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Associations of Illness Perception, Resignation Coping, and Social Support With Self-Regulatory Fatigue in Patients With Type 2 Diabetes: A Cross-Sectional Study.

AIMS: To examine the associations among illness perception, resignation coping, social support, and self-regulatory fatigue (SRF) in patients with Type 2 diabetes mellitus. The study specifically explores whether resignation coping and social support exhibit indirect associations with SRF in the context of illness perception. DESIGN: A cross-sectional study. METHODS: From November 2024 to October 2025, a convenience sample of 302 adult patients with T2DM was recruited from a tertiary general hospital in China. Participants completed validated instruments with established psychometric properties, namely the Brief Illness Perception Questionnaire, the Medical Coping Modes Questionnaire, the Perceived Social Support Scale, and the Self-Regulatory Fatigue Scale. Statistical analyses included Spearman correlation and serial mediation analysis using the PROCESS Macro (Model 6) with bias-corrected bootstrapping. RESULTS: SRF was positively correlated with negative illness perception (r&#x2009;=&#x2009;0.579, p&#x2009;<&#x2009;0.01) and resignation coping (r&#x2009;=&#x2009;0.612, p&#x2009;<&#x2009;0.01), and negatively correlated with social support (r&#x2009;=&#x2009;-0.598, p&#x2009;<&#x2009;0.01). Serial mediation analysis revealed that illness perception was associated with SRF through indirect pathways involving resignation coping and social support. Resignation coping and social support mediated the association between illness perception and self-regulatory fatigue, both individually and sequentially. CONCLUSIONS: Negative illness perception correlates with higher SRF. This observed correlation is additionally linked to indirect pathways involving resignation coping and lower social support. Collectively, these findings highlight a pattern of interrelated cognitive (illness perception), behavioural (resignation coping), and resource (social support) factors that are associated with self-regulatory fatigue in this cross-sectional study. IMPLICATIONS FOR THE PROFESSION: The findings offer a clear, evidence-based framework for nursing practice. They highlight the potential value of integrated assessment and intervention that simultaneously addresses patients' illness beliefs, maladaptive coping strategies, and social support systems, which are associated with lower SRF and better diabetes self-management. REPORTING METHOD: This study adheres to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for cross-sectional studies. PATIENT OR PUBLIC CONTRIBUTION: Patients participated solely as research participants by providing survey data. They were not involved in the study design, implementation, data analysis, interpretation, or manuscript preparation. All patients provided written informed consent prior to questionnaire completion.

Humans

Perceptions of Pharmacogenomic Testing Among People With Treatment Resistant Depression: Legitimization as a Facilitator of Acceptance.

Pharmacogenomic testing for psychiatric medications has been proposed as both an early intervention to optimize treatment response, and for use among patients who have tried multiple medications without symptom remission. Therefore, this testing may be particularly salient to the subset of individuals with major depressive disorder for whom depression has been labeled as "treatment resistant". Understanding the impact of this diagnostic label on illness identity and attitudes towards new therapies is important as genomic technology expands and rates of depression increase. We sought to explore perceptions and attitudes towards pharmacogenomic testing among individuals who had received a diagnosis of treatment resistant depression. We conducted a qualitative study with a constructivist orientation. Participants were recruited from a larger genomic research study and interviewed by phone or video call. We took an inductive approach to coding guided by reflexive thematic analysis. Themes were then organized into a relational framework following principles of interpretive description. Twelve individuals were interviewed. Key themes included internalized acceptance/hopelessness, and external validation/frustration, which were cyclically interconnected. These themes were situated within a larger framework illustrating the ways that illness identity and modifying factors such as relief of guilt, social support, pharmacogenomic testing and depressive symptoms can either facilitate acceptance and validation or contribute to feelings of hopelessness and frustration. Though participants expressed some skepticism around its effectiveness, pharmacogenomic testing may contribute to the shift towards acceptance and validation by legitimizing individuals' experiences with lack of treatment response. Genetic counselors and other healthcare providers should be aware of the complex balance between hope and frustration underlying conversations around pharmacogenomic testing, and factors that are more likely to foster self-acceptance.

