Search Results (5,582)

Anxiety and depression are common comorbidities in patients with chronic obstructive pulmonary disease (COPD), which can contribute to increased morbidity, reduced quality of life, and worse clinical outcomes. Nevertheless, these psychological conditions remain largely overlooked. This narrative review includes studies published between 1983 and 2025 to synthesise the current evidence on the risk factors, clinical impacts, and therapeutic strategies for these comorbidities. While the exact mechanisms leading to their increased prevalence are not fully understood, growing evidence implicates a combination of biological (e.g., systemic inflammation), social (e.g., isolation and stigma), and behavioural (e.g., smoking and inactivity) factors. Despite current guidelines recommending the identification and management of these comorbidities in COPD, they are not currently included in COPD assessments. Undetected and unmanaged anxiety and depression have serious consequences, including poor self-management, non-adherence to medications, increased risk of exacerbation and hospitalisations, and even mortality; thus, there is a need to incorporate screening as part of COPD assessments. There is robust evidence showing that pulmonary rehabilitation, a core non-pharmacological intervention, can improve mood symptoms, enhance functional capacity, and foster psychosocial resilience. Psychological therapies such as cognitive behavioural therapy (CBT), mindfulness-based approaches, and supportive counselling have also demonstrated value in reducing emotional distress and improving coping mechanisms. Pharmacological therapies, particularly selective serotonin reuptake inhibitors (SSRIs) and serotonin–norepinephrine reuptake inhibitors (SNRIs), are commonly prescribed in moderate to severe cases or when non-pharmacological approaches prove inadequate. However, the evidence for their efficacy in COPD populations is mixed, with concerns about adverse respiratory outcomes and high discontinuation rates due to side effects. There are also barriers to optimal care, including underdiagnosis, a lack of screening protocols, limited provider training, stigma, and fragmented multidisciplinary coordination. A multidisciplinary, biopsychosocial approach is essential to ensure early identification, integrated care, and improved outcomes for patients with COPD. Full article

Active learning strategies and methodologies place the students at the core of the learning process. The objective is to engage students in their own learning through significant activities that involve active participation. These activities are designed to promote collaboration, reflection, and practical application of the knowledge acquired to develop cognitive, social, and emotional competences. These methodologies are of particular interest in STEM disciplines and vocational education, where practice is a key element in the assimilation of theoretical concepts. In this line, a case study is presented where active methodologies have been applied to two groups of Vocational Education and Training in the area of Computer Science to improve interest and commitment. The present study focuses on two groups of first-year students enrolled in the Web Application Design course, one in the Programming subject and the other in the Markup Language subject. Both groups are heterogeneous, composed of young adults with significantly different backgrounds, skills, and motivation. The teaching–learning process is based on active methodologies, such as Project-Based Learning, Design Thinking, Flipped Classroom, or gamification, which are adapted for different subjects in the field of Computer Science. These methodologies facilitate the experimental design and testing of diverse solutions for programming problems, thereby enhancing students’ motivation and interest, while promoting creativity and reflection. The results show an improvement in the interest and commitment of the students in both groups. Despite the fact that less than 50% of students successfully passed in the initial examination, more than 75% students passed after the second-chance examination. The findings have consistently suggested that the implementation of active methodologies leads to significant enhancements in the proficiency, development, motivation, and self-learning capabilities of students, and that these methodologies make students more aware of their learning process. Full article

