Eur. J. Investig. Health Psychol. Educ., Volume 13, Issue 11 (November 2023) – 26 articles

Autism is a relatively common neurodevelopmental condition that affects social communication and behavior, affecting the overall quality of life. The prevalence of autism is constantly increasing, but timely diagnosis allows for effective treatment. The aim of our research was to construct a Russian version of the RAADS-14, a brief self-report questionnaire originally designed for autism screening, and to perform its initial validation to provide a reference point in developing autism self-assessment tools for the Russian-speaking population. Psychometric properties of the RAADS-14 Rus were evaluated on a sample of 1724 participants, including a general sample of non-psychiatric young adults (n = 794) and adults with clinically established ASD (n = 49); a brief Russian inventory assessing Big Five personality traits (FFQ) was administered to a part of the sample (n = 364) to provide the first assessment of criterion validity. Confirmatory factor analysis of the RAADS-14 Rus confirmed the factor structure of the original Swedish version yielding acceptable fit indices. The discriminating properties were substantially worse than in the original study. The correlations between the RAADS-14 Rus domain scores and the Big Five factors were similar to previously obtained findings. Overall, the results suggest that the RAADS-14 Rus can be used as a screening tool for ASD in adults with proper caution and considering its discriminating properties. Full article

Under certain circumstances, masks are an effective and immediate solution to reduce the spread of viral infection. However, the impact of masks on the ability to perform vigorous exercise remains an area of concern. Primarily, this impact has been explored in healthy subjects, yielding contradictory findings, and little is known of it among COVID-19-infected individuals. This study examined the effects of surgical masks, N-95 masks, and unmasked conditions on the performance and perceived exertion (RPE) of infected vs. non-infected young women during high-intensity, repeated sprint exercise (5mSRT). Following a familiarization session, eighty-three (42 COVID-19-previously infected (PIG) and 43 non-infected (NIG)), female participants (age 20.02 ± 1.05 years, BMI 21.07 ± 2.1 kg/m²) were randomly assigned to one of three mask conditions: unmasked, surgical mask, or N95 mask. All participants attended three test sessions (i.e., one session for each mask condition) at least one week apart. At the beginning of each test session, data related to participants’ physical activity (PA) and sleep behaviours during the previous week were collected. In each test session, participants performed the 5mSRT, during which performance indicators (best distance (BD), total distance (TD), fatigue index (FI) and percentage decrement (PD)) were collected, along with RPE. ANOVA indicated no significant main effects of Groups and Masks, and no significant interaction for Groups × Masks for BD, FI, PD, RPE and most sleep and PA behaviours (p > 0.05). For TD, the Groups × Mask interaction was significant (p = 0.031 and ƞp² = 0.042). Posthoc analysis revealed, in the unmasked condition, there was no difference in TD between PIG and NIG (p > 0.05). However, when wearing a surgical mask, PIG covered lower TD compared to NIG (p < 0.05). Additionally, different types of masks did not affect TD in NIG, while PIG performed the worst using the surgical mask (p < 0.05). These results suggest post-COVID-19 individuals can maintain physical fitness through regular exercise (i.e., sport science curricula) in unmasked conditions, but not when wearing a surgical mask. Furthermore, the impact of different types of face masks on physical performance seems to be minimal, particularly in uninfected populations; future research is warranted to further explore this impact in post-COVID conditions. Full article

Background: Professional values are the foundation of nursing practice. Current research evidence on the influence of professional values on clinical competence among acute care nurses in the clinical area is lacking. Purpose: The purpose of this study was to examine the professional values and self-reported clinical competence among acute care nurses. Methods: This quantitative study used a cross-sectional, correlational design. A convenience sample of 403 nurses was recruited to answer the survey utilizing the Nurses Professional Values Scale-3 and the Nurse Competence Scale. The Pearson correlation coefficient was computed to test the relationship between study variables, and a stepwise multiple regression analysis was then performed to investigate the predictors of nurses’ professional values and clinical competence. Results: The professional value of “caring” received the highest mean score, followed by “professionalism”, while the factor “activism” was rated the lowest. Education was a significant predictor of all three factors of professional values. For clinical competence, “managing situations” was rated as the highest dimension, while “ensuring quality” was rated as the lowest. Moderate positive correlations were revealed between the three factors of professional values and all dimensions of nurses’ clinical competence. Area of practice and “activism” were the only significant predictors of the nurses’ clinical competence. Conclusions: Nurses perceived all three factors of professional values with high importance in influencing their clinical competence. These findings can contribute to the development of educational interventions to improve and sustain professional values and clinical competence among acute care nurses. Full article

