Smokeless tobacco use remains highly prevalent among adolescents in many regions, driven by complex socio-cultural influences that extend beyond individual choice. Understanding the perceived social, cultural, and familial factors that contribute to initiation is essential for informing effective prevention strategies. A qualitative systematic review was conducted following JBI Methodology to identify and explore socio-cultural factors influencing smokeless tobacco initiation among adolescents. Electronic searches were performed in MEDLINE (Ovid), Scopus, Embase, CINAHL, PsycINFO, and Cochrane CENTRAL. Grey literature was identified through ProQuest Dissertations, OAIster, and Google Scholar. Studies published in English between January 2002 and March 2026 were eligible. Qualitative studies examining socio-cultural determinants of smokeless tobacco initiation were included, while studies focusing on cigarette smoking, alternative tobacco products, or cessation interventions were excluded. Two independent reviewers undertook study selection, data extraction, and critical appraisal using standardized JBI qualitative appraisal and data extraction tools. Data were synthesized through meta-aggregation of findings and categories, with interpretation informed by a socio-ecological framework, and the review was reported in accordance with PRISMA guidelines. Fourteen studies met the inclusion criteria, yielding 42 findings that were grouped into eight categories and three synthesized findings. Key drivers of initiation included curiosity, perceived pleasure, low cost, easy availability, and beliefs regarding the relative harmlessness of smokeless tobacco products. Social influences such as familial role modelling, peer pressure, socio-cultural identity, and normalization of smokeless tobacco use further contributed to initiation among adolescents. These findings reflect influences operating across individual, interpersonal, and socio-cultural levels. Based on ConQual assessment, confidence in the synthesized findings ranged from low to moderate. This review highlights the central role of socio-cultural environments in shaping smokeless tobacco initiation among adolescents. The findings underscore the need for comprehensive prevention strategies and policies that address intergenerational transmission, social normalization, and misconceptions surrounding smokeless tobacco. Targeting these broader societal influences is critical for reducing early initiation and long-term tobacco use. The review is prospectively registered in PROSPERO under the registration number: CRD42021240588.
Digital health interventions (DHIs) have gained momentum in improving access to sexual and reproductive health (SRH) education and services. DHIs are increasingly recognised for reducing healthcare providers' workload, minimizing patients' long waiting times, and decreasing the distance patients must walk to access health care, thereby enhancing the quality of health services. However, the limited cultural adaptation of DHIs has undermined their usability and acceptability for improving SRH education. Evidence in sub-Saharan Africa indicates that DHIs often fall short of achieving the expected outcomes because they lack cultural relevance and are misaligned with local belief systems and sociocultural contexts. Given these gaps, this scoping review aims to systematically map existing SRH education initiatives that utilize DHIs, to assess the extent of cultural adaptation and to identify evidence-based strategies that could enhance transcultural utility in SRH DHIs. This scoping review will be guided by the framework of Arksey and O'Malley. A systematic search will be undertaken across major sources, such as PubMed, Scopus, PsycINFO, Web of Science, and other relevant sources. The review selection process will be reported using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (Prisma-ScR) flow diagram to ensure transparency, and EndNote will be used to eliminate duplicates during the selection of eligible studies. Eligible studies will be screened against predefined inclusion and exclusion criteria, and data will be charted to capture key characteristics, and by paying particular attention to cultural adaptation strategies of SRH-focused DHIs. Findings will be synthesised to map the current evidence base and highlight gaps for future research and practice. This scoping review protocol was registered with Open Science Framework and can be accessed at https://osf.io/fx75p.
