Search Results (3,570)

Background: Mental health problems are highly prevalent among university students in Saudi Arabia; however, help-seeking behaviors remain low despite the availability of mental health services. There is limited evidence regarding students’ intentions to seek help and preferred sources of support, especially formal or informal sources. This study examined help-seeking intentions for mental health problems among university students. Methods: This cross-sectional descriptive study was conducted using an online self-administered questionnaire. Participants were 248 undergraduate students from various Riyadh universities. Help-seeking intentions were assessed using the General Help-Seeking Questionnaire. SPSS software was used to perform independent t-tests to assess differences in preferred sources across demographic groups, and Pearson’s correlation analyses were conducted to examine relationships between preferred sources and demographic variables. Multiple linear regression analyses were conducted to examine demographic and academic predictors of intentions to seek help from formal and informal sources. Results: Students demonstrated a low overall propensity to seek help. Online sources were the most preferred help-seeking option, followed by mothers, friends, and general physicians, whereas faculty, relatives, and religious persons were the least preferred. Preferred help-seeking sources differed by gender. Seeking help from mental health specialists was positively correlated with age and grade point average. Additionally, the regression analysis for formal help-seeking was significant, explaining 8.4% of the variance, with gender as the only significant predictor. Conclusions: These findings suggest the need for targeted interventions to improve students’ help-seeking behaviors. Universities should prioritize mental health literacy initiatives, stigma reduction strategies, and accessible support pathways, particularly by integrating digital and hybrid services and enhancing the role of faculty and institutional support systems in promoting timely and appropriate help-seeking. Full article

Background: In Spain, the number of patients anticoagulated with vitamin K antagonists (VKAs) is high. Among them, poor adherence is common, which may be justified by a low level of knowledge, and could affect their quality of life. We analyzed treatment adherence, health-related quality of life, and knowledge level about treatment, and evaluated the possible influence of these factors on patients’ time in the therapeutic range while also studying potential differences between patients under routine monitoring or self-monitoring. Methodology: A cross-sectional descriptive study was conducted using three validated and cross-culturally adapted questionnaires to study therapeutic adherence, health-related quality of life, and knowledge level about VKA treatment in a sample of anticoagulated patients. Additionally, it was assessed whether they were self-monitoring or not; the Rosendaal Time in Therapeutic Range (TTRr) was also administered for each patient at the time of recruitment. Descriptive analysis of all variables was performed, and a logistic regression model was constructed to evaluate the possible interaction of variables. Results: Ninety-eight patients participated and were selected sequentially from those attending the oral anticoagulation clinic at Hospital Universitario Virgen de la Victoria in Malaga. Of these, 39 were men and 59 were women. The mean age of these participants was 60.62 years (SD 11.67). Sixty-six were under conventional monitoring and thirty-two followed the self-monitoring program. The DecaMIRT had a mean score of 39.22 (SD 8.57), the SF-12 mean score was 31.73 (SD 6.21), and the knowledge questionnaire’s was 14.2 (SD 2.6). The mean TTRr value was 63.88 (SD 22.99). Self-monitored patients showed better results in DECAMirt and knowledge. Discussion: Overall, patients included in the sample presented satisfactory values in these three questionnaires, which seems to indicate that this was a treatment-compliant group with a correct quality of life, and adequately informed about their treatment. Conclusions: The work of nurses responsible for these aspects appears crucial in achieving these results. We aim to extend this study by focusing on groups with poorer results to design specific activities that allow for improvement in care and, as much as possible, homogenize outcomes. For this purpose, we intend to use all available tools, including those derived from the use of health-oriented artificial intelligence. Full article

Background: Delirium is a frequent and serious complication in intensive care units (ICUs), associated with increased mortality, prolonged mechanical ventilation, extended length of stay, and long-term cognitive impairment. This study aimed to assess ICU nurses’ knowledge and practices regarding delirium management in Cyprus and to identify predictors of knowledge. Methods: A cross-sectional study was conducted among nurses working in adult ICUs in Cyprus. Data were collected using a structured self-administered questionnaire that included demographic characteristics, sedation and analgesia practices, and an adapted Delirium Knowledge Questionnaire incorporating ICU-specific items. Results: A total of 70 ICU nurses participated, most of whom were female (60%) with a mean ICU experience of 5.1 years. Only 27.1% reported daily delirium screening, although 65.2% perceived delirium as frequent. Sedation protocols were reported by 34.3%, sedation scales were used by 44.3%, and daily sedation interruption by 61.4%. Only 15.7% had received formal delirium training, while 87.1% expressed the need for further education. Knowledge scores were moderate to high (68.5–84.0%), with higher scores among nurses with prior training and female nurses (p = 0.003). Hospital type was associated with sedation practices, with greater use of sedation scales in public ICUs (p < 0.001) and propofol more commonly used as first-line sedation compared with midazolam in private ICUs (p = 0.018). Conclusions: Although ICU nurses demonstrated moderate knowledge of delirium, systematic screening and protocolized management remain suboptimal. Structured education and standardized implementation strategies are required to strengthen patient safety in critical care settings. Full article