In the current study, we evaluated the students’ foreign language lexical and grammatical skills in the course based on the peer teaching methodology and analyzed the effect of their altruistic and egoistic behaviors on learning results. This experiment was conducted in a groups of senior students majoring in linguistics. The total number of participants accounted for 197 students (101 students in reference groups and 96 in exposure groups); the difference between the reference and exposure groups was that the undergraduates in the latter were to prepare a fragment of a lesson, create exercises, and act in the capacity of a teacher during the course. To evaluate students’ foreign language lexical and grammatical skills, the diagnostic test was conducted at the beginning and at the end of the experiment. Apart from comparing the diagnostic and final tests, we also circulated a questionnaire which checked the students’ egoistic and altruistic tendencies. The data appeared to be quite noisy; therefore, we processed them with a tool which proves effective when it comes to solving such problems, i.e., neural networks. According to the results on learning outcomes, students improved their English proficiency in the exposure groups to a greater extent than in the reference groups. At the same time, the results of the psychological tests revealed that the higher the students’ training level, the less altruistic they are. Also, it was detected that the more altruistic learners’ progress in outcomes was higher than those of the more selfish students, regardless of the way in which the learning process was organized. Moreover, the statistical data proved the efficiency of the peer teaching methodology for students’ majoring in linguistics, despite their psychological characteristics. Full article

This literature review aims to analyze studies published by researchers on the topic of the relationship between the psychological constructs of the Dark Triad and Cognitive Empathy. This study hypothesizes how having good cognitive empathic skills could benefit people who demonstrate Dark Triad traits, as this could facilitate the implementation of manipulative strategies. Through the process of identifying studies via databases and registers, 23 studies were included in this literature review, and the results and theories brought forward by the researchers find more agreement regarding the individual components of the Dark Triad than the whole construct: narcissism seems to have, for the most part, relatively small and typical positive correlations (more than 50% of correlations), Machiavellianism has relatively small and typical negative relationships (about 80% of correlations), and psychopathy has relatively large negative relationships (about 90% of correlations). This study conveys that Machiavellians and psychopaths, having reduced empathic abilities, use manipulation techniques that do not have to do with empathy (for example seduction, intimidation etc.), while narcissists would be, among these three dimensions, those most likely to understand others’ states of mind and thus be able to use this knowledge to their advantage—although there are doubts about the veracity of the statements and answers given by narcissists in the tests administered to them. This literature review could be a valid aid to professionals dealing with people who exhibit Dark Triad traits; understanding how those exhibiting Dark Triad traits manage their empathic abilities, the areas in which the various dimensions show deficits or not, and how they act to implement their manipulative and controlling tactics could aid in the development of more effective helping strategies to be utilized in therapy settings. Full article

The use of substances to improve sports performance is a widespread phenomenon among adolescents. Several anti-doping programs have been developed, mainly based on knowledge-based evidence. The main aim of the present study was to implement an anti-doping intervention in sports high school students, based on a psychological framework, such as Socio-Cognitive Theory, through the development of a Serious Game (SG), i.e., digital learning based on the game. The experimental design included an intervention group (n = 167; F = 37.7%; Mean_age = 17.5 years; SD = 0.58) and a control group (n = 112; F = 42%; Mean_age = 17.6; SD = 1). Both of the groups completed the same questionnaire on two different occasions (i.e., time 1 and time 2) for measuring doping intention, self-regulatory efficacy to resist social pressure for the use of substances, moral disengagement, and doping knowledge. Data were analyzed through repeated measures of Group X Time ANOVA, demonstrating some degree of efficacy of the intervention, in particular in terms of the decrease in doping intention and the strengthening of doping knowledge. Moreover, the study demonstrated that the score obtained during the implementation of the SG could partially represent a coherent measure of the participants’ beliefs regarding doping. These results could be considered a starting point for future research to better develop technological anti-doping interventions. Full article