The purpose of this article is to examine a previously unrecognized role for the vasopressin–oxytocin (VP-OT) system in mammalian “stress-response hormesis.” The current review adds hormesis to the long list of beneficial effects of OT. Hormesis, a biphasic adaptive response to low-level stressors, is introduced here to contextualize the dynamic roles of oxytocin and vasopressin. As with hormesis, the properties of the VP-OT system are context-, time-, and dose-sensitive. Here we suggest that one key to understanding hormesis is the fact that VP and OT and their receptors function as an integrated system. The VP-OT system is capable of changing and adapting to challenges over time, including challenges necessary for survival, reproduction and sociality. Prior research suggests that many beneficial effects of OT are most apparent only following stressful experiences, possibly reflecting interactions with VP, its receptors and other components of the hypothalamic–pituitary–adrenal axis. The release of OT is documented following various kinds of hormetic experiences such as birth, vigorous exercise, ischemic events and the ingestion of emetics, including psychedelics. The phasic or cyclic modulation of VP and related “stress” hormones, accompanied or followed by the release of OT, creates conditions that conform to the core principles of hormesis. This concept is reviewed here in the context of other hormones including corticotropin releasing hormone (CRH) and urocortin, as well as cytokines. In general, VP and classic “stress hormones” support an active response, helping to quickly mobilize body systems. OT interacts with all of these, and may subsequently re-establish homeostasis and precondition the organism to deal with future stressors. However, the individual history of an organism, including epigenetic modifications of classical stress hormones such as VP, can moderate the effects of OT. Oxytocin’s effects also help to explain the important role of sociality in mammalian resilience and longevity. A hormetic perspective, focusing on a dynamic VP-OT system, offers new insights into emotional and physical disorders, especially those associated with the management of chronic stress, and helps us to understand the healing power of social behavior and perceived safety. Full article

Background: Cerebral palsy (CP) is a lifelong neurodevelopmental disorder characterised by motor impairment and commonly associated with comorbidities such as cognitive, communicative, and behavioural difficulties. While the physical and functional aspects of CP have been extensively studied, the mental health needs of this population remain largely underexplored, particularly concerning suicidal ideation and self-injurious behaviours. The purpose of this review is to synthesise the existing literature on suicidality in individuals with CP, explore theoretical and clinical risk factors, and identify key gaps in the current evidence base. Methods: A narrative literature review was conducted focusing on studies addressing suicidal ideation, self-harm, or related psychiatric outcomes in individuals with CP. Additional literature on risks and protective factors was included to support theoretical inferences and clinical interpretations. Results: Only a limited number of studies addressed suicidality directly in CP populations. However, several reports document elevated rates of depression, anxiety, and emotional distress, particularly among adults and individuals with higher levels of functioning. Communication barriers, chronic pain, social exclusion, and lack of accessible mental health services emerged as critical risk factors. Protective elements included strong family support, inclusive environments, and access to augmentative communication. Conclusions: Suicidality in individuals with CP is a neglected yet potentially serious concern. Evidence suggests underdiagnosis due to factors such as communication barriers and diagnostic overshadowing. Future research should prioritise disability-informed methodologies and validated tools for suicidal ideation, while clinicians should incorporate routine, adapted mental health screening in CP care to ensure early detection and person-centred management. Full article

Social media has become a vital communication tool for higher education institutions (HEIs) to reach larger targets, attract followers, and engage with diverse audiences. This study conducted a quantitative and qualitative analysis of 4148 Facebook posts from 16 public and private HEIs in the United Arab Emirates (UAE). The aim of the study is to evaluate users’ engagement through their reactions to various post characteristics, including format, language, and content type. The posts generated 177,022 emotes, 17,269 shares, and 8374 comments. The results showed that images are an efficient format for boosting interaction, whereas plain text posts did not generate high engagement. The English language was more conducive for generating shares, while Arabic-language posts generated more emotes and likes. The comparative analysis results showed that private HEIs are more active on their Facebook pages than public HEIs. The content analysis suggested that student-related posts generate the highest level of engagement, while announcements and faculty- and research-related posts drive the lowest levels of engagement. These results offer valuable insights into how HEIs can optimize their social media strategies to enhance user engagement. Full article

This study assessed whether COVID-19 pandemic experiences were associated with excessive alcohol use during the first year of the pandemic in Iowa, a heavy-drinking midwestern US state. We analyzed survey data from 4047 adult residents of Iowa collected in August 2020, focusing on three pandemic-related stressors (e.g., emotional reactions to the pandemic; disruption of daily activities; and financial hardship) and salient social support. Using multiple logistic regression, we tested correlates of increased drinking, heavy drinking, and binge drinking, controlling for demographic characteristics and health status. We found that nearly half (47.6%) of respondents did not change their drinking compared to before the pandemic; however, 12.4% of respondents reported increasing their drinking and 5.3% reported decreasing their drinking. Emotional reactions to the pandemic and disruption of daily activities were associated with higher odds of increased drinking, and rurality was associated with lower odds of increased drinking. No pandemic-related stressor was associated with heavy or binge drinking, but social support was associated with lower odds of binge drinking. Thus, we concluded that some pandemic-related stressors may explain increased drinking but not heavy or binge drinking. Understanding the nuances of alcohol use can inform preventive interventions, policy decisions, and preparations for future catastrophic events. Full article

