Search Results (463)

Aging is a progressive and heterogeneous biological process influenced by multiple factors that may compromise physical and cognitive capacities and increase the risk of frailty, functional decline, and falls in older adults. Falls represent a major public health concern due to their impact on independence and long-term care demand. Immersive virtual reality (IVR) delivered through active video games (exergames) has emerged as a preventive strategy that integrates sensory, motor, and cognitive stimulation within controlled and engaging environments, particularly where traditional programs face challenges related to adherence and individual adaptation. This study aims to determine the feasibility and implementation of an IVR-based program for falls prevention in older adults at risk of frailty in primary health care (PHC). A quasi-experimental pre–post design will be conducted with an intervention group (IVR/exergames) and a conventional control group, including a total sample of 40 participants (20 per group). The protocol comprises three phases: baseline assessment and IVR familiarization; a 12-week intervention delivered twice weekly; and post-intervention assessment. The primary outcome will be fall risk assessed using the Timed Up and Go (TUG) test. Secondary outcomes include physical performance (Short Physical Performance Battery, SPPB, and handgrip dynamometry) and psychological aspects related to falls (Falls Efficacy Scale International, FES-I, and Activities-specific Balance Confidence Scale, ABC). Feasibility indicators will include recruitment, adherence, retention, and cybersickness. A reduction in TUG time is expected, providing preliminary evidence on the feasibility of integrating IVR-based programs for falls prevention within PHC systems. Full article

Background/Objectives: The coparenting relationship newly formed during the transition to parenthood is a relational system focused on parenting. This study was positioned as an exploratory survey, because it evaluated a preventive intervention program developed for couples expecting their first child with the goal of promoting coparenting, focusing solely on the prenatal period. This self-guided program was primarily composed of brief video for viewing and homework that were provided to couples through the pregnant women. The primary objective of this study was to evaluate the feasibility and acceptability of the intervention, and the secondary objective was to explore its preliminary effects; all assessments were based on data collected from pregnant women. Methods: This was a pilot study employing a mixed-methods approach with intervention and comparison groups. The evaluation utilized self-reported data collected at 22–27 weeks’ and 36 weeks’ gestation, along with data gathered through responses to questions in Microsoft Forms and semi-structured interviews, particularly in the intervention group. Ultimately, 20 couples in each group were included in the analysis. Results: Approximately 80% of couples in both groups agreed to participate, enhancing the feasibility of the intervention that included approaches to couples through pregnant women. The intervention completion rate was high (87%), and many women found the program acceptable. Analysis of covariance for between-group comparisons revealed no significant differences in relationship satisfaction (p = 0.267) or prenatal coparenting (p = 0.239). Conclusions: This program was recognized as feasible and acceptable, but its preliminary effects during pregnancy were not confirmed. Randomizing participants and including outcome assessments after childbirth in future studies could contribute to enhancing the potential for beneficial interventions. Full article

During pregnancy, women are more inclined to modify their habits and lifestyle to find a new balance and promote well-being for themselves and the child-to-be. However, the availability of nutritional and psychological support is often limited by stigma, geographic barriers, and a lack of services. Digital health tools are emerging as possible solutions to cover these needs. This study explores the acceptability, feasibility, and user experience of Demetra, a virtual coach based on Acceptance and Commitment Therapy (ACT), designed to promote healthy lifestyles and mental well-being. Fifty pregnant women will be enrolled in the feasibility study of the intervention. It starts with an educational part on the foundations of healthy eating and suggestions about lifestyle habits, followed by a six-week psychoeducational module. Content is delivered through text, audio, and video formats. User experience and engagement will be measured through validated questionnaires and semi-structured interviews. Psychological well-being will be evaluated both before and after the program. The intervention is expected to be well-received, with high levels of satisfaction and engagement, leading to a greater awareness of healthy behaviors, improved psychological flexibility, and enhanced overall well-being. Demetra offers an accessible solution to support women through the transformative experience of motherhood with a multidisciplinary and innovative approach. Full article

