Search Results (7,479)

Background/Objectives: Research across multiple disciplines has explored how nutrition is shaped by social isolation and feelings of loneliness, especially in the elderly population. Evidence from neuroscience highlights that loneliness may alter eating patterns, encouraging emotional eating or other compensatory food behaviors. Conversely, isolation from social contexts is often linked to a reduced variety of nutrient intake. This study set out to examine how psychosocial aspects, particularly social connectedness and feeling alone, relate to adherence to the Mediterranean diet among older adults residing in Sicily, southern Italy. Methods: Dietary habits of 883 adults were collected through food frequency questionnaires and assessed for adherence to the Mediterranean diet. Loneliness was measured through a targeted question from a standardized tool designed to capture depressive symptoms. Direct questions asked whether participants were engaged in social networks, such as family, friends and neighborhoods, or religious communities, in order to assess objective aloneness. Logistic regression analyses were performed to assess associations between variables of interest. Results: After accounting for potential confounders, both loneliness and aloneness showed an association with stronger adherence to the Mediterranean diet. Specifically, individuals experiencing loneliness and aloneness were less likely to have high adherence to the Mediterranean diet (OR = 0.28, 95% CI: 0.15, 0.51, and OR = 0.26, 95% CI: 0.12, 0.54, respectively). Conclusions: These findings underscore the importance of fostering social engagement among older populations, who may particularly benefit from maintaining active social ties to support healthier eating behaviors. Full article

Mind–body practices integrating movement and meditation, such as Tai Chi and Aikido, have been proposed to influence the gut–brain axis through combined physiological and psychological pathways. However, evidence regarding their association with gut microbiota composition remains limited. This study explored gut microbiota diversity and taxonomic profiles in regular practitioners of Tai Chi and Aikido across different levels of meditation depth. Forty-two adults practicing Tai Chi or Aikido provided fecal samples for 16S rRNA sequencing, and meditation depth was assessed using the Meditation Depth Questionnaire (MEDEQ). Alpha diversity did not differ significantly between groups, although a descriptive trend toward higher diversity with increasing meditation depth was observed. Beta-diversity analyses suggested compositional differences associated with meditation level (ANOSIM R = 0.191, p = 0.035), along with an exploratory interaction signal between practice type and meditation depth (ANOSIM R = 0.296, p = 0.001). Taxonomic profiling highlighted distinct microbial patterns associated with both practice type and meditation depth. Short-chain fatty acid-associated genera, including Faecalibacterium and Roseburia, were relatively more abundant in Aikido practitioners with higher meditation scores, whereas Tai Chi practitioners showed higher relative abundances of Prevotella and Collinsella. Overall, these findings indicate that meditative movement practices are associated with distinct gut microbiota compositional patterns within this cohort. Given the exploratory and cross-sectional design, these results should be interpreted as hypothesis-generating. Future longitudinal studies incorporating functional and clinical outcomes are needed to clarify underlying mechanisms. Full article

Background/Objectives: This study examines prisoners’ quality of life by investigating which aspects of imprisonment conditions—including perceptions of the physical environment—best predict overall satisfaction with the prison (OSP). A key question is whether the staff–prisoner relationship is the single most important dimension, which is frequently emphasized in the literature but has scarcely been tested quantitatively. Methods: Data stemmed from a survey conducted in three closed prisons in Norway in 2022 (response rate: 63%, n = 163). The dependent variable was assessed by asking: “Generally speaking, on a scale from 1 to 10, how satisfied are you with this prison?” This outcome was regressed on seven subscales from the Prison Climate Questionnaire and four single-item measures of the physical environment that have been shown to influence health and well-being. Results: As expected, the quality of staff–prisoner relationships had a unique statistical impact on OSP. Ratings of the outdoor areas and the view from the cell were about equally strong predictors. No statistically independent effects were observed for perceived quality of relationships with fellow prisoners, reintegration measures, receiving visits, personal safety, autonomy, access to natural light and a global rating of the prison building (noise, temperature, layout, etc.). Conclusions: This study further emphasizes the importance of staff–prisoner relationships in shaping prisoners’ experiences and perceptions of imprisonment. Moreover, it provides new insights into the significance of the physical environment for prisoners’ overall perceptions of prison quality, which is likely to affect their mental health and well-being. These findings have potential implications for the design and siting of new correctional facilities and for improving the quality of existing ones. Full article

