Search Results (13,316)

Background: Burnout is a prevalent issue among mental health nurses. While various interventions have been implemented to address burnout, their effectiveness and sustainability remain unclear in specialised mental health settings. This systematic review aims to clearly evaluate the effectiveness of interventions specifically designed to reduce burnout among mental health nurses, focusing on intervention types, their impact, and the sustainability of results. Methods: A comprehensive search of databases (Embase, CINAHL, Medline, PubMed, Scopus, and Web of Science) identified studies on burnout reduction interventions for mental health nurses. Inclusion criteria focused on mental health nursing populations with pre- and post-intervention burnout measures. Methodological quality was assessed using JBI Critical Appraisal Tools. A narrative synthesis guideline was used to analyse data. Results: Among 2502 studies retrieved, only 4 met the inclusion criteria after a rigorous screening process. These studies explored specific intervention types, including a two-day burnout prevention workshop, an eight-week group-based psychoeducational programme, a twelve-week mindfulness-based psychoeducational intervention, and an eight-week guided self-help mindfulness programme delivered via a digital platform. Significant reductions in burnout were observed across these studies; however, the sustainability of these effects varied. Interventions of greater duration, such as the 12-week mindfulness-based programme and the 8-week group psychoeducational intervention, yielded more enduring improvements. In contrast, shorter interventions, like a two-day workshop, showed transient benefits that diminished over time. Conclusions: This review highlights a critical gap in research on burnout interventions for mental health nurses. While the reviewed interventions showed promise in reducing burnout, the findings underscore the need for sustainable, adaptable interventions and more robust research. Full article

Trauma often causes long-lasting functional impairment, but the extent varies across populations. This study investigated disability six months after moderate to severe injury and identified sociodemographic and early injury-related predictors, including estimated rehabilitation complexity. Further, we assessed the implementation of direct transfer from acute care in the trauma centre to specialised inpatient rehabilitation, bypassing local hospitals. In this prospective study 398 adults, treated from January 2020 to January 2021 at two Norwegian trauma centres, were included. Self-reported disability was measured using the 12-item World Health Organization Disability Assessment Schedule 2.0. Ordinal logistic regression was applied to identify predictors of the 6-month disability outcome. At follow-up, 22% reported no disability, 49% mild/moderate and 29% severe. In multivariable analyses, low education, comorbidities, number of injuries and higher estimated rehabilitation complexity at discharge from acute care were significantly associated with greater disability. Only 20% were transferred directly to specialised inpatient rehabilitation, while 17% went via local hospitals. Participants with orthopaedic injuries and women were less likely to be transferred directly. In summary, most participants experienced some disability at 6 months. Indirect pathways to specialised rehabilitation via local hospitals remained common. Understanding predictors of disability and optimising rehabilitation pathways may improve trauma rehabilitation outcomes, highlighting the need for guidelines that identify patients with high rehabilitation needs. Full article

Background/Objectives: Although COVID-19 may cause cognitive impairments for up to six months, the long-term effects of mild cases remain unclear. Given their high exposure and critical role in public health, assessing this impact on healthcare workers is essential. Aim: The present study aimed to examine the cognitive and emotional effects of mild COVID-19 in 92 healthcare workers one year after infection. Methods: In total, 50 had experienced mild COVID-19, while 42 had not been infected. Participants completed a neuropsychological assessment evaluating attention, memory, and executive functions, along with self-reported measures of anxiety, depression, post-traumatic stress, occupational stress, and burnout. Results: No significant cognitive differences were observed between the groups. However, both exhibited moderate-to-severe psychological distress, with the COVID-19 group showing higher trait anxiety (p = 0.032). Emotional symptoms were significantly associated with neuropsychological performance—higher burnout (ρ from −0.20 to −0.28, p < 0.05) and stress (ρ from −0.25 to −0.33, p < 0.01) correlated with slower responses and more errors in tasks such as the D2 variation index, TESEN execution speed, Rey–Osterrieth Figure recall, and Digit Span forward span. Conclusions: These findings suggest no long-term cognitive impairment after mild COVID-19 but highlight the substantial emotional toll of the pandemic on healthcare workers. Future research should explore cognitive reserve as a protective factor. Full article

