Search Results (184)

Background/Objectives: This study examined how different types of language activities in educational settings predict language ability in preschoolers with cochlear implants (CIs) versus normal-hearing (NH) peers. Predictor variables included two dimensions of language activities (language learning activities: shared reading, word games, and story retelling; daily communication activities: routine conversations and free play talk), as well as auditory utilization status (awareness of sounds, perception of speech sounds, and attentive listening to teachers/peers), learning attentional state, and family socioeconomic status (SERS). The outcome variable was language ability, measured with the Mandarin Clinical Evaluation of Language for Preschoolers’ Core Scale (MCELP-CS), and control variables included age and, for the CI group only, age of implantation. Methods: Participants included 189 CI (mean age = 4.53 years, SD = 0.83) and 210 NH preschoolers (mean age = 4.64 years, SD = 0.83). All predictor and control variables were collected via teacher-reported questionnaires (self-compiled by the research team). Statistical analyses used hierarchical regression with separate models for each group. Results: For the CI group, after controlling for age and age of implantation, engagement in language learning activities emerged as the most stable and independent predictor of language ability. Auditory utilization status was another significant predictor, and its inclusion substantially increased the model’s R². For the NH group, language ability was primarily predicted by age-related maturation, with language learning activities showing additional predictive value, while daily communication activities and learning attentional state contributed very little. Conclusions: Findings suggest that for educational rehabilitation of CI preschoolers: increasing engagement in language learning activities in classrooms may be more beneficial than relying on daily conversation or merely improving attention alone; meanwhile, auditory utilization skills should also be fostered synergistically. Importantly, language intervention models designed for NH preschoolers cannot be directly transferred to CI preschoolers. Full article

Background: Puberty is a period of visible bodily change, heightened self-consciousness, and increased sensitivity to social evaluation. While prior studies have linked pubertal development to broad psychological outcomes, less attention has been given to adolescents’ social evaluative distress, defined here as discomfort when feeling looked at or talked about by others. Parenting style may also be relevant to this outcome. Methods: Using secondary survey data from 3591 secondary-school students in Shenzhen, China, this study employed Bayesian analysis to examine whether puberty stress, authoritarian parenting, and permissive parenting were associated with adolescents’ social evaluative distress, and whether authoritarian and permissive parenting moderated the association between puberty stress and social evaluative distress. Results: Puberty stress was positively associated with social evaluative distress, and authoritarian parenting was also positively associated with this outcome. Permissive parenting did not show a clear direct association. Neither authoritarian nor permissive parenting showed clear evidence of moderating the association between puberty stress and social evaluative distress. Conclusions: Social evaluative distress during adolescence appears to be associated more clearly with puberty stress and authoritarian parenting as direct correlates than with interaction effects between puberty stress and parenting style. The study extends existing literature by focusing on a narrower, socially focused form of adolescent distress in the Chinese context. Full article

Suicide is commonly approached through clinical and psychological frameworks centred on the individual, alongside social explanations emphasising collective conditions. These perspectives offer complementary leverage for understanding and preventing suicidal behaviour. Between these levels, a clinically decisive segment can be specified with greater precision for psychiatric practice, namely the processes through which suffering becomes speakable, socially legitimate and clinically actionable, or is displaced into self-censorship, isolation and delayed help-seeking. This paper advances a service-facing biosemiotic model of suicide risk that formalises this segment as a communicative infrastructure and links it to the public circulation of suicide narratives across media and digital environments. The model comprises two coupled modules. The first, the communicative-classification module, characterises labelling and delegitimation operations that allocate epistemic credibility to crisis talk, foster self-stigma and increase the social cost of disclosing suffering. The second, the public-feedback module, specifies how media representation and repetition regulate the symbolic availability of narrative scripts, with closure- and openness-oriented configurations positioned along the Werther–Papageno continuum. Coupling the modules yields testable propositions concerning mediation via anticipated sanction and moderation by stigma and speakability and identifies conditions under which protective content may show limited translation into help-seeking behaviour. Implications are outlined for how the model may inform therapeutic risk assessment, continuity of care, and prevention. These implications are framed as hypotheses and implementation-relevant considerations derived from the model, with emphasis on (i) operationalising speakability as a clinically evaluable dimension, (ii) identifying institutional conditions that may reduce the communicative cost of help-seeking, and (iii) aligning public communication strategies with international reporting standards. The model is intended to support future empirical testing rather than to establish effectiveness at this stage. Full article