People from culturally and linguistically diverse (CALD) backgrounds are disproportionately impacted by chronic pain. To inform the design of culturally responsive pain care that can reduce health disparities and improve health outcomes, this scoping review examined the perspectives and experiences of pain and pain care of people from CALD backgrounds in Australia. Scoping review design based on Arksey and O'Malley's framework. Six databases (MEDLINE, EMBASE, APA PsychInfo, CINAHL, SCOPUS, Social Sciences Abstract - Proquest) were searched from inception to July 2023 and repeated in February 2024 using the keywords 'chronic pain', 'CALD' and 'Australia'. Inclusion criteria were qualitative or mixed-methods studies exploring the perceptions and experiences of adults aged ≥18 years with non-cancer pain of ≥3 months duration from CALD backgrounds (born in a non-English speaking country and/or speak a language other than English at home). Qualitative data were analysed using thematic analysis. Of 546 studies screened, five met the inclusion criteria. These studies involved 167 participants from Assyrian (Iraq), Mandaean (Iraq), Vietnamese and Indian communities. Whilst perspectives and experiences unique to each community were observed, three major themes characterised the CALD communities' chronic pain experiences: holistic beliefs about pain including physical, mental, cultural and spiritual aspects; the importance of social support networks; and barriers to accessing the healthcare system such as cost and lack of trust. To improve access, uptake, and outcomes for people from CALD backgrounds, future research is needed to co-design a multidisciplinary pain programme that is widely accessible through primary care, adopts a strengths-based approach, and is delivered by trusted healthcare professionals with the support of the wider community. The findings of this study give rise to recommendations at the clinician, health service, and broader health system levels, including the hiring of culturally diverse staff who reflect the community.
Adequate maternal nutrition in the postpartum period is crucial for maternal recovery, optimal breast milk composition, and healthy infant development. Nutritional knowledge and culturally influenced dietary practices play a key role in shaping mothers' dietary behaviors. This study aimed to assess nutritional knowledge, practices, and cultural food beliefs among postpartum lactating mothers in Saudi Arabia. A cross-sectional study was conducted among 442 postpartum mothers within 6 months after delivery, recruited using a two-stage cluster random sampling technique from maternal and child health centers in Bisha and Ha'il cities. A standardized interviewer-administered questionnaire encompassing sociodemographic traits, nutritional knowledge, dietary habits, and culturally influenced eating habits was used to gather data. To find determinants of adequate dietary practices and strong nutritional awareness, binary logistic regression analysis was used. Overall, 54.8% of mothers were classified as having good nutritional practices, and 50.9% were classified as having good nutritional knowledge. Good nutritional knowledge was significantly associated with older maternal age, higher educational attainment, and employment status. Good nutritional practices were significantly associated with employment, better income status, and planned pregnancy. Regarding cultural beliefs, 65.8% of mothers consumed culturally prepared traditional foods, 63.6% avoided certain foods based on cultural beliefs, and 69.2% participated in celebratory food practices following childbirth. Herbal tea, puerperium nuts, and Moghate were the most commonly consumed traditional foods. Although more than half of postpartum mothers reported good dietary practices, only half demonstrated adequate nutritional knowledge. To improve maternal and infant nutritional outcomes in Saudi Arabia, culturally sensitive, evidence-based nutritional education programs must be integrated into prenatal and postnatal healthcare services.
Heathlands are a significant land cover type across the circumpolar boreal biome. A growing body of knowledge has developed around the ecology of heathland ecosystems, but little work has been done to document their cultural significance to Indigenous Peoples. In this study, we integrate plot-based vegetation surveys, a desktop review of Indigenous Mi'kmaq ethnobotany, and interviews with Miawpukek First Nation community members to understand Indigenous values, uses and perspectives of heathlands across the Ktaqmkuk boreal region (Newfoundland, Canada). Although historically perceived as unproductive land of limited value for development or conservation, we found that heathlands provide a diversity of culturally significant habitats and plants used by Indigenous Peoples for berry picking, hunting, traveling, and food preservation. Specifically, Miawpukek First Nation community members hold detailed environmental knowledge of biodiversity, ecology, environmental change, and ethics of respect, reciprocity, and responsibilities to heathland landscapes. Heathlands also facilitate personal and shared community experiences of being on the land that are crucial for sustaining Indigenous customary foods, fostering social and intergenerational bonding, supporting the maintenance and transmission of Indigenous knowledge, and instilling a sense of cultural identity. By highlighting the tangible and intangible cultural values associated with boreal heathlands, our analysis draws attention to the biocultural significance of open and sparsely treed ecosystems of the boreal biome and their importance to conservation and sustainable use.
