Search Results (12,039)

Background: The increasing prevalence of diabetes mellitus and metabolic risk factors among young adults has become a major public health concern. University students are particularly vulnerable to unhealthy lifestyle changes, including sedentary behavior, insufficient physical activity, and academic stress, all of which may be associated with an elevated risk of metabolic disorders. Objective: This study aimed to examine the associations of academic stress, physical activity, and sedentary behavior with diabetes risk among university students. Methods: A cross-sectional analytical study was conducted among 264 university students recruited through an online survey. Academic stress was assessed using a six-item Likert-scale instrument, while diabetes risk was evaluated using a composite score derived from indicators adapted from the modified Finnish Diabetes Risk Score (modified FINDRISC). Statistical analyses included descriptive statistics, Cronbach’s alpha reliability testing, exploratory factor analysis (EFA), Spearman’s correlation analysis, and multivariable logistic regression. Results: The academic stress instrument demonstrated good internal consistency (Cronbach’s alpha = 0.85). Exploratory factor analysis supported the construct validity of the instrument, with all six items loading substantially on a common academic stress factor. Correlation analysis revealed that academic stress was positively associated with sedentary behavior and diabetes risk, whereas physical activity was negatively associated with diabetes risk. Multivariable logistic regression showed that academic stress was significantly associated with an increased risk of diabetes (adjusted odds ratio [aOR] = 1.18, 95% confidence interval [CI]: 1.02–1.36; p = 0.028). Moderate-to-vigorous physical activity was associated with a lower risk of diabetes (aOR = 0.74, 95% CI: 0.60–0.92; p = 0.011), while longer sitting duration was associated with an increased risk of diabetes. Conclusions: Academic stress, sedentary behavior, and physical activity were significantly associated with diabetes risk among university students. These findings highlight the importance of developing university-based health promotion programs that integrate stress management, physical activity promotion, and sedentary behavior reduction to support the prevention of metabolic risk factors in young adults. Full article

This research aims to understand Chinese international students’ perceptions of the academic support provided by Spanish universities. It explores students’ feedback on their participation in such support, its perceived effectiveness, and their expectations and needs. Drawing from a hybrid sociocultural framework, this study employed a qualitative research design, conducting semi-structured interviews to collect data from 14 Chinese postgraduate students at the Autonomous University of Barcelona. Data were analysed using thematic analysis to uncover key themes related to the students’ experiences with the academic support system. The findings reveal that, although UAB offers various forms of academic support, both participation in, and the perceived effectiveness of, these provisions remain limited. Chinese students encounter challenges such as language barriers, unfamiliarity with the academic support system, and varying attitudes from faculty. The findings highlight a need for more practical and systematic academic writing and speaking courses, as well as culturally sensitive and internationalised support mechanisms. As a practical implication, the study suggests that universities should prioritise “situational” oral communication training that prepares students for active classroom participation and implement proactive outreach strategies, such as engaging departmental coordinators to directly promote available library and digital resources, thereby overcoming the current lack of student awareness. This study contributes to addressing a gap in the literature by providing empirical insights into the learning experiences of Chinese postgraduate students regarding academic support in Spain. It offers recommendations for UAB and other Spanish institutions to enhance their academic support systems, promoting a more inclusive and international environment for international students. Full article

Sound has an important role in how users perceive their environment. Under this context, a soundscape approach was followed for the evaluation of indoor spatial experience of university architecture studios. A tailored framework of factors affecting sound perception and spatial experience was proposed for this study and used in the questionnaire. An indoor soundscape questionnaire investigating architecture students’ perception of their acoustical environment and how it affects their spatial experience was designed and applied. The survey was conducted with a total of 191 first-grade and fourth-grade students. Demographic characteristics were found to be statistically associated with users’ indoor environment expectations and acoustic perception. Among many statistically significant correlations between soundscape perception and spatial experience, correlations between intelligibility perception and architectural design expectations, as well as between perception of and reaction to sound sources and perception of spatial experience factors, stood out. Full article

