Search Results (15,497)

Background and Objectives: Abortion on request, contraceptive access barriers, and mental health may jointly shape women’s quality of life (QoL). We examined how abortion history, structural barriers, and psychosocial factors relate to modern contraceptive use, depressive and anxiety symptoms, and QoL among women attending a Romanian tertiary center. Methods: We conducted a single-center observational study combining retrospective chart review with an online survey of 200 women aged 18–45 years. Validated instruments (Patient Health Questionnaire-9 [PHQ-9], Generalized Anxiety Disorder-7 [GAD-7], World Health Organization Five-Item Well-Being Index [WHO-5], and World Health Organization Quality of Life–BREF [WHOQOL-BREF]) and indices of access barriers, perceived stigma, and social support were used. Analyses included multivariable regression, structural equation modelling, latent class analysis, and moderation analysis. Results: Overall, 55.0% of women reported ≥1 abortion on request. Compared with those without abortion history, they were older (31.2 ± 4.9 vs. 26.8 ± 4.8 years, p < 0.001), more often had lower levels of education (51.8% vs. 33.3%, p = 0.013), and were less likely to use modern contraception at last intercourse (52.7% vs. 71.1%, p = 0.012). PHQ-9 (8.8 ± 4.0 vs. 7.3 ± 4.3) and GAD-7 (7.0 ± 3.2 vs. 5.7 ± 3.4) scores were higher (both p = 0.010), while QoL was lower (55.4 ± 8.1 vs. 59.5 ± 7.8, p < 0.001). In adjusted models, access barriers (OR per point = 1.3, 95% CI 1.1–1.6), but not abortion history, predicted non-use of modern contraception. QoL correlated strongly with PHQ-9 (r = −0.6) and WHO-5 (r = 0.5; both p < 0.001). Latent class analysis identified a “high-barrier, distressed, abortion-experienced” profile with the poorest mental health and QoL. Conclusions: Structural access barriers and current depressive and anxiety symptoms, rather than abortion history alone, were key correlates of contraceptive gaps and reduced QoL, underscoring the need for integrated reproductive and mental health care. Full article

Mental health conditions have become an increasing concern among university students, particularly those pursuing health science disciplines such as pharmacy. Rigorous academic demands, high workloads, and sustained psychological pressure place pharmacy students at a high risk of mental health disorders, including depression, anxiety, stress, and suicidal ideation. This study aimed to systematically review and quantitatively synthesize existing evidence on the prevalence of mental health conditions among pharmacy students in Thailand and globally using a meta-analytic approach. A comprehensive literature search was conducted across the major academic databases, including PubMed, ScienceDirect, Scopus, and ThaiJo, using predefined search terms and stringent inclusion criteria to ensure methodological rigor and relevance. Data from eligible studies were extracted and analyzed using STATA software to ensure statistical precision and reliability of the pooled estimates. A total of 51 studies, comprising 17,717 pharmacy students across 16 countries, including the United States, Thailand, Brazil, Malaysia, Syria, Pakistan, Poland, France, Portugal, Nigeria, Saudi Arabia, Sudan, Lebanon, Egypt, the United Arab Emirates, and Vietnam, were included. The meta-analysis revealed pooled prevalence rates of 44.26% for depression (95% CI: 36.08–52.61), 52.01% for anxiety (95% CI: 42.86–61.09), 48.10% for stress (95% CI: 32.96–63.43), and 24.52% for suicidal ideation (95% CI: 14.10–36.70). These findings reflect a substantial mental health burden among pharmacy students, necessitating immediate and context-specific interventions. Considering these findings, academic institutions must develop and implement comprehensive mental health support strategies. Such initiatives should include early identification and screening programs, access to psychological counseling services, resilience-building interventions, and stress management workshops to effectively address the psychological needs of pharmacy students and enhance their academic and personal well-being. Full article