The stereotype that people of color are less American than White Americans may lead to hiring and employment discrimination. We test this prediction in four experiments that simulate hiring decisions with White adults, White students, and racially diverse students (total N = 2,146) and one archival analysis (330 discrimination cases). We further identify job contexts where this form of discrimination is likely to occur and which groups may be most vulnerable. In Studies 1 and 2, Asian and Latino Americans were less likely to be selected than Black Americans for a job that emphasized stereotypically American characteristics (e.g., English skills, familiarity with American culture), even when their first names were Anglicized. Stereotypes about Asian and Latino Americans' cultural foreignness mediated their lower perceived hireability. Extending to a broader range of racial identities, gender identities, and job contexts revealed that for a stereotypically American job, Asian, Arab, and Latino/a American men and women were perceived as less hireable than Black Americans, who were perceived as less hireable than White Americans. However, when a job favored stereotypically high-status characteristics (e.g., technical skills, advanced education), Black, Latino/a, and Arab American men and women were perceived as less hireable than Asian and White Americans (Studies 3 and 4). An analysis of U.S. employment discrimination court cases revealed that Asian, Arab, and Latino American plaintiffs were more likely than Black American plaintiffs to report experiencing discrimination based on cultural foreignness stereotypes (Study 5). Findings illuminate when, why, and for whom stereotypes about cultural foreignness shape experiences with racial discrimination in the U.S. labor market. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Cultural diversity is a defining feature of very high Human Development Index countries of the Western world. Asian immigrants represent a growing demographic in these countries and are a vulnerable group at risk of experiencing health disparities, including individuals surviving cancer. We synthesized available research evidence to evaluate the unmet needs, cancer care experience and factors affecting health-related quality of life of Asian immigrant cancer survivors living in countries in the Western world ranked as very high Human Development Index. This systematic review is reported in accordance with Preferred Reporting Item for Systematic Reviews and Meta-Analyses guidelines. Three electronic databases (MEDLINE, EMBASE, and CINAHL) were systematically searched in September 2023 and again in May 2024 to identify research studies of any design. Predefined inclusion criteria were applied, and findings from the included studies were synthesized narratively. Of 515 records identified, 31 studies met the inclusion criteria: 19 qualitative, 10 quantitative, and two mixed-methods studies. Thirty studies reported on samples of Chinese origin (25 studies with exclusive focus on Chinese immigrants). Six studies reported on samples of Arab origin (one study with exclusive focus on Arab immigrants). Frequently reported unmet needs for both Chinese and Arab immigrants included access to high-quality information, psychological and social support services, and professional interpreter services. Communication with healthcare professionals was often reported as problematic. Psychological burden was commonly reported and negatively affected health-related quality of life in both groups. Cultural beliefs strongly influenced cancer experiences, particularly among Chinese immigrants, who often reported experiencing stigma. While our findings apply predominantly to Chinese and Arab immigrant cancer survivors, it is evident that wealthy living environments and well-developed healthcare systems/services are not panacea. Addressing the unique needs of immigrant cancer survivors, as well as barriers experienced in accessing supportive cancer care in the host country is essential to promoting equitable cancer care. Improving accessibility, navigation, and health literacy are key strategies to optimize outcomes for these populations, together with a need to re-shape supportive care approaches to suit cultural norms and preferences. To promote equity, nurses are required to demonstrate cultural sensitivity and proactive awareness of how immigrant status might influence how cancer as a personal and family illness can be experienced. Nurses should carefully assess the specific needs of immigrant cancer survivors and enable bespoke navigation within the health care system and in the community to effectively respond to these needs.
