Search Results (2,653)

Muscle–joint flexibility is defined as the ability of a muscle to stretch in a controlled manner, allowing a wide range of movement at the joints. While numerous methodologies exist for improving flexibility, few studies have investigated the role of athletes’ perceptual processes and awareness related to their own body and movement control during such training. In this pilot study, we explored how two different training protocols—static and dynamic stretching (control group, CON) and multi-joint resistance training (experimental group, EXP)—influence both flexibility and psychophysical awareness, understood as a multidimensional construct involving perceived flexibility improvements, self-assessed control over exercise execution, and cognitive-emotional responses such as engagement, motivation, and satisfaction during physical effort. The study involved 24 male amateur track-and-field athletes (mean age 23 ± 2.5 years), randomized into two equal groups. Over 12 weeks, both groups trained three times per week. Flexibility was assessed using the Sit and Reach Test at three time points (pre-, mid-, and post-intervention). A 2 × 3 mixed ANOVA revealed a significant group × time interaction (F = 20.17, p < 0.001), with the EXP group showing greater improvements than the CON group. In the EXP group, Sit and Reach scores increased from pre = 28.55 cm (SD = 4.91) to mid = 29.39 cm (SD = 4.67) and post = 29.48 cm (SD = 4.91), with a significant difference between pre and post (p = 0.01; d = 0.35). The CON group showed minimal changes, with scores of pre = 28.66 cm (SD = 4.92), mid = 28.76 cm (SD = 5.03), and post = 28.84 cm (SD = 5.10), and no significant difference between pre and post (p = 0.20; d = 0.04). Psychophysical awareness was assessed using a custom questionnaire structured on a 5-point Likert scale, with items addressing perception of flexibility, motor control, and exercise-related bodily sensations. The questionnaire showed excellent internal consistency (Cronbach’s α = 0.92). Within the EXP group, psychophysical awareness increased significantly (from 3.50 to 4.17; p = 0.01; d = 0.38), while no significant change occurred in the CON group (p = 0.16). Post-hoc power analysis confirmed small to moderate effect sizes within the EXP group, although between-group differences lacked sufficient statistical power. These results suggest that resistance training may improve flexibility and concurrently enhance athletes’ psychophysical self-awareness more effectively than traditional stretching. Such findings offer practical implications for coaches seeking to optimize flexibility training by integrating alternative methods that promote both physical and perceptual adaptations. Full article

The structure and interpersonal interactions of traditional residential communities have also been impacted and recreated as a result of the fast development of urban space and related communities. This study explores the interrelationship between neighborhood social cohesion and the life satisfaction of urban adult residents through the mediating effect of place attachment. A comprehensive theoretical model was constructed to analyze the action mechanism among these variables. Data were collected through an online questionnaire platform (n = 301), and structural equation modeling (PLS-SEM) was employed for analysis. The findings revealed a significant positive relationship between neighborhood social cohesion and residents’ place attachment. Place attachment appeared to play a mediating role between neighborhood social cohesion and life satisfaction, in which place dependence was also a potential effective mediator between the three dimensions of neighborhood social cohesion (neighborliness, sense of community, and neighborhood attractiveness) and life satisfaction. The results suggest that enhancing community cohesion may contribute to urban adult residents’ well-being by strengthening their functional dependence on the community. Full article

Objectives: The objectives are to evaluate the influence of different maternal characteristics on ultrasound image quality and operator satisfaction, and to assess, preliminarily, a rating scale to stratify the difficulty level of ultrasound examination in early gestation. Methods: A multicentric observational study of ultrasound scans was carried out on singleton pregnant women undergoing routine gestational ultrasound at 11–14 weeks and 19–21 weeks of gestation at two Prenatal Care Centers in the Apulia region (Southern Italy). Inclusion criteria included the presence of one or more limiting features, i.e., obesity, retroverted uterus, myomas, previous abdominal surgery, and limited echo-absorption. Each woman was given an overall pre-echographic limiting score from 0 to 9. The outcome measure was the operator’s satisfaction with the examination, scored on a Likert scale. Nested linear regression models (raw, semi- and fully adjusted) were built for each of the two trimesters on the pre-ecographic limiting score (0–9 points) as dependent variables, with the operator’s satisfaction as the regressor. Results: The whole sample included 445 pregnant women. The two-center samples did not show statistically different baseline features. The operator’s satisfaction with the sonographic examination was significantly (and inversely) related to the pre-echographic limiting score, regardless of the mother’s age, the operator performing the ultrasound, the Hospital Center where the ultrasound examination was performed, and the duration of the sonographic examination. Conclusions: A number of maternal conditions need to be monitored for good ultrasound performance; using a specific rating scale to stratify the level of difficulty of the ultrasound examination at early gestation could represent a potentially useful tool, although it requires further validation. Full article

