Search Results (3,044)

Spinal cord injury (SCI) profoundly affects motor–sensory functions, reducing mobility and quality of life. Robotic exoskeletons offer a promising solution to support gait training, improve mobility, and prevent secondary complications. Existing research predominantly focuses on complete SCI, with limited exploration of long-term effects and tailored training for incomplete SCI. This study investigates device-based outcomes of personalized exoskeleton gait training in 33 individuals with incomplete SCI, with different lesion levels: cervical, thoracic, and lumbar. Participants underwent up to 39 sessions of gait training with a commercially available lower limb exoskeleton. Session parameters, including duration, intensity, and modality, were tailored to each individual’s clinical needs as determined by a medical team. Analysis focused on endurance, performance on the device, and patient-reported outcomes related to walking fluidity, safety, and satisfaction. Results showed overall improvement in endurance and performance, with the most significant gains observed in participants with thoracic-level injuries. All participants reported increased perceived safety, walking fluidity, and high satisfaction with the training. These findings support the potential of personalized exoskeleton training to enhance outcomes and experiences for individuals with incomplete SCI. The difference in improvement between lesion levels highlights the need for customized approaches to address the diverse clinical conditions within this population. Full article

Intelligence, academic achievement and an unfavorable discrepancy between them (i.e., underachievement) have been proposed to influence students’ subjective well-being. However, previous research on these effects remains scarce and inconsistent. The present study examined the associations between said variables in a sample of 695 fifteen-year-old students in Germany, differentiating between those with and without a migration background. Our findings unexpectedly revealed that students with a migration background reported higher life satisfaction than those without a migration background. Intelligence was unrelated to life satisfaction, regardless of migration background. Academic achievement, measured by the grade point average, was positively associated with life satisfaction among students without a migration background but showed no such relationship in students with a migration background. Segmented regression analyses further indicated that an unfavorable discrepancy between IQ and grade point average, reflecting underachievement, was associated with lower life satisfaction among students with a migration background but not among those without. These findings partially challenge previous research and theoretical assumptions. We discuss the theoretical and practical implications of our findings for educational policy and emphasize the importance of targeted interventions to address underachievement in students with a migration background. Our findings suggest that poor academic performance can have a particular impact on well-being in this group. Accordingly, interventions aimed at reducing the achievement gap of those students should not only target cognitive and academic skills but also promote emotional support, cultural inclusion and social integration in the school environment. Full article

Background: This study aimed to examine the association between different exercise goals and their impact on subjective well-being (SWB) variables, namely, positive affect (PA), negative affect (NA), and satisfaction with life (SWL), as well as to explore the mediating role of basic psychological needs (BPNs) in this relationship within a sample of Portuguese older adults. Objectives: The present study aimed to analyze the association between extrinsic and intrinsic motivation for exercise, basic psychological needs (BPNs), and subjective well-being (SWB) in older Portuguese people. Methods: The sample study constituted 298 individuals (233 females, 65 males), aged between 60 and 90 years (M = 68.43; SD = 6.48). Through model four of the Process macro for SPSS version 3.5, a simple mediation analysis was carried out. Results: The results show that BPNs mediated the relationship between goal content for exercise health management and positive affect (PA) and satisfaction with life (SWL); goal content for exercise skill development and PA; goal content for exercise image, PA, and SWL; and goal content for exercise social affiliation and PA. Conclusions: Thus, we can conclude that BPNs stand out as a relevant mediator in the relationship between goal content for exercise and SWB variables, which reinforces the importance of BPNs in SWB promotion in the older population. Full article