Low back pain (LBP) is the leading cause of disability worldwide. Unhelpful beliefs, low pain resilience, and overreliance on imaging contribute to chronicity and poor outcomes. Despite growing recognition of psychosocial influences, culturally adapted assessment tools for Urdu-speaking populations are lacking. This study aimed to translate and cross-culturally adapt Urdu versions of the back pain attitudes questionnaire (BackPAQ), pain resilience scale (PRS), and medical scans beliefs questionnaire (MSBQ), and to conduct an initial evaluation of their structural validity and internal consistency. Following Beaton's six-step protocol and COSMIN guidelines, the BackPAQ, PRS, and MSBQ were translated and culturally adapted into Urdu. A cross-sectional sample of 461 adults with LBP (mean age=38.5 ± 12.3 years; 66.6 % female) completed the translated instruments. Item distributions, internal consistency, and exploratory factor analyses (EFA) were examined. Reliability was evaluated using Cronbach's α and standard error of measurement (SEM). Associations with established Urdu versions of the oswestry disability index and pain catastrophizing scale, were visually examined using scatter plots. EFA supported a four-factor structure for the Urdu BackPAQ (14 items, 46.0 % variance explained, α=0.69). The PRS retained its original two-factor structure (51.5 % variance explained, α=0.88), and the MSBQ demonstrated a unidimensional structure (46.2 % variance explained, α=0.71). Scatter plots indicated small, directionally consistent associations between the Urdu instruments with disability and catastrophizing. The Urdu versions of the BackPAQ, PRS, and MSBQ demonstrated acceptable structural validity and internal consistency, with the PRS showing excellent content validity. Test-retest reliability, responsiveness, and predictive validity should be evaluated in future clinical and longitudinal studies before broader clinical application.
Blood transfusion is a critical component of healthcare systems worldwide, yet maintaining adequate blood supplies remains challenging, particularly when voluntary donation rates are low. In Saudi Arabia, women are markedly underrepresented among blood donors despite national efforts to promote donation. Understanding the cultural, social, and physiological factors influencing women's participation is essential for developing effective, gender-sensitive strategies. A cross-sectional, online survey was conducted among Saudi women aged 18-65 years between April and September 2025. The questionnaire assessed sociodemographic characteristics, knowledge, attitudes, health-related concerns, and accessibility related to blood donation. Descriptive statistics and nonparametric tests were used to analyze data from 503 respondents. Although more than 85% of participants considered blood donation a social responsibility, only 15.1% reported a history of donation, indicating a clear attitude-behavior gap. Health-related uncertainty was prominent, with 47.7% avoiding donation due to uncertainty about eligibility and 24.1% reporting previous deferral for health reasons. Cultural misconceptions, particularly regarding menstruation and female health, were common. Structural barriers were also evident; nearly half cited lack of time, while willingness to donate increased substantially if mobile donation units were available (74.2%). Saudi women's low participation in blood donation is driven by the interaction of health-related uncertainty, cultural misconceptions, and limited accessibility rather than lack of altruistic motivation. Addressing these barriers through culturally sensitive education, clear communication about eligibility, and improved access-especially via mobile and community-based donation services-may help convert willingness into sustained donor participation and strengthen the national blood supply.
Black men face elevated risks for chronic disease and cognitive decline yet remain underrepresented in exercise and brain-health research. Although resistance training (RT) improves cognition in older adults, little is known about how older Black men perceive RT as a brain-health strategy. This study examined beliefs, motivations, and barriers related to RT (Aim 1) and used these findings to inform the design of a culturally-grounded RT intervention (Aim 2). A mixed-methods exploratory design included surveys (N = 37) and semi-structured interviews with Black men ≥55 years old. Quantitative measures assessed RT behavior, stage of change, cognitive-health beliefs, and perceived barriers and motivators. Qualitative data were analyzed thematically using phenomenology and theory-informed frameworks. Integrated findings informed a design thinking-based, community-centered 12-week intervention framework. Only 21.6% engaged in RT two or more times weekly, though most expressed concern about cognitive aging and interest in maintaining mental clarity. Cognitive-health beliefs were strongly associated with RT participation (Pseudo R2 = .71). Practical barriers-time, pain, limited knowledge, and access-were more influential than attitudinal barriers. Qualitative themes highlighted cultural influences and a strong desire to maintain independence with aging. Findings indicate high motivation to protect cognitive health but limited culturally responsive pathways for RT adoption. Results support the use of mixed-methods, community-engaged approaches to develop feasible strategies promoting cognitive vitality and independence among aging Black men.