The literature has consistently shown the link between parental depressive symptoms and adolescent depressive symptoms. Emotion regulation processes may explain this association, with self-compassion acting as a potential mediating mechanism. This study aimed to explore these developmental trajectories using a longitudinal design. The sample comprised dyads of parents and adolescents (N = 311), assessed across two assessment waves (T1 and T2) over 12 months. The adolescents’ mean age was 13.63 years (SD = 1.30; 173 males). Mediation analyses using structural equation modelling supported the role of self-compassion in mediating the relationship between parental and adolescent depressive symptoms over time (53% of outcome variance explained). The results suggest that fostering self-compassion early in adolescence may help prevent the later adverse effects of depressive symptoms. Full article

Background: Undergraduate nursing students (UNSs) often enter clinical training just as they are still mastering the emotional labor of the profession. In Nepal, where teaching hierarchies discourage upward dialogue and hospitals routinely struggle with overcrowding, supply shortages, and outward nurse migration, these learners confront a distinct, under-documented burden of psychological distress. Objective: This study examines how UNSs interpret, negotiate, and cope with the mental health challenges that arise at the intersection of cultural deference, resource scarcity, and migration-fueled uncertainty. Methods: A qualitative design employing reflexive thematic analysis (RTA), guided by the Reflexive Thematic Analysis Reporting Guidelines (RTARG), was used. Fifteen second-, third-, and fourth-year Bachelor of Science in Nursing students at a major urban tertiary institution in Nepal were purposively recruited via on-campus digital flyers and brief in-class announcements that directed students (by QR code) to a secure sign-up form. Participants then completed semi-structured interviews; audio files were transcribed verbatim and iteratively analyzed through an inductive, reflexive coding process to ensure methodological rigor. Results: Four themes portray a continuum from silenced struggle to systemic constraint. First, Shrouded Voices, Quiet Connections captures how students confide only in trusted peers, fearing that formal disclosure could be perceived as weakness or incompetence. Second, Performing Resilience: Masking Authentic Struggles describes the institutional narratives of “strong nurses” that drive students to suppress anxiety, adopting scripted positivity to satisfy assessment expectations. Third, Power, Hierarchy, and the Weight of Tradition reveals that strict authority gradients inhibit questions in classrooms and clinical placements, leaving stress unvoiced and unaddressed. Finally, Overshadowed by Systemic Realities shows how chronic understaffing, equipment shortages, and patient poverty compel students to prioritize patients’ hardships, normalizing self-neglect. Conclusions: Psychological distress among Nepalese UNSs is not an individual failing but a product of structural silence and resource poverty. Educators and policymakers must move beyond resilience-only rhetoric toward concrete reforms that dismantle punitive hierarchies, create confidential support avenues, and embed collaborative pedagogy. Institutional accountability—through regulated workloads, faculty-endorsed wellbeing forums, and systematic mentoring—can shift mental health care from a private struggle to a shared professional responsibility. Multi-site studies across low- and middle-income countries are now essential for testing such system-level interventions and building a globally resilient, compassionate nursing workforce. Full article

Most sweet cherry varieties exhibit typical gametophytic self-incompatibility (GSI) characteristics, necessitating careful configuration of pollination trees to ensure adequate yields. This requirement increases the costs associated with orchard labor, management, and other related expenses. Consequently, cultivating and developing sweet cherry cultivars with self-compatibility can effectively address these challenges. Research into the molecular mechanisms underlying GSI formation can provide vital theoretical support and genetic resources for breeding self-compatible sweet cherries. In this study, we assessed the fruit set rates of ‘Tieton’ following both self- and cross-pollination. Additionally, we conducted a transcriptome analysis of the ‘Tieton’ style (which includes the stigma) at 0, 12, 24, and 48 h post-pollination to identify key genes involved in the self-incompatibility process of sweet cherries. The results indicated that the self-fruiting rate of ‘Tieton’ was significantly lower than that of cross-pollination. We identified a total of 8148 differentially expressed genes (DEGs) through transcriptome analysis, with KEGG pathway analysis revealing that the plant-pathogen interaction, plant hormone signal transduction, and plant MAPK signaling pathways were primarily involved in sweet cherry GSI. Furthermore, we identified 13 core transcription factors (TFs) based on their differential expression patterns, including three ERFs, three NACs, three WRKYs, two HD-ZIPs, one RAV, and one MYB. Co-expression analysis identified 132 core DEGs significantly associated with these TFs. Ultimately, this study provides initial insights into the key genes within the sweet cherry GSI network, laying a theoretical foundation and offering genetic resources for the future molecular design breeding of new self-compatible varieties. Full article