Background and Objectives: With the widespread integration of digital media into daily life, social media addiction (SMA) has become a growing concern for university students’ mental health. Based on attachment theory, this study examined how attachment anxiety and avoidance influence SMA through fear of negative evaluation (FNE) and loneliness. Methods: A sample of 400 Chinese university students completed the 16-item short version of the Experiences in Close Relationships Scale (ECR), the 8-item Brief Fear of Negative Evaluation Scale (BFNE), the 6-item Revised UCLA Loneliness Scale–Short Form (RULS-6), and the 6-item Bergen Social Media Addiction Scale (BSMAS). Using the PROCESS macro (Model 6), a chained mediation model was tested. Results: Attachment anxiety positively predicts SMA (β = 0.42); the chained mediation pathway through FNE and loneliness accounts for ab = 0.06 of this effect, alongside additional single-mediator paths. In contrast, attachment avoidance shows a weaker total effect (β = −0.08) and a small negative chained mediation effect (ab = −0.02), offset by opposing single-mediator paths via FNE (negative) and loneliness (positive), resulting in a nonsignificant total indirect effect. Discussion: These findings suggest that in the Chinese cultural context, where social evaluation and belonging are emphasized, insecure attachment may heighten emotional reliance on social media. This study elucidates the socio-emotional mechanisms underlying SMA and extends the application of attachment theory to the digital media environment. Full article

Despite the extensive evidence supporting the effectiveness of cognitive stimulation, differences in results may be due to the influence of cognitive and non-cognitive aspects in people with dementia. The aim of this systematic review is to identify the most reliable variables in forecasting the effectiveness of cognitive stimulation in people with mild to moderate dementia. According to PRISMA guidelines, the research was conducted using five databases (PubMed, Scopus, Cochrane, Web of Science, APA PsycInfo), considering randomized controlled trials. A total of six studies were included. Different aspects moderating the gain resulting from cognitive intervention were collected and assessed in terms of demographic, cognitive, emotional, social, and quality of life parameters. People with dementia benefit more from cognitive intervention if they are female, if they have a low formal education level, a low baseline level of cognitive function, and lower depressive symptoms, and if caregivers actively participate in sessions. Quality of life, if low at baseline, also seems to improve following CST intervention. A deeper understanding of the cognitive and non-cognitive aspects ensuring improvement after cognitive stimulation may guide future research to develop more personalized interventions. Full article

Background: Rapid urbanization has intensified the challenges of freight transport, particularly in last-mile (LM) delivery, leading to rising costs and environmental externalities. Autonomous vehicles (AVs) have emerged as a promising innovation to address these issues. While much of the existing literature emphasizes business and operational perspectives, this study focuses on the acceptance of AVs from the standpoint of e-consumers—individuals who make purchases via digital platforms—in an emerging market context. Methods: Grounded in an extended Unified Theory of Acceptance and Use of Technology 2 (UTAUT2), which is specifically suited to consumer-focused technology adoption research, this study incorporates five constructs tailored to AV adoption. Structural Equation Modeling (SEM) was applied to survey data collected from 304 e-consumers in Northeast Brazil. Results: The findings reveal that performance expectancy, hedonic motivation, and environmental awareness exert significant positive effects on acceptance and intention to use AVs for LM delivery. Social influence shows a weaker, yet still positive, impact. Importantly, price sensitivity exhibits a minimal effect, suggesting that while consumers are generally cost-conscious, perceived value may outweigh price concerns in early adoption stages. Conclusions: These results offer valuable insights for policymakers and logistics providers aiming to implement consumer-oriented, cost-effective AV solutions in LM delivery, particularly in emerging economies. The findings emphasize the need for strategies that highlight the practical, emotional, and environmental benefits of AVs to foster market acceptance. Full article

