Search Results (231)

Background: Health-related quality of life (HRQoL) and job satisfaction are important indicators of nurses and physicians’ wellbeing and system sustainability, particularly under conditions of high clinical demand. Although organizational determinants of nurses and physicians’ wellbeing have received increasing attention, evidence regarding protocol-based work as a specific organizational characteristic remains limited. Methods: A multicenter cross-sectional study was conducted in 11 Greek public hospitals between September 2022 and March 2023. The study included 405 nurses and physicians (214 nurses and 191 physicians). HRQoL was assessed with the SF-36 and job satisfaction with the MSQ-Short Form. Protocol-based work was assessed using a single self-reported dichotomous item referring to the use of standardized clinical protocols during the pandemic. Associations between workplace characteristics and outcomes were examined using multivariable linear regression models. Results: Vitality (57.24 ± 17.61 among nurses and 53.92 ± 16.93 among physicians) and general health (56.58 ± 19.81 and 53.42 ± 16.32, respectively) were the lowest-scoring HRQoL dimensions in both professional groups. Compared with physicians, nurses reported higher mental health (62.52 vs. 58.11, p < 0.05), social functioning (67.17 vs. 58.96, p < 0.05), and overall job satisfaction (3.23 vs. 2.98, p < 0.01), whereas physicians scored higher in physical functioning (83.47, p < 0.05) and bodily pain (72.87, p < 0.05). Conclusions: Several organizational characteristics were associated with wellbeing among nurses and physicians. Protocol-based work showed consistent associations with better HRQoL and job satisfaction across multiple outcomes. However, longitudinal studies are needed to determine whether these associations reflect causal relationships. Full article

In South Africa, traditional healing and indigenous knowledge systems are formally recognised. However, persistent epistemological domination by the West is reflected in ambivalent attitudes towards culturally specific beliefs and practices. In South African Nguni languages such as isiZulu and isiXhosa, the word ukuthwasa refers to a call to do ancestral work or become a traditional healer. Such a call often manifests itself with symptoms that, from a Western perspective, could be interpreted as suggesting neurodivergence. In recent years, mental health attracted increasing public and media attention in South Africa, where up to one in three people is estimated to suffer from mental health issues. The people concerned are understood and represented in terms of either deficit (medical model) or deviation from the norm (social model). More recent and progressive understandings of disability foreground voice and experience as part of an affirmative model. We analyse purposively selected online texts (X, Instagram, and Facebook posts) concerning ukuthwasa. These provide evidence of social media (self) representations sourced from the accounts of traditional healers, hashtags related to specific incidents, and searches using keywords in English or isiXhosa. Through a qualitative content analysis, presented thematically, the present paper contributes with a critical and decolonial exploration of the representation of ukuthwasa as a culture-bound condition in digital media. Full article

Background and Objectives: Running-related musculoskeletal injuries remain highly prevalent among recreational runners, and the absence of population-specific biomechanical reference values limits clinical and sports interpretation in Latin American populations. This study aimed to establish reference values for spatiotemporal and selected running kinematic/mechanical values (initial contact angle, vertical leg stiffness, and vertical oscillation) in healthy adult recreational runners from Barranquilla (Colombia) using three-dimensional motion capture. Methods: A cross-sectional observational study was conducted in 25 healthy adults (13 men, 12 women; mean age 32.7 ± 7.4 years, range 20–47 years). Running biomechanics were assessed using a BTS SMART-DX three-dimensional motion capture system and a Modified Helen Hayes marker model with 30 reflective markers. Participants completed treadmill running trials at 7, 9, 11, and 13 km/h. Key spatiotemporal parameters and global kinematic/mechanical metrics were processed using BTS Smart Clinic software. Reference values were defined using the 10th and 90th percentiles, stratified by sex and running speed, and accompanied by bootstrap 95% confidence intervals. Effects of sex and speed were tested by two-way ANOVA with partial eta squared and Holm-adjusted p values, with a linear mixed-effects model as a robustness check. Results: Motorized treadmill-specific biomechanical reference values (10th and 90th percentiles) were established and stratified strictly by running speed (7, 9, 11, and 13 km/h) and sex. Under the primary linear mixed-effects model, running speed significantly affected all ten evaluated biomechanical variables (all adjusted p < 0.001), including initial contact angle and vertical oscillation, confirming that speed-disaggregated estimates are mandatory for clinical interpretation. Conversely, sex effects were robust to multiplicity adjustment only for flight time and vertical leg stiffness. Compared with a European reference cohort, and after adjustment for sex, age, stature, body mass and speed through the published reference equations, this cohort showed a 6.6% shorter flight time, a 19.0% lower vertical oscillation, a 3.8% shorter stride length, and a 3.1% higher cadence. Conclusions: This study provides the preliminary regional reference database for running spatiotemporal and selected kinematic parameters in a cohort of healthy adult recreational runners from Barranquilla (Colombia). These preliminary values provide a baseline restricted to motorized treadmill running at fixed speeds; while they support standardized treadmill screening and rehabilitation tracking, their direct applicability to overground or self-paced running remains limited and warrants caution. Full article