(1) Background: Integrating assessment with training helps to enhance precision prosthetic rehabilitation of trans-radial amputees. This study aimed to validate a self-developed closed-loop rehabilitation platform combining accurate measurement in comprehensive assessment and immediate interaction in virtual reality (VR) training in refining patient-centered myoelectric prosthesis rehabilitation. (2) Methods: The platform consisted of two modules, a multimodal assessment module and an sEMG-driven VR game training module. The former included clinical scales (OPUS, DASH), task performance metrics (modified Box and Block Test), kinematics analysis (inertial sensors), and surface electromyography (sEMG) recording, verified on six trans-radial amputees and four healthy subjects. The latter aimed for muscle coordination training driven by four-channel sEMG, tested on three amputees. Post 1-week training, task performance and sEMG metrics (wrist flexion/extension activation) were re-evaluated. (3) Results: The sEMG in the residual limb of the amputees upgraded by 4.8%, either the subjects’ number of gold coins or game scores after 1-week training. Subjects uniformly agreed or strongly agreed with all the items on the user questionnaire. In reassessment after training, the average completion time (CT) of all three amputees in both tasks decreased. CTs of the A1 and A3 in the placing tasks were reduced by 49.52% and 50.61%, respectively, and the CTs for the submitting task were reduced by 19.67% and 55.44%, respectively. Average CT of all three amputees in the ADL task after training was 9.97 s, significantly lower than the pre-training time of 15.17 s. (4) Conclusions: The closed-loop platform promotes patients’ prosthesis motor-control tasks through accurate measurement and immediate interaction according to the sensorimotor recalibration principle, demonstrating a potential tool for precision rehabilitation. Full article

Information on the relationship between facial thermal responses and emotional state is valuable for sensing emotion. Yet, previous research has typically relied on linear methods of analysis based on regions of interest (ROIs), which may overlook nonlinear pixel-wise information across the face. To address this limitation, we investigated the use of machine learning (ML) for pixel-level analysis of facial thermal images to estimate dynamic emotional arousal ratings. We collected facial thermal data from 20 participants who viewed five emotion-eliciting films and assessed their dynamic emotional self-reports. Our ML models, including random forest regression, support vector regression, ResNet-18, and ResNet-34, consistently demonstrated superior estimation performance compared to traditional simple or multiple linear regression models for the ROIs. To interpret the nonlinear relationships between facial temperature changes and arousal, saliency maps and integrated gradients were used for the ResNet-34 model. The results show nonlinear associations of arousal ratings in nose = tip, forehead, and cheek temperature changes. These findings imply that ML-based analysis of facial thermal images can estimate emotional arousal more effectively, pointing to potential applications of non-invasive emotion sensing for mental health, education, and human–computer interaction. Full article

(1) Background: Data literacy is becoming increasingly important for healthcare professionals in both outpatient care and research. Since healthcare data and the possibilities for its use and misuse are increasing in these areas, healthcare professionals need diverse knowledge regarding the collection, use and evaluation of data. A core component of this is an understanding of the ethical, legal, and social implications (ELSI) of working with health data. (2) Methods: Within the DIM.RUHR project (Data Competence Center for Interprofessional use of Health Data in the Ruhr Metropolis), the challenge of training in data literacy for different healthcare professionals is addressed. Based on a learning objectives matrix for interprofessional data literacy education, an ELSI concept was developed through collaboration with interprofessional project partners. The study was conducted between December 2024 and April 2025. (3) Results: The foundational structure of the ELSI concept was based on the learning objectives matrix and an unstructured literacy search for ELSI concepts in similar contexts. Using an iterative design-based research approach, a group of experts from different fields (didactics, applied ethics, health sciences, law, sociology, informatics, and psychology) developed an ELSI concept for healthcare professionals. The following categories were identified as crucial: 1. philosophy of science: a basic understanding of science and the hurdles and opportunities; 2. ethics: an overview of the biomedical principles and a technological assessment; 3. law: an overview of the reservation of permission and self-determination; 4. social aspects: an overview of health inequalities and different forms of power relations and imbalances. (4) Conclusions: The ELSI concept can be used in the orientation of healthcare professionals in outpatient care and research—regardless of their profession—to develop data competencies, with the aim of providing a holistic view of the challenges and potential in the collection, use, and evaluation of healthcare data. The DIM.RUHR project’s approach is to develop open educational resources that build on the ELSI concept to teach specific skills at different competence levels. Full article