Mental health conditions, including anxiety disorders, are a major cause of morbidity across Sub-Saharan Africa. There are scarce mental health resources and providers in Madagascar, which substantiates a need for clear and accessible assessment tools for assessing mental health conditions. Yet, before this study, there were no validated scales to measure anxiety disorder symptoms in Madagascar. We assessed the psychometric properties of the culturally adapted 10-item Hopkins Symptom Checklist (HSCL-10-SW) anxiety subscale in the Bay of Ranobe region, in southwestern Madagascar. The study participants were part of the ongoing HIARA cohort study. The HSCL-10-SW includes the original HSCL-10 anxiety subscale in addition to three culturally relevant items that were derived through qualitative research: irritability, lost in thoughts/overthinking and forgetfulness. We administered the HSCL-10-SW to 809 participants (41.2% males) aged 16 years (mean age 36.9) and above in October 2023. Our exploratory factor analysis supported a two-factor structure: Fear Anxiety and Cognitive-Somatic Anxiety. We found discriminant validity between Fear anxiety and Depression factors. Although the HSCL-10-SW demonstrated acceptable psychometric validity, we suggest that additional qualitative studies should be conducted to explore the local conceptualization of anxiety disorders in southwestern Madagascar.
Vaccine hesitancy, amplified by the COVID-19 "infodemic," has emerged as a pressing public health challenge. Communication strategies are pivotal for enhancing vaccine literacy, countering misinformation, and sustaining immunization programs. This systematic review evaluates the association between communication channels and vaccine hesitancy and adherence, while examining the moderating role of sociodemographic factors. A PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)-compliant search was conducted across PubMed, Scopus, and Web of Science, yielding 17,407 records screened according to predefined eligibility criteria (peer-reviewed studies with N>1000 adults assessing communication media targeting vaccine hesitancy and adherence, excluding pediatric, health care-specific, and non-English research). After full-text assessment, studies were appraised using the Modified Medical Education Research Study Quality Instrument for methodological quality and the Joanna Briggs Institute Critical Appraisal Checklist, ROBIN-I (Risk of Bias in Nonrandomized Studies of Interventions), or RoB 2.0 (Risk-of-Bias 2.0 tool for randomized trials) tools for risk of bias. Thirty-six studies were included (26 cross-sectional, 4 quasi-experimental, 4 randomized controlled trials, 1 cohort, and 1 global analysis). Randomized and nonrandomized experimental studies demonstrated that tailored communication strategies delivered via radio, web platforms, and social media significantly improved vaccine acceptance. Adaptive public health campaigns achieved up to an 8% weekly increase in uptake in Madagascar (relative risk 1.08; 95% CI 1.01-1.15) and a 7.8% higher vaccination rate among Nigerian adults at first follow-up compared with controls. Digital and social media campaigns effectively reduced hesitancy and enhanced trust among hesitant pregnant women in the United States. Sociodemographic factors significantly moderated communication outcomes: a COVID-19 chatbot proved most effective among individuals with lower education and minority backgrounds, while religiosity (b=0.17; 95% CI 0.05-0.30; t810=2.80; P=.005) and cultural congruence (odds ratio 1.89; P<.01) influenced message credibility and engagement, respectively. The persuasive effect of online memes on COVID-19 vaccine intentions was not significantly influenced by gender (P=.83), age (P=.60), or political orientation (P=.44). Age-specific effects were observed, with greater responsiveness to a social media campaign among adults aged 25-34 years and reduced hesitancy among older groups. Multiple cross-sectional studies indicated higher adherence among audiences exposed to traditional media (television, radio, newspapers) and lower trust among social media users. Other studies suggested significant influences of gender, age, socioeconomic status, education level, and political orientation. By synthesizing fragmented evidence, this review provides a systematic examination of the interplay between multichannel media and vaccine acceptance. It diverges from existing literature by integrating both traditional and digital media perspectives through the lens of sociodemographic moderation. This work offers a critical framework for public health interventions, advocating for rigorous longitudinal research to establish definitive causal links between communication and behavior. Consequently, these findings support a "precision" communication model, enabling the development of culturally congruent strategies tailored to specific recipient profiles to bolster vaccine adherence. PROSPERO CRD42025637441; https://tinyurl.com/4r9w83kw.