The Perth Empathy Scale (PES) is a 20-item self-report questionnaire that assesses people’s ability to recognize emotions in others (i.e., cognitive empathy) and vicariously experience other’s emotions (i.e., affective empathy), across positive and negative emotions. Originally developed in English, the aim of our study was to introduce the first Polish version of the PES and test its psychometric performance. Our sample was 318 people (184 females, 134 males) with ages ranging from 18 to 77. The factor structure was verified with confirmatory factor analysis. Reliability was tested in terms of internal consistency and test–retest reliability. To explore convergent, divergent, and discriminant validity, we examined relationships between the PES and measures of depression, anxiety, and emotional intelligence. It was shown that the scale was characterized by the intended four-factor solution, thus supporting factorial validity. The internal consistency reliability was also good and test–retest reliability was moderate. The convergent, divergent, and discriminant validity were strong. The clinical importance of assessing affective empathy across both positive and negative emotions was supported. Overall, our results therefore suggest that the Polish version of the PES has strong psychometric performance and clinical relevance as a measure of the multidimensional empathy construct. Full article

The incorporation of artificial intelligence (AI) into education has heralded a transformative era in the way students learn and faculties teach. Among the burgeoning array of AI tools, ChatGPT stands out as a versatile and powerful resource. Developed by OpenAI, ChatGPT is an AI-driven conversational model that generates human-like responses. This research draws on the Constructivism Learning Theory to uncover the key drivers pushing higher education students to use ChatGPT for academic purposes, and the multifaceted consequences it brings to the academic environment, by integrating the perspectives of key stakeholders: students, faculty, and education experts/leaders. The key findings of in-depth, face-to-face, interviews with key stakeholders revealed 12 main drivers that motivate students and their faculty to use ChatGPT mainly for learning purposes. However, the findings identified the multifaceted (six positive and another six negative) consequences of using ChatGPT for academic purposes. Recommendations for mitigating the negative consequences of ChatGPT were discussed with key stakeholders, particularly education experts/leaders, who were more concerned about using ChatGPT for academic reasons. The research reveals that higher education institutions should establish clear guidelines as a part of higher education policy, supplemented with training sessions for students and their faculty, about the responsible use of ChatGPT for academic purposes to mitigate any ethical concerns. Full article

The present study assesses the evolution of stressful events and psychological distress in male and female students over three different time periods of the COVID-19 pandemic in Spain: the initial “lockdown”, with no face-to-face teaching; the “new normality” period, when classes were resumed; and two years after the first wave of the pandemic. The participants were 1200 Spanish university students who were assessed for psychological distress, COVID-19-associated stressful events, social support, and self-esteem. Female students reported more stressful events and higher levels of psychological distress than male students during the “lockdown” and “new normality” time periods of the first wave of the pandemic. However, these differences disappeared in the third period tested, two years after the first wave of the pandemic, with female and male students showing no differences in psychological distress or in the number of stressful events. The main risk predictors of psychological distress during the first wave of the pandemic were lower self-esteem and having suffered a high number of stressful events. The last variable, number of stressful events associated with COVID-19, lost most its effect two years later, when only self-esteem presented a strong and highly significant predictive role. Full article

Previous research has suggested a favorable impact of self-kindness on subjective well-being. The present experiment investigated the effects of an app-assisted self-kindness intervention for increasing self-esteem and self-face gaze, and for decreasing depression. We explored self-face processing via a time-course analysis of eye-tracking data. Eighty participants (56 female, 24 male; mean age: 23.2 years) were randomly allocated to one of two intervention groups, each receiving daily instructions to enhance either self-kindness or relaxation (active control). Following a one-week intervention period, both groups reported improved self-esteem (p = .035, η_part² = .068) and reduced depression (p < .001, η_part² = .17). The duration of self-face gaze increased in both groups (p < .001, η_part² = .21). Self-face processing was characterized by an early automatic attention bias toward the self-face, with a subsequent reduction in self-face bias, followed in turn by an attentional self-face reapproach, and then a stable self-face bias. We thus identified a complex temporal pattern of self-face inspection, which was not specifically altered by the intervention. This research sheds light on the potential for app-assisted interventions to positively impact psychological well-being, while also highlighting the complexity of self-face processing dynamics in this context. In the future, we propose the inclusion of personalized self-kindness statements, which may amplify the benefits of these interventions. Full article