Background: Seaweed consumption is a major source of dietary iodine in Korea, particularly among lactating women during the postpartum period. This practice raises concerns regarding short-term iodine excess and its potential effects on thyroid function. We examined the prevalence of thyroid disease and hormone abnormalities 1 year after childbirth among postpartum women with varying levels of seaweed-derived iodine intake. Methods: Between 17 July 2021 and 10 December 2021, 147 postpartum women were enrolled within two weeks after childbirth at postpartum care centers in Korea, which provide structured residential maternal and infant care, including standardized meals, during the early postpartum period. Participants provided informed consent and completed baseline questionnaires and dietary assessments. Iodine intake, including seaweed soup consumption during the 8-week postpartum period, and infant growth indicators were evaluated. A total of 81 participants completed the 1-year follow-up. At follow-up, dietary records, thyroid disease prevalence, hormone levels, urinary iodine concentration, and infant growth indicators were assessed. Results: At 1 year, none of the 81 participants had thyroid disease. The prevalence of abnormal triiodothyronine (T3), free thyroxine (FT4), and thyroid-stimulating hormone (TSH) was analyzed by iodine-intake quartiles, revealing no significant differences (T3: p = 0.4175; FT4: p = 0.1591; TSH: p = 0.9344). Conclusions: These findings suggest that the evidence regarding an association between short-term postpartum iodine intake and thyroid outcomes one year after childbirth remains inconclusive. Owing to the limited sample size, high attrition, and observational design, the study may have been underpowered to detect clinically meaningful differences, and potential effects cannot be excluded. Therefore, these results should be interpreted cautiously, and larger, well-designed longitudinal studies with repeated thyroid assessments are needed to better clarify the long-term implications of postpartum iodine exposure. Full article

Background: Heart failure (HF) affects not only the cardiovascular system but also mental health. The majority of patients with HF experience symptoms of mental disorders, such as depression, which are proportionally related to the severity of HF. This results in a significant comorbidity of HF, which might be associated with poor clinical outcomes, including decreased health-related quality of life (HRQOL). In Türkiye, data concerning the extent of this complication among outpatients with HF are limited. Therefore, the aim of this study was to assess the prevalence of depression in outpatients with HF and consequently the HRQOL; the secondary aim was to identify the related factors contributing to the incidence of depression and HRQOL in patients with HF in Bursa, Türkiye. Methods: An outpatient, descriptive, observational, cross-sectional study was conducted in a cardiology outpatient clinic in Bursa Province, Türkiye, between September and December 2022. The study was conducted via a validated questionnaire consisting of four sections. Depression was measured using the Beck Depression Inventory (BDI) scale, and the HRQOL of HF patients was evaluated using the Turkish version of the Minnesota Living with HF Questionnaire (MLHFQ). Simple linear regression and multiple linear regression analyses were used to determine the effects of variables. Limitations of the study include its design as a descriptive, observational, cross-sectional study from a single center that relies on self-reported data. Results: A total of 166 patients were enrolled, with a mean age of 64.96 ± 11.33 years. Nearly half of the participants had moderate or severe depression (33.1% and 15.7%, respectively). The mean MLHFQ score of the study participants was 54.15 ± 18.20. Patients suffering from severe depression had the lowest HRQOL (71.46 ± 12.4). There was a significant increase in depression level, and a decrease in HRQOL in patients with a duration of HF diagnosis of more than 3 years (p = 0.001), a number of HF hospitalizations (p = 0.001), and those diagnosed with NYHA class IV (p = 0.001). Multiple linear regression analysis revealed a significant relationship between the duration of HF disease, number of comorbidities, number of medications used, and BDI [(0.30 < r: 0.31/0.43/0.43 ≤ 0.70), respectively]. The simple linear regression analysis revealed that the BDI has positive and significant explanatory power for the MLHFQ (F: 168.29; R²: 0.51; t: 12.97; p < 0.001), and 51% of the change in the MLHFQ score is recorded by the BDI (R²: 0.51). Conclusions: The results of this study revealed that comorbid depression and HRQOL are closely related. This was observed in nearly half of the patients with HF, who had comorbid moderate and severe depression, which is associated with poor HRQOL. The factors associated with high depression and poor HRQOL were the duration of HF diagnosis of more than 3 years, an increased number of HF hospitalizations, polypharmacy, and NYHA class IV diagnoses. Full article