Aim: We aimed to assess the impact of a Health and Nursing course on the professional commitment of first-year undergraduate nursing students and obtain quantitative and qualitative feedback on teaching. Design: This study employed a quasi-experimental design. Methods: Fifty first-year undergraduate nursing students who attended the Health and Nursing course were recruited. A self-designed basic information questionnaire, the Nursing Professional Commitment Scale, the Students’ Perceived Teaching Quality Questionnaire, and two quick open-ended questions were used to collect the data. Professional commitment before and after the intervention was compared using an independent samples t-test. The correlation between the students’ perceived teaching quality and professional commitment was assessed using Pearson’s correlation coefficient. Content analysis was used to analyze qualitative feedback. Results: The participants experienced a significant improvement in their professional commitment. The students’ perceived teaching quality was significantly correlated with their professional commitment. According to the students’ feedback, the most impressive aspects of the course were case-based learning and visits to healthcare institutions. Conclusions: A Health and Nursing course with high-quality teaching increased the professional commitment of first-year undergraduate nursing students. The findings suggest that nursing educators should consider the external macro-sociopolitical environment when designing an introductory course to equip students with a broader perspective on nursing professional development. Teaching content and pedagogy should be improved to promote knowledge delivery and internalization. Full article

Background/Objectives: This study assessed how to best prepare pediatric and adolescent cancer patients for amputation and support them afterward. Methods: This pilot qualitative study explored pre- and post-amputation experiences from the perspectives of nine pediatric and adolescent survivors who underwent amputation. Hour-long audio-recorded semi-structured interviews were transcribed and analyzed using the Sort and Sift, Think and Shift qualitative approach. Results: Participants described the informational supports they received before surgery, including guidance on what to expect, contact with amputation-related organizations, and exposure to tangible tools, such as a physical model of a knee joint. Emotional support from fellow amputees and healthcare providers, particularly surgeons, was also found to be meaningful. Individuals also identified unmet needs and gaps in emotional care. These included clearer guidance on post-surgical adaptations (e.g., basic self-care and navigating physical limitations) and the need for information tailored to their learning styles. Many emphasized the importance of improved pain management resources, expanded access to mental health services for both them and their families, and support in adjusting to changes in body image and social relationships. Participants also shared advice for future patients, recommending strategies such as personalizing hospital rooms, connecting with other amputees through social media, and using art to process their experience and say goodbye to the lost limb. Conclusions: Interviews with nine cancer survivors provide guidance for improving holistic, patient-centered care throughout the amputation process. Informational and emotional support should be tailored to an individual’s learning style and specific needs, in addition to their age at the time of surgery. Full article

This study aimed to validate the Robot Acceptance Questionnaire (RAQ), a self-report instrument designed to assess user acceptance toward social robots. Originally structured around four theoretical domains—pragmatic, hedonic (identity and feelings), and attractiveness—the RAQ was empirically found to converge into two robust and inversely related dimensions: Positive Attitude (PA) and Negative Attitude (NA). A total of 208 participants (mean = 43.1; S.D. = 21.4) viewed a short video of a humanoid robot (Pepper) and completed the RAQ. Factorial structure (Principal Component Analysis), internal reliability (Cronbach’s alpha), and construct validity were assessed. Results showed excellent internal consistency for both PA and NA (α = 0.93), and intuitive associations with independent measures of ease of use, mastery, and willingness to interact. The RAQ thus offers a concise and reliable tool for assessing general robot acceptance, especially suitable for remote and large-scale studies. Full article

