Search Results (813)

Background/Objectives: Benzodiazepines (BZDs) are used routinely in cases requiring sedation for anxiety, insomnia, and procedures that require pain management, and daily use of these agents may extend over several months; therefore, monitoring patients is essential to reduce the risk of developing dependence. However, the high patient volume in pain and palliative-care settings often limits physicians’ ability to both conduct consultations and perform comprehensive evaluations. In this context, the pharmacist plays a key role in supporting patient care by contributing professional activities that enhance patient well-being, such as conducting systematic reviews of electronic medical records. This pharmacist-led EMR assessment enables the identification of benzodiazepine dependence patterns and supports a more robust epidemiological evaluation within the institution. Methods: A descriptive observational study (January 2022–May 2025) using electronic medical records and prescription data was conducted. Consecutive adults with an active BZD prescription and a documented BDEPQ-MX (Benzodiazepine Dependence Questionnaire, Mexican version) were included. Outcomes were BDEPQ-MX categories (No dependence; Pleasurable effects; Perceived need; Dependence) and a binary endpoint was stablished as “any dependence” (either scored in Perceived need or Dependence category) vs. No dependence (either scored as No dependence or Pleasurable effects categories). Group comparisons used χ², Student’s t, and one-way ANOVA. A logistic regression modeled any dependence; a general linear model (GLM) examined the BDEPQ-MX total score. Results: Of 181 complete cases, BDEPQ-MX categories were No dependence 33.2% (60/181), Pleasurable effects 7.2% (13/181), Perceived need 17.1% (31/181), and Dependence 42.5% (77/181); hence, 59.7% met “any dependence.” Women comprised 67.4% overall. Compared with No dependence, the any-dependence group had higher comorbidity (83.3% vs. 65.8%, p = 0.006) and markedly greater duration of BZD use (months) (22.6 ± 11.5 vs. 5.9 ± 4.9, p < 0.001), with no difference in daily dose (p = 0.6). Benzodiazepine medications shifted toward alprazolam in dependence (38.9% vs. 20.5%, p = 0.009) and away from clonazepam (43.5% vs. 58.9%, p = 0.042). In the adjusted model, the male sex was associated with lower odds of any dependence (aOR 0.29, 95% CI 0.11–0.76; p = 0.013), while the duration of BZD use (per month) increased the odds (aOR 1.32, 1.20–1.45; p < 0.001). In the GLM, the duration showed the largest effect on BDEPQ-MX total (F = 203.26; p < 0.001; partial η² = 0.545). Conclusions: In this outpatient pain and palliative-care population, benzodiazepine-related dependence phenomena were common: 59.7% of patients met the criteria for dependence based on the pharmacist-led EMR review. The involvement of the pharmacist was essential, as this systematic evaluation would have been difficult to perform within routine medical consultations. The pharmacist’s contribution enabled a detailed epidemiological characterization, revealing that the exposure duration—more than daily dose—was the principal, modifiable correlate of dependence, and that alprazolam was disproportionately represented in the higher-dependence categories. These findings underscore the value of pharmacist-supported surveillance to identify and measure BZD dependance. Full article

With the development of information technology, live shopping has emerged as a new approach to product marketing and has attracted considerable attention. However, in the context of an aging population, little is known about the factors influencing the intention of the elderly to engage in live shopping. The aim of this study is to determine the psychological and cognitive mechanisms that influence the willingness of elderly people to engage in live shopping. This study integrated the Flow Theory and the Information System Success Model to construct a live shopping acceptance model for the elderly based on the Stimulus–Organism–Response model. It was used for in-depth insight into the live shopping behaviors of elderly users. The structural equation model was used in the study to analyze 337 valid questionnaires. The results showed that interactivity, authenticity, attractiveness, and entertainment could improve the flow in livestreaming shopping among elderly users. Entertainment and attractiveness had a positive influence on perceived pleasure, and flow in live shopping, and perceived pleasure had a direct and significant influence on the elderly’s intention to make a live purchase. The factors of information quality and ease of use have no direct impact on perceived pleasure. This study enriched the user behavior theory of live shopping and provided inspiration for the aging-friendly and sustainable development of live shopping services of shopping platforms, live streamers, and service providers. Full article