The phenomenon of doping is a public health issue that poses threats to sport and society. In recent decades, the emphasis on efforts to address the issue and reduce the incidence of doping by young people in sport has shifted from deterrence through testing and punishment to the promotion of clean sport behaviours through values-based education. The “I Run Clean project” sought to develop new and effective tools targeting grassroots athletes and those around them (coaches, medical support personnel, sport leaders, parents). These included sport-specific e-learning and in-person peer-to-peer workshops led by trained volunteer ambassadors. The aim of all “I Run Clean” measures is to go beyond the warnings and provision of factual information about early anti-doping campaigns to a more holistic educational approach that focuses participants on their personal and sport-related values in order to encourage good decision-making and resistance to doping-related behaviours. This study evaluates the efficacy of the peer-to-peer workshops and their impact on selected psycho-social variables. The collaboration of the volunteer ambassadors is shown to effectively transmit the desired reasoning, reduce doping risk factors and enhance protective factors. Full article

The COVID-19 pandemic has caused substantial disruptions in the lives of higher education students, with detrimental repercussions for academic performance and overall mental health. Therefore, we aimed to evaluate the prevalence of depression, anxiety, and stress symptoms among Portuguese higher education students during the first wave of the coronavirus pandemic and investigate DASS-21’s psychometric characteristics and whether it functions effectively during a pandemic. A convenience sampling procedure was used to recruit 1522 participants (75.1% women and 79.2% undergraduate students) for this cross-sectional research. Participants completed an e-survey created using DASS-21. The results revealed a considerable prevalence of symptoms of depression [≥10] (N = 434, 28.5%), anxiety [≥7] (N = 551, 36.2%), and stress [≥11] (N = 544, 35.7%). Confirmatory factor analysis (CFA) revealed the scale’s three-factor structure, which matched the three DASS-21 subscales. Subsequently, the heterotrait–monotrait (HTMT) correlation ratio evaluated the scale’s discriminant validity, which was relatively good. Cronbach’s alpha measured the internal consistency of the DASS subscales, which was excellent (Cronbach’s α > 0.90). DASS-21 was shown to be a reliable and appropriate measure for assessing students’ mental health. Furthermore, DASS-21 is recommended for use by academics and healthcare professionals in measuring students’ psychological distress. Further validation studies of this scale are needed with larger and more representative samples. Full article

The prevalence of T2DM represents a challenge for health agencies due to its high risk of morbidity and mortality. Physical Activity (PA) is one of the fundamental pillars for the treatment of T2DM, so Physical Exercise (PE) programs have been applied to research their effectiveness. The objective of the study was to analyze the effects of PE methods on glycemic control and body composition of adults with T2DM. A systematic review without meta-analysis was performed, using the PubMed database. Quasi-experimental and pure experimental clinical trials were included, which were available free of charge and were published during 2010–2020. In the results, 589 articles were found and 25 passed the inclusion criteria. These were classified and analyzed according to the methods identified (AE, IE, RE, COM, and others), duration and variable(s) studied. It is concluded that PE is effective for glycemic control and body composition in adults with T2DM using different methods (AE, IE, RE, COM, and others), both in the short and long term. Adequate organization of PE components such as frequency, duration, volume, and intensity, is essential. Full article