Background/Objectives: Hepatitis A virus (HAV) infection is a relevant biological risk in some occupational settings and has long been discussed as an occupational health concern among municipal waste collection workers. Data on HAV seroprevalence and vaccination history in this occupational group remain limited in Italy. This study investigated HAV seroprevalence, self-reported vaccination history, and factors associated with HAV seropositivity among waste collection workers in Sardinia. Methods: This retrospective cross-sectional study analyzed HAV seroprevalence and self-reported vaccination history among 326 workers in Sardinia, Italy, using occupational health surveillance data (2017–2024). Recorded variables included age, sex, smoking habits, years of service, work setting, vaccination status, and serological results. Chi-square and Mann–Whitney U tests assessed group differences; logistic regression identified factors independently associated with HAV seropositivity. Results: HAV seroprevalence was 44.2%; only 0.9% of participants reported previous HAV vaccination. Multivariable analysis identified older age, but not years of service, as independently associated with HAV seropositivity once age was modeled as a continuous variable—a pattern more consistent with birth-cohort differences in lifetime HAV exposure than with cumulative occupational exposure. Worksite 7 showed a higher prevalence ratio of HAV seropositivity relative to the reference site, but this finding was based on a small subsample and should be considered exploratory; observed worksite-level differences may reflect organizational rather than geographic factors. Conclusions: Older age, rather than occupational tenure, was independently associated with HAV seropositivity among Sardinian waste workers, a pattern consistent with birth-cohort differences in lifetime exposure. The high seroprevalence and very low vaccination uptake highlight the need to strengthen prevention through improved vaccination access, awareness, and better integration of occupational and public health strategies. Full article

Background/Objectives: Self-awareness constitutes a key metacognitive construct supporting self-regulation and adaptive functioning in aging. This systematic review examined how self-awareness fluctuates across the Alzheimer’s disease (AD) continuum and explored its associations with cognitive performance and neuroimaging markers. Methods: A systematic search was conducted in databases including PubMed, Scopus, Science Direct and Web of Science covering the period from 2016 to 2026, and the review was registered on the Open Science Framework (OSF). The selection process followed PRISMA guidelines, and a total of 334 studies were screened for eligibility while 42 met the inclusion criteria. Studies were eligible if they examined self-awareness in relation to cognitive and/or neuroimaging parameters, with individuals in the preclinical and clinical spectrum of AD as the reference population. Results: The included studies highlighted self-awareness as a dynamic construct closely linked to cognitive performance and neural integrity, with measurable deviations emerging along the continuum from subjective cognitive decline to dementia. Accordingly, the findings suggest that alterations in self-awareness may reflect the stage-dependent cognitive and neurobiological changes that characterize the progression of AD. Conclusions: Converging evidence suggests that assessing fluctuations of self-awareness, ranging from heightened awareness to reduced awareness, may contribute to the early identification of individuals at risk of progression across the AD continuum. However, the substantial methodological heterogeneity across studies precludes definitive conclusions regarding its clinical utility. Future longitudinal studies employing standardized assessment protocols are needed to determine whether these changes can reliably predict disease progression. Full article