Background/Objectives: Chronic medical conditions are comorbid with psychological disorders, often attributed to the weight of managing persistent demands associated with debilitating illness. Lifestyle adjustments, physical pain, and costs of health care can impose impairment of functioning, exacerbated by the onset of a chronic disease. While cause-and-effect directionality is difficult to ascertain, it is widely assumed that psychological stress can exacerbate the ability of patients to manage chronic medical conditions. Methods: The current study examined a novel model comprising five psychological factors which might explain variations in patients’ level of adherence, satisfaction, and quality of life. The sample consisted primarily of 124 low-income, female Hispanic patients, who were patients diagnosed with rheumatic and endocrine medical diagnoses. Results: Psychological distress and the lingering psychological effects of the COVID-19 pandemic were negatively associated with patient adherence, satisfaction, and quality of life, and that patients’ reports of the working alliances with their doctors moderated (i.e., significantly lessened) the negative association between the lingering impact of the COVID-19 pandemic and their satisfaction with care. Patients’ self-efficacy, resilience, and working alliance were all positively and significantly associated with adherence, satisfaction, and QOL. The association between working alliance and satisfaction represents a very large effect (r = 0.77, p < 0.001). Path analysis found a direct effect between psychological distress (stand. est. = 0.28, p = 0.05) and treatment adherence and a direct effect between COVID-19 impact and adherence (stand. est. = −0.19, p = 0.05). Conclusions: This study provides evidence of the role that both psychological stress and psychological strengths play in the experience of receiving medical care for low-income patients with rheumatic and endocrine conditions. Psychological stress inhibits adherence, and the physician–patient working alliance moderates the negative correlation between COVID impact and treatment satisfaction. Full article

Background: This systematic review aims to summarize the most recent data from the literature on the psychological aspects of parents of children prenatally diagnosed with congenital heart defects (CHDs). Methods: A comprehensive literature search was conducted to identify relevant studies on the psychological issues faced by parents of children prenatally diagnosed with CHD. Searches were performed in multiple scientific databases, including PubMed, Science direct, Embase, Scopus, Medline, Clarivate, to ensure the broad coverage of the literature. The search was limited to studies published up until February 2025. The search strategy included the following terms and combinations: “congenital heart defect” OR “CHD” AND “prenatal diagnosis” AND “psychological impact” OR “parental distress” OR “coping”. Results: Eighteen studies involving the 673 parents of fetuses diagnosed with congenital heart defects were included. Studies spanned four continents and employed both qualitative (n = 14) and quantitative (n = 4) designs. Key psychological outcomes reported were anxiety, depression, stress, post-traumatic stress, coping strategies, maternal–fetal attachment, and life satisfaction. Anxiety and depression were the most frequent issues, with maternal anxiety reaching 65% and depression up to 45.7%. Stress related to diagnostic uncertainty was common. While some parents used adaptive coping (social support, emotional regulation), others experienced maladaptive patterns such as avoidance. One study reported increased maternal–fetal attachment following prenatal CHD diagnosis. Predictors of psychological distress included time of diagnosis, parental gender, education level, social support, and severity of the defect. Recommended interventions included early psychological screening, empathetic communication, structured counseling, and long-term emotional support. Despite heterogeneity in design and moderate overall bias, findings highlight a consistent psychological burden among parents, underscoring the need for integrated psychosocial care following a prenatal CHD diagnosis. Conclusions: Parents whose children have been prenatally diagnosed with a congenital heart defect are at an increased risk for psychological distress. To improve the quality of care, a multidisciplinary team is needed to provide parents with the necessary information on diagnosis, interventions, and potential outcomes. Full article

With the ongoing advancement of urbanization in China, a disparity has arisen between population demands and the allocation of community resources, resulting in a persistent increase in residential vacancy rates. The integration of service facilities into vacant residential spaces has enabled functional housing transformations. This study analyzes three typical types of communities in Xi’an to examine these transformations, identifying distinct types and patterns across five scenarios, which include social, health, leisure, cultural, and educational contexts. Through structured questionnaires and in-depth interviews, we collected data on residents’ life satisfaction and NIMBY (not in my backyard) perceptions. Applying a NIMBY index algorithm, we quantified characteristics and identified root causes. The results demonstrated that leisure scenarios most significantly affected satisfaction, while social scenarios showed the highest NIMBY index. Using an ordered logistic regression model, we determined key NIMBY factors influencing satisfaction across scenarios, revealing their differential impact mechanisms. Drawing on the findings, we investigated coordination mechanisms between the transformations of residential spaces and the needs of residents. Based on this analysis, the research objective was to explore how vacant housing can integrate service facilities while mitigating NIMBY effects and meeting resident needs. Proposed strategies include hierarchical facility allocation, NIMBY mitigation measures, and spatial planning optimization, ultimately adapting to diverse lifestyles and housing demands. Full article