Humans

Walking Together: A Cross-Cultural Study of the Relationship Between Religiosity and Substance Use Disorder.

The literature suggests that religiosity is a protective factor for substance use. However, individuals with substance use disorder (SUD) may actively cultivate their religiosity during substance use. This qualitative study analyzed the perceptions and meanings homeless people attribute to their substance use trajectories and religiosity, as well as the potential connections between these two themes. The analysis was conducted based on the content analysis technique proposed by Bardin. A total of 40 semi-structured interviews were conducted with 20 Brazilian and 20 Portuguese participants. The present study found that religiosity can play a role in the substance use trajectory and the development of SUD by offering a subjective sense of protection, serving as a marker for the need for change, or providing relief from the suffering associated with SUD. We discuss how homeless people with SUD experience religiosity and how religious aspects traditionally seen as protective in the literature, such as church attendance, may paradoxically become risk factors for these socially vulnerable populations.

Humans

The wider erection angle in hypospadias: A neglected feature affecting surgical outcomes.

INTRODUCTION: Penile curvature often accompanies hypospadias, and numerous techniques have been described for its correction; however, in some cases, an abnormal erection angle may also be present, further exacerbating the perception of curvature. OBJECTIVE: This study investigates the significance of the erection angle in hypospadias cases and its correlation with the severity of the anomaly. STUDY DESIGN: A retrospective analysis of intraoperative photographs of hypospadias cases operated between 2019 and 2023 was performed. Erection angle was measured with a digital goniometer during a full artificial erection. Erection angles in proximal and distal hypospadias cases were analyzed and compared to data from Kinsey's subgroups representing healthy male erection angles. RESULTS: This study involved images of 68 patients, with 31 having proximal and 37 distal hypospadias. The median age of the whole group was 11 months (6-156, IQR 9). Median erection angle was 91 (63-119, IQR 11) for distal cases, whereas it was 96 (75-138, IQR 21) for proximal cases. The difference was statistically significant (p = 0.009). The erection angle distribution in our cohort, including both proximal and distal hypospadias cases, skewed toward wider angles, highlighting a distinct pattern compared to data constituted by Kinsey and Sparling. DISCUSSION: Our findings indicate that the erection angle in hypospadias is significantly wider in proximal cases, suggesting a correlation between erection angle and severity of the hypospadias. While we acknowledge the limitation of comparing our prepubertal cohort with Kinsey's adult data, the absence of evidence suggesting significant post-pubertal changes in erection angle justifies this approach. Additionally, the use of digital images for angle assessment is not a standardized technique in hypospadias evaluation; these images were initially captured for curvature assessment. Despite these limitations, our study provides novel insights into seldom mentioned association with hypospadias - a wide erection angle, emphasizing the need for further research on its implications for surgical planning and long-term outcomes. CONCLUSION: This study introduces a wider erection angle as an additional characteristic of hypospadias particularly pronounced in proximal cases. To our knowledge, this is the first focused investigation on addressing this aspect of the condition. It emphasizes the need for further research on adults with wide post-repair erection angles to explore its long-term impact on sexual function and aesthetics.

Humans

Molecular mechanisms underlying umami taste perception: A DIA-based proteomic analysis of Agrocybe aegerita peptides.

The mechanisms underlying the modulation of the salivary perception of umami peptides remain poorly understood. Herein, three umami peptides (DDL, DEL, and ENG) obtained from Agrocybe aegerita were used to investigate the regulatory role of saliva in umami taste perception via a combined approach involving sensory evaluation and proteomics analysis based on 4D-DIA technology. The results revealed that umami intensity peaked at 10&#xa0;s after ingestion and was accompanied by a significant increase in saliva secretion (p&#xa0;<&#xa0;0.05). Further proteomics analysis revealed that lactotransferrin and proline-rich proteins are closely associated with the sensory perception of umami peptides. Differentially expressed proteins were mainly enriched in pathways related to saliva secretion and proteasome function. This study provides new insights from the perspectives of salivary proteomics and dynamic salivary secretion, contributing to a deeper understanding of the mechanisms by which saliva regulates umami perception.