The left-to-right spatial representation of time is reflected in faster responses when past-related concepts are associated with the left side of space and future-related concepts with the right. Most research has examined this time–space congruency effect using general temporal concepts, leaving unclear whether it also characterizes personally relevant temporal contents. The present study investigated whether the time–space congruency effect extends to self-referential negative events referring to the past and the future, and whether its expression is related to individual differences in maladaptive negative thinking. Forty-seven adults categorized individually generated words referring to past or future negative personal events, as well as neutral temporal words, by making left- or right-hand responses. A significant time–space congruency effect was observed for both self-referential and neutral words. The congruency effect was numerically smaller for self-referential words, and its strength was significantly and inversely related to anxiety sensitivity, whereas no such association was found for neutral words. These findings extend the mental timeline account to personally relevant negative events and provide initial evidence that individual differences in anxiety sensitivity are related to the spatial representation of such events. Psychological distance may represent a plausible mechanism underlying this association, a possibility that warrants direct testing in future research. Full article

Rehabilitation in long-term conditions requires not only clinical capacity but also sustained patient engagement, yet retention is commonly reduced to crude completion metrics. This theory-informed conceptual mini-review used a purposive, non-systematic synthesis of literature identified from the authors’ existing knowledge base, targeted PubMed/MEDLINE searches last updated on 9 August 2026, and backward reference checking; the final article cites 76 sources. Retention is reframed as six related phases comprising referral and eligibility, uptake or initiation, early attendance, ongoing attendance or dose, completion or planned discharge, and post-program maintenance, while time to dropout is treated as a longitudinal metric. Across these phases, disengagement may reflect interactions among clinical severity, symptom interpretation, illness beliefs, distress, motivational climate, therapeutic relationships, social context, and structural access. Four author-generated hypotheses concern psychological flexibility and acceptance, illness coherence and rehabilitation self-efficacy, autonomy-supportive care and therapeutic alliance, and social support and peer belonging. Direct evidence is concentrated in selected rehabilitation settings, whereas several stage-specific and cross-condition pathways remain theoretical extrapolations. Rehabilitation resilience is therefore proposed as a provisional interaction between patient adaptive resources and responsive care systems, not as a validated trait or a synonym for observable retention. Structural barriers may prevent participation directly, and discontinuation may be appropriate when treatment is unsafe, ineffective, burdensome, or inconsistent with informed patient goals. The framework is intended to guide prospective, condition-specific testing rather than imply causal validation or scientific consensus. Full article

Background: Tattooed teachers are increasingly visible in schools, yet the norms governing their professional acceptability remain poorly understood. This study tests whether pluralistic ignorance—private acceptance systematically exceeding the acceptance attributed to others—operates in attitudes toward tattooed teachers, and identifies individual-level predictors of this misperception. Methods: A cross-sectional online survey was conducted with 1226 individuals in Hungary across four groups: physical education (PE) teacher trainees, university students from other disciplines, secondary school students, and in-service teachers. Participants rated their own acceptance of tattooed PE and academic-subject teachers and the acceptance they attributed to other teachers and to parents, and reported tattoo status, gender, and professional background. Results: Own acceptance exceeded attributed acceptance in all four groups and for both reference targets, consistent with pluralistic ignorance; gaps were largest among secondary school students and smallest—though still positive—among in-service teachers. Personal tattoo experience was the strongest individual predictor of acceptance after group membership, and among teachers both age and experience were negatively associated with acceptance. Acceptance was predominantly conditional, structured by a visibility hierarchy in which arm placements were most acceptable and facial or neck placements least so. Conclusions: The apparent disapproval of tattooed teachers reflects collective misperception more than genuine consensus, suggesting that making actual peer attitudes visible could reduce conformity pressure and support more authentic professional self-expression. Full article

