Search Results (16,167)

Suicidal ideation among college students is a multicausal public health concern shaped by individual, family, social, and academic factors. Although prior research has consistently documented associations between psychological distress and suicide risk in this population, most studies analyze risk factors in isolation, leaving the joint contribution of variables across ecological levels insufficiently understood. The present study, framed within Bronfenbrenner’s ecological model of human development and Joiner’s interpersonal theory of suicide, examined the simultaneous influence of clinical, protective, academic, and victimization variables on suicidal ideation in college students. A cross-sectional design was employed with a sample of 553 undergraduate and graduate students (68.9% women; mean age = 20.93 years, SD = 3.81) from the University of Málaga (Spain), recruited through snowball and convenience sampling. Participants completed validated self-report measures of suicidal ideation (Paykel Suicide Scale), depression and anxiety (HADS), eating disorders (CBCAR), self-esteem (RSE), academic stress (SISCO), academic procrastination (APS-SF), bullying, cyberbullying, and social exclusion (QAEU), social support (QFSSS), family satisfaction, healthy habits, and family history of mental illness. Data were analyzed through Pearson and Spearman correlations and a robust multiple linear regression (ordinary least squares with HC3 robust standard errors and bias-corrected and accelerated bootstrap confidence intervals from 5000 resamples), complemented by an ordinal regression as a sensitivity analysis. The regression model accounted for 44.1% of the variance in suicidal ideation, with depression, anxiety, eating disorders, family history of mental illness, and bullying showing significant positive associations and self-esteem the strongest protective association. An ordinal regression sensitivity analysis yielded a consistent pattern, supporting the robustness of these findings. Family and social support, although correlated with lower ideation, lost statistical weight in the multivariate models, suggesting that their contribution operates indirectly, mainly through depression and self-esteem. Findings support the integration of clinical, social, and personal-resource components into college prevention programs, prioritizing early detection of psychopathology, anti-bullying protocols, interventions to strengthen self-esteem, and greater visibility of campus psychological services. Full article

(1) Background: Ambulatory services are the main interface between populations and health systems, yet their benefits are unevenly distributed due to structural inequalities—systemic differences rooted in the social, economic, and political organisation of society. Inequities in access and quality are well documented, but patient safety remains the least examined. (2) Methods: Following Joanna Briggs Institute methodology and PRISMA-ScR guidelines, PubMed/MEDLINE and Scopus were searched for studies published from 2010 to 2026. In total, 44 studies were included, predominantly from the USA (n = 31), and synthesised narratively. (3) Results: Inequalities operated through geographic maldistribution, financial barriers, exclusionary institutional cultures, and market-driven practices. Access and quality were each addressed by 17 studies, whereas only four examined patient safety directly; the limited safety evidence indicated disproportionate diagnostic errors, medication-safety failures, and care-coordination breakdowns among vulnerable groups. Evidence was concentrated in the USA. (4) Conclusions: Structural inequalities are well documented for access and quality but are markedly under-studied for patient safety—the principal evidence gap identified. Patient safety warrants treatment as an equity outcome, measured with stratification by structural disadvantage and addressed through system-level interventions. Full article

Automatic detection of stress in social media text holds promise for supporting digital mental health, but most existing Transformer-based approaches are opaque and computationally demanding. This work presents DR-Transformer, a Dual-Regularized Transformer that combines two complementary mechanisms: (i) a group sparsity penalty ($L_{2,1}/L_2$ elastic net) applied to the query and key projection matrices of every attention head, which encourages whole-row sparsity, producing more concentrated and inspectable attention patterns; (ii) a supervised contrastive loss on the [CLS] projection, which organizes the latent space according to the stress label. The architecture is intentionally lightweight (six layers, eight heads, 256-dim embeddings; ∼9.5 M parameters) and runs entirely on consumer-grade hardware (NVIDIA GTX 1660, 6 GB). Experiments on the publicly available Dreaddit dataset (binary stress classification, 2838 train/715 test segments) compare DR-Transformer against Logistic Regression, BiLSTM, a Standard Transformer of identical architecture, and MentalBERT. Across five seeded runs, DR-Transformer (Full) reaches $F_1=0.876$ (bootstrap 95% CI $0.852$–$0.898$), outperforming the Standard Transformer ($F_1=0.842$; McNemar $p<0.001$ with Bonferroni correction) and performing comparably to the much larger MentalBERT ($F_1=0.879$; $p=0.421$). Sparse regularization increases the fraction of near-zero attention weights (below $0.01$) from $0.215$ to $0.682$, while the supervised contrastive loss improves the silhouette score of [CLS] embeddings from $0.312$ to $0.483$. Dual regularization thus combines accuracy, efficiency, and structurally induced attention concentration in a single model which can be trained without specialized infrastructure. We use the term “interpretable” throughout in this restricted, structural sense—to refer to concentrated and inspectable attention—rather than in the sense of established causal or mechanistic faithfulness; this is only partially and indirectly supported by our token deletion analysis. Full article

