles of attitude and perceived risk toward green products as articulated in prior literature. Building on contemporary research in sustainable marketing and consumer psychology, the article proposes a conceptual framework in which AI-enabled engagement influences green purchase intention via attitudes, with perceived risk operating as a boundary condition that moderates these effects. To qualitatively substantiate the salience and practical relevance of these constructs, an exploratory sentiment analysis of Amazon reviews for green products was conducted to surface emotional responses, perceived value drivers, and behavioral cues. The review corpus predominantly reflects positive sentiment alongside mixed subjectivity and factual commentary, highlighting recurring decision factors such as product quality, packaging, sustainability claims, and price sensitivity. Consistent with literature, the evidence aligns with the view that personalization and transparency can bolster trust and more favorable attitudes, while perceived risks—spanning greenwashing concerns, cost, and performance doubts—remain obstacles to adoption. Crucially, the sentiment analysis is presented as illustrative and does not statistically test the proposed mediation or moderation pathways; rather, it offers qualitative support that complements the literature-based conceptual model. The study contributes by integrating insights from digital technologies, consumer psychology, and sustainable marketing to guide authentic, strategic engagement practices that can encourage eco-conscious behavior. Full article

The aim of this study is to examine the impact of personality traits on students’ intention to accept the SAP S/4HANA business software. Grounded in the Big Five Factor (BFF) model of personality and the Technology Acceptance Model (TAM), the research analyzed the role of individual differences in students’ learning performance using this ERP system. The study was conducted on a sample of N = 418 first-year students who underwent a quasi-experimental treatment based on realistic business scenarios. The results indicate that conscientiousness emerged as a positive predictor, while agreeableness demonstrated negative predictive value in learning SAP S/4HANA, whereas neuroticism did not exhibit a significant effect. Moderation analysis revealed that both Perceived Usefulness and Actual Usage of technology moderated the relationship between conscientiousness and SAP learning performance, enhancing its predictive strength. These findings underscore the importance of individual differences in the process of SAP S/4HANA acceptance within an educational context and suggest that instructional strategies should be tailored to students’ personality traits in order to optimize learning outcomes. Full article

On construction sites, it is crucial and and in most cases mandatory to wear safety equipment such as helmets, safety shoes, vests, and belts. The most important of these is the helmet, as it protects against head injuries and can also serve as a marker for detecting and tracking workers, since a helmet is typically visible to cameras on construction sites. Checking helmet usage, however, is a labor-intensive and time-consuming process. A lot of work has been conducted on detecting and tracking people. Some studies have involved hardware-based systems that require batteries and are often perceived as intrusive by workers, while others have focused on vision-based methods. The aim of this work is not only to detect workers and helmets, but also to identify workers through labeled helmets using symbol detection methods. Person and helmet detection tasks were handled by training existing datasets and gained accurate results. For symbol detection, 14 different shapes were selected and put on helmets in a triple format side by side. A total of 11,243 images have been annotated. YOLOv5 and YOLOv8 were used to train the dataset and obtain models. The results show that both methods achieved high precision and recall. However, YOLOv5 slightly outperformed YOLOv8 in real-time identification tests, correctly detecting the helmet symbols. A testing dataset containing different distances was generated in order to measure accuracy by distance. According to the results, accurate identification was achieved at distances of up to 10 meters. Also, a location-based symbol-ordering algorithm is proposed. Since symbol detection does not follow any order and works with confidence values in the inference mode, a left to right approach is followed. Full article

Given the nexus between food insecurity and body dissatisfaction, a deeper understanding of this complex relationship in college students is needed. The purpose of this cross-sectional study, using the American College Health Association—National College and Health Assessment 2021 (n = 2003) at a large public university, was to explore the associations between food insecurity, personal appearance distress, and compensatory behaviors associated with body dissatisfaction. An analysis of variance with Tukey’s post hoc comparisons was performed to assess the relationship of outcomes associated with personal appearance distress by food security status. Structural equation modeling, using multivariable logistic and ordinal regression, were constructed to explore the impact of personal appearance distress, perception of body weight, weight control attempts, and dietary behaviors, adjusting for age, sex, race/ethnicity, body mass index, and food security status. Food insecurity was associated with lower grade point average, higher overall stress, and personal appearance distress. Personal appearance distress was associated with fewer servings of vegetables (p = 0.006) and fruits (p = 0.01), higher perceived body weight (p < 0.001), and more weight modification attempts (p < 0.05). The associations between food insecurity, personal appearance distress, and compensatory behaviors could extend to disordered eating behaviors, necessitating awareness and interventions from college campus programming and administration. Full article