Objective: Intertemporal decision-making ability refers to an individual’s capacity to evaluate and integrate temporally distributed outcomes, regulate goal-directed behavior, and construct future representations in intertemporal choice contexts. This construct reflects a core psychological processing capacity rather than a mere preference for specific choice outcomes. It plays a critical role in employees’ long-term performance management, career development, and self-regulation. However, existing research lacks standardized measurement instruments that directly assess intertemporal decision-making ability among employee populations. Therefore, the present study aimed to develop and validate a structurally clear, reliable, and valid scale of employees’ intertemporal decision-making ability applicable to Chinese organizational contexts. Methods: Using a sample of full-time employees from China, this study developed the scale based on a three-process framework of intertemporal decision making, encompassing three core psychological mechanisms: cognitive control, value evaluation, and future representation. Exploratory factor analysis (N = 433) and confirmatory factor analysis (N = 281) were conducted to examine the scale’s factor structure. Impulsivity and job autonomy were employed as criterion variables to assess criterion-related validity. Results: The findings supported a three-factor structure comprising career executive control, long-term career reward trade-off, and career future representation. The final scale included 14 items. The Employee Intertemporal Decision-Making Ability Scale demonstrated good internal consistency and stable structural validity at both the overall and dimensional levels. In addition, intertemporal decision-making ability was significantly negatively correlated with impulsivity and significantly positively correlated with job autonomy, providing support for criterion-related validity. Conclusions: The Employee Intertemporal Decision-Making Ability Scale developed in this study demonstrates satisfactory reliability and validity and can serve as an instrument for assessing employees’ intertemporal decision-making ability. Full article

Background/Objectives: Empowerment strategies promoting healthy behaviors are important for preventing chronic diseases and cancer, while individual health responsibility (IHR) plays a significant role. Although widely discussed in the literature, the concept of IHR does not have clearly defined domains or a validated instrument for assessment. Its overlap with locus of control theory, self-motivation, and personality type creates further difficulties. Meanwhile, perception of one’s own responsibility for health is an intuitive, simple item to answer, reflecting a person’s belief related to this topic. Moreover, for ethical reasons, this concept cannot be separated from personal beliefs and should not be adjusted according to strict scales and externally imposed definitions. Therefore, this study aimed to: (1) explore whether there is an association between self-perception of IHR and preventive/risk-taking behaviors; and (2) examine socio-demographic factors associated with the IHR score and three self-perceived characteristics, namely self-perceived locus of control, health literacy, and health status. Methods: A cross-sectional study with 968 healthcare workers was conducted in a large, multidisciplinary hospital covering several behaviors (smoking, alcohol consumption, diet, and participation in a screening program for hepatitis C). IHR was evaluated on a scale from 1 to 10, where 1 meant “to very little extent” and 10 meant “to a great extent”. Results: The average IHR score was 8.80 (SD = 1.88). In the univariate analysis, the IHR score was significantly related to gender, age, education, marital status, and all three personal characteristics. In the multivariate analysis, the socio-demographic associations lost statistical significance. IHR maintained its association with the healthy diet score in the multivariable model (B = 0.113, p = 0.036). In the unadjusted analyses, the distribution of IHR differed between participants who declared alcohol consumption and those who declared abstinence (χ² = 17.157, p = 0.002). However, this association was not retained in the multivariable model. Self-perceived internal locus of control was negatively associated with screening acceptance, but not with IHR. The OR of 0.927 refers to a one-point increase on the 1–10 scale. Across the full observed scale range, this corresponds to an OR of 0.51 (95% CI: 0.29–0.89), indicating lower odds of screening acceptance among participants with higher perceived internal control. Because this estimate assumes linearity across the entire scale, it should be interpreted cautiously. Conclusions: The gap between perceived responsibility and actual behavior suggests that IHR messaging alone is unlikely to be sufficient. Future research should consider social desirability and external locus of control when analyzing IHR and health behaviors. Full article