Humans

Innovation-related perception as a key driver of alternative protein acceptance: evidence from an early-stage model for cultivated meat and algae-/microalgae-based alternative protein products in Italy.

Alternative proteins are increasingly considered part of the transition toward more sustainable food systems, yet their diffusion depends critically on consumer acceptance. This study investigates the early-stage acceptance of two alternative protein categories in Italy-cultivated meat and algae-/microalgae-based alternative protein products. Focusing on the first three phases of acceptance, the analysis examines how innovation-related perception (IRP) shapes consumer perceived value (CPV), consumer perceived risk (CPR), and subsequent affective (AFF), cognitive (COG), and conative (CON) responses. Data were collected through an online survey administered to 238 Italian respondents and analysed using partial least squares structural equation modelling (PLS-SEM). The results show that IRP is the main upstream driver of early-stage acceptance in both product domains: more favourable perceptions strongly increase perceived value and reduce perceived risk. In turn, CPV exerts a much stronger influence than CPR on both affective and cognitive attitudes. A tentative cross-model comparison suggests only a descriptive variation in the final transition toward conative acceptance: affective and cognitive responses were both significant in the two models, with a relatively larger affective coefficient for cultivated meat and more balanced coefficients for algae-/microalgae-based products. Overall, the findings support a process-based interpretation of alternative protein acceptance and highlight the central role of innovation-related perception in shaping early consumer responses. These results provide relevant implications for communication strategies, product positioning, and policy actions aimed at improving the acceptability of alternative proteins in food cultures characterised by strong culinary traditions.

Italy

The impact of routine traffic encounters that include procedural justice on police perceptions.

OBJECTIVES: Despite procedural justice in police-citizen interactions being widely studied, there is limited research regarding police perceptions of these interactions. This study addresses this by exploring police perceptions of two different types of random breath test (RBT) - standard and procedurally just - in an experimental trial. Officers were asked to report on whether they believe that their RBT interaction with drivers and riders changed behaviour, developed more positive perceptions of police and resulted in slower travel. Additionally, they were asked if they thought that the RBT interaction took too long. METHODS: This study was a six month randomised control trial with two operational conditions: a control condition with a standard (n&#xa0;=&#xa0;18&#xa0;days) and an experimental condition with a procedurally just (n&#xa0;=&#xa0;17&#xa0;days) RBT. Police officers completed post-operation surveys (n&#xa0;=&#xa0;80). RESULTS: Police officers incorporating the principles of procedural justice into RBT had limited impact on officer perceptions. However, those officers who were more open to innovation believed that the interaction would result in more positive perceptions of police. Police officers who believed that their RBTs with motorcycle riders would make a difference perceived that the riders would both change their behaviour and travel more slowly after the interaction. There were no differences in perceived interaction length by police officers across both conditions. CONCLUSIONS: This study has shown that police officer openness to innovation has an important role to play in police officers having more positive perceptions regarding the outcomes of RBT interactions. As such police organisations should undertake activities, such as training, to improve innovation. The lack of perceived differences in RBT length between standard and procedurally just interactions suggests that these enhanced interactions can be implemented without concerns that police officers believe that they 'take too long'.

Humans

Experiences and perceptions of lay bystanders responding to out-of-hospital cardiac arrest: A qualitative systematic review.

BACKGROUND: To synthesize the experiences and perceptions of lay bystanders before, during, and after responding to out-of-hospital cardiac arrests. METHODS: Seven English and Chinese databases were searched from their inception to July 31, 2026, supplemented with citation tracking. Two reviewers independently selected studies, appraised methodological quality using the Joanna Briggs Institute (JBI) critical appraisal checklist for qualitative research, and extracted the findings and supporting illustrations. Unequivocal and credible findings were synthesized using JBI meta-aggregation, and confidence was assessed using confidence in the evidence from reviews of qualitative research. RESULTS: Eight studies involving 209 participants were included. Thirty-three findings were grouped into 12 categories and 4 were synthesized findings concerning the motivators and inhibitors of response, recognition and appraisal of out-of-hospital cardiac arrest, conditions facilitating or impeding cardiopulmonary resuscitation and automated external defibrillator use, and post-event psychological responses and adjustment. Confidence in the evidence from reviews of qualitative research was moderate for the 1st 3 synthesized findings, and low for the 4th. CONCLUSION: Bystander response is a continuum that extends from event recognition and action to post-event adjustment. Out-of-hospital cardiac arrest systems should provide realistic preparations, clear on-scene support, proportionate information, and psychological support after an event.