The present study explores the relationship between the systemic approach, educational innovation, and the use of digital technologies in higher education, with an emphasis on military academies. The aim of the research is to shed light on how systemic thinking can support strategic planning, the quality of education, and the effective integration of innovative practices, such as artificial intelligence, information and communication technologies, and virtual reality. The methodology was based on quantitative research using a questionnaire, which was distributed to 452 members of the Hellenic Non-Commissioned Officers Academy educational community (teaching staff, cadets, and recent graduates). Data analysis showed that the adoption of a systemic approach is positively associated with the readiness of trainers, including both instructors and future professionals (cadets), to support and implement educational innovations. Furthermore, it was found that the clarity of educational objectives and the alignment of critical elements of the educational system (resources, technology, instructors, trainees, and processes) significantly reinforce the intention to adopt innovative practices. The findings also show that educators’ positive perceptions of artificial intelligence and virtual/augmented reality are associated with a higher appreciation of learning benefits, such as improved performance, trainee satisfaction, and collaboration. In contrast, demographic and professional factors have a limited effect on attitudes toward innovation. Overall, findings indicated that innovation in military academies is not limited to the technological dimension, but requires a holistic, systemic approach that integrates organizational, pedagogical, and strategic parameters. The study contributes both theoretically and practically, providing empirical evidence for the role of systemic thinking in the design and implementation of innovative educational policies in military and broader academic education. Full article

With the increasing competition in elite sports, pre-competition anxiety has become increasingly prevalent among high-level competitive athletes, and high levels of such anxiety may impair sports performance and threaten athletes’ psychological health. Traditional psychological interventions (e.g., cognitive-behavioral therapy) are often poorly accepted and costly; however, pre-competition anxiety in these athletes may be alleviated through multiple pathways of traditional mind–body exercises like Tai Chi. Yet, the psychological mechanism by which mind–body exercises such as Tai Chi training influence pre-competition anxiety remains insufficiently explored, particularly the chain-mediating effect of the “flow experience → mental toughness” pathway. This study thus aimed to investigate the impact of Tai Chi training on pre-competition anxiety in high-level competitive athletes and verify the chain-mediating role of the “flow experience → mental toughness” pathway, thereby providing a theoretical basis and practical reference for sports psychology interventions. Using a randomized controlled experimental design, 86 high-level competitive athletes were randomly divided into an experimental group (n = 43) and a control group (n = 43). The experimental group received standardized Tai Chi training for 8 weeks, while the control group maintained their regular training regimen. Data were collected at baseline, week 4, and week 8 of the intervention using the Competition State Anxiety Inventory-2 (CSAI-2), Flow State Scale-2 (FSS-2), and Sport Mental Toughness Questionnaire (SMTQ), and chain-mediating effects were tested via hierarchical regression analysis and the bootstrap method with 5000 resamples. The results indicated that Tai Chi training could reduce pre-competition anxiety levels (β = −0.30, p < 0.5), and both flow experience (β = 0.38, p < 0.5) and mental toughness (β = 0.21, p < 0.5) exerted significant mediating effects. The chain mediation model further revealed that Tai Chi training alleviated pre-competition anxiety by enhancing flow experience and improving mental toughness sequentially (β = 0.01, 95% CI [0.00, 0.03]), accounting for 78.9% of the total mediated effect. In conclusion, Tai Chi training is associated with reduced pre-competition anxiety in high-level competitive athletes, and this relationship is statistically mediated by the sequential pathway of flow experience and mental toughness. These findings offer a new theoretical basis and practical direction for mind–body interventions in sports psychology. It should be noted that future research could further optimize and refine the intervention protocol, and explore the underlying mechanism of mind–body interventions at the neurobiological level. Full article

Urban noise and soundscape assessment is critical for sustainable, human-centered city planning. A comprehensive overview of key standards is essential to ensure consistent measurements, enable cross-study comparisons, and support practical applications. This review examines standards from the American National Standards Institute/Acoustical Society of America (ANSI/ASA), ASTM International, and the International Organization for Standardization (ISO), highlighting their principles, methodologies, and roles in evaluating urban acoustic environments. It discusses how these standards facilitate accurate noise quantification, capture human perceptual responses, and guide soundscape design and management across occupational, community, and experimental settings. Standardized questionnaires, rating scales, and perceptual frameworks are also reviewed. Finally, this paper identifies gaps in current guidance, including limited approaches to continuous monitoring, cultural adaptation, multisensory interactions, and integration with urban planning. Full article