Potato late blight, Phytophthora infestans, remains a major global threat to potato production due to the rapid genetic change, long-distance dispersal and fungicide resistance. To clarify the genetic structure and phenotypic characteristics of P. infestans populations in southwestern China during 2019–2025, this study analyzed 241 isolates collected from Sichuan, Chongqing, Guizhou, Yunnan and Hubei. The isolates were characterized using 14 SSR markers, together with mating-type determination, metalaxyl sensitivity assays, mitochondrial haplotype identification and virulence profiling. A total of 70 alleles and 118 multilocus genotypes were detected, with certain genotypes (SW-40, SW-48 and SW-81) broadly distributed across regions, while the simultaneous presence of numerous low-frequency genotypes reflected high overall genetic diversity. Population genetic analyses revealed weak regional differentiation and strong genetic connectivity, with most genetic variation occurring within regional populations, where self-fertile isolates, metalaxyl-resistant phenotypes and mitochondrial haplotype Ia were predominant. Cluster and principal component analyses separated the isolates into three major genetic groups, with the largest group containing most isolates and showing close genetic similarity to the Blue_13 reference genotype. These findings indicate that southwestern China harbors a highly diverse and admixed P. infestans population, likely driven by frequent pathogen movement among potato-growing regions. Full article

Background/Objectives: Contemporary secondary students increasingly learn in technology-rich classrooms characterized by digital stimulation, multitasking demands, compressed pacing, platform switching, and persistent attentional competition. Established scholarship on cognitive load, multimedia learning, self-regulated learning, disciplinary literacy, attentional control, and environmental restoration identifies mechanisms relevant to these conditions, but these mechanisms are often examined at different levels of analysis. This conceptual review develops the Cognitive Ecology of Learning Framework (CELF) as an applied, classroom-level framework for examining how disciplinary cognitive demand, attentional fragmentation conditions, and restoration opportunities may interact during sustained secondary science learning. Methods: An integrative conceptual-review and theory-synthesis design was used. Iterative searches conducted from January through May 2026 identified theoretical, empirical, and review literature across education, psychology, attentional science, digital learning, environmental psychology, and secondary science education. Sources were selected purposively according to their relevance to the research questions and synthesized through cross-domain comparison. Results: The synthesis proposes CELF as a hypothesis-generating framework organized around three classroom-level dimensions: Disciplinary Cognitive Demand, Attentional Fragmentation Conditions, and Restoration Opportunities. The framework also proposes cognitive malnourishment and cognitive endurance as context-sensitive constructs requiring empirical validation. Cognitive malnourishment describes a possible ecological mismatch in which substantial informational or disciplinary demand coincides with persistent fragmentation and insufficient opportunities for elaboration, reflection, consolidation, and coherent reengagement. Cognitive endurance refers to the context-sensitive capacity to sustain attention, conceptual processing, and disciplinary reasoning during extended, cognitively demanding work. Preliminary indicators, measurement approaches, and testable propositions are presented for future classroom-based research. Conclusions: CELF organizes selected task-level, learner-level, disciplinary, attentional, and environmental constructs within a bounded framework for technology-rich secondary science classrooms. It does not revise or replace the foundational theories from which these constructs are drawn, nor does it claim causal validation. Instead, CELF provides a structure for investigating how classroom conditions may support or constrain attentional continuity, conceptual persistence, restoration, and sustained disciplinary engagement. Full article

Space cooling is one of the fastest-growing end uses in the building sector, and reflective (“cool”) coatings have emerged as a low-cost passive strategy to limit solar heat gain through the envelope. This study evaluates the summer thermal behaviour of three building-envelope materials commonly used in flat roofing—self-protected asphalt sheet, steel sheet, and ceramic tile—under outdoor conditions in Valencia, Spain. Sealed cubic prototypes were monitored to compare uncoated reference specimens with specimens coated with a conventional high-performance white acrylic paint produced by SOETAM and with an advanced reflective coating based on a laminar TiO₂ nanostructure produced by Q+TERMIK. External surface temperatures were assessed by infrared thermography and internal air temperatures by autonomous data loggers. External white coatings significantly reduced surface temperatures across all substrates, with the effect most pronounced in low-thermal-inertia materials: the advanced reflective coating achieved peak surface-temperature reductions of 21.0 °C (33.2%) for asphalt and 17.4 °C (28.8%) for steel, outperforming the high-performance coating, with corresponding internal reductions of up to 9.7 °C (22.0%) and 8.1 °C (18.6%). The results indicate that the advanced reflective coating produced greater thermal mitigation than the conventional coating under the tested outdoor conditions, despite both coatings being applied with similar thicknesses. The advanced reflective coating generally produced the greatest thermal mitigation, particularly for low-thermal-inertia substrates, while the ceramic tile exhibited a different internal thermal response, highlighting the influence of substrate properties on coating performance. Full article