The internet is increasingly embedded in daily life; however, excessive use may lead to internet addiction, adversely affecting health and academic performance. This study aimed to determine the prevalence of internet addiction and its association with depressive symptoms among pharmacy students at Mahasarakham University. A cross-sectional survey was conducted between 1 October and 31 December 2025 among undergraduate pharmacy students (years 1–6) aged ≥18 years who provided voluntary consent. Data were collected via street-based and online self-administered questionnaires validated for content and reliability. Descriptive and inferential statistics were applied, and binary logistic regression was used to identify associated factors. Among 396 participants, the mean internet use was 9 h 43 min per day. The prevalence of excessive use (risk) was 75.95%, while 17.47% met criteria for internet addiction. High to very high psychological problems were significantly associated with internet addiction (aOR = 3.89; 95% CI: 1.70–8.89; p = 0.001). Risk of depression (2Q) was also significantly associated (aOR = 2.67; 95% CI: 1.39–5.15; p = 0.003). Internet addiction is strongly associated with mental health factors, highlighting the need for targeted prevention and institutional mental health interventions. Full article

Background: Probiotics have emerged as an effective therapeutic intervention in critically ill patients receiving enteral nutrition, yet their use remains inconsistent across intensive care units (ICUs). Understanding knowledge, attitudes, and practices (KAP) among healthcare professionals (HCPs) is essential for optimizing evidence-based probiotic administration in enteral nutrition, identifying perceived implementation barriers, and examining associations between KAP scores and study variables. Methods: A multicenter, cross-sectional online survey was administered to ICU physicians, nurses, clinical dietitians, pharmacists, and respiratory therapists. Participants completed a self-reported questionnaire assessing their knowledge of probiotic mechanisms, indications, and safety; attitudes toward probiotic therapy; and current practices in probiotic administration during enteral feeding. Results: A total of 935 ICU HCPs participated. Overall knowledge was insufficient, with only 33.2% achieving high knowledge scores (mean: 12.4/18 points), whereas attitudes were moderately favorable, with 35.5% demonstrating positive attitudes (mean: 23.9/30 points). A majority of respondents (58.7%) reported recommending or prescribing probiotics, most frequently clinical dietitians (84.5%). KAP varied significantly by profession, age group, and years of experience (p < 0.01). The most reported barriers were a lack of information about available probiotic products (73.2%), limited knowledge (41.2%), limited availability of clinically proven products (37.8%), and cost concerns (29.7%). Conclusions: Although ICU HCPs show interest and cautious acceptance of probiotics in enteral feeding, knowledge gaps, attitudinal variability, and practice inconsistencies persist across disciplines. These findings highlight the critical need for targeted, multidisciplinary educational interventions and the development of standardized, evidence-based institutional protocols to optimize probiotic use and improve patient outcomes. Full article

Background: H007 is a novel selective AMP-activated protein kinase (AMPK) activator with demonstrated efficacy against hyperlipidemia; however, its oral bioavailability is limited by poor solubility and low intestinal permeability. This study aimed to develop a self-microemulsifying drug delivery system (SMEDDS) incorporating a H007–phospholipid complex (H007-PC) to improve both solubility and intestinal permeability. Methods: H007-PC-SME was prepared by integrating phospholipid complexes into an SMEDDS formulation. The formulation was optimized on the basis of emulsification efficiency, droplet size, and zeta potential, and was then evaluated for stability, in vitro drug release, and cellular uptake. Different H007 formulations were orally administered to golden hamsters to assess bioavailability, and a chylomicron flow blockade hamster model was used to evaluate lymphatic transport. Results: The optimized H007-PC-SME showed good stability, rapid self-emulsification, and improved drug solubility. Relative to ordinary H007 tablets, the relative bioavailability of H007-SME and H007-PC-SME was 376.65% and 464.62%, respectively, when calculated from M1 exposure, and 314.01% and 463.55%, respectively, when calculated from MP exposure. When evaluated in a cycloheximide model, H007-SME and H007-PC-SME increased the lymphatic transport fraction of M1 from approximately 0% to 22% and 54%, and that of MP from approximately 1% to 28% and 52% compared with ordinary H007 tablets. Conclusion: H007-PC-SME combines stable phospholipid complex formation with strong self-emulsification performance and effective drug dissolution. By overcoming the intrinsic limitations of the H007 active pharmaceutical ingredient and ordinary H007 tablets, this formulation improves membrane permeability and lymphatic transport, thereby enhancing oral bioavailability and therapeutic potential. The formulation shows good stability and acceptable in vitro biocompatibility under the tested conditions. The preparation process is straightforward, reproducible, and suitable for further pharmaceutical development. Full article