Diabetes has detrimental effects on many organs, including the kidneys, heart, and the central nervous system, with ophthalmic involvement and Diabetic Retinopathy (DR), specifically, being among the most severe and prominent consequences. Diabetic Retinopathy and especially advanced stages of the disease, have a crucial impact on patients’ quality of life and emotional status. In this context, emotional imbalance, psychological side effects and comorbidities, like anxiety disorders, could emerge, deteriorating the patients’ condition further. A number of questionnaires can be employed in the evaluation of the potential impact of Diabetic Retinopathy on patients’ quality of life, including the Beck Anxiety Inventory (BAI) and The National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25). Purpose: The purpose of this study was to evaluate the association of Diabetic Retinopathy (DR) and diabetic macular edema with vision-related quality of life, as well as the potential association between the disease’s severity, emotional status of patients and the manifestation of anxiety and psychological features. Results: Patients with fundoscopic findings had significantly lower scores in all VFQ-25 subscales, indicating worse quality of life in comparison to patients without DR. Severity of DR, greater levels of anxiety, daily sitting time, unemployment and lower education level, were all found to be significantly, negatively associated with a worse quality of life. Regarding emotional status, more years of suffering from diabetes, treatment with insulin and the hours being idle per day were associated with an increased burden of anxiety. In addition, the presence of a concomitant disease, findings in fundoscopy, diabetic macular edema and treatment with anti-VEFG injections, as well as the number of doses, were significantly associated with greater anxiety. Multivariate analysis showed that having Severe Non-Proliferative Diabetic Retinopathy or having Proliferative Diabetic Retinopathy and receiving insulin therapy (alone or in combination with another treatment), were significantly associated with higher levels of anxiety. Conclusion: The well-established impact of DR on the patients’ well-being, quality of life and emotional status render DR and CME prevention, stabilization or delaying progression as a necessity in order to protect patients from developing psychiatric symptoms. On the other hand, the speculated bi-directional association between emotional problems and DR progression highlights the importance of acknowledging and dealing with psychological issues with the aim of delaying DR progression. Full article

At a time when distance vocational training is on the rise, it seems logical to investigate the variables that can affect the quality of such teaching. The usability of the virtual environment, as well as the behaviour and disposition of the teaching staff, emerge as key factors that influence burnout, engagement, and academic satisfaction. Using a cross-sectional sample of 208 distance vocational training students, the mediating role of burnout and academic engagement in the relationships established between the usability of the virtual environment, teacher support, and academic satisfaction was analysed. On the other hand, multiple regression analyses were carried out in order to investigate the relationships between the challenges and obstacles faced by distance vocational training students and their level of burnout or engagement. Our results confirm the mediating role of academic burnout and engagement in students’ academic satisfaction. Regression analyses suggest that the obstacles faced by distance vocational education and training (D-VET) students influence their level of academic burnout or engagement. Our findings are consistent with the current understanding of the role that certain variables play in the well-being of students and which, in turn, influence the quality of teaching. Full article

Therapist expertise is a complex, multifaceted, and continually evolving concept. Defining this construct and its constituent components can yield a substantial contribution to the field of psychotherapy, consequently enhancing the comprehension of the fundamental factors that underlie its effectiveness. Within this framework, the present research aimed at developing and assessing the psychometric properties of the Psychotherapy Expertise Questionnaire (PEQ), a self-report measure to assess therapist expertise. A sample of 260 psychotherapists of various theoretical orientations were involved in this research. They completed a survey that included the PEQ as well as other self-reported measures aimed at evaluating personality traits, self-efficacy, self-esteem, and insight orientation. The analysis provided evidence of a good fit for both a correlational model with eight factors and a higher-order model, where the eight subdimensions were grouped into subjective (performance; cognitive functioning; personal and relational qualities of the therapist; therapist self-assessment) and objective (experience; reputation with clients and colleagues; training and professional updating; deontological ethics and setting rules) factors. The eight dimensions, two higher-order factors, and total score all showed excellent levels of internal consistency. Furthermore, significant associations were found between PEQ scores and insight orientation, general self-efficacy, self-esteem, personality traits, and time exercising clinical practice. To conclude, the Psychotherapy Expertise Questionnaire (PEQ) is a valuable, theoretically guided, and psychometrically robust self-report measure designed to assess therapist expertise and its constitutive dimensions. This measure can have practical applications in guiding tailored training and customised supervision. Full article