Background/Objectives: The emergence of biologic therapies has transformed the management of severe asthma, offering targeted treatments that improve symptom control and reduce exacerbations. However, taking a biologic solely based on the initial response may not be optimal. Clinicians must regularly reassess the suitability of the selected biologic, considering evolving patient characteristics and the growing availability of treatment options. This article aims to highlight the importance of individualized decision making in the long-term management of pediatric patients receiving biologic therapy, exploring the various reasons that may justify switching biologic treatment. Methods: We present a case to illustrate this approach: a 14-year-old adolescent girl with severe allergic asthma who initially received Omalizumab, achieving clinical, laboratory, and functional improvements. Despite this positive response, the patient reported low-level satisfaction due to the frequency of injections and hospital visits, leading to poor adherence. After a comprehensive reassessment, the treatment was switched to Tezepelumab. Results: Following the switch, the patient maintained stable disease control with a slight improvement in lung function, while adherence, satisfaction, and quality of life improved significantly. The number of hospital visits was reduced from 24 to 12 per year, and the number of injections decreased from 104 to 12 annually. The patient reported high-level satisfaction with the new treatment plan, and the economic burden of therapy was also substantially reduced. We present a table summarizing the essential and secondary factors to consider when initiating or switching biologic therapy. Conclusions: This case highlights the need to go beyond the traditional criteria, such as lack of efficacy and adverse reactions, when evaluating a switch in biologic therapy for pediatric asthma. Factors such as comorbidities, injection frequency and number, route of administration, and cost should also be considered, as they can directly influence adherence and the clinical outcomes in children and adolescents. As the therapeutic options expand, regular reassessment and personalized adjustments remain essential. Full article

Purpose: Grounded in Social Cognitive Theory and Self-Determination Theory, this study analyzed gender differences in the relationships between teachers’ sense of efficacy, basic psychological need satisfaction and frustration (competence), and life satisfaction among Physical Education (PE) pre-service teachers. Method: A sample of 368 PE pre-service teachers (Mage = 23.41 ± 2.37; 48.1% women) participated. A multi-group structural equation modeling approach was used. Results: Male participants reported significantly higher levels of competence satisfaction compared to their female counterparts. Teaching efficacy positively predicted life satisfaction, both directly and indirectly via competence satisfaction. Notably, the indirect effects were stronger among women, while direct effects were observed only in the female group. Conclusions: The findings emphasize the key role of competence satisfaction in explaining how teaching efficacy influences life satisfaction in pre-service teachers. Gender differences suggest that while both men and women benefit from feeling competent, the pathways differ, highlighting the importance of gender sensitive strategies in teacher education programs. Full article

Background: Mental health issues among PhD students are rising, a trend believed to be driven by academic and social challenges. Method: A total of 1265 doctorate students from a large university in Barcelona, Spain (739 women; 414 men; 112 marked other options), with a mean age of 32.36 years (SD = 8.20, range: 23–67), were evaluated by means of standardized instruments. Results: Totals of 40.6% and 46.5% of the sample exceeded the cut-off point for anxiety and depression symptoms, and 57.7% for life satisfaction. The proportion of females exceeding the cut-off point was significantly higher than that of males for both anxiety (women: 43.8%, men: 34.5%) and depression (women: 49.3%, men: 39.8%), but not for life satisfaction (women: 57.6%, men: 58.4%). Arts and Humanities PhD students’ disciplines reported higher anxiety and depression scores than those in Social Sciences, Experimental Sciences and Mathematics, and Health Sciences, respectively, while Social Sciences students showed higher life satisfaction and mentoring support than the other groups. Depression scores were significant predictors of life satisfaction across all doctoral programs. Conclusions: These findings highlight the importance of mentoring in supporting doctoral students’ mental health and life satisfaction and can also inform policies in educational institutions, given that PhD students experiencing psychopathological disorders are at a higher risk of academic failure and dropout. Full article