The purpose of this narrative review is to examine women’s cognitive health and to highlight its association with four major pillars: (1) aging, (2) estrogen decline and loss, (3) diet, and (4) neuroinflammation, and their contribution to cognitive decline, with a focus on this combination to increase awareness and address the progression and potential amelioration of Alzheimer’s disease (AD). Often overlooked, estrogen decline during perimenopause and loss of estrogen production from the ovaries after menopause negatively influences almost every tissue and organ in the body, including the brain. This estrogen loss leads to inflammation, as can poor nutritional choices, both of which have a profound impact on short- and long-term health and can increase the risk of dementia, including AD. Thus, this overview covers the following four pillars (1) a brief background on cognitive decline and AD with aging, (2) the importance of and changes in estrogen with aging, (3) influence of dietary choices on overall well-being and brain health, and (4) the biochemical and molecular mechanisms by which this combination of factors may lead to neuroinflammation, resulting in cognitive decline and AD. Finally, this review briefly presents a hypothesis on whether women during perimenopause should be administered estrogen to span the transition into menopause to protect against cognitive decline and possibly ameliorate the risk of AD. This article is based on previously conducted studies and does not contain new data/results (studies) of human participants or animals performed by the authors. Full article

Background/Objectives: Missed Nursing Care is a global concern that affects nurses’ well-being and patients’ safety. Despite global recognition of Missed Nursing Care, there is limited synthesized evidence that determines its characteristics in a Middle Eastern context. The purpose of the study is to synthesize the existing evidence about the prevalence of Missed Nursing Care among nurses in hospitals, the types of care missed, and reasons for Missed Nursing Care in the Middle East. Methods: A systematic literature review is conducted by using a comprehensive search in CINAHL, Scopus, and ScienceDirect databases for studies published between 2020 and 2025 and utilizing the MISSCARE Survey. Results: 25 studies met the inclusion criteria. The reported prevalence of Missed Nursing Care ranged between 1.06 and 2.9 out of five, indicating a low to moderate level. Frequent missed care activities included ambulation, hygiene, mouth care, and patient teaching. Contributing factors were staffing shortages, heavy workload, resource limitations, and communication issues. Missed Nursing Care critically affected patients’ outcomes, reduced job satisfaction, and caused moral distress and a higher intent to leave the profession. Conclusions: Missed Nursing Care remains a significant, complex challenge in the Middle East. Therefore, understanding this phenomenon in the region is needed. Collaborative efforts among policymakers, administrators, and nursing leaders are essential to implement targeted interventions, supportive policies, and ongoing research to minimize Missed Nursing Care across the Middle East. Full article

Background and Objectives: Immunosenescence is a complex biological process associated with aging, characterized by a progressive decline in immune function and increased chronic inflammation (“inflammaging”), with clinical implications such as frailty, functional decline, multimorbidity, and a higher risk of adverse events in older adults. Nurses in community and primary care settings play a central role in preventive and health promotion interventions that may indirectly influence these processes. However, the available literature remains fragmented. Therefore, this scoping review aims to map and synthesise nursing interventions targeting older adults (≥60 years) that may indirectly influence immunosenescence by acting on its clinical correlates and modifiable determinants, organising the evidence within a four-pillar conceptual framework. Materials and Methods: A scoping review was conducted following JBI methodology and the PRISMA-ScR checklist. We included primary studies on nurse-led interventions in community, home care, primary care, territorial, or long-term care settings. PubMed, Scopus, and Web of Science were searched (English; last 10 years). Interventions were classified into four pillars: nursing nutrition and immunonutrition support, physical activity and exercise support, nursing vaccination coaching, and frailty monitoring and prevention of functional decline. Results: Twenty-five primary studies were included, mostly randomised or cluster-randomised trials in community, primary care, home care, and transitional care settings. Interventions mapped mainly to Pillar 4 and Pillar 2, while Pillar 1 was less frequent and usually part of multicomponent programmes; no primary studies targeted Pillar 3. Overall, effectiveness appeared driven more by intervention intensity and integration than by frailty identification alone: structured, multicomponent nurse-led programmes combining exercise with nutritional and psychosocial components showed the most consistent benefits on frailty, functional outcomes, and well-being, whereas low-intensity preventive consultations and Comprehensive Geriatric Assessment (CGA)-based models often showed limited improvements over usual care. Conclusions: This scoping review highlights the key role of community and primary care nurses in preventive interventions targeting clinical correlates of immunosenescence. Multicomponent nurse-led programmes integrating physical activity, nutrition, and psychosocial support appear most promising for frailty and functional outcomes, while low-intensity interventions show limited effectiveness. No primary studies addressed nurse-led vaccination coaching, representing an evidence gap. Future research should include biological/immunological markers alongside clinical outcomes. Full article

