Search Results (3,428)

From a sustainability perspective, lifestyle choices shape behavioral patterns that extend beyond individual experiences, influencing both human well-being and environmental outcomes. Amid escalating human-induced climate change and its widespread social and ecological consequences, understanding lifestyle transformation has become increasingly important. This study traces the trajectories of lifestyle change within globalized contexts and examines the evolving relationships between lifestyle orientations and life satisfaction, with the aim of informing individual-level strategies to support sustainable development aligned with China’s 2060 carbon neutrality goal. Using data from Chinese General Social Survey across three time points (2003, 2013, 2023), a series of two-way analyses of variance reveal that individuals aged 19–35 with higher levels of income and education are more likely to adopt consumption-oriented lifestyles, whereas those aged 60 and above with middle income and lower educational attainment tend to exhibit leisure-oriented lifestyles. Hierarchical multiple regression analyses further indicate that both consumption-oriented and leisure-oriented lifestyles are positively associated with life satisfaction beyond the effects of income alone, although the strength of these associations varies across stages of the life course. Overall, the findings suggest that promoting leisure-oriented lifestyles may offer a viable pathway for enhancing subjective well-being while advancing long-term sustainability goals in contemporary China. Full article

Background: Health-related quality of life (HRQoL) in adolescents reflects their perception of physical, psychological, and social well-being within a specific cultural context, considering developmental stage and individual differences. The KIDSCREEN-27 is a self-report instrument designed to assess HRQoL in children and adolescents, with demonstrated validity and reliability in international samples. Objective: To examine the psychometric properties (i.e., reliability, construct validity, convergent and discriminant validity, and measurement invariance) of the KIDSCREEN-27 questionnaire in a sample of Mexican adolescents. Method: A cross-sectional study was conducted with a sample of 1124 Mexican adolescents aged 10–17 years (M = 13.37, SD = 1.08; 53.5% female; 83.6% secondary education) obtained through non-probabilistic convenience sampling. Reliability (Cronbach’s α, McDonald’s ω), structural validity through exploratory (AFE) and confirmatory factor analyses (CFA), measurement invariance by gender, and convergent and discriminant validity via correlations with self-esteem, well-being, stress, and anxiety–depressive symptoms were evaluated. Results: Analyses showed strong internal consistency (α = 0.912, ω = 0.914). EFA supported a five-dimensional structure. CFA showed an optimal fit after including specific covariances (χ²/df = 3.62, RMSEA = 0.048, CFI = 0.929, TLI = 0.919, SRMR = 0.043). Metric and scalar gender invariance were supported. Positive correlations emerged with well-being (r = 0.76, p < 0.01), self-esteem (r = 0.64, p < 0.01), and satisfaction with life (r = 0.52, p < 0.01), and negative correlations with stress (r = −0.61, p < 0.01), academic stress (r = −0.32, p < 0.01) and anxiety–depressive symptomatology (r = −0.53, p < 0.01), providing evidence of convergent and discriminant validity. Conclusions: The KIDSCREEN-27 demonstrated adequate psychometric properties, supporting its use among Mexican adolescents, enabling the identification of well-being needs, monitoring of interventions, informed decision-making in health and educational practice and supporting cross-cultural comparisons of adolescent well-being. Full article