Background and Objectives: While the effectiveness of video modeling (VM) in teaching academic, daily living, and social skills to individuals with Autism Spectrum Disorder (ASD) is frequently investigated, studies examining the use of VM in teaching gymnastics-based motor skills are limited. This study aimed to examine the effects of VM on the acquisition and maintenance of a gymnastics-based motor skills in preschool children with ASD. Methods: The study employed a multiple-probe method across participants in a single-subject research design. Three preschool children diagnosed with mild ASD participated in this study. Baseline, intervention, and follow-up data were systematically collected and analyzed. Social validity data were obtained through semi-structured interviews with parents and special education teachers. Results: The percentage of correct responses increased throughout the VM intervention sessions, and all participants reached the proficiency criterion. Follow-up data collected after the intervention showed that the acquired skill was maintained, and the percentages of correct responses ranged from 80% to 100%. Social validity findings revealed that both teachers and parents perceived VM as an effective and feasible teaching approach for teaching motor skills to children with ASD. Conclusions: The research findings demonstrate that VM is an effective and socially valid teaching method for teaching and maintaining gymnastics-based motor skills in preschool children with ASD. These results contribute to the existing literature by demonstrating the applicability of video modeling in the context of gymnastics-based training. Full article

Background/Objectives: Acute pancreatitis is a prevalent pathology with increasing incidence. Despite advances in treatment, some patients still present a severe clinical course with high morbidity and mortality rates. We evaluated the association between implementation of a step-up-based management strategy and clinical outcomes in patients with severe acute pancreatitis (SAP) treated at a tertiary referral center. Method: A retrospective observational study was conducted, including patients treated for SAP at a tertiary care center. Clinical outcomes, including mortality, morbidity, and length of hospital stay, were compared between two periods: Period A (1998–2010, classical treatment) and Period B (2011–2021, step-up approach). A subanalysis on minimally invasive techniques was also performed for Period B. Results: In total, 116 patients were included (39 Period A; 77 Period B). Pancreatic fistulas were reduced in Period B (15.38% vs. 5.33%; p = 0.088), as was mortality (30.76% vs. 18.67%; p = 0.15). Open surgeries decreased significantly in Period B (71.9% vs. 16.9%; p = 0.043), as did the mean hospital stay (60.5 ± 28 vs. 33.08 ± 28 days; p < 0.001). When comparing endoscopy management versus Video-Assisted Retroperitoneal Debridement (VARD), the rate of pancreatic fistulas was higher in the VARD group (0% vs. 57.1%; p < 0.01). Patients requiring VARD presented with larger collections (710 cc vs. 1737.9 cc; p = 0.03) and fewer procedures (4.2 ± 2.3 vs. 1.5 ± 0.5; p = 0.002). Conclusions: The step-up management in patients with SAP was associated with a decrease in open surgical approches and length of stay. VARD was performed in patients with higher volume collections and was associated with fewer interventions than patients treated by endoscopic necrosectomy; however, the incidence of pancreatic fistulas was higher. Full article

Background: research suggests that adolescents with a migrant background may be particularly vulnerable to behavioral addictions, including problematic gaming and Internet use. Methods: we compared Italian (ITA) and non-Italian (WIC) students on Internet Gaming Disorder (IGD) and Internet Addiction (IA) and examined whether coping strategies and interpersonal-relationship quality were associated with these outcomes, using robust linear models estimated with the GENLIN procedure in IBM SPSS Statistics 31 and regression-based models on observed variables. A total of 535 students (64.5% female; aged 9–18) completed the Video Games Addiction Questionnaire (VGA), the Internet Addiction Test (IAT), the Children’s Coping Strategies Checklist–Revised (CCSC), and the Assessment of Interpersonal Relations (AIR). Results: robust generalized linear models showed that WIC adolescents reported significantly higher IGD levels than their Italian peers, while no differences emerged for IA. Gender differences were evident only in unadjusted models, with males reporting higher IGD and females higher IA; however, these effects were not significant once age and nationality were considered simultaneously. Age was positively associated with IA but not with IGD. Avoidance coping was associated with higher levels of both IGD and IA, whereas active coping was negatively associated with IGD. Relationship quality was not associated with IGD but showed protective effects for IA: better relationships with mothers and with both male and female peers were associated with lower IA scores. Overall, the findings highlight that IGD and IA follow partially distinct developmental patterns. Migrant background emerged as a specific vulnerability factor for IGD, while IA appears more closely linked to age-related processes, coping styles, and interpersonal-relationship quality. Conclusions: the results call for differentiated prevention and intervention approaches targeting the distinct etiological mechanisms of each problematic behavior, focusing on coping and migration-related stress and belonging for IGD, and on strengthening coping repertoires and relational resources for IA. Full article