Background: Mothers with gestational diabetes mellitus (GDM) face specific challenges in breastfeeding, yet data on the long-term effectiveness of mobile-based interventions remain limited. This study aimed to evaluate the long-term effectiveness of a Mobile-Based Breastfeeding Promotion Program for GDM (M-BFGDM) on breastfeeding knowledge, self-efficacy, and practice rates up to 6 months postpartum. Methods: A nonequivalent control group pretest–posttest quasi-experimental study was conducted. Participants were recruited from an online community. The intervention group received the M-BFGDM, which included Information–Motivation–Behavioral Skills (IMB) model-based educational videos and KakaoTalk counseling. Data were collected at prenatal, 1-week, 1-month, and 6-month postpartum time points. Data were analyzed using generalized estimating equations (GEE) and repeated-measures ANOVA. Results: The final analysis included 38 participants (experimental group, n = 18; control group, n = 20). The M-BFGDM was effective in improving breastfeeding knowledge among women with GDM (p = 0.003). However, the intervention did not significantly influence the trajectory of breastfeeding self-efficacy or prevent the decline in practice rates over 6 months compared to the control group. Conclusions: These findings suggest that while mobile education enhances knowledge, sustained breastfeeding requires more intensive, individualized support to address physical barriers, such as low milk supply and latch difficulties. Full article

Background: The psychosocial needs of families involving a child with a life-limiting or life-threatening condition are well recognized. However, evidence-based interventions that address the needs of the entire family remain scarce, even though family health can be maintained and supported if interventions encompass each individual family member, as well as the family as a unit. The aim was to evaluate the family talk intervention (FTI), regarding family communication, and psychosocial health, for families involving a child with a life-limiting or life-threatening condition. Methods: This pre-post study without a control group involved families of children with a life-limiting or life-threatening condition receiving FTI at a pediatric hospital and a hospice in Sweden. The study is registered at clinicaltrials.gov (ID NCT05020158, date of registration: 23 August 2021). FTI is a family-based intervention with the goal of facilitating family communication about illness-related topics, e.g., prognosis, support parenting, and making all children’s needs visible. In total, 105 participants from 29 families were included. Surveys measuring self-assessed family communication and satisfaction, anxiety, resilience, parenting skills, and children’s mental problems were answered at three time points: baseline (before intervention), at the end of the intervention, and six months later. Changes over time were analyzed using linear mixed-effects models. Results: Significant improvements were reported in family communication, family satisfaction, parenting skills, and levels of anxiety over time. Children’s mental health problems were reduced over time regarding emotional symptoms, conduct problems, peer relationship difficulties, and hyperactivity. No changes were found regarding resilience. Conclusion: The results suggest that FTI contributes to improved family communication and psychosocial health for families involving a child with a life-limiting or life-threatening condition. This highlights the value of a systemic approach that actively involves all family members. Full article

School-based mental health screening typically relies on single-time-point assessments, which assume that students’ emotional well-being is sufficiently stable for classification based on a single measurement. The present study examined this assumption by evaluating the stability of emotional well-being classifications under repeated mood monitoring. Students from two secondary schools (United Kingdom, n = 413; Australia, n = 354) completed the Brief Emotional Experience Scale weekly across six to seven weeks. Emotional well-being classifications were examined relative to a predefined low well-being threshold to assess stability across time, and a post-monitoring survey examined students’ self-reported perceptions of the monitoring experience. Most students (78%) showed consistently above-threshold classifications across monitoring occasions, while a small proportion (5%) showed persistently low classifications. However, 17% of students fluctuated above and below the low well-being threshold across weeks, indicating that classification status for this group was sensitive to assessment timing. When monitoring data were aggregated using different decision rules, the proportion of students flagged as low well-being varied substantially, ranging from approximately 5% under a conservative stability-based criterion to around 12% when classifications were based on averaged monitoring scores. Classifications derived from averaged monitoring scores showed high agreement with single-time-point classifications, while identifying a partially different subset of students as low well-being, underscoring the sensitivity of threshold-based decisions to classification approach. Student feedback provided preliminary contextual insight into the acceptability of repeated monitoring under routine school conditions, with over half of respondents reporting that the process supported their emotional understanding. A substantial minority also reported greater inclination to talk with others about their well-being. Overall, the findings indicate that single-time-point screening may provide an incomplete basis for emotional well-being classification for some students, and that repeated assessment offers additional temporal context for interpreting threshold-based screening decisions. Full article

Teachers play a key role as gatekeepers in adolescent suicide prevention, and knowledge about suicidality is a well-established predictor of teachers’ gatekeeper self-efficacy. However, little attention has been paid to other potential predictors, particularly teachers’ empathy and self-efficacy in collaborating with colleagues to support adolescents experiencing mental distress. This cross-sectional study examined the associations between suicide-related knowledge, teacher empathy (perspective taking, empathic concern, and personal distress), collaborative self-efficacy, and gatekeeper self-efficacy. A convenience sample of 455 Italian secondary school teachers (84% female; mean age = 46.7 years, SD = 10.5) completed an anonymous self-report questionnaire. Data was analyzed using descriptive statistics and multiple regression analyses. Overall, teachers demonstrated adequate knowledge of adolescent suicidality. However, several myths persisted, including the belief that openly talking about suicide may increase risk. Higher gatekeeper self-efficacy was associated with greater knowledge, higher levels of perspective taking and empathic concern, lower levels of empathic distress, greater collaborative self-efficacy, and prior exposure to adolescent suicidality. These findings underscore the joint contribution of personal and relational factors to teachers’ gatekeeper self-efficacy and offer important implications for the development of teacher-focused gatekeeper training programs. Full article