Background/Objectives: Cognitive dysfunction, or “brain fog”, following COVID-19 viral infection is strongly associated with diminished work capacity which disproportionality affects working-age adults. This study examined an existing method of cognitive rehabilitation training applied to adults struggling with workplace functioning and self-efficacy due to post-COVID-19 brain fog. Methods: Nine adults with post-COVID-19 cognitive dysfunction participated in this single arm pilot trial of a severity-adaptive cognitive training program. The participants completed 45–90 h of clinician-delivered cognitive training exercises delivered remotely in 60- to 90-min sessions, two or three times per week. The primary outcome measure was overall workplace self-efficacy with subskills of perceived workplace functioning, perception of cognitive functioning, and perception of home functioning assessed through pre and post surveys and qualitative interviews. The secondary outcome was cognitive function operationalized by an IQ score administered before and after the intervention. Results: The participants achieved significant improvements in workplace self-efficacy and cognition following cognitive training. The main qualitative themes of self-reported improvements were in executive function, health and energy, daily living activities, productivity, and socioemotional functioning. A cross-case synthesis of pre-intervention struggles, and post-intervention improvements revealed subthemes at work or school in cognitive processing and comprehension, memory, executive function, fatigue, emotional distress, confidence in work or academics, and work/academic performance impairment. As a group, the mean gain in IQ score was 10.5 points. Conclusions: This study adds to the growing body of literature examining the possibility of using cognitive rehabilitation for post-COVID-19 cognitive dysfunction impacting workplace self-efficacy and work functioning. Full article

Background/Objectives: Knowledge of plant-based diets is gaining increasing significance in adolescents due to the growing popularity of vegetarian and vegan dietary patterns. To date, there has been limited research examining the level of awareness and understanding of these diets among secondary school students, as well as the factors influencing their knowledge. The aim of the study was to determine the prevalence of plant-based diets and to assess knowledge regarding these dietary patterns among high school students, as well as to identify factors associated with both diet adherence and achieving sufficient nutritional knowledge. Methods: A cross-sectional study was conducted among 341 high school students. Data were collected using a self-administered paper questionnaire that included demographic information, self-reported body weight and height, adherence to plant-based diets, and knowledge of vegetarian and vegan nutrition. Nutritional knowledge was assessed using a structured 19-item questionnaire (25 scorable items) and verified for reliability (test–retest, Krippendorff’s alpha = 0.88). Based on a 25-point scale, a score of >60% (16–25 points) was categorized as ‘sufficient’ knowledge. Statistical analyses included the chi-square test, Mann–Whitney and Kruskal–Wallis non-parametric tests, and multivariable logistic regression to estimate adjusted odds ratios (aOR) for factors associated with sufficient knowledge. Results: The prevalence of plant-based diets in the study group was 16.1% (n = 55), with a significantly higher frequency observed among female students and those with sufficient nutritional knowledge. The majority of students (81.2%) achieved sufficient knowledge. Higher scores were observed among female students, those in higher grade levels, and those individuals adhering to plant-based diets (p < 0.05). Multivariate regression analysis indicated that male sex (aOR = 0.38 compared to females), higher grade level (aOR = 3.66 for grade 3 vs. grade 1; aOR = 3.62 for grade 4 vs. grade 1), residence in a rural area (aOR = 0.50), and non-adherence to a plant-based diet (aOR = 0.32) were independently associated with sufficient knowledge. Conclusions: The majority of high school students demonstrate sufficient knowledge regarding plant-based diets, with significant variations associated with sex, grade level, place of residence, and experience with plant-based diets. These findings underscore the need for targeted educational interventions, particularly among male students, those in lower grade levels, and individuals residing in rural areas. Full article