Background: Dentofacial deformities (DFDs) comprise heterogeneous sagittal, vertical, transverse, and asymmetry components, yet clinical severity is often summarized using isolated measurements. Objectives: To operationalize a reproducible composite DFD severity score and evaluate its cross-sectional associations with quality of life, function, airway-related screening indicators, and psychosocial burden. Methods: In this single-center cross-sectional study, consecutive adults assessed in an orthognathic surgery pathway underwent a prespecified 0–100 severity scoring framework integrating sagittal discrepancy (|Wits| and |ANB deviation|), vertical pattern (SN-MP angle), and asymmetry/transverse variables (chin deviation, asymmetry index, transverse discrepancy, and absolute overjet). Outcomes included the Oral Health Impact Profile-14 (OHIP-14), Orthognathic Quality of Life Questionnaire (OQLQ), FACE-Q facial appearance satisfaction scale, PHQ-9, GAD-7, STOP-Bang, functional testing, and CBCT-derived upper-airway metrics. Results: Severe DFDs had higher composite severity (62.9 ± 12.8 vs. 25.3 ± 10.9), larger sagittal discrepancy (|Wits| 6.3 ± 2.8 vs. 3.1 ± 1.8), and higher SN-MP angles (39.8 ± 7.4 vs. 34.7 ± 7.2) (all p < 0.001). Severe DFDs also had worse OQLQ (36.2 ± 6.2 vs. 24.1 ± 7.2), OHIP-14 (18.3 ± 4.2 vs. 12.4 ± 4.1), FACE-Q satisfaction (45.7 ± 10.3 vs. 67.6 ± 9.6), masticatory performance (59.4 ± 8.5 vs. 75.1 ± 7.5), and smaller airway area (126.7 ± 29.6 vs. 161.4 ± 27.7) (all p < 0.001). In multivariable logistic regression, |Wits|, SN-MP angle, asymmetry index, and lower airway area independently predicted severe status; PHQ-9 was associated with severity in unadjusted analyses but did not retain independent significance after multivariable adjustment. Model discrimination was high (AUC 0.91). Conclusions: This multidimensional severity framework captures clinically meaningful cross-sectional differences across morphologic, functional, airway-related, and psychosocial domains. Its interpretability remained stable in sensitivity analyses, but external and longitudinal validation is still required before broader implementation. Full article

Background/Objectives: Psychological variables such as body image, self-esteem, and life satisfaction have become important research topics in recent years, particularly in their relationships with individuals’ eating attitudes. The purpose of this study is to examine the predictive effect of body image and self-esteem on eating attitudes in emerging adults and to evaluate the mediating role of life satisfaction in this relationship. Method: The study included 402 participants aged 18–30. Data were collected using the Eating Attitudes Test (EAT-26), the Rosenberg Self-Esteem Scale (RSS), the Body Image Scale (BIS), and the Life Satisfaction Scale (LSS). The analyses included correlational analyses to examine relationships among eating attitudes, body image, self-esteem, and life satisfaction; multivariate regression to test the predictive roles of body image, self-esteem, and life satisfaction on eating attitudes; and structural equation modeling to evaluate the mediating role of life satisfaction in the relationships between body image, self-esteem, and eating attitudes. Result: The correlational analysis revealed that eating attitudes are associated with body image, life satisfaction, and self-esteem. Body image was identified as the most influential predictor of eating attitudes. Structural equation modeling indicated that life satisfaction mediates the relationship between self-esteem and eating attitudes. Conclusions: Body image, self-esteem, and life satisfaction play a crucial role in shaping eating attitudes among emerging adults. The mediating effect of life satisfaction underscores psychological well-being as a key regulatory factor rather than solely an outcome. Promoting positive body image, strengthening self-esteem, and enhancing life satisfaction through preventive and psychoeducational programs may help protect against disordered eating attitudes in this population. Full article

Background/Objectives: The coronavirus disease 2019 (COVID-19) pandemic presented significant psychosocial challenges to intensive care unit health care workers (ICU HCW). Prior studies typically used single cross-sectional samples to focus on elements of burnout and psychological stress. We sought to serially assess quality of life and willingness to work before, during, and after the first peak of COVID-19. Methods: Two survey instruments were prospectively administered at regular intervals to multidisciplinary ICU HCWs, initiating at the local onset of COVID-19 and ending 6 months after the first peak ICU census of COVID-19 patients. Results: ICU HCWs reported high levels of compassion satisfaction, burnout, and secondary traumatic stress before, during and after the first peak of COVID-19. Motivation to work declined, and hesitation to work increased from study initiation to the peak ICU census of COVID-19 patients. Hesitation to work was greater in female HCWs and cardiothoracic ICU HCWs. Motivation to work was higher in those working in operating rooms compared to those in the ICU. Concerns about becoming infected, feelings of isolation, and exhaustion were associated with high hesitation to work. Feeling protected by the government and hospital was associated with decreased hesitation and increased motivation to work. Conclusions: ICU HCWs experienced high levels of stress throughout the first year of COVID-19, while satisfaction with work remained high. Willingness to work was associated with gender, work location, ICU subtype, concerns about infection risk, feelings of exhaustion, and feelings of institutional protection. Because the study methodology precludes causal inference and low survey response rates indicate that findings should be interpreted with caution, these results are best viewed as hypothesis-generating for future work aimed at improving stress mitigation in ICU HCWs. Full article