Hypertension-induced renal injury is a major cause of chronic kidney disease and end-stage renal disease. Increasing evidence indicates that disease progression is not driven solely by hemodynamic stress but results from the interplay of multiple molecular mechanisms. In this review, we propose a stage-structured and network-based framework to systematically integrate current mechanistic insights into hypertension-induced renal injury. Early events, mainly including endothelial dysfunction and renal hypoxia, establish a permissive microenvironment for disease progression. These insults activate amplifying pathways such as the renin–angiotensin–aldosterone system (RAAS) overactivation, oxidative stress, immune and inflammatory responses, and sympathetic nervous system hyperactivity, which interact through cross-talk and positive feedback loops. Ultimately, these signals converge on fibrotic programs characterized by epithelial–mesenchymal transition (EMT), fibroblast activation, and extracellular matrix deposition, leading to irreversible structural remodeling and functional decline. Furthermore, epigenetics, the gut–kidney axis, autophagy dysfunction and renal aging also contribute to this process. We highlight two critical and underappreciated aspects: the existence of a permissive ‘early-window’ dominated by endothelial dysfunction and hypoxia, which sets the stage for later amplification; and the hierarchical interplay between amplifying mechanisms where cross talk creates self-reinforcing loops that may explain therapeutic resistance. In addition, this review highlights emerging biomarkers for early diagnosis and disease monitoring, and discusses therapeutic advances that extend beyond blood pressure control to disease-modifying interventions that confer renoprotective effects. By integrating molecular mechanisms with diagnostic and therapeutic perspectives, this review provides a comprehensive framework for early detection and precision intervention in hypertension-induced renal injury. Full article

Steatosis extends beyond the liver to the pancreas, heart, and skeletal muscle, yet prevailing definitions remain narrowly organ-focused. This narrative review introduces the Metabolic Steatotic Axis (MSA) as a framework that captures the dynamic, bidirectional interactions among these organs, driving systemic metabolic dysfunction. We synthesize evidence linking lipotoxicity, inflammatory signaling, and endocrine cross-talk into a self-amplifying network accelerating insulin resistance, β-cell failure, and cardiometabolic risk. The MSA concept provides a rationale for axis-based staging systems and composite biomarker panels to quantify cumulative disease burden better and refine risk stratification. We highlight phenotypic heterogeneity within MSA stages, the possible hierarchy of organ vulnerability, and the implications for prognosis and therapy. Viewing pharmacological and lifestyle interventions through the MSA lens reframes them as systemic modulators rather than organ-specific treatments, underscoring the need for multi-organ endpoints in clinical trials. Finally, we outline priorities for longitudinal imaging, multi-omics integration, and global harmonization to translate the MSA from a conceptual construct to a clinically actionable paradigm. By unifying fragmented observations into a systemic model, the MSA has the potential to reshape disease classification, therapeutic strategies, and precision medicine in metabolic disorders. Full article

Selective mutism (SM) is an anxiety disorder that prevents speech in certain situations. Increasingly, it is reported that a proportion of those with SM may also be autistic and that physical freezing may be an important feature of SM. Information on speech and freezing behavior in children with a diagnosis of autism only (n = 20), SM only (n = 61), both autism and SM (n = 19), or neither diagnosis (n = 131) was collected via a self-selected cross-sectional online parent survey with an embedded child survey completed by a small subsection of the children (total n = 27: autism only n = 1, SM only n = 13, both autism and SM n = 3, neither diagnosis n = 10). Throat and body freezing were reported by children with SM, whether they were also autistic or not. The most common reasons given by the children that increased their difficulty in speaking were pressure to talk, worries about how they would be perceived, and fear of making mistakes. The Selective Mutism Questionnaire (SMQ) gave the lowest median score for children with both autism and SM, with median scores increasing in the order SM only, autism only, and neither diagnosis. Children who reported more freezing tended to have lower SMQ scores. Full article