Artificial intelligence (AI) technologies have appeared in many specific clinical nursing scenarios, but its actual adoption effect remains challenging. Assessing nurses' attitude toward the use of artificial intelligence technologies will help optimize the integration of AI technologies in the field of nursing. The aim of this study is to cross-culturally adapt the Attitude Scale towards the Use of Artificial Intelligence Technologies in Nursing (ASUAITIN) to the Chinese nursing cultural context and verify its reliability and validity in the nurse population. This cross-sectional study adhered to the STROBE guidelines and was designed to translate the ASUAITIN into Chinese. Experts and clinical nurses were invited to discuss and modify the content and concepts, as well as to assess its alignment with the Chinese cultural context. A total of 436 clinical nurses from 20 hospitals in Fujian Province, China, were surveyed from March to April 2025, and the psychometric properties of the Chinese version of ASUAITIN were evaluated. The Chinese version of ASUAITIN consists of 15 items and 2 dimensions, namely, positive attitude and negative attitude, which demonstrates acceptable content validity. Exploratory factor analysis showed that the scale consists of 2 factors, explaining 68.92% of the total variance, with loadings of each factor ranging from 0.704 to 0.912. Confirmatory factor analysis supported the two-factor structure and indicated acceptable model fit and good convergent validity and was able to fully represent the scale structure. Meanwhile, the internal consistency and test-retest reliability were satisfactory. The Chinese version of ASUAITIN showed acceptable validity and reliability and can, therefore, be used to assess Chinese nurses' attitudes toward the use of AI technologies. The scale provides the nursing management with a practical tool to assess nurses' attitudes toward the use of AI technologies and promote smoother integration of AI technologies. It supports targeted training programs to enhance nurses' AI application.
Despite the common belief that horizontal stripes in clothes make someone look wider, behavioral studies show that horizontally striped stimuli are perceived as thinner compared to equally wide non-striped stimuli. In the present study, we examined the extent to which participants' beliefs regarding the thinning or widening effect of horizontal stripes were related to their visual perception of horizontally striped versus neutral stimuli in a behavioral task. Data were collected across three countries to explore possible cross-cultural generalizability of the phenomenon. In Experiment 1 (n = 316; Greece, Netherlands), we measured participants' beliefs regarding the effect of horizontal stripes in clothes, verifying the popular belief that horizontal stripes are, indeed, thought to have a widening effect regardless of country. In Experiment 2 (n = 419; Greece, Netherlands, Taiwan), participants self-reported their beliefs regarding the effect of horizontal stripes and, also, completed a behavioral task comparing the width of a striped and non-striped dress. The results showed that (a) in line with previous research, the horizontally striped dress was perceived as thinner compared to the non-striped dress, and (b) the more participants believed that horizontal stripes make someone look thin, the more they perceived the striped dress as thinner. However, the relation between beliefs and size perception was non-significant for participants who believed that horizontal stripes make someone look wider. No cross-cultural differences were found for this asymmetrical effect, highlighting the universality of the findings.
This qualitative literature review examines Somali perceptions of mental health and illness in Western Europe, focusing on how cultural, religious, and biomedical frameworks intersect to shape experiences and help-seeking behaviors. Using a narrative literature review, we analyzed 11 qualitative studies from Scandinavia and Western Europe. Findings indicate that Somalis communities understand mental health primarily through cultural and religious perspectives. The relationship with God is considered crucial, while recognizing external factors such as war and migration that can affect mental health. Somalis conceptualize mental health along a continuum, often using culturally specific idioms of distress rather than biomedical diagnoses. Shame, stigma, and fear of discrimination within and outside Somali communities present significant barriers to seeking mental health care. Additionally, the challenges of migration, acculturation, and cultural differences with healthcare systems further complicate access to support. The discussion emphasizes the importance of cross-cultural competence in clinical care and identifies gaps in research, particularly regarding second-generation Somali immigrants and their evolving mental health narratives. Additionally, there is a need for qualitative data to better understand the perceptions and experiences of young second-generation Danish-Norwegian-Somali individuals regarding worries of the mind and their approaches to seeking help. Future studies should explore how generational differences influence mental health perceptions and help-seeking behaviors. Future studies must address these gaps to inform culturally responsive interventions for Somali communities in Europe.