Background: Hypermobile Ehlers–Danlos Syndrome (hEDS) results in multiple, complex health-related risks and associated fear of movement (kinesiophobia). Therefore, the purpose of this research study was to examine how a holistic, embodied, and performative movement program (EDS-HEART) can affect body schema, physical and mental health, and lifestyle, which contribute to the joy of movement and physical activity participation among adult women with hEDS. Methods: This was a hermeneutic, phenomenological, quasi-experimental, and community-based research study among six women with hEDS, who participated in the EDS-HEART movement program at a local physical therapy clinic. The seven-week program incorporated stretching and strength training activities as well as performative-thematic movement sequences. Results: Based on the qualitative analysis, three themes emerged regarding reasons for the joy of the EDS-HEART program: (a) improved body schema: body awareness, confidence, posture, and proprioception; (b) highly motivating program: holistic, embodied, performative, pleasant, and safe; and (c) psychosocial reasons: supportive setting, sense of pleasure and euphoria, and freed from social comparisons and the fear of movement. Conclusions: Based on the study results, public health experts should develop and implement easily accessible and holistic movement programs among people with hEDS and similar conditions to improve physical health, psychosocial health, and the joy of movement. Full article

Background: Our growing understanding of the brain basis of mind has seen an interest in evolutionarily ancient structures, most notably the brainstem. This paper offers an interesting example of this underexplored territory, by considering the mesencephalic component of the trigeminal nucleus. This largely uncelebrated brainstem structure is central to control of the jaw, and for the foundational acts of eating, oral exploration, and biting. Objectives: This paper explores the interesting anatomy of the mesencephalic trigeminal: unique in the nervous system as a centrally located sensory ganglion, which combines sensory and motor function for the jaw. An unexplored aspect of its anatomy is that the mesencephalic component of the nucleus lies directly adjacent to the brain’s core system for the experience of emotion, the peri-acqueductal gray (PAG). Results: The data suggest a role for the jaw, and more broadly the oral cavity, in relation to a range of feeling states, from pleasure to aggression. This is supported by behavioural and classic neuropsychological findings, such as the Klüver-Bucy syndrome. However, the proposal is not well-supported by findings of direct connections between the trigeminal nucleus and the PAG. Conclusions: While these contrasting findings present a conundrum, there may be a role for non-synaptic signalling, of the sort increasingly understood to be important for interoception and homeostasis. Full article

Huysmans’s novel À rebours can be seen as an epitome of the dialectic implied by the term peccata lectionis: reading can only come into its own through certain ‘sins’ inherent to it while possibly compromising it. Such ‘sins’ are involved in the decision of the novel’s single protagonist and anti-hero, Des Esseintes, to withdraw into the solitude of his country house to live a life dedicated to aesthetic and intellectual pleasure. While celebrating his own eccentric fancies and artificiality of taste, the protagonist’s days of decadence, in their very antagonism towards both society and nature, are spent pursuing what can be called ‘reading of culture’. As ‘the reading of culture’ and its dialectics in the novel extend to and draw upon a wealth of references to the Catholic cultural tradition, the latter leads to a textual logic and a particular kind of lectio. It is in keeping with the novel being widely regarded as a harbinger of the ‘Catholic turn’ in its author’s career, Des Esseintes, at one point of the narrative, comes to explore the so-called ‘Catholic idiom’. Whereas his critique is aimed at 19th century Catholic writers in France and their indebtedness to the definitive rhetoric of the French Grand Siècle, the ‘Catholic idiom’, its particular textuality and the ‘reading of culture’ that is manifest in it may lie elsewhere in Huysmans’s novel itself. These likely reside in the textual logic of catalogues or ‘compendia’, that is, the listing of names within a category, which evokes mediaeval textual practices. The catalogue or ‘compendium’ as a genre within Huysmans’s novel fulfils the artificiality and vigour of the protagonist’s ‘reading of culture’—and the whole dialectic of the peccata lectionis. Full article

Background/Objectives: Behavioral inhibition (BI) has been extensively studied as an early-appearing risk factor for adverse developmental outcomes. One pathway through which BI may confer risk is via reduced competence to interact effectively with peers. Research demonstrating concurrent relations between BI and social competence supports this pathway, yet not all inhibited children experience social difficulties. This study adopted a person-centered approach to examine heterogeneity of temperament traits within a highly inhibited preschool sample and to identify how broader temperament traits contribute to variability in social functioning. Methods: Parents of preschoolers (N = 254) who met criteria for BI (≥85th percentile on the Behavioral Inhibition Questionnaire) completed measures of their child’s temperament (Children’s Behavior Questionnaire) and social competence (Social Skills Improvement System). Latent Profile Analysis was conducted using six temperament traits reflecting regulation and reactivity (anger, attentional focusing, inhibitory control, high-intensity pleasure, perceptual sensitivity, and approach). Profile differences in social competence were examined using multivariate analyses controlling for age and gender. Results: A three-profile solution emerged: Regulated, Unregulated and Angry, and Typical BI. Profile membership accounted for almost 37% of the variance in social skills scores. The Regulated group, marked by high attentional and inhibitory control and low anger, demonstrated the strongest social skills and lowest internalizing and externalizing problems. The Unregulated and Angry group, characterized by high anger and poor regulation, exhibited the greatest social difficulties. BI level itself did not significantly differentiate profiles or predict social competence. Conclusions: Findings underscore that BI is not a uniform risk factor but joins with other temperamental traits to shape social outcomes. Level of BI did not differentiate profiles or relate to social functioning, highlighting the importance of considering co-occurring regulatory and reactive traits to explain variability in outcomes among inhibited children. Identifying specific temperamental constellations may enhance early identification and inform targeted interventions for socially at-risk inhibited children. Full article