Background: This research explored how psychological capital (PsyCap) is associated with innovative work behavior (IWB) through the serial mediation of career adaptability (CA) and work engagement (WE) among Pakistani healthcare practitioners. The study was grounded in the Career Construction Model of Adaptation (CCMA). Methods: Data were collected from 355 healthcare practitioners. Model 6 of the PROCESS macro with bias-corrected bootstrapping was used to examine the proposed serial mediation model while controlling for the effects of gender, age, tenure, and professional category. Results: The total indirect effect through both serial mediators was statistically significant, suggesting that CA and WE help explain how PsyCap is associated with IWB. In line with the CCMA, the findings support a sequential pattern of associations whereby psychological resources (adaptive readiness) are associated with adaptable career functioning (adaptability resources), which in turn is linked with motivational engagement at work (adapting responses), and this state of engagement is subsequently associated with innovation-oriented actions (adaptation results). Conclusions: This study applies and extends the CCMA by examining its adaptation process in the healthcare sector, as well as conceptualizing WE as an adapting response and IWB as a behavioral adaptation outcome. The findings provide practical insights by highlighting the potential value of targeted interventions that strengthen PsyCap, CA, and WE to support IWB while also fostering the career adaptation process in healthcare organizations. Full article

Background: With the rising demand for fast and reliable diagnosis the radiology departments struggle to keep up. In Slovakia however it is difficult to find more employees for radiology clinics and departments, therefore the employees are ever more overburdened, which may lead to burnout. Objective: The aim of our study was to assess the burnout situation among radiology clinics and departments employees and asses the specific causes that increase the risk of burnout. Compare the burnout profile of radiologists and technicians. And look for potential targets for intervention in order to stabilize and improve the situation. Methods: Standardized Burnout assessment tool (BAT), validated in Slovak and an author-developed exploratory instrument were distributed among employees of ten hospitals in Slovakia. Convenience sampling was used in ten radiology clinics and departments in big, small and specialized hospitals. The entire questionnaire consisted of 55 questions. The received responses were processed statistically and correlations were analyzed. Results: There have been 213 questionnaires distributed and 105 complete and valid responses received. 26 respondents (24.76%) had an overall BAT score at or above 3.02 and can be considered at risk of burnout. The dominants dimensions of burnout in our set were exhaustion (3.06) and cognitive impairment (2.76). The highest score in the author-developed exploratory instrument was in visual exhaustion of radiologists (3.78). In the group of workers with 5 or more 24 shifts monthly mental distance is elevated (3.05). Burnout profiles in equal groups (N = 46) of radiologists and radiology technicians were compared with significantly higher levels of cognitive impairment found in radiologist. Conclusions: In our study 24.76% of respondents can be considered in risk of burnout, with highest scores in exhaustion and cognitive impairment dimensions, emotional impairment was relatively lower. Cognitive impairment seems to be more prevalent among radiologist compared to radiology technicians. Higher number of 24-h shifts was associated with higher mental distance scores. The highest Likert scale scores in the author developed exploratory instrument are in visual exhaustion, professional isolation and the feeling of anonymous service. Full article