This study diagnoses the level and profile of university lecturers’ digital competence at a Chilean higher education institution, drawing on the DigCompEdu and OpenEdu frameworks. A non-experimental correlational design was used, based on a self-perception questionnaire adapted from the DigCompEdu Check-In tool and administered to 569 lecturers through the Qualtrics platform. The instrument underwent external expert validation and demonstrated excellent internal consistency (Cronbach’s α = 0.96). Results indicate that 44% of lecturers position themselves at the “Integrator” level, 22% at the “Explorer” level, and 19% at the “Expert” level, with three clearly differentiated competence profiles. These findings informed the development of a structured training programme centred on three components: the pedagogical use of digital technologies, the incorporation of open educational practices aligned with OpenEdu, and the strengthening of students’ digital competence. The programme includes modular workshops, mentoring led by high-competence lecturers, and the creation of open educational resources. Overall, the study provides empirical evidence to guide institutional policies and to foster a reflective, ethical, and pedagogically grounded integration of digital technologies in university teaching. Full article

Digital twin (DT) technology is recognized for its transformative potential to enhance efficiency in the construction process. However, the full potential of DT in construction practices remains largely unrealised. Moreover, few studies explore how DT success factors affect efficiency improvement (EI), energy optimization (EO), and cost control (CC) in the context of economic strength (ES). The study applied a hybrid research method to examine the impact of key DT success factors on EI, EO, and CC under the moderation of ES. After a critical literature review, five key DT success factors were identified. Then, 490 valid questionnaires were analyzed with the Partial Least Squares Structural Equation Model (PLS-SEM) to assess how success factors affect DT effectiveness. This is complemented using extreme gradient boosting (XGBoost) to assess prediction accuracy and understand which factors most influenced EI, EO, and CC. Research shows that ES exerts a significant positive influence on the relationships between most success factors and performance outcomes. High levels of ES enhance the contribution of success factors to performance in EI, EO, and CC. Resource management (RM) has a strong influence on EI and EO, but a weaker influence on CC; process optimization (PO) has the strongest influence on EO, a moderate influence on CC, and the weakest influence on EI; real-time monitoring (R-Tm) primarily affects EI; sustainable design (SD) has a comprehensive and significant regulatory effect on EI, EO, and CC; and predictive maintenance (PM) has a strong influence on both EI and CC. In practice, it offers practical guidance for implementing DT and supports policy and resource planning for building stakeholders. Full article

Background: Globally, stroke is a significant health problem and is considered one of the leading causes of mortality and permanent disability worldwide. Nurses are key stakeholders and integral members of the stroke care team, contributing to every stage of care. Objective: This study aimed to assess the effects of a nurse-led stroke training program on the knowledge, attitudes, and practices of registered nurses working in Berea primary health care facilities, Lesotho, before and after an educational intervention. Methods: To evaluate the effectiveness of the nurse-led intervention, this study used a pre-experimental one-group pretest–posttest design. Participants completed a structured questionnaire before the intervention to assess their baseline knowledge, attitudes, and practices related to stroke. Following the intervention, which consisted of educational sessions led by trained nurses, the same questionnaire was administered again to measure changes in participants’ knowledge, attitudes, and practices. Paired t-tests compared results. Results: A total of 34 registered nurses from 18 primary healthcare facilities participated in this pre- and post-intervention questionnaire study. When comparing knowledge, attitudes, and practices related to stroke before and after the educational intervention, the increase in correct response rates was statistically significant (p < 0.001). The training evaluation received positive feedback from the participants. Conclusions: Structured nurse-led educational interventions enhance nurses’ knowledge, attitudes, and practices in stroke care, leading to improved patient outcomes and stronger community-based prevention. These findings highlight the need to integrate continuous stroke education into nursing policies and primary health care practice. Full article

The Atlantic slave trade was one of the most significant and violent processes in global history, and the Iberian empires played a central role in its development. Yet in Spain and Portugal, the historical and public memory of slavery remains fragmented, producing silences that contrast with its historical magnitude. This study examines these silences through two complementary lenses: the academic preparation of future history teachers and the heritage narratives presented in Iberian museums, adopting a mixed-methods design. A total of 138 pre-service teachers from eight Spanish and Portuguese universities completed a questionnaire providing quantitative data to assess how the Atlantic slave trade was addressed in their university training and which didactic and heritage resources they consider most appropriate for teaching it. In parallel, exhibitions and institutional discourses were analysed in seven national and regional museums related to America, colonisation or maritime expansion, drawing on qualitative data from written interviews with museum professionals. The findings reveal limited curricular attention to the Atlantic slave trade, uneven valuation of heritage resources, and highly variable museum narratives. These results highlight the need for coordinated educational and heritage strategies that strengthen historical understanding, support democratic and intercultural competencies, and contribute to a more inclusive and critically informed public memory. Full article