Background and Objectives: Orthodontic treatment aims to enhance dental aesthetics and function, yet many patients report dissatisfaction. This study was designed with the following objectives: To assess overall patient satisfaction during active orthodontic treatment; to identify key psychosocial and clinical predictors of satisfaction, including self-confidence, social experiences, and cost perception; to evaluate the impact of orthodontist–patient communication on satisfaction and perceived treatment outcomes; to explore the relationship between aesthetic improvement and willingness to undergo treatment again. Materials and Methods: A cross-sectional survey was conducted using structured questionnaires to assess satisfaction, pain perception, treatment expectations, and communication quality. Statistical analyses, including correlations and regression models, were used to identify predictors of satisfaction. The study included 450 orthodontic patients from the north-eastern region of Romania, undergoing active treatment at the time of data collection. Results: The strongest predictor of satisfaction was improved self-confidence and smile aesthetics (r = 0.62). Effective communication with orthodontists significantly increased satisfaction (r = 0.58, p = 0.002), while perceived high costs had a negative impact (r = −0.41). Pain and discomfort were common, with 90% of patients experiencing treatment-related pain, leading to reduced compliance. Social embarrassment due to braces also contributed to dissatisfaction (r = −0.47). Conclusions: Patient satisfaction with orthodontic treatment is primarily influenced by aesthetic improvements and effective communication. While enhanced smile perception boosts confidence, financial concerns and social discomfort may negatively affect the overall experience. Improving accessibility to treatment and providing comprehensive patient support are essential for optimizing patient satisfaction. Full article

With the rapid digital transformation of healthcare services in India, this study investigates the factors influencing the behavioral shift from traditional hospital visits to e-health consultations. The primary objective was to analyze patient attitudes, satisfaction, and perceived barriers to adopting virtual healthcare, especially in urban and semi-urban settings. Methods: The methodology adopted in the study was descriptive, and a convenience sampling technique was used for data collection because the feasible times of the patients’ availabilities were taken into consideration for data collection. Both primary and secondary data were collected using questionnaires and literature. A sample size of 385 participants was used in this study. Various statistical tools, such as frequency, ANOVA, and Chi-square tests, were used to test the hypotheses. Results: It was observed from ANOVA and Chi-square tests that the factors for switching from traditional consultation to e-health services have a positive association. It was found that integrating data through influencing factors significantly (p < 0.001) improved decisions on e-health services. Conclusion: This study highlights the shift from in-person to e-health consultations driven by convenience, flexibility, and pandemic-related needs while acknowledging barriers such as digital literacy, infrastructure gaps, and trust issues. It recommends strategies, such as secure platforms, training, and integrated care models, for a more inclusive digital health future. Full article

This study examines the implementation of problem-based learning in the teaching of physics within the context of technical–professional higher education in Chile. The research aimed to evaluate meaningful learning, competency development, and student satisfaction. The study involved 122 first-year students enrolled in technical programmes related to the field of mechanics. The findings revealed significant improvements in both conceptual and propositional learning, as well as in the development of technical competencies such as problem-solving, information selection, and teamwork. Additionally, high levels of student satisfaction were observed, indicating that problem-based learning not only enhances learning but also fosters greater engagement and motivation among students. These results highlight the potential of problem-based learning to transform the teaching of physics in technical–professional higher education settings, aligning academic content with practical applications and providing students with relevant and high-quality education. Full article