Humans

The Moral of the Story-Perception of Leadership With Moral Distress in Registered Nurses: A Qualitative Systematic Review.

AIM: To understand how Registered Nurses perceive the impact of nursing leadership on managing moral distress and mitigating burnout. BACKGROUND: Moral distress and burnout are pervasive issues in nursing, compromising well-being, patient safety and workforce sustainability. Leadership is a critical factor in shaping workplace culture and mitigating these challenges, yet evidence remains limited. DESIGN: Qualitative systematic review. METHODS: A qualitative systematic review was conducted following JBI methodology and PRISMA guidelines. Comprehensive searches across MEDLINE, PsycINFO, Embase, CINAHL and Scopus identified 5927 articles, with two studies meeting the inclusion criteria. Data were appraised using the JBI Critical Appraisal Checklist and synthesised via meta-aggregation. Confidence in findings was assessed using the ConQual approach. RESULTS: Four major themes emerged: (1) Behind the barriers, (2) Breaking point, (3) Weathering the storm and (4) Leadership for lasting change. Leadership influenced nurses' psychological safety, ethical decision-making and resilience. Inadequate support amplified moral distress, and effective strategies included authentic communication, team solidarity and systemic interventions. CONCLUSIONS: Leadership plays a pivotal role in mitigating moral distress and burnout. Evidence highlights the need for structural changes and support to sustain registered nurses' well-being and retention. RELATIVE TO CLINICAL PRACTICE: Findings offer direction for leadership strategies that promote ethical workplaces, shared decision-making and mental health supports to enhance resilience and patient care. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Strengthening leadership capability is vital for workforce sustainability, care quality and nurse retention. REPORTING METHOD: Authors have adhered to relevant EQUATOR guidelines. PATIENT OR PUBLIC CONTRIBUTION: This study did not involve patients or the public in its design, conduct or reporting.

Leadership

Differences in Radiological Risk Perceptions Following Online and In-Person Workshops.

Nuclear energy is widely regarded as a critical part of the pathway toward a secure, low-carbon electricity grid, yet long-term management of used nuclear fuel remains a persistent challenge. Although technically viable options for interim and consolidated storage exist, public concern and community opposition - rooted in historical distrust and risk perception - continue to complicate siting decisions. In response, recent federal efforts have emphasized collaboration-based approaches and community engagement, though empirical evidence on the effectiveness of different engagement strategies remains limited. This study examines how the structure and delivery of community engagement influence changes in public attitudes toward hosting interim used nuclear fuel storage facilities. Using survey data from 13 educational workshops around the United States, we evaluate: (1) the inclusion of trust-building content prior to technical content, and (2) engagement format, comparing online and in-person workshops. Analyses focus on participant changes in perceptions of safety, risk, and support for hosting, using the Wilcoxon rank-sum test and other non-parametric hypothesis tests on surveys conducted before and after workshops. Results indicate that workshop participation is associated with some measurable attitude changes, with significant (p < 0.05) differences in response variability for some questions across workshop formats. In particular, when comparing nuclear energy to other clean energy sources, in-person workshop participants are substantially more likely to gain a more favorable opinion of nuclear energy than online participants. These findings contribute empirical evidence on how trust-building and delivery mode shape outcomes in public engagement on complex and contested energy policy issues such as storage of used nuclear fuel.

nuclear fuel cycle

Wounds that echo: community perceptions of the socio-structural determinants of community violence in post-apartheid South Africa in the context of COVID-19.