There are different degrees of cracks in prestressed concrete (PC) beams, especially the transverse cracks in the bottom plate and the vertical cracks in the web of prestressed concrete box girders, which will reduce the bearing capacity of the structure. In order to clarify the evolution law of cracks in prestressed concrete box girders after cracking, a 25 m prestressed concrete box girder was poured and a full-scale model test was carried out. At the 1/4 span position of the test beam, the test beam was cracked in 19 steps to 1900 kN. Then at the 3/4 span position, the test beam was cracked in 18 steps to 1800 kN, and after that the bending load test was carried out in 17 steps to analyze the influence of existing cracks on the bending cracks of the test beam. Combined with fractal theory, the evolution law of cracks, the development law of fractal dimensions, and their relationship under different loading conditions were analyzed. The results showed that the crack distribution of the test beam satisfies self-similarity and had fractal characteristics in a statistical sense, which could reflect the process of crack occurrence, propagation and damage, and could quantify the crack shape. The fractal dimension of cracks gradually increased with the increase in concentrated load on the test beam, and the fractal dimension of cracks had a linear relationship with the concentrated load. The crack propagation process of the concrete beam reflected the fractal dimension increasing process; that is, the crack damage evolution process of test beam was a dimension increasing process, and the fractal dimension of crack distribution increased linearly with the applied load. The functional relationship between prestressed concrete crack width and fractal dimension was constructed, which provided a new path for bridge safety evaluation. The research results provide engineering reference for the cause analysis and maintenance treatment of similar bridge cracks. Full article

Background: Psychiatric inpatients may be vulnerable to head trauma; however, associations among psychiatric diagnosis, trauma mechanisms, and acute trauma-related neuroimaging findings among patients requiring neurosurgical consultation remain unclear. Methods: This retrospective observational study included psychiatric inpatients referred for neurosurgical consultation after head trauma at a tertiary neuropsychiatric specialty hospital between July 2022 and December 2025. Psychiatric diagnoses were grouped into psychotic, mood, substance use, organic/symptomatic, and other disorders. Trauma mechanisms were classified as falls, self-harm, assault/fight-related injuries, and other trauma types. Radiological findings were classified as trauma-related abnormalities or secondary incidental findings, including age-related changes. Associations were evaluated using chi-square tests, with false discovery rate correction applied to global and binary comparisons. Exploratory multivariable regression models were used as sensitivity analyses. Results: The cohort comprised 461 psychiatric inpatients who sustained head trauma, underwent radiological imaging, and were referred for neurosurgical consultation. Trauma mechanisms differed significantly across psychiatric diagnostic groups (χ² = 30.89, p = 0.002). Falls were the most common mechanism (189/461, 41.0%). Assault/fight-related trauma showed the clearest diagnosis-associated pattern (χ² = 19.72, p < 0.001, Cramér’s V = 0.207) and remained the only significant binary outcome after false discovery rate correction. Acute trauma-related imaging findings were observed in 35 patients (7.6%) and were not associated with psychiatric diagnosis (χ² = 6.16, p = 0.187). Calcifications were the most frequent imaging finding (191/461, 41.4%). Conclusions: In psychiatric inpatients, while head trauma patterns and neuroimaging findings have the potential to be explained by psychiatric diagnoses, they may also reflect unmeasured behavioral and clinical factors. Full article