The construction industry is one of the major sources of carbon emissions, and green retrofitting of buildings is an effective pathway to promoting sustainable development in the sector. However, existing research and implementation strategies often struggle to reconcile the needs of governments, businesses, and residents. Therefore, this study proposes a comprehensive research framework that employs bibliometric and text analysis methods to examine implementation barriers in retrofitting projects across four dimensions: policy, cost, technology, and resident satisfaction. The results indicate that retrofitting costs are the primary factor, while technology is a secondary factor. Furthermore, existing policies feature vague technical standards, insufficient incentives, and a lack of differentiation. Conflicts of interest and challenges regarding cost allocation persist throughout the renovation life cycle. Decision-support tools and renovation technologies face limitations and issues regarding applicability. Residents face constraints from multiple factors, including their knowledge base and economic capacity. Based on these findings, the government urgently needs to improve a differentiated policy system and encourage technological R&D and knowledge dissemination. Enterprises must actively respond to policies and optimize their technologies and management practices. Residents need to enhance their energy-saving awareness, participate in retrofitting efforts, and improve their energy consumption behaviors. Full article

Background: Ulcerative Colitis and Crohn’s Disease are the most common forms of inflammatory bowel disease (IBD), with increasing prevalence both globally and in Poland. Many aspects of how a patient’s everyday function and treatment remain underexplored. Methods: This study recruited adult patients with IBD hospitalized in the Department of Digestive Tract Diseases of the Medical University of Lodz, Poland. The data were collected between June and July 2025 using an author-developed questionnaire assessing patients’ opinions on therapy, their expectations, and overall life satisfaction. Results: A total of 87 patients with IBD were included in the analysis. Overall, 59 patients (67.82%) reported strong satisfaction with their current treatment, indicating a generally positive perception of disease management. Higher treatment satisfaction was associated with patients’ perception that their preferences were respected by the gastroenterologist. Further analysis revealed significant associations between different types of treatment, disease activity, and patient-reported outcomes. Those patients who were treated with biological agents more frequently reported complete satisfaction with the treatment (41/52 vs. 18/35; p = 0.014), low-to-moderate disease activity (42/52 vs. 19/35; p = 0.016), and fewer limitations in their social lives (16/52 vs. 20/35; p = 0.026) compared to the remaining group. Furthermore, the study demonstrated that those patients who reported remission were less likely to have their physical activity limited (27/55 vs. 27/32; p = 0.002). There were significantly more patients under 50 years of age than older patients getting biological therapy (48/74 vs. 4/13; p = 0.045). Additionally, women in the studied group had a higher rate of IBD-related surgical interventions compared to men (15/36 vs. 9/51; p = 0.026). Despite the high overall satisfaction with treatment and physician communication, 20 patients (22.99%) admitted to taking additional, non-prescribed medication or dietary supplements. Similarly, 21 (24.14%) patients modified treatment regimens by discontinuing the medication intake or changing the prescribed dose. Furthermore, 57 patients (65.52%) reported that they feared the possibility of surgical intervention. Nonetheless, the majority of patients who underwent surgical treatment (22/24; 91.67%) were satisfied with the results. Reported rates of undergoing regular colorectal cancer screening were also unsatisfactory—4/37 (10.81%) patients with disease duration >8 years, suggesting inadequate awareness. Conclusions: Biological treatment can positively impact multiple aspects of patients’ lives by lowering the disease’s activity. Gastroenterologists should spend more time discussing patients’ preferences and concerns, as well as explaining the colorectal cancer screening rules. Full article