Background: Chronic stress contributes to mental and physical disorders, including burnout, anxiety, and depression. While self-report assessments remain valuable, they are inherently subjective and may be insensitive to short-term psychophysiological fluctuations. Remote photoplethysmography (rPPG) enables non-contact extraction of cardiovascular signals from facial videos and has increasingly been explored for stress-related monitoring through heart rate and heart rate variability features. Objective: This preliminary study aimed to assess the feasibility, usability, and preliminary construct validity of a mobile rPPG-based application for psychophysiological stress monitoring in daily life by examining usability, stress index distributions, and associations with self-reported psychological distress. Methods: A total of 252 participants from the general population and university students completed standardized facial video acquisition using a smartphone-based rPPG application and self-report questionnaires. The app extracted pulse wave signals, computed cardiovascular features related to heart rate and pulse rate variability, and integrated them into three indices: Stress Level, Stress Recovery, and Stress Response. Correlation and regression analyses examined associations with psychological distress. Results: The three indices showed substantial inter-individual variability. Stress Level was significantly associated with anxiety (r = 0.13, p = 0.036), depressive symptoms (r = 0.13, p = 0.047), and General Emotional Distress (r = 0.17, p = 0.006). In regression analysis, Stress Level emerged as the only significant independent correlate of General Emotional Distress (β = 0.21, p = 0.017). Younger participants and women showed higher Stress Level scores. Conclusions: The present findings should therefore be interpreted as preliminary and exploratory evidence of construct validity, suggesting that the app-derived indices may capture individual differences in stress-related physiological activation in everyday contexts. Currently, the observed associations were weak, the model explained limited variance, and the results do not demonstrate clinical validity, diagnostic utility, or predictive accuracy. Looking ahead, further longitudinal studies, repeated rPPG assessments, correction-aware analyses, and validation against reference physiological measures are needed before these indices can be considered suitable for clinical or preventive use. Full article

Background: Sleep quality plays an essential role in cognitive performance, memory consolidation, learning efficiency, and overall wellbeing. University students are particularly vulnerable to sleep disturbances because of academic stress, irregular sleep schedules, and lifestyle-related factors. Poor sleep quality has been associated with impaired academic performance and reduced cognitive functioning. Objective: This study aimed to evaluate the relationship between sleep patterns, sleep quality, and academic performance among female university students. Methods: A cross-sectional study was conducted among 201 female university students at Qassim University, Saudi Arabia. Data were collected using an electronic self-administered questionnaire that included demographic characteristics, sleep-related behaviors, and the Pittsburgh Sleep Quality Index (PSQI). Academic performance was assessed using self-reported Grade Point Average (GPA). Statistical analysis included descriptive statistics, Spearman correlation analysis, one-way ANOVA with Tukey post hoc analysis, Chi-square tests, and multiple linear regression analysis. Results: The mean GPA of the participants was 4.13 ± 0.60 (on a 5-point scale), while the mean PSQI score was 8.81 ± 3.26, indicating generally poor sleep quality. A significant negative correlation was observed between PSQI score and GPA (rho = −0.200, p = 0.0047). Students with good sleep quality demonstrated significantly higher GPA scores compared with students with poor sleep quality (F(2,194) = 6.31, p = 0.0022). Significant associations were also identified between sleep quality and both bedtime (p = 0.0009) and sleep duration category (p = 0.0002). However, after adjustment for other variables, the independent effect of PSQI on GPA was attenuated and did not reach statistical significance (p = 0.138). This discrepancy between the significant bivariate correlation (rho = −0.200, p = 0.005) and the non-significant multivariate result represents the most important finding of this study, suggesting that sleep quality alone does not independently predict GPA when other academic and behavioral factors are considered. Conclusion: Poor sleep quality was highly prevalent among female university students and showed a significant bivariate association with lower academic performance, though this relationship was attenuated in the multivariate model. Promoting healthy sleep behaviors may support student wellbeing and academic functioning, cognitive wellbeing, quality of life, and the advancement of Sustainable Development Goal 3 (Good Health and Well-Being). Full article