LENA Start^TM is a community-based parent education program designed to promote early language development in children from birth to 3 years of age. In this study, the contributions of three intervention components—home recordings, individualized feedback, and parent education—were examined over 10 weeks across three groups: LENA Start^TM program (n = 347), Recordings + Feedback (n = 66), and Recordings Only (n = 51). Linear mixed-effects models were used to examine change over time, group differences, and group differences in trajectories while accounting for baseline values and child characteristics. There were improvements in child language, as measured by the parent-reported LENA^® Developmental Snapshot, across measurement periods for all groups, whereas parent-reported confidence and knowledge survey scores increased only for families participating in the LENA Start^TM program. Families receiving feedback (LENA Start^TM and Recordings + Feedback) reported greater increases in reading time than families completing recordings alone. After accounting for baseline values, no overall group differences or differences in trajectories were observed in the number of adult words, conversational turns, or child vocalizations as measured by LENA^® recordings. These findings suggest that different components of LENA-based interventions may influence distinct outcomes and underscore the importance of evaluating parent language interventions using multiple measures, extending beyond quantitative indicators of parent–child talk. Full article

Growing geopolitical instability has led to increasing concerns about the psychological impact of war beyond directly affected populations, highlighting the need for culturally appropriate instruments to assess fear of war. In this study, we evaluate the psychometric properties of the Turkish version of the Fear of War Scale (FOWARS) and examine its associations with sociodemographic characteristics and personality traits. A total of 643 adults across two independent samples (sample 1 = 360; sample 2 = 283) completed the FOWARS, the Tolerance of Uncontrollability Questionnaire, the Next Big Five Inventory (BFI-2), the Depression Anxiety Stress Scale-21 (DASS-21), and a sociodemographic information form. Confirmatory factor analysis supported the original two-factor structure of the FOWARS, with the Turkish version demonstrating satisfactory structural validity, convergent validity, discriminant validity, criterion-related validity, strong internal consistency, and measurement invariance across gender. Fear of war was negatively associated with tolerance of uncontrollability and positively associated with depression, anxiety, and stress. In addition, fear of war was significantly associated with gender, socioeconomic status, agreeableness, neuroticism, and conscientiousness. These findings expand the understanding of the individual determinants of fear of war, underscoring the importance of developing targeted interventions for vulnerable populations. Full article

This study examined the relationship between loneliness and sleep disturbances and explored the roles of community resilience and psychosocial factors (social support, anxiety, and substance use coping) in shaping this relationship. A spatially stratified random sampling approach was applied to select households between Interstate 10 and the Gulf of Mexico coastline across three Mississippi counties: Hancock, Harrison, and Jackson. Amos version 30 was used to analyze the proposed structural equation model (SEM) based on responses from 310 participants (mean age = 50.47 years, SD = 17.57; 53.3% female). Data were collected using validated self-report instruments, including the Communities Advancing Resilience Toolkit (CART), the Multidimensional Scale of Perceived Social Support (MSPSS), the UCLA 3-item Loneliness Scale, the GAD-2, and the Brief COPE. Results revealed that initially, a significant association was observed between loneliness and sleep disturbances. However, this direct association was non-significant upon the inclusion of anxiety and substance use coping, showing instead a statistically significant indirect association operating through anxiety symptoms. Higher levels of loneliness were associated with increased anxiety symptoms, which in turn were associated with higher sleep disturbances. No indirect relationship between loneliness and sleep disturbances through substance use coping was found. The results also found that higher levels of community resilience and social support were associated with lower levels of loneliness. These findings highlight the need for multilevel strategies to improve sleep quality, which creates a nested system in which community strengths and individual support systems are jointly positioned as upstream correlates of lower individual isolation. Full article

Cultural heritage management today faces the challenge of addressing increasingly complex realities. In this context, international organisations focus on identifying heritage attributes that consider not only physical and artistic values, but also symbolic, social and environmental dimensions, a task that has been implemented in recent years and in which significant progress has been made. The aim of this research is to develop a detailed protocol for identifying heritage attributes, using the Alcázar of Seville, a World Heritage Site, as an example. Based on a consolidated methodology, the aim is to outline the work process by identifying the sequence of tasks from the collection, selection and distribution of information to the formation of the transdisciplinary team, the analysis process and the selection of attributes. The result shows a sequenced process in which a wide range of material is reviewed in depth from various disciplines, allowing the identification of attributes beyond cultural significance. This methodological update involves increasing the size of the transdisciplinary team and taking a more social approach to the management of this heritage. The proposal takes the form of a useful working tool for heritage professionals and public administrations responsible for managing world heritage properties. Full article