Background: Fear of falling (FOF) is a significant concern among older adults, especially after total knee arthroplasty (TKA). FOF can limit daily activities, reduce quality of life, and hinder recovery. This study aimed to investigate the prevalence, severity, and impacts of FOF in patients undergoing TKA and identify factors contributing to increased FOF. Methods: A prospective observational study was conducted at King Abdulaziz Medical City in Riyadh, Saudi Arabia, from April 2024 to December 2024. This study included 52 participants aged 20 to 75 years who had undergone primary TKA. Data were collected at two time points: after TKA and at three months post-surgery. The Short Falls Efficacy Scale-International (SFES-I) was used to assess the severity of FOF, and the Short Form 36 (SF-36) was used to measure the quality of life. Descriptive statistics, t-tests, and logistic regression were used for analysis. Results: This study included 52 participants (mean age: 63.77 ± 6.65 years; 82.7% female). Post-TKA, all participants exhibited high FOF (mean SFES-I score: 56.75 ± 8.30). After three months, the mean SFES-I score decreased significantly to 49.04 ± 12.45 (t = 4.408, p < 0.05). Post-TKA, SF-36 showed significant improvements in the physical function, role of physical limitations, bodily pain, vitality, social function, role of emotional limitations, and mental health subdomains. Bilateral total knee arthroplasty, body mass index, and some SF-36 subcomponents—such as general health, vitality, and role of emotional limitations—were identified as factors leading to increased FOF. Conclusions: FOF remains prevalent and severe in TKA patients, even at three months post-surgery, affecting rehabilitation outcomes. Early identification and tailored interventions for FOF should be considered essential components of comprehensive TKA recovery programs. Full article

(1) Background: Rapid population aging in China intensifies physical and mental health challenges, including negative emotions and social barriers. Physical activity (PA) fosters resilience, adaptability, and successful aging through emotional and social benefits. This study examines the relationship between square-dancing exercise and psychological capital (PsyCap) in middle-aged and elderly individuals using cross-validation, subgroup analysis, and a cross-sequential design. (2) Methods: A cross-sectional study with 5714 participants employed a serial mediation model. Online questionnaires assessed square-dancing exercise, cognitive reappraisal, prosocial behavior tendencies, PsyCap, and interpersonal relationships. Statistical analyses were conducted using SPSS 27.0 and Mplus 8.3, incorporating correlation analysis, structural equation modeling, and subgroup comparisons. (3) Results: (a) Cognitive reappraisal and prosocial behavior mediated the link between square-dancing and PsyCap through three pathways; (b) model stability was confirmed across two random subsamples; (c) cross-group differences emerged in age and interpersonal relationships. Compared with secondary data, this study further validated PsyCap’s stability over six months post-pandemic. (4) Conclusions: The study, based on China’s largest square-dancing sample, establishes a robust serial mediation model. The findings strengthen theoretical foundations for PA-based interventions promoting psychological resilience in aging populations, highlighting structured exercise’s role in mental and social well-being. Full article

Physics concepts are considered an essential component of STEM (science, technology, engineering, and mathematics) education and fundamental for economic and technological development in the world. However, there can be student academic underperformance, such as the school environment, learning media and infrastructure, student interest and emotions, as well as social and economic development factors in communities. These problems are even more acute in rural areas of developing countries, where poverty is high and teachers often lack the necessary technological skills. The aim of this study was to evaluate the impact of a low-cost STEM tool focused on motivation in learning, in terms of five variables of interest in physics in rural areas, as well as the durability of the tools used to learn 12 physics concepts. A quasi-experimental study was conducted with the participation of 78 high school students, with an average age of 15.82 years, in a rural area of Guerrero, Mexico. The results showed that using the STEM tool significantly increased students’ interest in learning methodology, active participation, and attitude towards physics, facilitating the teacher’s work. In addition, the 3D construction kit used in the experimentation, besides being low-cost, proved to be affordable and durable, making it ideal for use in rural areas. Full article