Background: Poloxamers are promising biomaterials for drug delivery applications due to their ability to enhance biopharmaceutical properties. Methods: This study focused on designing solid dispersions of ivermectin using poloxamer 407 by the fusion method and evaluating how variables of synthesis affect the polymer’s behavior and the resulting biopharmaceutical properties of ivermectin. Poloxamer 407 was selected based on a solubility test of preformulation studies. Initially, eight formulations were developed using different synthesis conditions, including polymer proportion, cooling gradient, and final process temperature. These were assessed by several characterization studies. Finally, saturation solubility dissolution profiles and in vitro drug release were also evaluated. Results: A combination of techniques confirmed the compatibility between poloxamer 407 and ivermectin in the solid dispersions. The rate of temperature in the cooling process of synthesis showed a significant impact on the polymer self-assembly, affecting their ability to entrap ivermectin. The optimized solid dispersion comprised ivermectin and poloxamer 407 in a 1:1 w/w ratio prepared by rapid cooling. This decrease in the crystallinity index and the nanometric size of particles of the solid dispersions could explain their ability to improve 1600-fold the aqueous solubility, as well as enhance the drug dissolution and in vitro drug release compared to pure ivermectin. Conclusions: Therefore, it follows that these poloxamer-based solid dispersions are promising alternatives to improve the bioavailability of ivermectin. Full article

Background/Objectives: Anosognosia for hemiplegia (AHP) is a multifaceted syndrome in which stroke survivors fail to recognize motor impairments. Although AHP has significant clinical implications, rehabilitation strategies have remained fragmented and underexplored. This systematic review aimed to critically evaluate rehabilitation interventions for AHP published between 2006 and 2025, categorize intervention types, and assess clinical outcomes to inform future research and practice. Methods: A structured search was conducted in the PubMed and PsycINFO databases on 31 March 2025, using predefined keywords related to stroke, anosognosia, and rehabilitation. The eligible studies included randomized controlled trials, case–control studies, and case studies. Following title, abstract, and full-text screening, nine studies focusing on rehabilitation interventions for AHP were selected and analyzed. Results: The interventions reviewed included sensorimotor recalibration techniques, neuromodulatory approaches, error-based cognitive training, and self-observation in video replay strategies. Interventions emphasizing motor intention monitoring, error correction, and self-observation were more consistently associated with durable improvements in motor awareness than neglect-based spatial interventions were. However, many studies were limited by small sample sizes and a lack of standardized outcome measures. Assessment methodologies vary widely, highlighting the need for multidimensional theory-driven evaluation tools. Conclusions: Effective rehabilitation for AHP requires strategies targeting disrupted self-monitoring and agency mechanisms, rather than spatial realignment alone. The video self-observation and error-based learning paradigms show particular promise. Future research should focus on controlled trials, longitudinal tracking, and the integration of individualized, mechanism-specific rehabilitation models to optimize outcomes for stroke survivors with AHP. Full article

Background: The World Health Organization (WHO) defines health promotion as the process of enabling individuals to gain control over and improve their health. This shifts the focus from lifestyle choices to broader social determinants of health, requiring involvement from healthcare, authorities, industry, civil society, and the media. Civil society engagement in health initiatives offers benefits such as empowerment, service delivery, flexibility, policy participation, and credibility. However, identifying specific health promotion actions for civil society organizations (CSOs) is challenging. The lack of assessment tools for CSOs hinders evaluation and improvement. Objective: To develop a tool, ‘PromoACTIVA-SC’, to assess CSOs’ health promotion practice by identifying essential actions that constitute the health promotion process. Methods: ‘PromoACTIVA-SC’ was developed through documentary analysis and validated by experts. CSOs’ members participated in cognitive interviews for comprehensibility, and the tool was pilot tested for administration and Likert scale evaluation. Results: The final questionnaire, consisting of 8 phases and 40 items, demonstrated good content validity. Its use can help to map CSOs’ practices and identify areas needing improvement. CSOs can use it for self-assessment and in collaborative health promotion and disease prevention efforts. Conclusions: ‘PromoACTIVA-SC’ is the first tool designed to assess civil society’s role in the health promotion process. Its future use will reveal the extent to which civil society organizations actively participate in health promotion. It can also be used to promote CSOs’ involvement in health policy and administration, enhancing public health outcomes through collaborative, cross-sectoral efforts. Full article