This paper aims to re-examine the roles of engravers and printers in the producing process of Nishiki-e, multicolored woodblock prints made in 18th–19th century Japan. Previous research has privileged the creative ideas of artists while regarding the craftsmen’s work as mere reproduction. In contrast, this paper re-evaluates the Nishiki-e production process, comprising publishers, painters, engravers, and printers, as a “meshwork,” a concept proposed by anthropologist Tim Ingold. By examining documents and specific works from three perspectives of imagery, coloring, and texture, this paper argues that the engravers and printers were also deeply involved in selecting lines and colors in the finished work. It reveals that Nishiki-e were products woven through the correspondence between humans and materials, reflecting economic factors and spectators’ pleasure. Full article

We can trace the convergence of electronic literature and narrative games through a focus on critical methods and experiential frameworks rather than relying on typologies or ontologies. This article offers examples of digital literary works that we experience across a literary–ludic continuum. The first section traces some historical markers of convergence between electronic literature and narrative games with reference to conference keynotes from the institutional history of the Electronic Literature Organization (ELO). The next sections will present two case studies. The first, Kentucky Route Zero by Cardboard Computer is a narrative game that benefits from a literary-critical method and rewards interpretative insights. The second, This is a COVID-19 Announcement by Peter Wills, is an analysis of a playable simulation that indulges the pleasures of iterative ludic engagement against a backdrop of narrative (yet not plot-centric) comforts. Just as literature enriches games and games enrich literature, the critical methodologies and imaginative experiences they engender can be mutually productive when understood across a continuum of literary and ludic practice. Full article

Sexual pleasure has attracted increasing scientific attention in recent years. In this cross-sectional study, we investigated self-esteem and body appreciation as potential determinants of sexual pleasure. We examined data from a community sample of young adult women and men. Specifically, we tested the hypotheses that self-esteem and body appreciation positively predict sexual pleasure, and that body appreciation moderates the association between self-esteem and sexual pleasure. We exploratively investigated the moderation of these effects by gender. Sexual pleasure was measured using seven items from the trait scales of the Amsterdam Sexual Pleasure Index 1.0. Self-esteem was measured with the Dutch translation of the Rosenberg Self-Esteem Scale. Body appreciation was measured using the Dutch translation of the Body Appreciation Scale 2. The results showed that self-esteem positively predicted a substantial proportion (19%) of the variance of sexual pleasure, whereas body appreciation did not directly predict sexual pleasure. Body appreciation did not moderate the association between self-esteem and sexual pleasure in the full sample and in women, but it was found to moderate this association in men; however, in the opposite direction of what was predicted in the hypothesis. The findings were discussed, and suggestions were made for future research. Full article

This paper investigates how the “Gastro Local” network in Brașov County, Romania, contributes to regional brand development by digitally communicating local gastronomic and cultural values. One hundred eighty social media posts created by Local Gastronomic Points (LGPs) were analyzed using a directed content analysis grounded in the Memorable Gastronomic Experience (MGE) and Online Destination Brand Experience (ODBE) frameworks. Results suggest that LGPs construct dense multimodal narratives combining gastronomic, environmental, emotional, and temporal cues, indicating that rural digital storytelling relies on layered experiential configurations. Hedonism, Local Culture, and Relaxation dominate experiential communication, while sensory and spatio-temporal cues structure online brand expression. Co-occurrence patterns and correspondence analysis indicate two potential branding logics: a sensory–hedonic strategy centred on visual pleasure, and an affective–symbolic contextual strategy anchored in heritage and rural temporality. The study contributes an integrated MGE × ODBE analytical model and suggests how small-scale food providers act as decentralized branding agents, supporting aspects of sustainable and authenticity-driven regional identity-building within this specific context. Full article