Background: Sexuality is a central aspect of being human, even if people experience it in different ways in various stages of life. Sexuality in older people may be expressed, as well as affection, companionship, touch, and physical contact. However, older peoples’ sexual needs are not properly considered by themselves, caregivers, or healthcare professionals. Reviews on barriers related to identification and satisfaction of sexual needs of people living in nursing home are scarce. In this scenario we intended to summarize the state of evidence regarding sexual need identification and satisfaction among older people living in nursing homes and possible barriers that could limit sexual need identification and satisfaction. Methods: We carried out a narrative review. The included studies responded to the research question, using the following key words: nursing homes, sexuality or sexual need, or sexual behavior, older people. Searched databases included PubMed, Embase, CINAHL, PsycInfo, and Scopus. Results: After searching and screening we included 22 studies, finding three main topics: 1. identification of sexual needs by residents and healthcare personnel attitude and practice; 2. barriers and reasons hindering the identification of sexual needs; and 3. manifestation and satisfaction of sexual needs. Conclusions: The findings showed that nursing homes’ residents have different sexual needs, but there are many organizational, educational, and cultural barriers and negative attitudes of healthcare personnel. Supporting nursing home residents to express their sexual needs is a challenge for the healthcare professionals and managers of nursing homes. Full article

We live in an era where digitalization and omnichannel strategies significantly transform retail landscapes, and accurate spatial analytics from Geographic Information Systems (GIS) can deliver substantial competitive benefits. Nonetheless, despite evident practical advantages for specific targeting strategies and operational efficiency, the degree of GIS integration into academic marketing literature remains ambiguous. Clarifying this uncertainty is beneficial for advancing theoretical understanding and ensuring retail strategies fully leverage robust, data-driven spatial intelligence. To examine the intellectual development of the field, co-occurrence analysis, topic mapping, and citation structure visualization were performed on 4952 peer-reviewed articles using the Bibliometrix R package (version 4.3.3) within R software (version 4.4.1). The results demonstrate that although GIS-based methods have been effectively incorporated into fields like site selection and spatial segmentation, traditional marketing research has not yet entirely adopted them. One of the study’s key findings is the distinction between “author keywords” and “keywords plus,” where researchers concentrate on novel topics like omnichannel retail, artificial intelligence, and logistics. However, “Keywords plus” still refers to more traditional terms such as pricing, customer satisfaction, and consumer behavior. This discrepancy presents a misalignment between current research trends and indexed classification practices. Although the mainstream retail research lacks terminology connected to geomarketing, a theme evolution analysis reveals a growing focus on technology-driven and sustainability-related concepts associated with the Retail 4.0 and 5.0 paradigms. These findings underscore a conceptual and structural deficiency in the literature and indicate the necessity for enhanced integration of GIS and spatial decision support systems (SDSS) in retail marketing. Full article

The aging of China’s population has created significant challenges for the mental health of older adults. However, limited research has examined how public sports facility availability in living communities supports older adults’ mental health. To explore this association, data were extracted from the 2016 China Longitudinal Aging Social Survey, which involved 7811 respondents. The ordinary least squares model and the instrumental variable approach were employed to test the association between public sports facility availability in Chinese older adults’ living communities and their mental health. The bootstrapping method was used to estimate the mediating effect of physical activity and life satisfaction. The results indicate that public sports facility availability in living communities was significantly correlated with a decrease in depressive symptoms among older people (coefficient = −0.225; p < 0.01), which suggests that a greater availability of public sports facilities in living communities is related to the better mental health of older adults. The results of the mediation analysis show that physical activity and life satisfaction were identified as mediating mechanisms. This study suggests that increasing the availability of public sports facilities in older adults’ living communities can alleviate depression and promote better mental health. Our findings provide valuable policy implications for enhancing public sports infrastructure and promoting healthy aging. Full article