Public schools often operate with shared devices, unstable connectivity, and limited support for digital tools, which can make feature-heavy platforms difficult to adopt and sustain. This study reports the first formal design iteration and formative evaluation of VLEPIC, a school-centred virtual learning environment (VLE) developed to support secondary English as a Foreign Language in a low-resource Ecuadorian public school. Using a design-based research approach with a convergent mixed-methods design, one Grade 10 cohort (n = 42; two intact classes) used VLEPIC for one month as a complement to regular lessons. Data were collected through questionnaires on perceived usability and motivation, platform usage logs, and open-ended feedback from students and the teacher; results were analysed descriptively and thematically and then integrated to inform design decisions. Students reported high perceived usability and strong motivational responses in attention, relevance, and satisfaction, while confidence was more heterogeneous. Usage logs indicated recurrent but uneven engagement, with distinct low-, medium-, and high-activity profiles. Qualitative feedback highlighted enjoyment and clarity alongside issues with progress tracking between missions, navigation on mobile devices, and task submission reliability. The main contribution is a set of empirically grounded, context-sensitive design principles linking concrete interface and task-design decisions to perceived usability, motivation, and real-world usage patterns in constrained school settings. Full article

(1) Background: Information and Communication Technology (ICT) integration in secondary education remains a critical challenge despite substantial investments in teacher training and infrastructure. This study investigated ICT certification levels, implementation patterns, and barriers among Greek secondary school teachers to understand the disconnect between policy aspirations and classroom realities. (2) Methods: A quantitative cross-sectional survey design was employed with 108 secondary teachers (61.1% female; mean age 47.3 years; 70.4% with >10 years’ experience) in the Prefecture of Ilia, Greece (response rate: 87.7%). Participants were permanent secondary school teachers employed in public schools during the 2021–2022 academic year; substitute teachers and private school staff were excluded. A three-section structured questionnaire was developed through literature review, expert validation (n = 3), and pilot testing (n = 10). Section A assessed demographics (5 items), Section B measured perceived barriers using a 7-item Likert scale, and Section C assessed implementation practices using a 10-item frequency scale (Cronbach’s α = 0.942). Data were analyzed using descriptive statistics, Mann–Whitney U tests, Kruskal–Wallis tests, and correlation analyses. (3) Results: While 74.1% of teachers held Level A certification, only 25.9% achieved Level B, with overall implementation remaining moderate (M = 2.92/5.00). Leadership support deficiency emerged as the primary barrier (76.9%), followed by inadequate technical support (74.1%). Younger teachers (24–35 years) demonstrated significantly higher ICT implementation than their older colleagues (56+ years), and teachers with less experience showed greater implementation frequency than veteran teachers—a finding that paradoxically challenges the “digital natives” assumption, given the barriers they face. Teachers preferred flexible Internet resources to formal educational software, indicating strategic adaptation to institutional constraints. Key limitations include convenience sampling, cross-sectional design, self-reported measures, and regional specificity. (4) Conclusions: The certification–implementation gap reveals that individual competencies cannot overcome unsupportive institutional environments. Effective ICT integration requires systemic transformation, encompassing leadership development, technical support, and structural reforms beyond traditional teacher training approaches. Full article

Museums are key institutions for cultural communication and public education, and their operating concept is shifting from exhibit-centered to experience-centered. As expectations for exhibition experience rise, museum fatigue has become a major constraint on visitors. Existing studies rely on questionnaires and other subjective measures, which makes it difficult to locate fatigue in specific spaces. At the same time, body pose detection and fatigue recognition techniques remain hard to apply in museums because of complex spatial configurations and dense visitor flows. Effective methods for quantifying and mitigating museum fatigue are still lacking. This study proposes a contact-free sensing scheme based on computer vision and builds a coupled analytical framework with three stages: Human Pose Estimation (HPE) for visitor posture detection, fatigue assessment, and fatigue mitigation. A Fatigue Index (FI) quantifies bodily fatigue. Applying this index to the exhibition space in both the baseline and adjusted configurations guides the formulation of mitigation strategies and shows a consistent reduction in FI, which indicates that the adopted measures are effective. The proposed approach establishes a complete frame from fatigue quantification to fatigue mitigation, supports evaluation of exhibition space design, and provides theoretical and methodological support for future improvements to museum experience. Full article