Thailand is facing a rapidly aging society, raising concerns about how retiring workers will maintain their quality of life. Insured persons in the social security system—especially voluntary members under Section 40 of the Social Security Act B.E. 2533 (1990), who are often informal workers—frequently lack formal retirement plans, underscoring the need for interventions that address financial security and subjective well-being (SWB) in later life. This study aimed to develop and evaluate a retirement planning program designed to enhance subjective well-being and improve the quality of life for pre-retirees in Songkhla Province. A Research and Development (R&D) design was employed in four phases. Phase 1 (R1) involved a needs assessment: survey data from 500 insured individuals (ages 40–60) were collected to identify gaps between current and desired retirement preparedness. Phase 2 (D1) utilized the needs assessment results and theoretical frameworks to design a Subjective Well-being Retirement Planning Program, encompassing financial, health, and psychosocial components. Content-relevance experts validated the draft program. Phase 3 (R2) involved implementing the program with 15 volunteer participants over four weekly workshops (each 3 h long) and evaluating its short-term pilot outcomes using pretest-posttest measures of subjective well-being. Phase 4 (D2) refined the program based on evaluation findings and expert feedback. Results indicated that following participation in the program, participants’ overall subjective well-being and all sub-dimensions (life satisfaction, positive and negative affect balance, sense of meaning, social connectedness, security, and health) were significantly higher than before (p < 0.001). Additionally, the proportion of participants classified as inadequately prepared for retirement (high-risk due to low planning) decreased markedly, suggesting increased readiness within the pilot group. Expert evaluations of the program design reflected a high content validity index and strong agreement on the program’s accuracy, appropriateness, and usefulness for the target group. In conclusion, the developed retirement planning program was associated with short-term improvements in subjective well-being and quality-of-life indicators among insured pre-retirees. This theory-informed program, developed through an R&D process, offers a model for supporting aging workers in the social security system, with implications for policymakers and practitioners seeking to promote healthy, happy, and secure retirements in an aging society. Full article

Choosing a future career represents a complex developmental task, often accompanied by multiple concerns and anxieties. The Social Cognitive Career Theory and Life Design paradigm emphasize the importance of supporting individuals in managing career-related challenges. However, global stressors—such as the COVID-19 pandemic, the war in Ukraine, and increasing awareness of the climate emergency—have introduced new and multifaceted sources of uncertainty that are not adequately captured by existing instruments. This gap highlights the need for a psychometrically sound measure to assess emerging career-related concerns in the contemporary context. Accordingly, the study aimed to develop and validate the Career Concerns related to Perceived Environmental Challenges (CC-PEC Scale). Four studies were conducted. Study 1 employed exploratory factor analysis, supporting a three-factor structure (Career-related COVID-19 pandemic concern, Career-related war concern, and Career-related climate emergency concern). Study 2 confirmed this structure using confirmatory factor analysis and demonstrated measurement invariance across gender, supporting a hierarchical factorial model. Study 3 provided evidence of concurrent and discriminant validity through associations with related constructs. Study 4 offered preliminary evidence of stability and predictive validity using life satisfaction and flourishing as outcome variables. Overall, the findings support the CC-PEC Scale as a reliable and valid instrument for assessing career-related concerns linked to global environmental challenges. These results have important implications for research and career guidance interventions aimed at supporting young people’s career development in increasingly uncertain contexts. Full article

The Western Liao River Basin is one of the cradles of Chinese civilization and is recognized as China’s third mother river, following the Yellow River and the Yangtze River. This study focuses on traditional settlements in the Western Liao River Basin and evaluates their spatial perception elements using the IPA (Importance–Satisfaction Analysis) method. By enriching research on the spatial perception evaluation of traditional settlements, this work provides guidance for the protection and inheritance of traditional settlements in the Western Liao River Basin. Based on a field survey of the current spatial conditions of these traditional settlements, an evaluation system for spatial perception elements is proposed. Using SPSS software, the importance and satisfaction scores of each evaluated element are determined. Using the IPA method, this study classified 18 spatial perception factors of traditional settlements in the West Liao River Basin into four categories: strengths, potential overkill, low priority, and urgent improvement. Differentiated conservation and optimization strategies were proposed based on these findings. The study also reveals that local residents’ spatial perception is an active construction process rooted in daily life and cultural practices, exhibiting characteristics of “place dependence” and “path orientation.” Elements rated as high in importance but low in satisfaction reflect residents’ cultural anxiety and sense of spatial loss. The study emphasizes that the conservation of traditional settlements should shift from expert-led approaches to local collaboration, fully incorporating residents’ cognitive patterns to construct a dynamic pathway for heritage transmission grounded in daily practices and cultural memory. Full article