Background: Tension-type headache (TTH) is the most prevalent primary headache disorder worldwide and represents a major source of disability related to chronic pain. Despite its high prevalence, uncertainty remains regarding optimal conservative management strategies, and limited evidence is available on how physiotherapists apply existing recommendations in routine clinical practice. Objective: The objective was to explore physiotherapists’ perceptions, clinical experiences, and treatment strategies in the management of tension-type headache, with particular emphasis on commonly used interventions, clinical decision-making, and characteristics of physiotherapy care. Methods: A cross-sectional survey study was conducted using a self-administered online survey developed in accordance with the CHERRIES guidelines. One hundred Spanish physiotherapists with clinical experience in treating patients with TTH participated. Quantitative data were analyzed descriptively, while open-ended responses were examined using inductive thematic analysis following the framework proposed by Braun and Clarke. Results: Manual therapy was the most frequently reported intervention (96%), followed by therapeutic exercise (61%) and invasive techniques, primarily dry needling (48%). The suboccipital and upper cervical regions were consistently identified as primary therapeutic targets, reflecting a predominant craniocervical treatment focus. Most respondents reported individualized treatment plans, typically delivered in weekly sessions lasting 45–60 min, with expected clinical improvement within 4–6 weeks. Pain education strategies were reported infrequently. Considerable variability was observed in the selection and combination of therapeutic techniques. Conclusions: Physiotherapists managing tension-type headache commonly adopt a multimodal approach, largely centered on manual and tissue-focused interventions. Although many reported practices are aligned with current evidence, the substantial heterogeneity observed and the limited integration of biopsychosocial strategies highlight the need for consensus-based guidelines and further research addressing real-world clinical effectiveness. Full article

Indoor air quality (IAQ) is a critical determinant of environmental health, yet awareness among young adults in rapidly urbanizing regions remains unclear. This study assessed knowledge, awareness, and practices related to IAQ among university students in Ras Al Khaimah, United Arab Emirates, and compared outcomes between medical and non-medical disciplines, while examining associations between knowledge levels and IAQ-related behaviors. A cross-sectional survey was conducted among 386 undergraduate students from three universities using a pre-validated, self-administered questionnaire. Overall, 52.1% of participants had heard of IAQ. Appropriate knowledge (≥60%) was demonstrated by 26.9% of students, and only 3.4% achieved high knowledge (≥80%). Medical students were significantly more likely than non-medical students to demonstrate appropriate knowledge (38.1% vs. 18.3%; p = 0.001), and female students scored higher than males (32.8% vs. 20.3%; p = 0.006). Awareness of IAQ guidelines was limited (65.3% unaware). Although 85.2% reported engaging in at least one IAQ-improving behavior, practices were mainly limited to ventilation and avoidance of indoor smoking. Higher knowledge levels were significantly associated with protective behaviors (p < 0.001). These findings indicate limited objective knowledge despite moderate recognition of IAQ importance, underscoring the need for structured educational interventions to enhance environmental health literacy. Full article

Background/Objectives: This study aimed to assess public stigma toward people with mental health problems and to examine the association between stigma and socioeconomic characteristics, personal mental health history, and contact with individuals with mental health problems. Methods: This observational, descriptive, and cross-sectional study was conducted among the general population in Spain using a sample of 404 participants, the majority of whom were women (71%), with a median age of 38 years (IQR = 26–49); most participants (86.4%) lived in urban areas. The participants completed a self-administered online questionnaire that explored socioeconomic variables and the Community Attitudes towards Mental Illness Scale (CAMI-S, Spanish version). Non-parametric tests (Mann–Whitney U, Kruskal–Wallis, and Spearman correlation), multiple linear regression, and statistical power analyses were performed. Results: The mean CAMI-S total score was 84.89 (SD = 11.122) out of 100, indicating relatively favourable attitudes toward people with mental health problems. Statistically significant associations (p-value ≤ 0.05) were found between CAMI-S scores and variables such as gender, age, place of residence, educational level, mental health disorder, and close contact with someone with mental health disorders. The regression model revealed four significant predictors of lower stigma: identifying as female (β = 2.523; p = 0.037), having a medium or higher educational level (β = 5.061; p = 0.002), experiencing a mental health diagnosis (β = 4.535; p = 0.014), and close contact (β = 4.183; p < 0.001). Conclusions: Social stigma toward people with mental health problems in Spain appears to be generally low, reflecting positive attitudes toward community integration. Being female, having higher education, and personal or close contact with mental health problems are associated with lower stigma. Full article