Perceived social support is considered essential for enhancing the inner academic motivational resources of students, in particular motivational self-regulation. We aimed to examine the possible associative mediation of motivational regulation strategies in the relationship between perceived support from family and teachers and academic achievement. A convenience sample of secondary education students was recruited. The students were asked to complete self-report questionnaires on perceived social support and motivational self-regulation strategies, and their academic grades were also recorded. Mediation regression analysis was used to test the mediation model proposed in the study. Three motivational regulation strategies mediated the relationship between perceived support and academic achievement: work-avoidance self-talk, self-efficacy enhancement, and enhancement of situational interest. Different support provisions were found to have cumulative positive and negative associations with the strategies. The findings suggest that perceived social support is associated with more autonomous forms of motivational regulation and lower levels of work-avoidance among students. Full article

The purpose of the present study was to examine the effects of a strategic self-talk intervention on a complex tennis performance test through the use of a narrow internal instructional self-talk plan. Fifty young beginner tennis players from two tennis academies were assigned into intervention and control groups. A pre/post quasi-experimental design was implemented, including baseline assessment, training intervention, and final assessment. The intervention lasted five weeks, during which all participants underwent the same training, with the experimental group using strategic self-talk. Repeated measures MANOVA revealed a significant time by group interaction for all tennis strokes; pairwise comparisons showed that the all strokes performance of the self-talk group improved from initial to final assessment and was better than the performance of the control group at final assessment. In addition, repeated measures ANOVA examining the overall performance of the rally showed that the intervention group achieved higher total rally scores than the control group. The effectiveness of the intervention in this multi-stroke task suggests that strategic self-talk facilitated movement sequences, possibly through an efficient shifting of attention. Accordingly, practitioners are encouraged to explore the potential of strategic self-talk for tasks requiring such attentional demands. Full article

Bullying is a significant social issue, yet research often relies on quantitative methods. Our study aimed to gain a deeper insight by giving students a voice in expressing their experiences and perceptions, focusing on how youth define and perceive bullying, the different roles involved, and the coping strategies they identify. We conducted 16 focus groups with 220 Italian students, using the Consensus Qualitative Research method. Seven key domains emerged, with core ideas classified by frequency: general (>75%), typical (25–75%), and variant (≤25%). In “Characteristics of bullying,” power imbalance was general, intentionality was typical, and repetition was variant. In “Bullying behaviors,” physical and verbal bullying were general; relational bullying was variant. Regarding “The bully,” moral disengagement and compensation were general, retaliation was typical, and intimidation was variant. For “The victim,” perceived weakness and well-being were general, ethnic victimization was typical, and victim blaming was variant. In “Other roles,” pro-bullies and passive bystanders were typical; defenders were variant. “Victim’s coping strategies” included nonchalance, distancing, and seeking social support as general; retaliation as typical; and talking with the bully as variant. Finally, “Bystanders’ coping strategies” included protecting the victim (typical) and self-protection (variant). These findings offer a nuanced perspective on bullying and inform more targeted interventions. Full article

The Talk More, Tech Less program was developed to promote healthier technology habits through a 30-day series of daily activities and reflections. This pilot study examined the short-term effectiveness of this program in improving mobile media habits. In Study 1, 30 participants who had already participated in the program completed post-program surveys reporting weekly device use before and after the program, rating their regulation skills (1–7), and offering feedback. Average self-reported weekly device use dropped from 26.02 to 15.93 h (p < 0.001), and self-regulation significantly improved (p < 0.05). Study 2, conducted during the 2025 Lenten season with 39 participants (66.7% female), used pre/post assessments and weekly surveys to track device use, mental health, and family rapport. The objective smartphone use captured by screenshots showed declines of 118 min on average (p < 0.001), with reductions in anxiety, stress, and depressive symptoms, alongside gains in regulation skills and confidence. Thematic coding reliability analysis showed participants valued the daily activity cards and increased awareness of their tech habits. Preliminary findings suggest that intentional reflection on technology use can reduce screen time, improve well-being, and strengthen family connections, offering a model for future healthy technology initiatives. The lack of diversity and control group, as well as the time period in which the program was administered, are limitations that future studies can address. Full article

A professional development program (PDP) combining direct and indirect promotion of self-regulated learning (SRL) was conducted with secondary school teachers in two parts. In the first part, the teachers were encouraged to promote student cognitive engagement through the inclusion of more interactive and constructive compared to passive and active lesson tasks in their teaching. In the second part, the teachers were provided with information which emphasized the importance of the direct promotion of SRL knowledge and strategies. The teachers were provided with excerpts from videos of classroom instruction to analyze and reflect upon. The results were based on an analysis of the talk and action of the teachers from videoed observations of their own classrooms before the PDP (Round 1), after the first part (Round 2), and after the second part (Round 3). The PDP influenced the teachers’ indirect promotion of SRL through the inclusion of more interactive and constructive and fewer passive and active lesson tasks in their teaching. Direct SRL promotion was also influenced although to a lesser extent, through the teachers’ inclusion of more motivational, metacognitive support statements to students to encourage them to keep on trying, as well as more explicit strategy promotion and reference to the benefits of SRL strategies. Full article