This paper investigates how Toronto’s Portuguese-Azorean community has shaped the city’s multicultural and psychological landscape, focusing particularly on intergenerational experiences of trauma among immigrant youth. Framed within North America’s broader migration dynamics, the study explores the creation and transformation of the ethnic enclave “Little Portugal” as both a space of cultural resilience and chronic urban stress. It introduces the concept of chronic urban trauma to describe the persistent psychosocial impact of displacement, assimilation pressures, and gentrification on young Portuguese-Azorean Canadians. While first-generation immigrants constructed cohesive ethnic infrastructures grounded in work, faith, and language, younger generations face cultural dissonance, linguistic loss, and identity fragmentation that manifest as emotional distress and social alienation. These experiences illustrate how structural urban change can perpetuate transgenerational trauma within immigrant families. By integrating perspectives from urban geography, trauma studies, and migration theory, this theoretical work underscores the need for trauma-informed educational and social policies that promote inclusion, belonging, and mental well-being among immigrant youth. Ultimately, the study positions “Little Portugal” as a microcosm of how multicultural cities negotiate the intersections of ethnicity, urban transformation, and psychological resilience. Full article

Objectives: Mindfulness has been proposed as an important health outcome and an indicator of mental well-being. This study aimed to evaluate the psychometric properties of the Five Facet Mindfulness Questionnaire (FFMQ-15) in two samples of mental health service users with diverse cultural and linguistic backgrounds (English- and Chinese-speaking). The study addresses the conceptual gap regarding the limited validation of the FFMQ-15 in Chinese-speaking clinical populations and examines the implications of measurement invariance. This study aimed at (1) confirming the reliability and validity of the FFMQ-15 in mental health service users; (2) assessing the validity of the FFMQ-15 in Chinese-speaking populations, where evidence is limited; and (3) examining measurement invariance across English- and Chinese-speaking groups to ensure cross-cultural applicability and comparable score interpretation. Methods: Participants were recruited using snowball sampling and social media advertising, targeting adults aged 18 or older who could read and write English or Chinese and had received mental health services. The English-speaking sample comprised 115 adults, and the Chinese-speaking sample included 118 adults. Exploratory factor analysis was used to identify structural dimensions, while confirmatory factor analysis was conducted for both samples to evaluate the five-factor structure of the FFMQ-15. Results: The EFA showed literature-aligned results supporting the 5-factor structure model, while the CFA model demonstrated acceptable fit: χ²/df = 159.50/80 = 1.99, p < 0.001; CFI = 0.927; TLI = 0.904; RMSEA = 0.065 (90% CI [0.050, 0.080]); SRMR = 0.060, BIC = 10,843.067, meeting established thresholds, and the non-significant measurement variance indicated the measurement model’s consistency among clinical patients and across different cultural contexts. Conclusions: The FFMQ-15 shows strong psychometric properties for measuring mindfulness in English- and Chinese-speaking mental health service users, supporting its value in clinical research and practice. Full article

Within the context of sustainable educational workforce development, enhancing the retention intention of early childhood educators is essential for ensuring educational quality and long-term talent sustainability. This study surveyed 200 early childhood educators in Taiwan and developed a parallel mediation model to examine how workplace friendship influences retention intention through workplace well-being and job embeddedness. Confirmatory factor analysis and structural equation modeling were conducted using AMOS 24.0. The results indicate that workplace friendship does not exert a direct effect on retention intention; however, it significantly enhances workplace well-being and job embeddedness, which in turn fully mediate the relationship. In line with the JD-R framework, workplace well-being is conceptualized as a core psychological resource, while job embeddedness reflects a structural resource shaping employees’ attachment to their organization. These findings suggest that workplace friendship must be transformed into a psychological and structural resource in order to promote retention. By identifying workplace friendship as an initial social resource that fosters well-being and embeddedness, this study contributes to sustainable human resource management and supports the stable development of the early childhood education system. Full article