This study investigates how cultural context shapes memorable tourism experiences at dark-tourism sites by comparing young visitors (aged between 18 to 34) from the Czech Republic and India. The Czech Republic and India were selected for this study because they offer two culturally and historically distinct contexts that allow for meaningful examination of cross-cultural variation in dark tourism experiences. It specifically aims to examine whether and how the seven dimensions of the Memorable Tourism Experience Scale (MTES), hedonism, refreshment, local culture, involvement, knowledge, meaningfulness, and novelty vary across these two cultural settings. A cross-sectional, comparative survey design was employed using a convenience sample of 100 Czech and 108 Indian university students who had previously visited dark-tourism attractions. Data were collected through a self-administered questionnaire based on the MTES, and analyzed using factor analysis and independent-sample t-tests to validate the scale and test for cross-cultural differences. Significant differences emerged for hedonic value and meaningfulness, with Indian participants reporting higher scores on both dimensions, while local culture, involvement, knowledge, novelty, and refreshment did not differ significantly between the two samples. The study contributes to the memorable tourism experience literature by demonstrating that dark tourism represents a hybrid eudaimonic–hedonic experience in which cognitive learning and reflective appraisal coexist with pleasure and arousal, and by showing that cultural context modulates affective and meaning-related dimensions more than cognitive ones. Practically, the findings suggest that dark-tourism managers should priorities interpretive designs that integrate knowledge acquisition with emotionally and morally resonant narratives, while tailoring hedonic and meaning framings to the cultural profiles of target markets. Full article

To facilitate emotionally adaptive built environments, this study investigates how spatial color design interacts with individual personality traits to shape emotional reactions in virtual reality (VR). Based on the stimulus–organism–response (S-O-R) framework, the research explores these dynamics through a rigorous experimental design. Sixty-three participants were exposed to 24 indoor scenes systematically manipulated in three dimensions: color combination, color shape, and area proportion. Multidimensional responses were recorded using self-reported SAM scales (pleasure, arousal, dominance), liking, and the objective physiological indicator skin conductance level (Z-SCL). The data were analyzed using linear mixed models (LMM) to account for repeated measures. The results reveal a functional hierarchy of design elements: area proportion emerged as the dominant structural variable, significantly driving the sense of control (dominance) and physiological arousal, whereas color and shape primarily influenced esthetic hedonic valence. Crucially, the study provides empirical evidence that personality traits act as cognitive filters. For instance, conscientiousness significantly moderated the effect of area proportion on dominance, reflecting a trait-specific need for spatial order. Exploratory analysis further identified that neuroticism acts as a “physiological sentinel” (heightened Z-SCL sensitivity to large-scale stimuli), while extraversion manifests as a “sensation seeker.” These findings suggest that color space cognition is not universal, advocating for more refined, personality-aware design strategies to enhance user comfort and psychological well-being. Full article

Pneumatic actuators are promising for wearable tactile interfaces, yet human perception of pneumatic stimulation is not well understood. This study examined how pressure and frequency affect tactile perception and emotional responses through three experiments. Experiment 1 measured the minimum perceivable pressure and just noticeable difference (JND). The perceptual threshold remained stable across low-frequency stimuli, while both upward and downward JNDs increased with pressure and frequency, indicating reduced sensitivity under stronger or faster stimulation. Experiment 2 evaluated perceived tactile intensity and found pressure to be the dominant factor, with frequency also contributing significantly. Experiment 3 examined emotional responses using the PAD model. Pressure and frequency jointly affected Pleasure and Arousal but minimally influenced Dominance. Moderate pressure and mid-range frequency (50 kPa, 5 Hz) produced the most positive, alert states; high-pressure, high-frequency stimulation (≥75 kPa, 10 Hz) generated unpleasant high-arousal responses; and low-pressure, low-frequency input (25 kPa, 1 Hz) led to low-arousal, negative affective states. These results offer quantitative and emotional insights that can inform the design of more realistic and expressive pneumatic haptic interfaces. Full article

Across the globe, adolescents often grow up surrounded by cultural silence, taboo, or discomfort regarding conversations about sexuality, relationships, and power. The absence of timely, comprehensive, and honest conversations about sexuality, power dynamics, and sexual pleasure during adolescence can significantly impact young people’s mental health and well-being. This commentary paper examines the detrimental effects of the “unspoken curriculum” surrounding sexuality, characterized by silence, misinformation, and avoidance, on the psychological development of young individuals. It examines how the lack of open dialogue contributes to anxiety, shame, distorted perceptions of sexuality, and vulnerability to exploitation. Furthermore, this article underscores the critical need for parents, educators, and society at large to engage in transparent conversations that encompass not only the biological aspects of sexuality but also the essential elements of power, consent, sexual pleasure, healthy relationships, and emotional literacy. By drawing on global research, this paper reveals both common challenges and unique regional barriers, advocating for culturally responsive yet universally rights-based solutions. By fostering open communication and providing accurate, age-appropriate information, we can empower young people to navigate their sexual development with confidence, respect, and a positive sense of self, thereby safeguarding their mental health and fostering healthier societal attitudes towards sexuality. Full article