Background: Art therapy is an experiential, non-threatening intervention, used especially with children. The current study aimed to explore the effect of integrative art therapy on the psychological well-being (mental health and self-perception) of pediatric cancer patients. Methods: Using a single-group pre–post research design, each therapy session was individually administered to participants for approximately 45 min. Fourteen participants (Boys = 9, Girls = 5) were recruited from the inpatient oncology unit at Shaukat Khanum Memorial Cancer Hospital & Research Centre over two months. The age range was from 5 years to 13 years (M = 7.95; SD = 1.65). Mental health, including physical and emotional symptoms associated with cancer, was assessed using the Edmonton Symptom Assessment Scale-Revised, while self-perception was measured with the House Tree Person projective drawing test. Results: The integrative art therapy model significantly improved positive self-image (F = 16.77, p < 0.01) and reduced negative self-image (F = 99.11, p < 0.01) and mental health problems from the baseline to the second and third phases (F = 19.50, p < 0.01). Conclusions: This integrative approach demonstrates its potential as an effective method to enhance self-perception, alleviate mental health challenges, and improve overall quality of life. Full article

Distance higher education places increased demands on instructors’ emotional and communicative competencies, as teaching and interaction occur in technologically mediated environments. This study examines the role of teachers’ emotional intelligence, empathy, and communication-related competencies in distance higher education, with particular emphasis on emotional management and instructor well-being. A quantitative research design was employed, using self-report instruments administered to higher education instructors engaged in distance teaching. Non-parametric statistical analyses revealed strong internal coherence among emotional intelligence dimensions and a pattern of functional empathy characterized by high perspective taking and low personal distress. Self-perceived communication was found to be consistent across interactional contexts, indicating a stable communicative disposition. Most notably, emotional management emerged as a key factor associated with positive work-related emotions among instructors. The findings highlight emotional management as a critical mechanism supporting both teaching effectiveness and emotional sustainability in online learning environments. The study contributes to the literature by integrating emotional intelligence, empathy, and self-perceived communication within a unified empirical framework and offers practical implications for professional development and institutional support in distance higher education. Full article

Background/Objectives: Cancer places emotional and psychosocial demands on healthcare professionals; therefore, this study aimed to examine sociodemographic and psychosocial determinants, including emotional competence, empathy, and stigma, and to assess their interrelationships with mental health, attitudes towards cancer, and cancer-related stigma among healthcare professionals involved in cancer care. Methods: This cross-sectional study was conducted from July 2025 to January 2026 via a self-administered questionnaire among 264 hospital and primary care healthcare professionals in Osijek, Croatia (69 men and 195 women; median age 37 years, IQR 31–47, age range 20–64 years), all directly involved in providing healthcare to cancer patients in Croatia. Results: Significant differences were observed by gender, age, occupation, and workplace. Men were more frequently physicians and had higher education levels and socioeconomic status, whereas women achieved higher scores in emotional competence and empathy. Physicians more often had shorter overall work experience and reported greater perceived controllability of cancer. Age-related differences were found in perceived discrimination, stigma, and controllability of cancer. Primary healthcare professionals showed a higher level of empathy and proactivity and a lower perception of cancer as an incurable disease. Higher empathy was associated with lower stigma, while negative emotions and greater proactivity were associated with higher stigma, and emotional competence was a strong predictor of empathy. Conclusions: The study identified notable sociodemographic and psychosocial differences among healthcare professionals. Emotional competence strongly predicted empathy, which was inversely associated with cancer-related stigma, suggesting potential targets for interventions to improve attitudes towards cancer care. Furthermore, women exhibited significantly higher emotional competence and empathy than men, highlighting the importance of incorporating gender-specific perspectives into developing educational and support strategies for cancer healthcare professionals. Full article

Background: Low back pain is a common musculoskeletal complaint among postpartum women due to physical changes that occur during pregnancy and delivery, which can lead to different disability levels. Therefore, the aim of this study was to evaluate the disability levels and associated factors of postpartum women within the first year after childbirth. Methods: A descriptive cross-sectional study design was used to gather data from post-partum women between 6 weeks and 12 months after childbirth using an online self-administered questionnaire. This questionnaire included demographic variables, the Nordic Musculoskeletal Symptoms Questionnaire, the Pain Intensity Numeric Rating Scale, and a back disability questionnaire. Results: Among 400 postpartum mothers, 71% reported low back pain, with 51.1% experiencing mild disability. Logistic regression showed significant predictors of disability, including cesarean delivery (6.49 times higher likelihood), having 4–5 children (1.98 times), and more than six children (3.45 times). Breastfeeding increased disability risk (2.44 times), while mixed feeding reduced it (0.52 times). The model explained 49.8% of disability variance (p < 0.001). Conclusions: Disability is a common problem among postpartum women, highlighting the importance of healthcare providers addressing these challenges. Full article