Zhuangzi, a seminal figure in ancient Chinese philosophy, offers profound insights into emotional well-being through his Qi-emotion theory. This paper examines Zhuangzi’s approach to emotional well-being by exploring the interplay between Qi (vital energy), atmosphere, and emotions. By drawing comparative perspectives from Neo-Phenomenology’s concept of atmosphere and the Chinese classical concept of Qi-feeling, the study challenges traditional views that emotions are solely internal phenomena. Instead, it proposes that emotions are field-like, arising from dynamic interactions between individuals and their environments. Through an in-depth analysis of Zhuangzi’s philosophy, particularly his methods of self-cultivation such as “fasting the mind” (xin zhai 心齋) and non-action (wu wei 無爲), this paper illustrates how aligning oneself with the Dao (the Way 道) and harmonizing Qi can lead to emotional balance and spiritual freedom. The study integrates Eastern and Western philosophical traditions, highlighting the significance of enlightened mind, embodiment, and atmospheric resonance in achieving emotional well-being. The findings suggest that Zhuangzi’s Qi-emotion theory provides valuable insights for contemporary philosophical practice and therapy by emphasizing the unity of mind, body, and environment. By fostering harmony with the natural world and transcending personal attachments, individuals can attain a state of inner peace and holistic well-being. Full article

Organic pig farming in Europe is endorsed as a promising route to more sustainable livestock production, but its ultimate contribution to the United Nations (UN) Sustainable Development Goals (SDGs) is a contested matter. This study takes a critical perspective on the potential of organic pig farming to contribute to SDGs that may include SDG 2 (Zero Hunger), SDG 3 (Good Health and Well-being), SDG 8 (Decent Work and Economic Growth), SDG 12 (Responsible Consumption and Production), SDG 13 (Climate Action), and SDG 15 (Life on Land). Organic farming systems delivered better animal welfare outcomes and positive benefits for biodiversity, soil health, and rural employment. Continued improvements in sourcing feed, greenhouse gas emissions per unit of product, animal health, and market could improve their contributions to agricultural sustainability. This study concludes that organic pig farming does not represent a guarantee of sustainable livestock production, but it could represent credible sources of sustainable livestock innovation if sufficient policy, practice, cost accounting, and sustainable metrics are organized together to support organic systems. Organic pig farming focused on innovation and policy support can make it a role model for the transition of European livestock sector towards the 2030 Agenda. Full article

In the last decade, the interdisciplinary field of neuroarchitecture has grown significantly, revealing measurable links between architectural features and human neural processing. This review synthesizes current research at the nexus of neuroscience and architecture, with a focus on how emerging virtual reality (VR) and artificial intelligence (AI) technologies are being utilized to understand and enhance human spatial experience. We systematically reviewed literature from 2015 to 2025, identifying key empirical studies and categorizing advances into three themes: core components of neuroarchitectural research; the use of physiological sensors (e.g., EEG, heart rate variability) and virtual reality to gather data on occupant responses; and the integration of neuroscience with AI-driven analysis. Findings indicate that built environment elements (e.g., geometry, curvature, lighting) influence brain activity in regions governing emotion, stress, and cognition. VR-based experiments combined with neuroimaging and physiological measures enable ecologically valid, fine-grained analysis of these effects, while AI techniques facilitate real-time emotion recognition and large-scale pattern discovery, bridging design features with occupant emotional responses. However, the current evidence base remains nascent, limited by small, homogeneous samples and fragmented data. We propose a four-domain framework (somatic, psychological, emotional, cognitive-“SPEC”) to guide future research. By consolidating methodological advances in VR experimentation, physiological sensing, and AI-based analytics, this review provides an integrative roadmap for replicable and scalable neuroarchitectural studies. Intensified interdisciplinary efforts leveraging AI and VR are needed to build robust, diverse datasets and develop neuro-informed design tools. Such progress will pave the way for evidence-based design practices that promote human well-being and cognitive health in built environments. Full article

Background/Objectives: Identifying consistent patterns across empathy domains can help clinicians understand how empathy relates to burnout, covert narcissism, and other personality traits, thereby enhancing the effectiveness of clinical training. We examined empathy and assessed whether burnout, covert narcissism, and other personality traits show consistent associations across empathy domains. Methods: This cross-sectional study included 213 medical residents from a teaching and public tertiary care facility in Mexico. The Jefferson Scale of Empathy, the Maslach Burnout Inventory, the Hypersensitive Narcissism Scale, and the Zuckerman–Kuhlman Personality Questionnaire were applied. Nonparametric partial correlations were calculated, controlling for sex, age, specialty, year of residency, and psychological well-being. Results: On a 7-point Likert scale, the mean scores for perspective-taking, compassionate care, and the ability to stand in the patient’s shoes were 6.0 ± 0.8, 6.0 ± 1.0, and 4.1 ± 1.2, respectively. Depersonalization was negatively correlated with all empathy domains: perspective-taking (Spearman’s ρ = −0.20, p = 0.04), compassionate care (Spearman’s ρ = −0.30, p < 0.0001), and the ability to stand in the patient’s shoes (Spearman’s ρ = −0.25, p < 0.0001). The associations between other components of burnout, covert narcissism, and the remaining personality traits varied according to the domain of empathy. Conclusions: Depersonalization showed consistent, albeit modest, negative associations with all empathy domains, whereas the remaining psychological factors showed domain-specific relationships. Differentiating between empathy domains is essential, as it allows medical educators and clinicians to tailor interventions to specific components rather than treating empathy as a unitary construct. Full article