The problem associated with the manifestation of burnout syndrome is the subject of ongoing interest. In recent years, occupational burnout has been actively studied among professionals in the helping professions (teachers, physicians, social workers, psychologists, prison officers, etc.). However, the phenomenon has been poorly studied among freelancers. Therefore, the aim of this study is to fill this gap by determining the level of burnout syndrome among Bulgarian freelancers and investigate the influence of some work environment factors on professional burnout in the sample. A survey of 1138 freelancers was carried out using the Burnout Self-Assessment Questionnaire developed by Maslach and a questionnaire developed in-house to explore the factors of the occupational environment and ask questions related to socio-demographic factors. Hypotheses are tested using correlation analysis and structural equation modelling. The study reveals high levels of emotional exhaustion (40.91%, n = 484). High values on the scale of depersonalization were reported for 26,3% of the respondents (n = 311). Only 3.1% of the respondents (n = 37) had high values on the reduced personal accomplishment scale. The high levels of burnout among freelancers could be influenced by the specific characteristics of their work environment and the nature of their tasks. Full article

Most academic papers on Jordanian colloquial Arabic allophonic consonant variants have primarily examined their influence on the social status of speakers and their role in shaping linguistic prestige. However, there is a significant lack of research exploring the potential for manipulation and establishment of power through the deliberate use of consonantal variants by Jordanian speakers in Arabic. Using a variety of allophonic consonantal variants, this study investigates how speakers of Jordanian colloquial Arabic attempt to construct their discourse of power. The targeted phonemes in the current study were /q/, /θ/, /ð/, and /k/. Focus groups were used to gather data, which were then examined within the framework of Fairclough’s technologized discourse and thematic approaches. Twenty persons, 10 women and 10 men, ranging in age from 18 to 45 years, comprised each of the two groups. The duration of each focus group session was 50 min. Analysis of the data indicates that the presence of [q], [θ], [ð], and [k] allophones in Standard Arabic is restricted to particular social circumstances, such as official and scientific environments. This usage is a common trait among those who have received formal education and privileged social standing. The findings also reveal that participants strategically utilize the allophonic variants [g], [ʔ], [k], [t̪], [d̪], and [tʃ] to exert influence over interlocutors by demonstrating authority related to social identity, gender, and emotional state. This study intends to advance discussions on allophonic consonant variants in Jordanian colloquial Arabic by providing insights into their manipulative functions. Full article

Background: Family caregivers are a vital yet often under-recognized part of the healthcare system. They provide essential emotional, physical, and logistical support to individuals with illness, disability, or frailty, and their contributions improve continuity of care and reduce system strain. However, many healthcare and social service providers are not equipped to meaningfully engage caregivers as partners. In Alberta, stakeholders validated the Caregiver-Centered Care Competency Framework and identified the need for a three-tiered education model—Foundational, Advanced, and Champion—to help providers recognize, include, and support family caregivers across care settings. This paper focuses on the development and early evaluation of the Advanced Caregiver-Centered Care Education modules, designed to enhance the knowledge and skills of providers with more experience working with family caregivers. The modules emphasize how partnering with caregivers benefits not only the person receiving care but also improves provider effectiveness and supports better system outcomes. Methods: The modules were co-designed with a 154-member interdisciplinary team and grounded in the competency framework. Evaluation used the first three levels of the Kirkpatrick–Barr health workforce education model. We analyzed pre- and post-surveys from the first 50 learners in each module using paired t-tests and examined qualitative feedback and SMART goals through inductive content analysis. Results: Learners reported a high level of satisfaction with the education delivery and the knowledge and skill acquisition. Statistically significant improvements were observed in 53 of 54 pre-post items. SMART goals reflected intended practice changes across all six competency domains, indicating learners saw value in engaging caregivers as partners. Conclusions: The Advanced Caregiver-Centered Care education improved providers’ confidence, knowledge, and skills to work in partnership with family caregivers. Future research will explore whether these improvements translate into real-world practice changes and better caregiver experiences in care planning, communication, and navigation. Full article