Effective teaching requires an educational environment that promotes learning, and yet, developing such an environment can be challenging within today’s agricultural-based classroom for educators due to the trend to a more virtual teaching format and less hands-on learning. Animal interaction, particularly equine activities, has been shown to assist educators in the development of an emotionally safe environment for promoting learning. However, research is lacking as to whether the interaction with the animal needs to be direct or indirect within the collegiate educational environment to observe benefits. Therefore, the objective of this study was to determine the impact of equine interaction, both direct and indirect, within an educational environment on the emotional safety and learning for the college student within the agricultural-based classroom. Three course types were observed within the agricultural-based educational environment that included courses with no equine interaction (Group A) and courses with equine interaction, both direct (Group B) and indirect (Group C) interaction with the horse. Indirect interaction included items such as observation of equine handling via a video or gaining knowledge from reading online materials, but not engaging in direct, hands-on activities with the horse. Development of emotional safety within the students enrolled within these courses was measured using a self-reporting emotional safety evaluation. Due to the structure of the scale, a decrease in emotional safety indicated a positive change. Learning, both development of semantic and procedural memory, was measured using a student-completed knowledge examination and an instructor-completed skill evaluation, respectively. While significant improvement in emotional safety was not observed within any of the course types, a weak negative correlation was found between emotional safety and semantic memory for students enrolled in equine courses, both direct (R = −0.55, R² = 0.28) and indirect (R = −0.25, R² = 0.06) interaction, finding as emotional safety scores lowered to the ideal range that knowledge improved. In addition, students within equine courses showed semantic memory development in specific areas of equine sciences (Group B: Grooming/Tacking, p = 0.03; Group C: Equine Behavior, p = 0.04) and direct equine interaction resulted in development of equine-based procedural memory in all four skill areas measured within the study (p = 0.00). As such, learning is promoted through equine interaction, whether direct or indirect interaction, within the agricultural-based classroom, suggesting that both forms of equine interaction can be a valuable educational tool for the instructor within the collegiate setting. Full article

Higher physical activity is generally associated with more favorable psychological functioning. However, the role of positive and negative affect in such associations is unclear. Accordingly, this cross-sectional study explored whether affect mediated the relationship of physical activity with psychological well-being (PWB) and psychological dysfunctioning (PD). Young Iranian adults (N = 200) completed self-rating questionnaires covering physical activity, positive and negative affect, and proxies of PWB and PD. Regression analyses indicated that higher physical activity levels and higher positive and lower negative affect predicted proxies of PWB. The same (albeit in the opposite direction) applied to proxies of PD. Structural equation modeling indicated that positive and negative affect mediated the relationship between physical activity and PWB/PD. Accordingly, change in affect might be an important mechanism behind the association of physical activity and PWB/PD. Future research should further explore this across target populations and cultural contexts. Longitudinal and/or experimental studies are needed to disentangle causality. Full article

Positive Youth Development (PYD) emerged as a holistic and strength-based perspective that focuses on the fact that young people may have the internal and external resources for healthy and successful development through five dimensions (5Cs) that empower them: Perceived Competence, Confidence, Character, Connection, and Caring. The aim of this study was to examine the relationship between the overall PYD factor, the 5Cs, and risk behaviors, in addition to analyzing gender differences. This study showed the results of a cross-sectional study of 1044 emerging adults from 11 Spanish universities in 2021. Data collection was performed by applying an online self-report measure. The results showed that the Character was protective against substance abuse, mainly in women, while the connection was related to the participation of betting money and online betting in men. Caring was protective against money bets in the men’s sample. However, controversial results were found regarding Perceived competence, which had a positive association with substance abuse, money bets, and drunk driving. It seems that high levels of Perceived competence, rather than objective competence, were associated with engagement in various risk behaviors. Concerning gender differences, men showed more risky behaviors than women. A partial mediation model pointed out that lower character and higher perceived competence in men partly explained the higher presence of risky behavior compared to women. These results underline the need to promote PYD within the university context to prevent risky behaviors by addressing gender differences and the separate role of the 5Cs. Full article

The literature has identified that a sense of coherence plays a protective role in the relationship between adverse events and mental health. The current study examines the role of a sense of coherence (SOC) in the relationship between fear of COVID-19, perceived stress, and dimensions of post-traumatic stress disorder (PTSD). Participants (n = 322) were students at a metropolitan university in South Africa who completed the Fear of COVID-19 Scale, the Perceived Stress Scale, the 13-item Sense of Coherence Scale, and the PTSD Checklist. Path analysis was used to conduct a serial mediation analysis. The results show that SOC mediates the relationship between perceived stress and the dimensions of PTSD but does not mediate the relationship between fear of COVID-19 and PTSD. Furthermore, the relationship between fear of COVID-19 and dimensions of PTSD was mediated by serial perceived stress and sense of coherence, supporting the hypothesis that higher levels of fear of COVID-19 leads to higher levels of perceived stress. However, while high levels of fear of COVID-19 increase perceived stress, SOC significantly mediates the subsequent impact on PTSD symptoms. Full article