Cultural ecosystem services (CESs) are the non-material benefits people derive from ecosystems and are important for human well-being. Most research has focused on individual CES supply–demand relationships, with little systematic study of the overall CES structure, interactions, and mechanisms in metropolitan areas. This study takes the Nanjing Metropolitan Area as a case study, integrating multi-source geospatial data and employing the MaxEnt model, self-organizing maps (SOMs), Spearman correlation analysis, and the Optimal Parameters-based Geographical Detector (OPGD). It analyzes supply–demand matching, trade-offs, synergies, and drivers for four CES categories: aesthetic (AE), recreational entertainment (RE), knowledge education (KE), and cultural diversity (CD). The main findings are as follows: (1) CES supply and demand are spatially zoned: the core area has surplus supply, secondary centers are balanced, and the periphery has both weak supply and demand. (2) Three supply–demand bundles have distinct synergy and trade-off patterns: Bundle 1 primarily exhibits strong synergy between AE and CD; Bundle 2 shows a weak trade-off relationship; and Bundle 3 forms a synergy centered on AE. (3) The explanatory power of driving factors exhibits pronounced spatial heterogeneity: Bundle 1 is dominated by non-quantifiable social factors; Bundle 2 features dual synergistic drivers of population and transportation; and Bundle 3 demonstrates synergistic effects driven by facilities and economic factors. Overall, this study contributes an integrated metropolitan-scale framework that connects CES supply–demand mismatch patterns with bundle typologies, interaction structures, and bundle-specific drivers. The results provide an operational basis for targeted planning and coordinated ecological–cultural governance in the Nanjing Metropolitan Area and offer a transferable reference for other metropolitan regions. Full article

This study examines the impact of role overload on female hoteliers’ intention to quit, highlighting the mediating role of work–family conflict and the moderating role of co-worker support. Drawing on Conservation of Resources (COR) theory, the research conceptualizes role overload as a key job demand that depletes employees’ personal and emotional resources, triggering strain and turnover intentions. Data were collected from 255 full-time female employees working in five-star hotels in Egypt and analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM) via WarpPLS software version 8. The findings reveal that role overload significantly increases both work–family conflict and intention to quit, while work–family conflict partially mediates the relationship between role overload and turnover intentions. Moreover, co-worker support plays a crucial buffering role, weakening the positive effects of both role overload and work–family conflict on intention to quit. The study contributes to hospitality research by providing a gender-sensitive understanding of how high-demand hotel environments affect female employees’ retention and highlights the importance of co-worker support as a practical intervention to mitigate turnover among women employees. These insights offer valuable guidance for hotel managers aiming to enhance employee well-being and reduce attrition in luxury hotel settings. Full article

With the growing demands and expectations associated with professionalised youth sport environments, there is an increasing need for psychosocial development initiatives to support young athletes and their healthy progression. The aim of this study was to extend and investigate the application of the 5Cs framework, a prominent psychoeducational approach in sport psychology, to a youth tennis Talent Development Environment (TDE). Using a collective case study design, five athletes, their parents and two coaches (n = 12) participated in a season-long multimodal 5Cs intervention programme at a British Regional Player Development Centre (RPDC). The 30-week programme was delivered by an embedded sport psychology practitioner (SPP) and incorporated a blocked educational curriculum supported by a range of athletes, coach and parent development strategies. Post-intervention semi-structured interviews were conducted with all participants, with reflexive thematic analysis leading to three overarching themes. Findings highlighted the positive influence of the programme, with perceptions of the framework’s effectiveness associated with its specificity to tennis and individual athlete needs, the collaboration of all stakeholders across the TDE and the use of developmentally accessible and innovative strategies enabling evidence of athlete improvements. Researchers, practitioners and sport organisations are encouraged to consider these impact factors in terms of supporting the development, performance and well-being of athletes and their families in competitive youth sport contexts. Full article