Background: Gastric cancer survivors frequently encounter a “care gap” after discharge because of complex postgastrectomy syndromes. We evaluated “WECARE,” a bidirectional digital health platform designed to provide real-time symptom monitoring and multidisciplinary support. The primary goal of this study was to assess the efficacy of the platform by measuring the change in the Korean Quality of Life Questionnaire for Gastric Cancer Survivors (KOQUSS-40) total score over a six-month recovery period. Methods: This nationwide, multicenter pilot randomized controlled trial was conducted by the Korean Quality of Life in Stomach Cancer Patients Study Group (KOQUSS) across nine tertiary centers in Korea. A total of 88 patients who underwent curative gastrectomy were enrolled. Following an initial optimization phase involving 22 patients, the remaining 66 patients were randomized at a 1:1 ratio to the WECARE group or the control group. The WECARE group used a platform integrating the KOQUSS-40 algorithm for structured symptom reporting, real-time feedback on nutrition and exercise, and educational content on meal planning, symptom coping, and recovery. Assessments were performed at baseline and at 1, 3, and 6 months after discharge. Results: The WECARE group showed high feasibility and acceptability, with an adherence rate of 86.7% and an 82% satisfaction rate. At 6 months, the KOQUSS-40 total score (primary endpoint) did not differ significantly between the WECARE and control groups (85.3 ± 1.6 vs. 83.8 ± 1.6, p = 0.603). However, the WECARE group showed a numerically favorable recovery trajectory from the acute postoperative phase. Subgroup analysis revealed a positive trend in reflux symptom management in the WECARE group (p = 0.0856). In addition, more than 77% of users reported that the platform improved their self-management capabilities. Conclusions: The WECARE platform is a feasible and acceptable digital intervention for gastric cancer survivors. Although the primary endpoint was not significantly different, the favorable recovery trajectory, high adherence, and patient engagement support further evaluation in larger studies with longer follow-up and broader healthcare settings. Full article

Background: Testosterone is the most abundant biologically active sex steroid in women, yet the therapeutic implications of its age-related decline remain undercharacterized. Published trials have focused predominantly on sexual function, leaving gaps in understanding how testosterone replacement therapy (TRT) affects broader symptom domains and metabolic biomarkers in women. Objective: To investigate whether individualized, biomarker-guided TRT in women is associated with improvements across multiple symptom domains and favorable hormonal, hematologic, and cardiometabolic biomarker changes, and to examine whether symptomatic benefit varies with treatment duration. Methods: In this retrospective observational study, women (n = 332; ages 27 to 78; mean 45.7 ± 7.1 years) receiving TRT as part of routine clinical care through a telehealth-based platform completed a structured survey at a single post-treatment time point assessing eight symptom domains: energy/fatigue, memory, concentration, irritability, depression, anhedonia, sexual interest, and relationship satisfaction. Respondents were stratified by TRT duration (1 month to >12 months) and a subset (n = 120) underwent paired biomarker assessment at baseline and 12 weeks for total testosterone, free testosterone, SHBG, hemoglobin, and triglycerides. Results: Improvement was reported across all eight domains, with energy/fatigue showing the strongest response (84.3% improved). Depression, irritability, anhedonia, and sexual interest each exceeded 65% improvement. Cognitive domains showed a delayed trajectory, with meaningful gains emerging at 4 to 6 months. Quality of life improvement was reported by 89.7%, with significant improvement rising from 5.4% at 1 month to 51.5% at greater than 12 months. Energy/fatigue (64.2%) and mood (49.7%) ranked above sexual desire (41.3%) as self-identified areas of greatest benefit. All five biomarkers changed favorably: total testosterone +151.8% (d = 3.60), free testosterone +216.7% (d = 3.01), hemoglobin +5.5% (d = 2.03), SHBG −13.3% (d = 1.57), and triglycerides −12.6% (d = 1.28). Conclusions: Individualized TRT in women was associated with broad symptomatic improvement spanning energy/fatigue, depression, irritability, anhedonia, cognitive function, and sexual interest, with duration-dependent gains and favorable biomarker changes across all five markers assessed. These findings suggest that the value of testosterone in women extends beyond sexual function and supports the need for larger controlled trials with extended follow-up. Full article