Background/Objectives: Young female cancer survivors often face specific informational needs related to the physical and emotional effects of cancer and its impact on life plans, particularly fertility and parenthood. However, few tools are tailored to assess these needs during this critical life stage. This study aimed to (i) validate a multidimensional measure—the Satisfaction with Information Provided to Young Oncology Patients Scale (SIPYF-CPS)—to assess the specific informational needs of young adult female cancer survivors; and (ii) explore preferences regarding the provision of information and counseling. Methods: A total of 124 women (M[age] = 38.18; SD = 5.49; range 21–45), 76.6% diagnosed with breast cancer, participated in the study. Psychometric analyses included exploratory factor analysis and correlation coefficients to assess reliability and construct validity. Convergent validity was evaluated through standardized measures of anxiety, reproductive concerns, and quality of life. Results: A final 22-item measure demonstrated strong reliability and validity, capturing four factors: (i) Disease-Related Information, (ii) Symptoms and Functional Limitations, (iii) Implications for Fertility and Parenthood, and (iv) Support Services. Participants expressed low satisfaction with information on fertility preservation, sexual health, and support services. Lower satisfaction was moderately associated with higher anxiety and depression while positively related to quality of life. Most participants preferred phased, face-to-face communication throughout the illness trajectory. Conclusions: The SIPYF-CPS is a valid, multidimensional tool that captures the complex and evolving informational needs of young female cancer survivors. Its clinical use may promote earlier, personalized, and emotionally responsive communication—supporting psychological well-being, informed decision-making, and long-term survivorship care. Full article

This paper clarified the correlation among quality of life (QoL) indicators, exercise implementation level, and exercise habits in middle-aged and older adults under identical exercise intervention conditions. The survey items were anthropometric and physiologic measurements, physical strength measurements, and exercise habits. During the 3-month experimental period, a weekly “health exercise course” served as the primary intervention. For all participants, anthropometric and physiologic measurements, physical strength tests, questionnaire surveys, and other surveys were conducted before and after the experiment; then, the pre- and post-intervention effects were compared. After the exercise intervention, significant differences were observed among middle-aged and older adults in terms of various parameters, such as weight, fat rate, diastolic pressure, systolic pressure, sit-up, standing on one foot, lower limb extension force, activity of daily living (ADL), and subjective well-being (PGC). ADL and PGC changed significantly in the participants who engaged in exercise more than twice a week. However, the participants who engaged in exercise for less than twice a week showed no significant differences in any parameters except the life satisfaction (LSI) mean; the LSI increased in the “Less than twice a week” exercise group but decreased in the “More than twice a week” group. In terms of average walking time per session, the “More than 30 min” exercise group showed significant differences in ADL and PGC, whereas the “Less than 30 min” group showed significant differences only in the LSI. The influence of exercise on QoL indicators of middle-aged and older adults, under the same exercise intervention conditions, is related to their exercise habits. This study highlights the benefits of physical exercise in middle-aged and older adults, emphasizing the importance of regular and sustained exercise for this population. Furthermore, the study provides a scientific basis for improving QoL in middle-aged and older adults, thus, to some extent, addressing the concerns related to the growing population of older adults. Full article

Background: Nursing students often experience heightened levels of stress during clinical training due to the dual demands of academic and clinical responsibilities. These stressors, compounded by environmental and organizational factors, can adversely affect students’ well-being, academic performance, and the quality of patient care they deliver. Aim: This study aimed to identify the key stressors influencing nursing students’ perceptions of single-shift quality (SSQ) during clinical training and to examine how well students can predict the quality of their shift based on pre-shift expectations. Methodology: A cross-sectional survey design was implemented, collecting pre- and post-shift data from 325 nursing students undergoing clinical training in Alabama. The survey measured 13 domains related to workload, environmental conditions, organizational interactions, coping strategies, and overall satisfaction. Paired t tests and linear regressions were used to assess changes in perception and identify key predictors of SSQ. Results: This study found significant discrepancies between students’ pre- and post-shift evaluations across multiple domains, including internal environment, organizational interaction with clinical faculty/preceptors, and coping strategies (p < 0.001). Students also accurately predicted stable factors such as patient characteristics and external environment. Pre-shift expectations did not significantly predict post-shift experiences. Post-shift perceptions revealed that stress-coping strategies and collegiality were the strongest predictors of shift quality. Conclusion: Students enter clinical shifts with optimistic expectations that often do not align with actual experiences, particularly regarding support and stress management. The SSQ framework offers a valuable tool for identifying gaps in clinical training and guiding interventions that foster resilience and better alignment between expectations and real-world practice. Full article