Background and Objectives: Advances in medical, surgical, and acute burn care have shifted burn care from survival alone to survivorship; such improvement can be accompanied by extensive morbidity and disability in chronicity not previously encountered. The epidemiological characteristics of patients treated at a burn rehabilitation center, in the context of evolving social and occupational environments, may provide insights into current trends and their clinical implications. Notably, updated epidemiological data reflecting these changes in burn injury patterns remain scarce worldwide. To date, no epidemiological data from a burn rehabilitation center have been reported in Taiwan. Therefore, this study aimed to bridge this gap by providing a recent epidemiological review from the perspective of a burn rehabilitation center. Materials and Methods: This is a single-center, retrospective cross-sectional study enrolling patients who sustained burn injuries between January 2016 and December 2023. Data were collected from medical records and analyzed using SPSS version 20.0. Results: A total of 143 patients were recruited, of whom 101 were male (70.6%). The mean age was 38.51 years (SD = 20.28), and the mean total body surface area (TBSA) burned was 20.83% (SD = 18.77). Flame burns were the most common etiology, accounting for 67 cases (46.9%). Among the 143 patients, 73 (51.0%) sustained work-related burns, which were associated with a higher incidence of eye involvement compared with non-work-related burns (28.8% vs. 14.3%, p = 0.036). The upper extremity was the most frequently involved anatomical site, affecting 98 patients (68.5%). Conclusions: The present findings highlight an underrecognized need for stronger safety measures that address both personal and environmental risk factors. Risk-reduction strategies should particularly account for the aging workforce and vulnerable anatomical sites to mitigate preventable human and economic losses. Full article

High-altitude regions are known as corridors assisting exchange among communities, and the implementation of economic corridors in these regions provides connections and networks based on two geographical territories. For example, the China–Pakistan Economic Corridor (CPEC), established as an infrastructural development project with wide-reaching socioeconomic and environmental implications, is regarded as a significant driver of regional transformation, with the potential to generate several businesses, build institutional resilience, reduce poverty, foster a circular economy, and create job opportunities. The current study explores the perceptions and attitudes of educated adult residents in selected mountain districts regarding CPEC, which is vital to ensure wide-ranging and sustainable infrastructure development in alignment with the SDG goals, explicitly SDG 4 (Quality Education), SDG 8 (Decent Work and Economic Growth), SDG 9 (Industry, Innovation, and Infrastructure), and SDG 15 (Environmental Protection). Grounded in Social Exchange Theory, Structural Equation Modeling (SEM) was used to assess local perceptions concerning the costs and benefits linked with infrastructural development projects and concentrating on its socioeconomic and environmental outcomes in Gilgit-Baltistan, Pakistan. The questionnaire was self-administered by respondents, who documented their own responses to all items. The researcher remained present throughout data collection to distribute the questionnaires, provide verbal explanations or translations into the local language for specific terms upon request, and collect completed forms; in total, 384 respondents completed the survey. Findings revealed that surveyed educated adult respondents perceived sustainable infrastructural development favorably, particularly regarding anticipated improvements in quality of life, job creation, alleviating poverty, and the current education system, with 59.9%, 53.1%, 53.1% and 41.7% agreement, respectively. Respondents also expressed concerns about environmental protection, such as health and safety, environmental risks, and construction/transportation-related pollution at 39.8%, 37.5% and 36.7%, respectively. Backed up by SEM direct path analysis, which showed significant positive relationships between infrastructural development and educational development (H1: β = 0.439), quality of life (H2: β = 0.638), job opportunities (H3: β = 0.603), poverty alleviation (H4: β = 0.534), and environmental protection (H5: β = 0.267). Thus, all hypotheses H1-H5 were supported. This study recommends that officials and policymakers promote stakeholder investment for regional sustainability transitions, formulate regional environmental policies and governance for sustainable development to enhance the benefits of CPEC. Full article