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

Background: The widespread use of Social Networks (SNS), particularly among youths, could promote Feeding and Eating Disorders (FEDs), but could also be a tool for implementing FED prevention strategies. This study aimed to identify which SNS could be most effective for implementing primary and secondary FED prevention. Methodology: A cross-sectional study was conducted via an Italian population-based survey, distributed using a snowball sampling strategy. The survey included 283 participants aged 18–35 by using the Bergen Social Media Addiction Scale (BSMAS), the SCOFF screening tool for FEDs, items from the Body Uneasiness Test (BUT), and the Mukbang Addiction Scale (MAS). Results: The sample was predominantly female (69.3%). Participants screening positive on the SCOFF were more frequently TikTok users. Stepwise logistic regression analysis showed that TikTok use was associated with SCOFF positivity (OR = 1.9) and body image concerns (e.g., spending a lot of time in front of the mirror; OR = 1.9). Instagram use was associated with body image dissatisfaction (OR = 3.9). In the overall sample, the likelihood of screening positive on the SCOFF was associated with TikTok use (OR = 1.7), higher BSMAS scores (OR = 1.1), exposure to body positivity/neutrality content (OR = 1.9), and watching Mukbang videos (OR = 1.8). Conclusions: TikTok and, to a lesser extent, Instagram appear to be widely used by young individuals vulnerable to FEDs and body image dissatisfaction. These platforms may therefore represent strategic channels for delivering educational and preventive interventions targeting eating behaviors and body image among young people. Further longitudinal research is needed to clarify causal relationships and evaluate the effectiveness of SNS-based prevention strategies. Full article

Background: Ataxic symptoms are characterized by causing motor, balance and coordination disorders. Virtual reality-based interventions (VRBIs) including video games and exergames can improve ataxic symptoms. The aim of this systematic review with meta-analysis was to assess the effectiveness of VRBI on severity of ataxia, postural balance, mobility and manual dexterity in patients with ataxia. Methods: According to the PRISMA guidelines, we searched PubMed Medline, SCOPUS, WOS, CINAHL, PEDro and other sources for randomized controlled trials (RCTs) that assessed the effectiveness of VRBI, compared to others, on the severity of ataxia, balance, mobility and manual dexterity in patients with ataxia. The pooled effect was calculated using Cohen’s standardized mean difference (SMD) and a 95% confidence interval (95% CI). Results: With data from seven RCTs, providing data from 171 patients with ataxia, our meta-analysis elucidated that VRBI is effective in reducing the severity of ataxia (SMD = −0.43; 95% CI −0.84 to −0.03; p = 0.04) and increasing functional balance (SMD = 0.97; 95% CI 0.16 to 1.78; p = 0.02) and manual dexterity (SMD = −0.63; 95% CI −1.16 to −0.11; p = 0.018). Conclusions: Our findings suggest that VRBI could be a promising and effective therapeutic approach in reducing ataxia disability and increasing balance and manual dexterity in ataxic patients. Full article