Background/Objectives: Early identification of terminally ill patients is crucial for enhancing care, patient and care partner satisfaction, and healthcare staff confidence in discussing disease trajectories. Yet, timely recognition remains challenging. To address this, we developed a minimally invasive intervention (MINI) for general hospital wards. We aimed to evaluate the MINI’s feasibility in facilitating an earlier identification of terminally ill patients and improving patient reported outcomes in a hospital setting. Methods: This prospective, two-arm pre-post intervention study at a university hospital evaluated the MINI alongside usual care. Patient-reported outcomes, including quality of life (SF-12), palliative care needs (IPOS), and functional status (ECOG), were collected at baseline and every three months over 12 months. Participants were allocated to a control or intervention group. Results: Of 188 patients identified using the Surprise Question, 58 completed the baseline assessment. While physical functioning (SF-12 PCS) remained comparable, the intervention group experienced clinically meaningful improvements in mental health (SF-12 MCS) at three months, with positive trends at six months. This group also showed a decline in palliative care needs, reduced emotional symptoms, and improved performance status, evidenced by significant differences in non-parametric analyses. These findings underscore the MINI’s potential to significantly improve patient well-being. Conclusions: This pilot study demonstrated the feasibility of the MINI and suggests it may foster meaningful system-wide change in patient-centred care within acute hospital settings, leading to improved patient outcomes and more confident healthcare staff in identifying terminally ill patients. However, given the small sample size, these findings should be interpreted with caution. Future research with larger cohorts and extended intervention periods is warranted to fully elucidate the MINI’s impact and refine strategies for improving care for terminally ill patients. Full article

This study investigates urban life satisfaction and residents’ settlement intention as emergent outcomes of interconnected urban systems and examines the moderating role of urban regeneration budget execution as a systemic policy input. Drawing on the bottom-up spillover perspective and policy feedback theory, this study posits that satisfaction with core aspects of urban living—such as housing, transportation, and public safety—reflects the functioning of multiple interrelated urban subsystems, which accumulate into a global sense of well-being that influences settlement intention. Furthermore, when urban regeneration budgets are visibly and fully executed, they operate as institutional feedback mechanisms, leading residents to attribute their life satisfaction to effective system performance and reinforcing their desire to stay. Using survey data from Incheon Metropolitan City and Gyeonggi Province in South Korea, the study employs stereotype logistic regression to test the proposed model. The findings reveal that urban life satisfaction significantly predicts stronger settlement intention, and this effect is amplified in municipalities with higher levels of budget execution. These results contribute to theoretical understanding by linking subjective well-being with institutional performance and offer practical guidance for South Korean local governments seeking to strengthen community resilience through transparent and outcome-driven urban policy delivery. Full article

Background: Eating disorder (ED) symptoms and body image (BI) concerns involve serious risks to the physical and mental health of women and men. Social networking sites have amplified the promotion of idealised body images, contributing to this issue. Objectives: This study examines the link between personal and emotional factors, social media body image-related behaviours, BI concerns, and ED symptoms, as well as the differential role of these factors according to gender. Methods: A cross-sectional design was applied. The participants were 201 Spanish adults (mean age = 28.26; 76.6% women) who completed self-reported measures on BI (MBSRQ), ED symptoms (EAT-26), perfectionism (EDI-2), anxiety, depression, stress (DASS-21), emotional dysregulation (DERS), life satisfaction (SWLS), and social media BI-related behaviours. Results: Significant relationships between ED symptoms and BI concerns with personal and emotional factors and social media body image-related behaviours have been found. Women have scored higher in ED symptoms and social media BI-related behaviours than men. Multiple regression analyses showed that the difficulty in accepting emotions and not posting images due to BI dissatisfaction were risk factors for ED symptoms in both men and women. Furthermore, the adverse effect of perfectionism and low life satisfaction on women’s ED symptoms were demonstrated, whereas in men, goal-directed behaviours were associated with ED risk. Conclusions: These results suggest that prevention programmes focusing on emotional regulation and healthier social media use can be effective for ED symptoms and BI concerns. Full article