The COVID-19 pandemic and its associated public health measures significantly altered the social, economic, and psychological landscape of communities worldwide. In South Africa, the post-COVID-19 period has been marked by a notable surge in homicide rates and interpersonal and community violence. Using a combined structural and social disorganisation framework, this qualitative study critically explores community members' perceptions of the socio-structural factors contributing to community violence, in the context of COVID-19. Utilising data from in-depth interviews and focus group discussions, this study examines the lived experiences of residents in a marginalised high-risk South African community, unpacking the interplay between structural inequities, social disintegration, and community violence. Community violence emerged not as periodic or individual, but as structurally generated, geographically concentrated, and socially normalised. The findings demonstrate that community violence is perceived as being embedded in cycles of survival, where long-standing systemic inequality, economic precarity, spatial disadvantage, and institutional neglect and inequity generate contexts in which community violence becomes normalised and self-reinforcing. The study findings advocate for interventions that not only address immediate catalysts of violence but also the deeper historical and structural determinants of violence in the post-pandemic era, while ensuring preparedness for effective violence prevention during future pandemics.

Humans

Exploring the perceptions, experiences, and behaviours that nurses and midwives face in relation to sleep: A systematic review of qualitative evidence.

BACKGROUND: The importance of sleep for nurses and midwives is increasingly being recognised. Poor sleep is known to have negative impacts on physical health, mental wellbeing, and work performance. This has prompted efforts to promote and support staff sleep. However, further efforts are needed to understand how nurses and midwives consider and manage sleep to ensure that meaningful and effective interventions are adopted and sustained. AIMS: This review of qualitative evidence aims to examine nurses' and midwives' perceptions, experiences, and behaviours around sleep. METHODS: This review followed JBI's systematic meta-aggregative approach including development of an a priori protocol. A systematic search of six electronic databases (MEDLINE, Embase, Emcare, PsycINFO, CINAHL, and Scopus) was undertaken to identify qualitative studies that examine nurses' and midwives' perceptions, experiences, and behaviours related to sleep. The search was conducted on the 10th of October 2024. Study selection, quality appraisal, data extraction, and synthesis followed JBI approaches and the ConQual approach was used to report assessment of synthesised findings. RESULTS: Thirty-three studies were included for review, and 245 findings were aggregated into 24 categories and nine synthesised findings related to the perceptions, behaviours, and experiences. While sleep was perceived as important, poor sleep was often understood as an expected and inevitable part of the job and that there was a need to always be awake to provide continual care. Experiences influencing sleep related to personal circumstances and work-related factors, as well as professional training and institutional practices. A range of behaviours, including planning time to sleep, using sleep aids, modifying the sleep environment, and altering daytime behaviours were also described. CONCLUSION: This review identified a range of perceptions, behaviours, and experiences that may influence the sleep of nurses and midwives which are vital to supporting individual and workforce wellbeing and safe, effective clinical practice. Insights from this review can be used to better understand nurses' and midwives' relationship with sleep and to develop and enhance targeted sleep interventions and programs that aim to promote and support healthy sleep among nurses and midwives. Open Science Framework Registration: 10.17605/OSF.IO/F32UM.

Humans

Exploring perceptions and willingness to recycle wastes among small businesses in selected townships of the Gauteng province in South Africa.