Background and Objectives: Chronic kidney disease frequently progresses to end-stage renal disease, requiring dialysis, which imposes significant physical, psychological, and social burdens. Age is a key factor influencing symptom experience and quality of life in dialysis patients, yet findings on its impact remain mixed. This study aimed to examine how age relates to a broad range of health domains—including fatigue, pain, cognition, mental health, sexual satisfaction, bowel control, visual impairment, social support, and quality of life—among hemodialysis patients. Materials and Methods: A cross-sectional study was conducted at a single dialysis center in Poland, involving 79 adult patients undergoing maintenance hemodialysis. Standardized, validated psychometric instruments were used, including the Modified Fatigue Impact Scale (MFIS), Perceived Deficits Questionnaire (PDQ), Pain Effects Scale (PES), Mental Health Inventory (MHI), Modified Social Support Survey (MSSS), Sexual Satisfaction Scale (SSS), Bowel Control Scale (BWCS), Impact of Visual Impairment Scale (IVIS), and WHOQOL-BREF for quality of life. Spearman’s or Pearson’s correlation coefficients were used to evaluate relationships between age and scale scores. Full and abbreviated versions of scales were also compared. Results: Age showed moderate positive correlations with fatigue (ρ = 0.44–0.53), cognitive deficits (ρ = 0.37–0.45), pain (r = 0.41), bowel control issues (ρ = 0.32), and visual impairment (ρ = 0.37), all statistically significant (p < 0.01). No significant associations were observed between age and mental health (MHI), perceived social support (MSSS), or quality of life (WHOQOL-BREF). Abbreviated versions of the scales showed strong correlations with their full versions (ρ > 0.9). Conclusions: While age is linked to increased symptom burden in select domains such as cognition, fatigue, and pain, it does not significantly affect mental health, perceived social support, or overall quality of life in hemodialysis patients. These findings support the use of age-sensitive, multidimensional assessments to inform individualized care strategies. Full article

International students are an important group at German higher education institutions. Yet few studies have considered the psychosocial situation of these students. The present study combines the study demands-resources model (SD-R model) and the acculturation framework to adapt the former to the specific situation of international students, and examines the effects of study demands, institutional resources, individual resources (acculturation orientations, i.e., affective and cognitive orientations towards the home and host country), stress, and engagement on their life satisfaction as one indicator of well-being. We used cross-sectional survey data from 503 international students across more than 20 higher education institutions. Latent structural equation models showed that lower study demands were associated with lower stress and higher student engagement, which in turn predicted greater life satisfaction. Although higher institutional resources also related to increased engagement and, thus, higher life satisfaction, they were unexpectedly linked to increased stress, which was in turn associated with lower life satisfaction. Additionally, the expected positive effect of affective host country orientation on life satisfaction, mediated through perceived stress and engagement, was confirmed. The consideration of acculturation orientations in the SD-R model helps to understand the specific conditions of well-being amongst international students in Germany. Full article

Introduction: Assessing the quality of patient care within healthcare systems remains a multifaceted challenge due to varying definitions of “quality” and the complexity of care delivery structures worldwide. Patient-centeredness, institutional responsiveness, and contextual adaptability are increasingly recognized as core pillars in quality assessment. Objective: This narrative literature review aims to explore conceptual models and practical frameworks for evaluating healthcare quality, emphasizing tools that integrate technical, functional, and emotional dimensions and proposing a comprehensive model adaptable to diverse health system contexts. Methodology: A systematic literature search was conducted in the PubMed, Scopus, and Cochrane Library databases, covering the years 2000 to 2024. Studies were selected based on relevance to quality assessment models, patient satisfaction, accreditation, and strategic improvement methodologies. The review followed a thematic synthesis approach, integrating structural, process-based, and outcome-driven perspectives. Results: Core frameworks such as Donabedian’s model and balancing measures were reviewed alongside evaluation tools like the Dutch Consumer Quality Index, SERVQUAL, and Importance–Performance Analysis (IPA). These models revealed significant gaps between patient expectations and actual service delivery, especially in functional and emotional quality dimensions. This review also identified limitations related to contextual generalizability and bias. A novel integrative model is proposed, emphasizing the dynamic interaction between institutional structure, clinical processes, and patient experience. Conclusions: High-quality healthcare demands a multidimensional approach. Integrating conceptual frameworks with context-sensitive strategies enables healthcare systems to align technical performance with patient-centered outcomes. The proposed model offers a foundation for future empirical validation, particularly in resource-limited or hybrid settings. Full article