Background: Stroke remains a leading cause of long-term disability globally, frequently resulting in persistent motor and cognitive impairments. Rehabilitation is critical for promoting recovery, and dance-based interventions have emerged as a promising complementary approach. Objective: This scoping review aimed to examine the recent literature on the application of dance in stroke rehabilitation, with a particular focus on its effects on motor function (including balance and gait), cognitive performance, and quality of life. Methods: A comprehensive literature search was conducted across four electronic databases, PubMed, Embase, Web of Science, and Scopus, between January and March 2025. Studies were eligible for inclusion if they involved adult participants with a history of stroke, implemented dance-based rehabilitation interventions, and reported outcomes related to motor function, cognition, or psychosocial well-being. The review process adhered to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Results: Of the 778 records initially identified, four studies met the inclusion criteria: two randomized controlled trials, one interventional study, and one feasibility study. Overall, dance-based interventions were associated with improvements in dynamic balance, gait coordination, and general mobility. Furthermore, the interventions demonstrated high levels of adherence and participant satisfaction. Conclusions: Dance-based rehabilitation may offer meaningful motor benefits for individuals recovering from stroke, particularly in improving balance, gait, and overall mobility. However, the heterogeneity of intervention protocols and the limited assessment of cognitive and psychosocial outcomes underscore significant gaps in the current literature. To establish the efficacy and underlying mechanisms of dance-based approaches, future research should prioritize high-quality randomized controlled trials employing standardized intervention designs and comprehensive outcome measures, including cognitive and quality-of-life domains. Full article

Background: Upper limb loss significantly impacts quality of life, and whereas myoelectric prostheses restore some function, conventional surface electromyography (sEMG) systems face challenges like poor signal quality, high cognitive burden, and suboptimal control. Phantom X, a novel implantable electrode-array-based system leveraging machine learning (ML), aims to overcome these limitations. This feasibility study assessed Phantom X’s performance using non-invasive surface EMG electrodes to approximate implantable system behavior. Methods: This single-arm, non-randomized study included 11 participants (9 able-bodied, 2 with transradial amputation) fitted with a 32-electrode cutaneous array around the forearm. EMG signals were processed through an ML algorithm to control a desk-mounted prosthesis. Performance was evaluated via gesture accuracy (GA), modified gesture accuracy (MGA), and classifier gesture accuracy (CGA) across 11 hand gestures in three arm postures. User satisfaction was also assessed among the two participants with transradial amputation. Results: Phantom X achieved an average GA of 89.0% ± 6.8%, MGA of 96.8% ± 2.0%, and CGA of 93.6% ± 4.1%. Gesture accuracy was the highest in the Arm Parallel posture and the lowest in the Arm Perpendicular posture. Thumbs Up had the highest accuracy (100%), while Index Point and Index Tap gestures showed lower performance (70% and 79% GA, respectively). The mean latency between EMG onset and gesture detection was 250.5 ± 145.9 ms, with 91% of gestures executed within 500 ms. The amputee participants reported high satisfaction. Conclusions: This study demonstrates Phantom X’s potential to enhance prosthesis control through multi-electrode EMG sensing and ML-based gesture decoding. The non-invasive evaluation suggests high accuracy and responsiveness, warranting further studies with the implantable system to assess long-term usability and real-world performance. Phantom X may offer a superior alternative to conventional sEMG-based control, potentially reducing cognitive burden and improving functional outcomes for upper limb amputees. Full article

Background/Objectives: Positive psychology interventions (PPIs) may enhance well-being in individuals with severe psychiatric conditions (SPCs), yet little is known about individual differences in treatment response. Methods: We conducted a secondary analysis of a single-blind, parallel-group randomized controlled trial. A total of 119 adults receiving outpatient mental health care were randomized to an 11-week multicomponent PPI plus treatment as usual (PPI + TAU) or TAU alone. A priori demographic and baseline clinical variables (e.g., age, gender, education, diagnosis, symptom severity) were tested as predictors and moderators of six well-being outcomes. Moderation analyses were conducted using the PROCESS macro (version 4.1) for SPSS version 29.0, with simple slopes explored for significant interactions. Analyses followed an intention-to-treat approach. Results: Individuals who were unemployed, had a diagnosis within the psychosis spectrum, or exhibited high interpersonal sensitivity showed improvements in well-being irrespective of the treatment modality received. Older patients, those attending more weekly therapy sessions, and individuals with less somatization, hostility, or life satisfaction levels responded particularly well to the specialized PPI + TAU treatment. While several interactions were significant at p < 0.01, none remained significant after Bonferroni–Holm correction. Nevertheless, the patterns were consistent and theoretically grounded. Conclusions: Individual characteristics may influence the effectiveness of PPIs in SPC populations. Identifying predictors and moderators can inform more personalized interventions. The findings warrant replication. Trial registration: ClinicalTrials.gov, NCT01436331. Full article