This study investigated waste segregation awareness and behavior, developed awareness-promoting activities, and evaluated their effectiveness among lower secondary school students in Phitsanulok Province, Thailand. The research was conducted in three phases: Phase I involved baseline data collection using interviews and structured observations. Phase II focused on developing awareness-promoting activities, including training workshops, printed public relations materials, video-based learning, and game-based waste segregation. Phase III evaluated the effectiveness of interventions using a pre-test–post-test design. The research instruments included awareness and behavior questionnaires, behavior observation forms, and records of segregated solid waste quantities. The results showed significant increases in awareness and waste segregation behavior scores after the intervention across all activity types (all p < 0.001). The mean awareness scores increased from 10.27 to 12.74 (p < 0.01), and mean waste segregation behavior scores increased from 11.82 to 13.64 (p < 0.001). However, after adjustment for pre-intervention scores and school, no significant differences were observed among activity types. Higher awareness levels were positively associated with improved waste segregation behavior, as reflected by changes in waste quantity and composition. These findings indicate that awareness-promoting activities can effectively enhance source-based waste management practices and may be applied in similar municipal and educational contexts. Full article

Background: Parental knowledge and perceptions towards Functional Foods (FFs) play a critical role in shaping children’s dietary behaviors. This study aimed to investigate dietary habits, FFs knowledge and perceptions among Greek primary school children and their parents and to evaluate the feasibility of a one-month pilot asynchronous nutrition education program. Methods: A cross-sectional study included 374 children aged 9–11 years and 159 parents from urban (Thessaloniki) and rural (Lemnos) areas. Children completed questionnaires on dietary habits, FFs knowledge and Mediterranean Diet (MD) adherence (KIDMED score), while parents provided sociodemographic information, BMI, dietary habits, FFs knowledge and perceptions. A pilot asynchronous nutrition education intervention was delivered via pre-recorded videos on FFs, the MD, portion sizes and food label interpretation, with participation tracked and program evaluation conducted among parents. Data was analyzed using IBM SPSS Statistics (version 28). Descriptive statistics were calculated, group differences were assessed with t-tests and ANOVA and associations between variables were examined using chi-square tests and Pearson correlations (p < 0.06). Results: Children showed moderate MD adherence, frequent fast-food and soft drinks consumption and low FF knowledge, with a substantial gap between perceived and actual understanding. Parental FF knowledge was uneven, higher among normal-weight participants and largely limited to fortified products. Positive associations were found between children’s and parents’ diet quality and natural FF consumption, as well as between parental and child physical activity. The asynchronous intervention was positively rated; substantial attrition was observed across sessions and follow-up, which limited the ability to assess the intervention’s effects on behavioral change. Conclusions: This study highlights critical gaps in FFs knowledge among families and demonstrates that asynchronous, family-based nutrition education is feasible but challenged by engagement attrition. Targeted interventions are needed to clarify FF concepts and promote healthier family dietary behaviors. Full article

Serving students with special educational needs (SENs) involves recognising that their learning is closely linked to their emotional needs. Self-esteem and socio-emotional well-being play a key role in their motivation and adaptation to school. In this context, physical activity-based interventions at school emerge as a possible way to strengthen their self-esteem and socio-emotional well-being. The aim of this study was to analyse the effects of a web-based active break programme on self-esteem in students aged 6 to 10 years with SENs and on socio-emotional well-being in the subgroup of first–second-grade students. A pre-specified sub-analysis was conducted of a multicentre randomised controlled trial with a sample of 161 students with special educational needs (7.8 ± 1.1 years, 32% girls), divided into a control group (85 students) and an experimental group (76 students). A programme of video-guided active breaks was implemented in the classroom, applied twice a day, five days a week for 12 weeks, via a web platform. Self-esteem was assessed using the School Self-Esteem Test (SSET), and socio-emotional well-being was assessed using the Self-Report of Socio-Emotional Well-Being (SRSEWB). A significant Time × Group interaction was observed for self-esteem, F_{(1, 157)} = 5.43, p = 0.021, η²_p = 0.033, but no statistically significant effects were detected for socio-emotional well-being. These findings suggest that active break interventions may help strengthen self-esteem in students with SENs. Future research should examine the temporal stability of these improvements, determine the optimal intervention duration required to generate sustained changes, and evaluate longer-term socio-emotional outcomes. Full article