The accurate identification of protein adhesive sources in polychrome relics is critical for their conservation. Conventional infrared spectroscopy faces limitations in the cross-species discrimination of such adhesives. To address this, we developed a high-resolution analytical system integrating attenuated total reflection Fourier-transform infrared spectroscopy (ATR-FTIR) with multidimensional chemometrics. Spectral fingerprints (4000-500 cm-1) were acquired from simulated mural samples containing collagen-based adhesives derived from bovine, fish, porcine, and rabbit. A detailed analysis was performed in the 1800-1600 cm-1 range, which encompassed the diagnostically critical amide I band. After dimensionality reduction via principal component analysis (PCA), classification models developed based on support vector machines (SVMs), bayesian neural network (BNN), and random forest (RF) achieved cross-validated accuracies exceeding 91.8% for the four-species classification in unaged samples and >82.5% after 168 hours of UV-accelerated aging. To address the contact limitations of conventional ATR probes on non-planar surfaces, a polyethylene glycol (PEG)-based hydrogel sampling strategy was introduced, enabling the effective extraction of trace collagen signals from complex substrates. This method yielded above 86% accuracy in well-preserved samples. However, classification performance decreased significantly with extended aging, with severely degraded samples, such as those subjected to 336 hours of UV-accelerated aging, becoming indistinguishable. This work established a novel protocol that integrates minimally invasive sampling with machine learning for the species-specific identification of protein adhesives in cultural heritage. The proposed framework proves particularly effective for well-preserved relics, offering significant potential for advancing provenance studies and tailored conservation strategies.
The purpose of this study is to translate the Grit Psychological Resources Scale (GPRS) for adults into Chinese and to evaluate the reliability and validity of the translated version in a Chinese population. In this study, the scale was subjected to transcription, back-translation, and cross-cultural adaptation using Brislin's dual translation-back translation method for pre-testing, to create an initial Chinese version of the Grit Psychological Resources Scale for adults. Convenience sampling was utilized to select 576 study participants from Shandong and Henan, China, who met the inclusion and exclusion criteria, to assess the scale's reliability and validity. The internal consistency and test-retest reliability of the Chinese version of the GPRS were analyzed. Factor analysis was conducted to examine the factor structure of the scale. The Chinese version of the Grit Psychological Resources Scale (GPRS) comprises 4 dimensions and 20 items. The overall Cronbach's alpha coefficient for the questionnaire is 0.956. The split-half reliability of the scale is 0.736, and the test-retest reliability is 0.763. Exploratory factor analysis yielded a Kaiser-Meyer-Olkin (KMO) value of 0.949, and the Bartlett's test of sphericity approximated a chi-square value of 5199.850 (p < 0.001). Principal Axis Factoring (PAF) was used to extract factors with eigenvalues greater than 1 as the main components, revealing a total of 4 principal components that account for 79.297% of the total variance explained. In confirmatory factor analysis, the model fit results were X2/df = 1.473, GFI = 0.92, AGFI = 0.90, NFI = 0.96, IFI = 0.99, TLI = 0.98, CFI = 0.99, RMSEA = 0.04. All model fit indices are within the acceptable range. The Chinese version of the Grit Psychological Resources Scale demonstrates good psychometric properties, making it suitable for assessing the psychological resources of grit in middle-aged and older Chinese adults. Future studies are needed to validate the scale in younger populations.