Background: Colorectal cancer (CRC) remains a significant global health challenge, particularly because of its associated complications. Among these, tumor perforation is a critical event linked to increased postoperative morbidity and mortality. This study aimed to evaluate and compare the surgical outcomes of patients with perforated colon cancer versus those with non-perforated colon cancer. Methods: A retrospective comparative study was conducted in the visceral surgery departments of Hassan II University Hospital in Fes, Morocco, including 198 patients who underwent surgical treatment for colon cancer between January 2014 and December 2022. Statistical analyses included descriptive assessments and comparative tests using the Chi-square and Student’s t-tests, with a p-value < 0.05 considered statistically significant. Results: Of the 198 patients, 22 (11%) presented with perforated colon cancer. Laparotomy was the predominant surgical approach in the perforated group (86.4%), whereas laparoscopy was more frequently used in non-perforated cases (56.2%, p = 0.001). Stoma creation was significantly more common in perforated cases (72.7% vs. 4%, p < 0.001), with a notably higher rate of stoma closure failure in the perforated group (37.5% vs. 0%, p < 0.001). Postoperative complications were also more frequent in the perforated group (36.4% vs. 13.6%, p = 0.006), with higher rates of R2 resections (27.3% vs. 0.6%, p < 0.001) and tumor recurrence (27.3% vs. 4.5%, p < 0.001). The mean hospital stay was significantly longer in patients with perforated cancer (11 days vs. 5 days, p < 0.001). Conclusions: This comparative study demonstrates that patients with perforated colon cancer are more likely to require a Hartmann’s procedure, to have prolonged intensive care unit stays, to experience higher rates of postoperative complications, to undergo R2 resections, and to have a greater incidence of tumor recurrence. A non-significant trend toward higher 30-day mortality was also observed. Full article

(1) Background: Artificial intelligence tools have become integrated into undergraduate students from academic assignments to seek help with psychological concerns, particularly during the crises period. Scales measuring Artificial Intelligence-help-seeking behavior (AI-HSB) are still limited. This study aims to develop a new bilingual scale (Arabic and English) to assess AI-HSB by providing a reliable and useful tool for researchers worldwide. (2) Methods: We conducted a methodological cross-sectional design among 416 undergraduate students in United Arab Emirates (AUE) between the period of 1 October 2025 and 10 December 2025, using an online Google Form. The development, translation, validation, and reliability processes were conducted for the AI-HSB scale. (3) Results: It has been found that 13 items (two factors) are strong indications of factorial validity, reliability, and construct validity of AI-HSB scale. The two factors explained about 58% of the total variance. The confirmatory factor analysis confirmed the two-factor structure with all items loading above recommended thresholds and the goodness-of-fit indices of AI-HSB all exceeded 0.90. (4) Conclusions: The AI-HSB is a valid and reliable tool for assessing AI-based psychological help-seeking behavior among university students in the UAE. This scale will allow universities, counselors, and policymakers to use a well-validated scale to measure the extent to which students are using AI for psychological coping. Full article

This study develops a digital tactile graphic learning framework based on Korean cultural heritage images to support potential concept learning of students with visual impairments and examines its educational appropriateness through expert validation. The lack of standardized tactile graphic guidelines in visual-centric educational environments imposes considerable burden on teachers, who must restructure content individually. Using a design-based research (DBR) methodology grounded in the Universal Design for Learning (UDL) framework, this study constructed a dataset of 200 cultural heritage images from elementary textbooks across four categories—architecture, artifacts, cultural symbols, and traditional objects—and restructured them through illustration simplification, initial tactile graphic conversion (informed by braille production principles), and two expert revision cycles. Ninety educationally applicable items were finalized for second-stage validation, and five tactile graphic design guidelines were derived. A panel of 15 experts evaluated the materials using a 5-point Likert scale and Content Validity Index (CVI) analysis. The overall mean was M = 4.69 (SD = 0.51), with the final 15-item instrument yielding an overall S-CVI/Ave of 0.99 (initial 0.98 across the original 16 items, refined after removal of one underperforming item per standard CVI practice); the practical usability domain reached S-CVI/Ave = 1.00, indicating full expert agreement. The study contributes a cultural heritage image dataset, a systematic image restructuring procedure, UDL-based design guidelines, iteratively refined and expert-validated CVI evaluation criteria, and a prototype TUI-based tactile learning environment configuration. Full article

Nature-based education, characterized by authentic contexts and experiential learning, has increasingly been recognized as a potentially effective educational approach for fostering sustainable development literacy among university students. This study aimed to examine the influence of nature-based education on university students’ sustainable development behavior. It further investigated the sequential mediating roles of sustainability knowledge and attitudes. A cross-sectional self-administered questionnaire survey was conducted among 1248 university students across 21 prefecture-level cities in China. Data were analyzed using SPSS (Version 28.0) and SmartPLS (Version 4.0). Partial least squares structural equation modeling (PLS-SEM) was employed to test the hypothesized model and assess the relationships among latent constructs. The results indicated that nature-based education was positively associated with sustainability knowledge (β = 0.337, p < 0.001) and, to a lesser extent, sustainability attitudes (β = 0.106, p < 0.01), but had no significant direct effect on sustainable development behavior. Instead, sustainability attitudes mediated the knowledge–behavior relationship, while sustainability knowledge and attitudes jointly formed a significant sequential mediation pathway. Full article