This study aims to investigate the effects of different smartphone lock screen wallpapers on weekly perceived well-being, procrastination, and productivity in young adults. Through a pre-registered within-subject experiment, 60 participants were exposed to three smartphone wallpaper conditions: nature, animal, and neutral (control). Each participant experienced each condition over three weeks, with the order of conditions counterbalanced. Using Frequentist and Bayesian analyses, we did not find any differences between conditions across the pre-registered confirmatory outcomes (i.e., life satisfaction, positive affect, negative affect, stress, productivity, and procrastination). Exploratory outcomes related to lock screen engagement, however, revealed some meaningful effects. Animal-themed smartphone wallpapers increased recognition and distractibility, while nature-themed smartphone wallpapers were rated as more pleasing than both animal and control images. Our findings suggest that brief visual exposure to nature or animal-themed lock screens may be insufficient to influence broader well-being or behaviour. Implications for designing strategies to promote psychological health in everyday technology use are discussed. Full article

Background: Treatment options for vulvar lichen sclerosus (VLS) remain limited; therefore, therapies that improve quality of life and reduce neoplastic risk are needed. Photodynamic therapy (PDT) is a potential option. This study aimed to evaluate quality of life and sexual function in patients treated according to the protocol used at our institution. Methods: Forty patients with refractory VLS underwent PDT using a 10% 5-aminolevulinic acid nanoemulsion (Ameluz^®) applied to lesions under an occlusive aluminum foil dressing. Patients received 1–6 sessions of 10 min illumination (LED: 37 J/cm², ~77 mW/cm²) at 4–6-week intervals. The Dermatology Life Quality Index (DLQI) and Female Sexual Function Index (FSFI) were used for assessment. Results: Thirty-seven participants answered DLQI, while 20 declared themselves to be sexually active and were included in the analysis. Greater number of PDT sessions was associated with a lower DLQI score (τ = −0.583; adjusted p < 0.001). The number of PDT sessions and the total FSFI score (p = 0.014), as well as desire (p = 0.016), arousal (p = 0.020), orgasm (p = 0.020), and satisfaction (p = 0.016) domains were significantly correlated. Age correlated positively with DLQI scores (p = 0.016), indicating greater disease burden in older patients. Longer disease duration was also associated with poorer quality of life (p = 0.020). Conclusions: PDT can be considered an effective treatment for patients with VLS refractory to standard topical corticosteroid and calcineurin inhibitor therapies when delivered using a refined, patient-centered protocol. This optimized approach used in our institution is based on short irradiation time and precise light delivery, providing a favorable balance between therapeutic efficacy, patient comfort, and treatment feasibility. Our findings also suggest that the cumulative number of PDT sessions is a key factor for clinical response. Further studies should address long-term outcomes. Full article

Background: Quality-of-life (QoL) assessment has become an essential component of outcome evaluation in oral and maxillofacial surgery (OMFS), particularly in interventions with functional implications for breathing, sleep, and oro-facial performance. Existing instruments often lack specificity for the postoperative OMFS population. This study aimed to develop and psychometrically validate the OMFS-QoL-18 questionnaire, a condition-oriented patient-reported outcome measure designed for postoperative assessment. Methods: A cross-sectional validation study was conducted on 226 adult patients evaluated 6–12 months after orthognathic or function-oriented OMFS procedures. Internal consistency was assessed using Cronbach’s alpha, and reproducibility using the intraclass correlation coefficient (ICC) based on a two-way random-effects model with absolute agreement. The internal structure of the instrument was explored through an exploratory dimensionality analysis using Principal Component Analysis (PCA), including Kaiser–Meyer–Olkin (KMO) testing and Bartlett’s test of sphericity. Descriptive statistics were calculated for item and domain scores. Results: The OMFS-QoL-18 demonstrated good internal consistency (Cronbach’s α = 0.789; standardized α = 0.783) and satisfactory reproducibility (ICC = 0.81; 95% CI: 0.74–0.87). The exploratory dimensionality analysis suggested a multidimensional structure, with five components explaining 67.1% of the total variance. Item clustering was broadly consistent with the predefined conceptual domains, including respiratory comfort, sleep quality, daytime function, oro-maxillofacial function, and global satisfaction. Given the use of PCA as a component-based method, these findings are interpreted as preliminary evidence of dimensional organization rather than confirmation of latent constructs. Conclusions: The OMFS-QoL-18 demonstrated good internal consistency and preliminary evidence of a coherent factor structure. These findings support its use as a promising condition-specific instrument, pending further validation studies. Further multicenter and longitudinal validation studies are warranted to confirm structural stability and responsiveness over time. Full article