Although small businesses play an important role in generating employment opportunities and local economic development, their involvement in recycling programs has not been characterized in greater detail. This study explored the perceptions and willingness of selected small businesses in Gauteng province townships to reuse or recycle some of their waste materials. This study used a quantitative research approach to explore the perceptions and willingness of selected small businesses to reuse or recycle some of the waste they generate. The results showed that the perceptions about the contribution of recycling to environmental pollution reduction among small businesses in the study differed significantly across the townships (&#x3c7;2&#x2009;=&#x2009;6.892, p&#x2009;=&#x2009;0.003). On the other hand, most formal businesses significantly agreed with the potential benefits of waste recycling on environmental pollution reduction (&#x3c7;2&#x2009;=&#x2009;16.118, p&#x2009;=&#x2009;0.003), saving landfill space (&#x3c7;2&#x2009;=&#x2009;11.610, p&#x2009;=&#x2009;0.003), improving environmental quality (&#x3c7;2&#x2009;=&#x2009;10.443, p&#x2009;=&#x2009;0.005), and providing job opportunities (&#x3c7;2&#x2009;=&#x2009;10.263, p&#x2009;=&#x2009;0.036). However, regardless of their formality (&#x3c7;2&#x2009;=&#x2009;2.957, p&#x2009;=&#x2009;0.228) or location (&#x3c7;2&#x2009;=&#x2009;9.463, p&#x2009;=&#x2009;0.051), there was no statistically significant variation in the recycling practices of the small businesses in this study. Moreover, businesses' willingness to use recycling facilities if they were located nearby differed across townships (0.05 > p&#x2009;=&#x2009;0.010) but was similar despite the formality of the enterprises. In conclusion, recycling perceptions and willingness of small businesses can vary significantly depending on whether they are formal or informal and across townships. As a result, relevant educational interventions should be uniquely developed to raise awareness about the need for waste minimization through recovery, re-use, and recycling among small businesses in the Gauteng province.Implications: Small, Medium, and Micro enterprises (SMMEs) play a crucial role in local economic development in South Africa. However, research on their environmental sustainability is scarce, despite their significant impacts on natural resources and contributions to pollution. Most waste management studies have focused on households and municipalities, leaving a gap in understanding SMMEs' waste management behaviors, particularly in townships.

South Africa

The voice clone intelligibility benefit in noise in middle-aged listeners.

Research with younger adults showed that cloned voices are more intelligible than human voices in noise, with a benefit of 13.4%. This study tested whether this benefit extends to 40 middle-aged listeners (45-65&#x2009;years), as this population may show emerging difficulties with speech-in-noise. Participants recognised sentences by ten human voices and ten voice clones in four noise levels. Cloned voices were 11.8% more intelligible, with benefits enhanced at the two most severe noise levels (15.9% at -6 dB and 17.5% at -3 dB), suggesting cloned speech enhanced perception in middle-aged listeners, potentially by reducing listening effort and compensating for emerging age-related auditory-cognitive decline.

Humans

A systematic review and meta-analysis of visuospatial attentional deficits in Parkinson's patients.

Parkinson's disease (PD) is a neurodegenerative condition primarily characterized by motor deficits, yet cognitive impairments are increasingly recognized. While deficits in executive functioning are well documented even in the absence of cognitive decline, evidence of attentional deficits in PD remains inconsistent, and the role of motor symptom lateralization is unclear. In this systematic review and meta-analysis, we examined visual attention in right-handed, cognitively unimpaired idiopathic PD patients, focusing on the canonical attentional domains (sustained, selective, divided) and processes (alerting, endogenous and exogenous orienting, reorienting), as well as visuospatial bias. Four databases were searched for studies comparing PD patients with healthy controls. Meta-analytic estimates were derived using Hedges' g within random-effects models, and studies that could not be quantitatively integrated were summarized narratively. In addition, studies directly comparing patients with left- and right-predominant motor symptoms (LPD vs. RPD) were reviewed qualitatively. Across 51 studies, PD patients exhibited deficits in sustained, selective, and divided attention. Among attentional processes, only exogenous orienting was impaired, whereas alerting, endogenous orienting, and reorienting were preserved. Findings from the few studies examining visuospatial bias indicated small, context-dependent shifts in spatial attention rather than a consistent directional bias. These findings indicate that PD patients show visual-attentional impairments, particularly under high-demand conditions, while basic alertness and voluntary orienting appear preserved. Exogenous orienting deficits and subtle rightward spatial tendencies in LPD suggest disruption of right-hemisphere attentional networks. These results have implications for early cognitive assessment, rehabilitation strategies, and understanding the neural bases of attentional dysfunction in PD.

Humans

The effect of olfactory training and odor exposure on visual selective attention.