Background: Antimicrobial resistance (AMR) is a major global health threat, yet awareness among adolescents remains low, especially in low-resource settings. Novel educational approaches are needed to appropriately inform and sustain the interest of young people to encourage behavioral change in the use of antimicrobials. This study aimed to evaluate the impact of a comic-based intervention in improving AMR knowledge and perceptions regarding the responsible use of antimicrobials among junior high school students in Ghana. Methods: We conducted a before-and-after educational intervention at the Kwame Nkrumah University of Science and Technology (KNUST) Basic Schools in Kumasi, Ghana, during the 2023 World AMR Awareness Week. All junior high students (JHS 1–3) present were exposed to a comic storyline illustrating appropriate antibiotic use and the risks of AMR, delivered via PowerPoint presentation and print, as an intervention. Questionnaires were administered pre- and post-intervention to assess changes in AMR knowledge and perceptions. Results: The median age of the student participants was 13 years. Out of the 1068 students involved, 611 matched responses were analyzed. Knowledge of AMR increased significantly after the comic intervention (p < 0.001). Correct responses increased across all items, and the proportion of students with a knowledge score increased substantially (33% to 70%). Attitudinal perceptions also shifted positively: 85.1% acknowledged their personal role in tackling AMR after the intervention, up from 67.4% before the intervention (p < 0.001). Conclusions: The educational intervention resulted in increased AMR knowledge and positive perceptions among the adolescents. The study findings suggest that comics and their deployment are viable tools for enhancing AMR awareness in school settings. Therefore, integrating and engaging visual storytelling in health education programs can increase awareness and promote responsible behavior towards the use of antimicrobials and support the global and national efforts for the containment of AMR. Full article

Access to authentic clinical learning experiences is often limited for undergraduate Health Sciences students. Immersive technologies such as 360-degree video may help bridge this gap, yet evidence regarding their use in home care education and Problem-Based Learning (PBL) remains scarce. To address this gap, we used a Design-Based Research (DBR) approach to develop and implement a 360-degree video-based home care learning experience and evaluated students’ perceptions of the video, VR headsets, and associated educational formats across three curricular tracks. The experiences of 251 undergraduate Health Sciences students across three different tracks (Policy, Mental Health and Digital) at Maastricht University were studied. Each track offered a different educational format using the 360-degree video as part of its Problem-Based Learning (PBL) curriculum. Students responded once to a combination of self-developed and standardized questionnaires, which included subscales from the Technology Acceptance Model 3 (TAM3) and the Video Transportation Scale (VTS). A DBR approach facilitated the iterative development and implementation of a 360-degree video-based home care learning experience embedded within a Problem-Based Learning curriculum. The intervention was successfully integrated across three tracks without compromising key PBL principles. Students generally perceived the 360-degree video and associated educational formats positively, particularly appreciating the opportunities for interaction and contextualized learning. The findings suggest that immersive 360-degree video delivered through VR headsets is a feasible and acceptable educational approach for undergraduate Health Sciences students and may provide meaningful exposure to clinical practice when access to placements is limited. Full article

This retrospective study examined group-level trends in science self-efficacy among undergraduate students from underrepresented racial/ethnic groups (URGs) over four years (2017–2020) at a public university in California. The study investigated the effectiveness of an undergraduate research experience program designed to increase URG participation in STEM fields. Using propensity score matching to control for selection bias, the final sample included 3146 students (344 intervention participants, 2802 non-participants) who completed the Student Annual Follow-up Survey. The Rasch measurement method was used to convert Likert scale responses into linear logit scores, which enabled group-level trend analysis using linking and equating techniques. A repeated measures analysis examined changes in science self-efficacy while controlling for first-generation status, URG status, and gender. Results revealed a significant overall increase in science self-efficacy across all four years. Intervention participants consistently demonstrated significantly higher science self-efficacy scores than non-participants. The interaction between time and intervention participation was statistically significant, indicating that intervention participants showed greater improvements over time. These findings support the effectiveness of culturally responsive undergraduate research experiences in fostering science self-efficacy among URG students. The study contributes to understanding how structured interventions can address persistent disparities in STEM education and career pathways. Full article