Background: Dental students need to qualify with a clear understanding of the continuum of biological development from the molecular (genetic, epigenetic and environmental interactions) to the cellular (morphogenesis and differentiation) to the emergence of the mature tissue or organ. Histogenetics provides a core component for this understanding. The aim of this study is to investigate whether a merged approach, combining traditional and recent methods, can enhance the teaching of histogenetics to dental students. Methods: This study blended traditional (lectures, drawings, microscopy) and recent approaches (flipped classroom elements, virtual microscopy, group-based poster construction, and interactive quiz-based discussion) to enhance student engagement and perceived learning in oral histogenetics. The intervention was delivered to master-level dental students across six core oral histogenetics topics. Teaching followed a structured three-phase model: Prepare (digital lectures and short microscopy-introduction videos); Engage (microscopy session and group-based poster creation); and Test and Discuss (teacher-led quizzing and discussion). Student perceptions were evaluated through an electronically distributed 17-item questionnaire at the end of the course. Items were grouped into self-evaluation, resources, and teaching method domains and rated on a five-point Likert scale. Results: A total of 45 of 51 students responded (88%). Across all domains, positive perceptions (Agree/Strongly Agree) predominated (p < 0.001). Self-evaluation items showed strong agreement for attendance and group contribution, with more variability in preparation time and motivation. Resources were rated highly, although the accessibility of physical guidance showed more mixed responses. The merged teaching method received strong endorsement, with students reporting engagement, enjoyment, ease of understanding, and clear emphasis on clinical relevance. Conclusions: The merged approach was perceived as pedagogically valuable and clinically meaningful by the students and appears to enhance perceived engagement, clarity, and relevance in oral histogenetics teaching. These findings support the adoption of blended, student-active methodologies to strengthen comprehension and promote clinically meaningful learning in oral histology. Full article

(1) Background: C-section-related health information is increasingly disseminated through short video platforms such as YouTube and Bilibili, yet the quality and audience engagement of this content remain insufficiently understood. (2) Methods: A cross-sectional study analyzed the top 90 C-section-related videos from each platform (180 total). C-section video characteristics and engagement metrics were collected. Information quality and reliability were assessed using GQS, DISCERN, and JAMA benchmarks. Associations between quality scores and engagement indicators were examined using Spearman’s correlation analysis. (3) Results: YouTube videos were longer and more frequently produced by medical professionals. Although GQS scores were comparable, YouTube content demonstrated higher reliability, with significantly higher DISCERN and JAMA scores (p < 0.001). C-section engagement metrics were strongly intercorrelated but showed weak associations with objective quality measures. (4) Conclusions: Significant cross-platform disparities exist in C-section information quality, with a pronounced dissociation between clinical reliability and audience engagement. This “quality-popularity paradox” underscores a critical mismatch between evidence-based rigor and digital dissemination. Our findings necessitate multi-sectoral interventions, including standardized creator credentialing and algorithm recalibration, to align high-quality obstetric knowledge with public attention. Full article

Modern football requires athletes to make rapid and effective decisions in highly dynamic environments. Although ecological dynamic approaches based on small-sided games have shown advantages over traditional training for decision-making development, the potential contribution of football eSports within integrated training protocols remains insufficiently explored. This study aimed to examine the effects of three training approaches—traditional training, ecological dynamic training with small-sided games, and a hybrid eSport-based protocol—on decision-making and reaction time in youth football players. Sixty-nine youth footballers (47 males and 22 females, mean age = 15.1 ± 0.9 years) were assigned to three groups and completed a 24-week intervention with pre-, mid-, and post-intervention assessments. General, offensive, and defensive decision-making were evaluated using the TacticUP Video Test, while reaction time was assessed through frame-by-frame video analysis. Data were analysed using mixed-design ANOVA (Group × Time) with Bonferroni post-hoc comparisons. Significant Group × Time interactions were observed for all variables, suggesting non-uniform longitudinal performance trends across the three training approaches, including a distinct pattern of change in the hybrid eSport-based group. In contrast, minimal changes were found in the traditional group, while moderate improvements were observed in the ecological dynamic group. Overall, the findings indicate that innovative training approaches are more effective than traditional training in enhancing decision-making and response speed in young footballers, with the hybrid eSport-based protocol showing the most pronounced effects. Full article