Since the onset of the COVID-19 pandemic, children and adolescents across Europe have experienced a significant rise in mental health challenges, including anxiety, depression, and behavioural disorders. Schools have observed a marked shift in social behaviour, with increased emotional instability, social withdrawal, and attention-related issues. Simultaneously, educational systems face a growing shortage of skilled professionals, particularly in psychological support roles. While digital technologies offer partial relief, their effectiveness is limited by concerns such as screen fatigue and a lack of embodied interaction. This paper conceptualises the use of social robots as a novel intervention tool in education, grounded in the 4E cognition framework—embodied, embedded, enacted, and extended—and informed by interdisciplinary research. Using design thinking and insights from empirical and practical work, we developed five use cases for integrating robots into the Swiss MindMatters mental health promotion programme. These five use cases demonstrate how robots can facilitate emotional learning, simulate social interactions, support conflict mediation, and reduce teacher workload. By combining physical presence with adaptive behaviour, social robots, which will serve as digital twins of pedagogical partners, offer a promising, ethically sensitive extension of classroom environments, fostering deeper engagement, social competence, and cognitive development in ways traditional technologies cannot fully replicate. Full article

This article examines whether and how work environments can foster social love, understood as a relational practice grounded in care, recognition, cooperation, and overabundance beyond instrumental exchange. Drawing on economic–managerial studies on love and agapic behaviour in organizations and sociological theories of social love, the paper analyses an experimental field study involving 200 young professionals from three Italian organizations. Participants were organized into heterogeneous and homogeneous work groups according to socio-emotional profiles assessed through standardized instruments, including BES, IRI, HSC, and BESSI. The groups collaborated on a project concerning the role of human relations in respect of artificial intelligence across three environments: face-to-face, online, and immersive virtual reality. Data were collected through focus groups, individual logbooks, peer evaluation, and lexical–thematic analysis supported by T-LAB. The findings show that relational quality emerged progressively through transitions from uncertainty to orientation, from diversity to cooperation, and from individual contributions to shared decisions. Face-to-face interaction proved particularly effective for trust, empathy, and decision-making, while digital and immersive environments supported coordination and engagement but required greater relational adaptation. The study concludes that social love is not reducible to individual soft skills but can develop within organizational interactions when work settings enable trust, solidarity, and mutual recognition. Full article

This study explored the lived experiences of youth workers within formal education settings in South Africa. Utilising a qualitative approach, the study sampled 22 youth workers participating in presidential youth employment initiatives in partnership with the Department of Basic Education. The findings indicate that youth workers play a vital role in promoting social development among young people within formal education settings, a result that aligns with the empowerment theory guiding this research. Specifically, youth workers provide essential psychosocial and mental health support, contributing to holistic youth development. However, their effectiveness is frequently constrained by operational issues, including limited institutional recognition and ambiguous role definitions. Furthermore, a lack of sustainable funding and restricted time allocations for youth work activities remain significant challenges. The study recommends the formal institutionalisation of professional youth work within South African education policy, supported by clear operational frameworks, structured collaboration, and enhanced training to ensure sustainable learner support. Full article

Community pharmacies are increasingly providing health care services like tobacco treatment and disease-related management but need sustainable models for implementation. As several state Medicaid programs reimburse for community health worker (CHW) services, one promising model is to have pharmacy technicians engage with patients as designated CHWs. This qualitative study interviewed staff in seven California pharmacies about their experience with and perspectives on implementing community pharmacy technicians as CHWs. Guided by implementation science frameworks, data were hand-coded and analyzed iteratively using thematic analysis. Relative advantage and compatibility of CHWs was high across all pharmacies. Pharmacy culture aligned with CHW values, and CHW integration helped formalize the work that pharmacy staff were already doing. Challenges included the complexity of billing and obtaining payment for services provided. Despite these barriers, pharmacies successfully integrated and expanded their CHW services, ranging from social service connections to tobacco treatment or disease-related management education. Pharmacy peer networks, health plan champions and patient outcome improvements accelerated diffusion. Community pharmacies provide a trusted setting for delivering both CHW education and extending health care services, but broad implementation will need health plans to improve policy and procedure with guidance specifically for the pharmacy context that helps overcome administrative barriers. Full article