This research explored the potential of developing a university healthcare and medical school within King Faisal University, Saudi Arabia, by merging four medical and/or healthcare colleges within the institution into a medical school. The objective of a medical school is to produce professionals who are capable of performing the most fundamental tasks in healthcare and medicine up to the expectations of the market. This research explored various case studies involving mergers, their importance, and how they were conducted to inform this research study. This study adopted a qualitative research approach to collect data from healthcare and medical colleges’ senior management, including deans, vice-deans, as well as heads of departments. The results showed several benefits of mergers, although some challenges were also raised. Culture, which some interviewees identified as change-resistant and risk-averse, was recognised as a key challenge for implementing mergers. Additionally, the need for generating funds for the merger projects was identified as a challenge at the start of the initiatives. Furthermore, compliance with regulations and laws at a public university is another challenge. This study identified the need for a strategic framework that builds on stakeholders’ involvement and proper communication and addresses the proposals’ repercussions. Some implications for educational performance and cost effectiveness were highlighted. Full article

During the pandemic, nurses experienced anger that stemmed from a sense of threat, frustration, or even a sense of injustice. The purpose of this study was to examine the relationship between vaccination hesitancy, anger, cynicism, and medical mistrust among nurses, as there are no relevant studies in the literature. This study was conducted online by completing self-report questionnaires. The Dimensions of Anger Reactions-5, the 8-item “Cynical Distrust” scale, and the Medical Mistrust Multiformat Scale were used. For vaccination hesitancy, two questions with a 5-point scale were used: one question examining hesitancy to get vaccinated with the COVID-19 vaccine, and another question examining hesitancy to get vaccinated with the influenza vaccine. In total, 387 nurses (66 men and 321 women) participated in this study. Nurses showed statistically greater hesitancy toward the COVID-19 vaccine compared to hesitancy toward the influenza vaccine. The variation in vaccine hesitancy was explained by the scores in the Medical Mistrust Multiformat Scale, the Dimensions of Anger Reactions, and the Cynical Distrust Scale. The Medical Mistrust Multiformat Scale mediated the relationship between the Cynical Distrust Scale and total vaccine hesitancy. The Dimensions of Anger Reactions Scale significantly moderated the indirect effect of the Cynical Distrust Scale on total vaccine hesitancy through the Medical Mistrust Multiformat Scale. In conclusion, it is highly likely that anger is involved in reported vaccine hesitancy both by activating schemas of distrust in others and by adopting anti-systemic views of mistrust in the medical system. Full article

Autism Spectrum Disorder (ASD) and epilepsy are increasingly prevalent comorbidities in our society. These two disorders are often accompanied by other comorbidities, such as sleep disorders, significantly impacting the quality of life of individuals with ASD and epilepsy. To date, clinical approaches have primarily been descriptive in nature. Therefore, this study aimed to analyze the relationship between ASD, epilepsy, and sleep disorders, exploring neurobiological dysfunctions and cognitive alterations. A total of 22 scientific articles were selected using a systematic literature review following the criteria established using the PRISMA model. The selected articles were gathered from major databases: Medline, PubMed, PsycINFO, Google Scholar, and Web of Science. Inclusion criteria specified that study participants had an official diagnosis of ASD, the article precisely described the evaluation parameters used in the study participants, and individual characteristics of the sleep disorders of the study participants were specified. The results indicate, firstly, that the primary cause of sleep disorders in this population is directly linked to abnormal serotonin behaviors. Secondly, significant alterations in memory, attention, and hyperactivity were observed. In conclusion, sleep disorders negatively impact the quality of life and neurocognitive development of the pediatric population with ASD and epilepsy. Full article