Ultra-processed foods (UPFs) are foods formulated through extensive industrial processing, with little or no natural food constituents, and include ingredients such as artificial colors, flavors, and other food additives to enhance shelf life and palatability. They are typically energy-dense and poor in essential nutrients, including products such as sugar-sweetened beverages, packaged snacks, processed meats, instant noodles and confectioneries. UPF intake has been associated with a wide range of metabolic and inflammatory diseases, especially obesity and adiposity. The transition to independent living and increased dietary autonomy among young adults, particularly university students, are associated with higher reliance on UPF. This narrative review aims to examine the global evidence on the association between UPF consumption and obesity and adiposity outcomes among young adults. Most reviewed studies demonstrated a consistent positive association between UPF consumption and increased obesity and adiposity risks among young adults. UPF consumption within this population is substantial, ranging between 25% and 50% of total energy intake (TEI). The association between UPF consumption and increased risk of obesity and adiposity can be explained through multiple biological and behavioral mechanisms, including high energy density and palatability, disruption of satiety signaling, gut microbiota alterations, and hormonal dysregulation. To reduce the long-term burden of obesity among young adults, public efforts should be directed to important health interventions, such as university awareness nutritional programs, front-of-pack labeling, and policy-level restrictions on UPF marketing. Full article

Architectural design decisions in educational buildings often rely on spatial parameters such as ceiling height and window layout, yet systematic methods for evaluating their influence on user experience during early design stages remain limited. This study investigates how spatial height, window position, and window-to-wall ratio affect students’ classroom usage intention (UI) through the mediating role of psychological experience. An evidence-based pre-occupancy evaluation approach was developed by integrating immersive virtual reality (VR) experiments with structural equation modeling (SEM). The study employed 61 university students for evaluating parametrically controlled virtual classrooms to examine perceived affective and cognitive experience (ACE), including emotional comfort, attentional focus, and spatial attractiveness, as well as classroom usage intention (UI). Using the data collected through VR experiment and followed by a questionnaire survey, using a stimulus–organism–response framework, the study modeled transmission pathways from spatial stimuli to behavioral outcomes. The results indicate that ACE is the strongest and most direct predictor of UI, highlighting psychological experience as the key pathway translating environmental exposure into behavioral preference. The relationship between perceived architectural attributes and psychological responses was context-dependent, suggesting a potential divergence between analytical spatial judgment and holistic emotional experience under explicit evaluation tasks. VR experience quality significantly influenced ACE but did not directly affect UI. The findings suggest the value of integrating VR and SEM as a pre-design evaluation tool and emphasize prioritizing experiential coherence as a measurable criterion for early-stage decision-making, rather than establishing direct causal links to long-term experiential responses. Full article

Background/Objectives: Dietary behaviors and physical activity are major risk factors of excess body weight; however, less is known about behavioral risk patterns and the role of physical activity in the context of unhealthy dietary patterns. The aim of this study was to identify behavioral risk patterns and multidimensional behavioral profiles associated with overweight/obesity and excess adiposity in physically active young adults. Methods: The cross-sectional study included 418 university students (199 men and 219 women). Physical activity was assessed using the IPAQ-LF, whereas dietary behaviors were evaluated using the QEB questionnaire. Healthy (fruit–vegetable) and unhealthy (fast food–sweets) dietary indices were derived from questionnaire responses. Logistic regression, predicted probability profiling, behavioral risk mapping, response surface analyses, and decision tree models were applied to evaluate behavioral associations with BMI- and FMI-defined outcomes. Results: The unhealthy dietary index emerged as the strongest behavioral predictor of excess body weight and adiposity. Higher fast food and sweets consumption was associated with increased odds of overweight/obesity (OR = 1.70, 95% CI: 1.31–2.24) and excess fat accumulation (OR = 1.96, 95% CI: 1.36–2.83). Physical activity demonstrated a positive association with BMI-defined overweight/obesity risk (OR = 0.69, 95% CI: 0.52–0.92), although no significant interaction effects were observed between physical activity and dietary behaviors. Multidimensional analyses identified distinct behavioral risk zones, whereas decision tree models indicated that unhealthy dietary behaviors represented the dominant factor underlying obesity-related risk classification. Conclusions: Unhealthy dietary behaviors demonstrated stronger associations with excess body weight and adiposity than protective dietary behaviors related to fruit and vegetable intake. Although physical activity was generally associated with lower obesity-related risk, unhealthy dietary behaviors showed stronger associations with adverse body composition outcomes. Full article