Conversational agents (CAs) are increasingly used in mental health care to enhance access and engagement. However, their safe, ethical, and user-sensitive design remains a challenge. Despite growing attention to trauma-informed approaches in human-computer interaction, there is limited work on how the trauma-informed care (TIC) framework could be applied in the design of mental health CAs and no comprehensive synthesis to date. Guided by the Substance Abuse and Mental Health Services Administration's TIC framework, this scoping review explored how TIC principles (safety; trustworthiness and transparency; collaboration and mutuality; empowerment, voice, and choice; peer support; and cultural, historical, and gender issues) are currently represented in the design and evaluation of mental health conversational agents (MHCAs) and identified gaps and opportunities to promote more trauma-informed design practices. Online databases, as well as a secondary survey of citation lists from an initial search, were used to identify English-language journal articles and conference proceedings from 2000 to 2024 that empirically evaluated an independent, web- or app-based, unassisted CA used for mental health and included concepts from TIC. Our analysis included 38 publications (n=28, 73.7%, published in 2020 or later) covering 28 distinct MHCAs. Most studies used experimental methods (n=23, 60.6%) or user studies (n=11, 28.9%), with samples skewed toward female (men: mean 34.92%, SD 18.64%), young in age (mean 32.52, SD 14.6 y), and predominantly nonclinical (n=29, 76.3%). MHCAs were largely rule-based prototypes. No studies explicitly referenced the TIC framework as a guiding lens for MHCA design or evaluation. A total of 26 studies referenced terminology from TIC core principles but rarely defined them, while all 38 included language that could be linked to one or more principles. Overall, TIC-related concepts appeared most often within intervention design descriptions, qualitative assessments, or as items embedded in questionnaires evaluating broader constructs. Trustworthiness and transparency, safety, empowerment, voice and choice, and collaboration and mutuality were comparatively well addressed, while peer support and cultural, historical, and gender issues were largely absent. Design recommendations, where present, were relatively broad and emphasized secure, customizable, reliable, human-like, and context-sensitive MHCAs that offered multimodal interaction, goal setting and tracking, and transparency. Studies did not self-identify as using Substance Abuse and Mental Health Services Administration's framework for TIC, making it more difficult to identify its elements. The fragmented terms, disciplines, and metrics used make it difficult to draw more systematic conclusions about the current research landscape related to TIC, but our analysis indicates TIC to be a descriptive and potentially unifying framework and provides a starting point for the explicit trauma-informed MHCA research and design.
The absence of a culturally adapted and validated Smile Aesthetics Scale for Peruvian stomatology students reveals a significant gap in aesthetic dentistry and public health research. Addressing this gap is essential for accurately assessing smile aesthetic perception based on standardized photographic stimuli within this demographic, ensuring the scale's relevance and effectiveness across Spanish-speaking cultures. The aim of the study was to translate, culturally adapt, and validate the Smile Aesthetics Satisfaction Scale for Peruvian university students. This research was applied, with an instrumental, cross-sectional, and descriptive design. Face validity was conducted with 10 students through unstructured interviews. Content validity was carried out by three experts. The validation of psychometric properties was performed on 190 students recruited through university dentistry social networks using simple random probability sampling. The Aiken test was used for face and content validity. Construct validity and internal consistency were examined through principal component and exploratory factor analysis, using promax and varimax rotations, and internal consistency was assessed with Cronbach's Alpha. Face and content validity confirmed that the items were relevant and applicable, highlighting the significance of the construct evaluated within the specific cultural context of the research. The adapted scale reflected high content validity, with a global Aiken's V of 0.83, emphasizing the clarity, coherence, and relevance of the items according to expert evaluation. The psychometric properties of the adapted scale were exceptional among the student population, evidenced by a Cronbach's Alpha of 0.889. The translation and cultural adaptation process of the Smile Aesthetics Satisfaction Scale has proven to be successful not only in terms of coherence and fidelity with the original instrument but also in its applicability and relevance within the context of university dental students.
This study investigates automaticity attribution bias (AAB), whereby consumers attribute autonomous product failures to the algorithmic nature, reducing satisfaction, particularly for high-autonomy products. This effect is amplified in high uncertainty avoidance (UA) cultures. Study 1 (N = 110 after exclusions, M_age = 31.28, 58.2% female) used a scenario-based experiment to test emotional responses and satisfaction across individual uncertainty tolerance and expectation conditions, examining psychological-level mechanisms. Study 2 analysed Amazon reviews (UK, France) of products varying in autonomy to examine cultural-level uncertainty avoidance, confirming AAB as a mediator between negative disconfirmation and outcomes. We acknowledge these operate at distinct analytical levels and avoid cross-level inferences. Findings highlight cultural and psychological factors shaping responses to autonomous product failures, offering insights for tailored marketing strategies in diverse markets. Study 1 employed a scenario-based experiment to explore emotional responses and satisfaction under manipulated individual uncertainty tolerance and expectation levels, generating varying disconfirmation. Study 2 complemented this with naturalistic text analysis of reviews from countries differing in cultural UA, triangulating experimental findings with real-world evidence. These studies emphasize how individual and cultural factors differentially influence consumer evaluations.