Walking is widely recognized as one of the most common and effective forms of physical activity, particularly for older adults. This study examined the comparative effects of two types of walking interventions, including supervised group-based intervention (SGBI) and non-supervised individual-based intervention (NSIBI), on frailty syndrome, cognitive functions or skills, and health-related quality of life among sedentary older Saudi individuals. A 15-week double-blinded, randomized controlled trial (RCT) including three groups (two were intervention groups while the other was the control group) was conducted among older adults who were inactive to examine the effect of different forms of walking interventions on frailty syndrome, cognitive functions, and health-related quality of life. A total of 107 participants, including 65 males and 42 females, were divided into three groups, which include SGBI, NSIBI, and the control group. Frailty syndrome was measured using the physical performance test (PPT), while cognitive function and health-related quality of life were assessed using the Mini-mental State Examination (MMSE) and the Short Form 36 (SF 36) health survey questionnaire. One-way repeated measures analysis of variance (ANOVA) and one-way analysis of covariance (ANCOVA) with the pre- and post-tests were performed for within- and between-group differences. while post-test data for the control group participants were absent due to the change in elderly center regulation, and they were excluded from the analysis. Hence, the comparison was stated only between the intervention groups. Both of the intervention groups (SGBI and NSIBI) showed significant within-subject differences in the Physical Function subscale of the health-related quality of life scale only, with F(1,20) = 23.03, p < 0.001, and F(1,18) = 27.22, p < 0.001, respectively. On the other hand, the Physical Performance Test revealed significant [F(2,51) = 9.21, p < 0.001] between-group differences in the post-test based on the baseline values. In addition, the average step count of older adults was increased from 4000 steps per session to around 7000 steps per session in the intervention group. The average heart rate of the NSIBI group did not show a visible change, and the resting heart rate of both groups showed a slightly declining trend throughout the intervention period. The walking intervention significantly increased participants’ physical function, which is a component of health-related quality of life and physical performance (frailty level), along with average daily step counts for older adults in Saudi Arabia. Regular engagement in the recommended level of walking is strongly advisable for Saudi Arabian older adults to maintain their overall quality of life at this stage. Full article

Background: Motivation is a central concept in self-determination theory (SDT). The Treatment Self-Regulation Questionnaire (TSRQ), which assesses motivation (autonomous, controlled, etc.), has been widely used. However, less is known about its applicability to samples such as college students, who may be at risk of having unhealthy behavior in many areas (including smoking, poor dietary habits, alcohol, or tobacco consumption). As this population is transitioning to adulthood, research is needed to understand motivation and changing health patterns. In addition, the lack of instruments for this population in Spain has made the measurement validation process a priority. The purpose of this psychometric study was to adapt the TSRQ to Spanish college students and to examine its structural and validity across four health domains. Methods: Two samples of Spanish college students (n = 347 and n = 244) agreed to participate in the study. Participants completed a booklet containing measures of motivation, well-being, general health, anxiety, depression, and lifestyle. Results: CFA supported a five-dimensional structure in each domain. Reliability values were also adequate for each questionnaire. Regarding other sources of validity, statistically significant relationships between self-determination, health, and well-being were clearly confirmed, and autonomy was a significant predictor of lifestyle. Conclusions: The Spanish version of the TSRQ showed adequate psychometric properties (dimensionality and internal structure, reliability, and validity evidence regarding its relationships with other constructs) in college students. The Spanish TSRQ will provide future research aimed to understand the motivational role in college students’ health behavior and well-being. Full article

Previous evidence has drawn attention to the fact that maladaptive perfectionism is a risk factor for engagement in nonsuicidal self-injury (NSSI). Until now, few studies have examined this topic, especially among community adolescents. The aim of this study was to explore the relationship between perfectionism dimensions and NSSI functions to examine the potential mediating effect of mental disorders. Altogether, 146 Hungarian community adolescents (ages 13–18 years) were involved. All participants completed the Hungarian adaptation of the Inventory of Statements about Self-Injury (ISAS), the Frost Multidimensional Perfectionism Scale (FMPS), and the Mini International Neuropsychiatric Interview Kid. To analyse the interrelationships among NSSI, perfectionism, and mental disorders, we conducted regression and network analysis. Of the 146 adolescents, 90 (61.64%, girls: 71.11%) engaged in NSSI. The Concern over Mistakes and Doubts about Action scales of the FMPS significantly and positively predicted both NSSI intrapersonal and interpersonal motivation, with comparable effect sizes, and this association was fully mediated by anxiety disorders. There was a significant direct negative relationship between the FMPS Organisation dimension and both main NSSI functions. This study draws attention to an increasing trend and the extremely high NSSI prevalence rate among community adolescents. Adolescents with perfectionistic concerns are at heightened risk for anxiety disorders, which can increase their vulnerability to NSSI engagement. Full article