Olfactory training (OT) is a well-established, non-invasive intervention that improves olfactory function by repeated, structured exposure to odorants. Beyond sensory outcomes, it also influences multiple aspects of cognition. Yet, its influence on attention, a fundamental process underlying many cognitive domains, remains unclear. This study examined the impact of a 12-week OT program on visual selective attentional performance and the effect of on-task odor exposure. Ninety-four healthy participants were initially included, and randomized into OT or placebo groups. Participants completed the d2 Test of Attention simultaneously with and without odor exposure in a randomized sequence at baseline, post-training, and a follow-up four weeks after stopping the training. The d2 test measures commission errors, omission errors, and concentration performance. Ninety-three participants (OT=51, placebo=42) completed baseline measurement, 74 (OT=39, placebo=35) returned for post-training session, and 57 participants (OT=29, placebo=28) returned for the follow-up appointment. Results showed that OT did not significantly improve d2 test performance. In the primary model, on-task PEA exposure reduced commission errors compared to the odorless condition, suggesting a possible transient effect of olfactory input on the inhibitory control in the context of the d2 attentional test. This effect, however, was no longer significant once the follow-up data were included and should be regarded as preliminary. Overall, these findings raise the possibility of a distinction between relatively long-term OT and short-term odor exposure: while OT did not improve visual selective attention, brief on-task odor exposure may transiently enhance inhibitory control during attentional tasks, a possibility that remains to be confirmed.

Humans

The Soundtrack of Everyday Life: Real-world Music Listening Habits of Adult Cochlear Implant Users.

OBJECTIVE: Characterize real-world patterns of music listening and reward sensitivity among adult cochlear implant (CI) users compared with normal-hearing (NH) listeners. STUDY DESIGN: Cross-sectional observational study. SETTING: Online. PATIENTS: Adults (&#x2265;18&#xa0;y) with a CI or NH who used a music-streaming platform as their primary listening method. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Objective measures included platform-derived audio features (acousticness, danceability, energy, tempo, and valence), listening volume, unique-song ratio, and decade preferences. Self-reported measures included listening habits and the Barcelona Music Reward Questionnaire (BMRQ). Group comparisons used ANCOVAs and mixed-effect models adjusting for age and gender; within-CI analyses compared prelingual versus postlingual deafness. RESULTS: Among 16 CI users (69% male, 39.0&#xb1;15.6&#xa0;y) and 29 NH listeners (38% male, 32.2&#xb1;11.3&#xa0;y), CI users demonstrated a higher unique-song ratio (&#x3b2;=-0.157, CI as reference; 95%CI [-0.281, -0.034]; P =0.014) and stronger preference for older music (Pillai trace=0.537; F8,35 =5.07; P <0.001), adjusting for age. No significant group differences were observed in weekly listening time, listening volume, audio features, or BMRQ scores (total and subscores). Equivalence was confirmed for Emotion Evocation and Sensory-Motor subscales. There were no statistically significant differences in listening environments after Holm correction. No statistically detectable differences were observed between pre- and postlingually deafened CI users. CONCLUSIONS: Musically active CI users showed no significant differences in listening volume or overall music-reward sensitivity compared with NH peers, but demonstrated higher unique-song ratios and a bias toward older music. Findings highlight the value of ecologically valid data in understanding real-world music experiences among CI users.

Adult

Nursing students' perspective of dignity: A systematic review.

AIM: This review synthesizes research on nursing students' perceptions of dignity shaped by education and clinical experiences. BACKGROUND: Respect for human dignity is central to nursing ethics. While dignity is well studied in patient care, less focus has been given to how nursing students perceive and experience dignity during their education. DESIGN: A systematic review of quantitative, qualitative, and mixed-methods studies. METHODS: A comprehensive search was conducted across the Medline, PubMed, ScienceDirect, Scopus, and Web of Science databases for English-language studies published from 2000 to 2025. Quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist and the Mixed Methods Appraisal. Tool. Data were synthesized thematically. Reporting followed PRISMA guidelines. RESULTS: A total of 24 articles were included. Students viewed patient dignity as linked to respect, privacy, and autonomy. Although students had solid theoretical knowledge, they encountered institutional and professional barriers in delivering dignified care. Supportive environments and participation in decision-making enhanced their sense of dignity. Finally, educational strategies such as role-playing, simulations, and empathy exercises enhanced emotional and psychosocial awareness. CONCLUSIONS: These findings indicate that dignity is crucial in shaping nursing students' professional identity and ethical awareness throughout their education. Reinforcing ethical values and dignity in nursing education is essential for high-quality care.

Humans