E-ISSN: 2981-2569 Editor-in-Chief: Dr. Hadi Nobari Owner: KMAN Research Institute Publisher: KMAN Publication Inc. (KMANPUB) Contact emails: healthnexus@kmanpub.com / healthnexusjournal@gmail.com Open access: YES Peer-review: Yes (Open Peer-review) Health Nexus is a multidisciplinary journal dedicated to publishing and disseminating groundbreaking research in human health. This journal uniquely focuses on the synergistic relationship among four key areas: sports sciences, psychology, public health, and emerging technologies in health. By embracing this diverse yet interconnected scope, Health Nexus serves as a dynamic platform for researchers to present their latest findings and contribute significantly to the enhancement of human health and well-being. The journal invites a wide array of submissions, including original research articles, comprehensive reviews, insightful meta-analyses, theoretical explorations, and practical applications. These contributions are expected to advance knowledge and understanding in each of the journal's core areas: sports sciences' role in physical and mental health, psychological perspectives on wellness, public health strategies for community and global health improvement, and the transformative impact of emerging technologies in healthcare. Health Nexus is committed to fostering the development of evidence-based practices and interventions. By integrating research from sports sciences, psychology, public health, and emerging technologies in health, the journal aims to offer a holistic view of human health. This approach ensures the promotion of well-being in all aspects of life, encouraging innovative solutions to health challenges in today's rapidly evolving world. About the Publisher Publisher: KMAN Publication Inc. Publisher Office: Unit 5‑10825 Yonge St, Richmond Hill, Ontario, Canada, L4C 3E3 https://journals.kmanpub.com Email: kmanpu@kmanpub.com Telegram: +1 (647) 656‑4401 | WhatsApp: +1 (437) 429‑3507 Germany Office: Dratelnstrasse, Wohnung A60, 21119 Hamburg, Germany (+4915207720487)
A Causal Model of Job Satisfaction Based on Perceived Social Support : The Mediating Role of Cognitive Adaptability among Physical Education Teachers
The present study aimed to develop and test a causal model of job satisfaction based on perceived social support, with cognitive adaptability serving as a mediating variable among physical education teachers in non-governmental schools. This study employed a descriptive–correlational design using structural equation modeling (SEM). The statistical population consisted of all physical education teachers in Tehran during the 2024–2025 academic year. Using multistage cluster sampling, 336 physical education teachers (134 females and 202 males) were selected from different educational districts of Tehran. Data were collected using the Perceived Social Support Questionnaire, the Cognitive Adaptability Questionnaire, and the Short Job Satisfaction Scale. Data analysis was conducted using SPSS and AMOS software. The findings indicated that perceived social support (from family, friends, and significant others) had a direct and positive effect on teachers’ job satisfaction. Perceived social support also positively influenced cognitive adaptability, which in turn had a direct effect on job satisfaction. Cognitive adaptability played a partial mediating role in the relationship between perceived social support and job satisfaction. The proposed model demonstrated an acceptable level of fit. Perceived social support enhances job satisfaction among physical education teachers by strengthening their cognitive adaptability. These findings highlight the importance of social and cognitive resources in promoting occupational well-being among teachers in non-governmental educational settings.
Job Satisfaction; Perceived Social Support; Cognitive Adaptability; Physical Education Teachers
Copyright (c) 2025 Mohammad Ali Nouri (Author); Ali Jalili Shishavan (Corresponding Author); Mehrangiz Shoaa Kazemi (Author)
Structural Relationships among Executive Functions and Behavioral Brain Activities with Social Skills of Children with Autism: The Mediating Role of Cognitive Emotion Regulation Strategies
The purpose of this applied study was to determine the extent of the relationship between executive functions and behavioral brain activities with the social skills of children with autism, mediated by cognitive emotion regulation strategies. In terms of purpose, the study was applied, and in terms of method and nature, it was a descriptive–correlational study using structural equation modeling. The statistical population consisted of children diagnosed with autism at the Tehran Autism Center. Based on Green’s formula, 235 questionnaires were distributed among the sample using non-random purposive sampling. Data were collected using the Coolidge Executive Function Inventory (2002), the Autism Social Skills Profile by Bellini and Hopf (2007), the Cognitive Emotion Regulation Questionnaire by Garnefski et al. (2001), and the Behavioral Inhibition/Behavioral Activation Systems Scale by Carver and White (1994). Structural equation modeling and SmartPLS software (version 3) were used to test the research hypotheses. The findings indicated that executive functions and behavioral brain activities were related both directly to the social skills of children with autism and indirectly through the mediating role of cognitive emotion regulation strategies (p < .05). The results can be utilized by centers working with children with autism and by their families to improve these children’s communication skills.
emotional cognitive regulation strategies
Copyright (c) 2025 Soudabeh Ershadi Manesh (Author)
The Effect of Aerobic and Resistance Training on Gut Microbiome Composition and Its Association with Irisin Protein Levels in Aged Mice: The Role of Faecalibacterium prausnitzii, Clostridium difficile, and Enterococcus faecalis
In the aging period, alterations in gut microbiome composition and the decline of myokine proteins—such as irisin—are considered major contributors to metabolic disorders, inflammatory conditions, and muscle weakness. In this context, the role of exercise interventions in simultaneously modulating these two biological indicators has gained increasing attention. The present study aimed to examine the effects of aerobic and resistance training on gut microbiome composition and plasma irisin levels in aged mice, with a focus on three key species: Faecalibacterium prausnitzii, Clostridium difficile, and Enterococcus faecalis. This experimental study was conducted over eight weeks on 40 male Wistar rats assigned to five groups: young control, aged without training, sham, aerobic training, and resistance training. Plasma irisin levels were measured using the ELISA method, and the relative abundance of bacteria was assessed using real-time polymerase chain reaction (qPCR). Data were analyzed using multifactorial ANOVA and Tukey’s post hoc test. The results indicated that aerobic and resistance training led to a significant increase in plasma irisin levels in aged mice compared with the inactive group. Resistance training showed the greatest increase. Additionally, the abundance of F. prausnitzii increased in the trained groups, while the abundance of C. difficile and E. faecalis decreased. Composite microbial health indices (F/BAD, F/Cd, F/Ef) also improved significantly. A positive association between irisin levels and microbial ratios was confirmed. The findings suggest that physical exercise—particularly resistance training—can simultaneously enhance gut microbiome composition and myokine status in the elderly. These results support the central role of the “gut–muscle axis” in the physiological response to exercise and provide a basis for designing personalized training interventions in geriatric medicine.
Copyright (c) 2025 Maryam Esmaeili Sirchi (Author); Jamshid Banaei Borojeni (Corresponding Author); Hossein Mojtahedi, Leila Sarrami (Author)
Effects of Aerobic Exercise at Different Circadian Phases on p53 Expression and β-Cell Survival in the Pancreas of Type 2 Diabetic NMRI Mice
Circadian rhythms regulate glucose homeostasis, insulin secretion, mitochondrial function, and apoptosis in pancreatic β-cells. The tumor suppressor gene p53 is a key molecular regulator of apoptosis and may contribute to β-cell loss in type 2 diabetes (T2DM). This study investigates the effects of aerobic exercise performed during different circadian phases on blood glucose, β-cell survival, insulin presence, and p53 gene expression in type 2 diabetic NMRI mice. Thirty male NMRI mice were assigned to six groups: healthy controls (CH-ZT3, CH-ZT15), diabetic controls (CD-ZT3, CD-ZT15), and diabetic exercise groups trained in light (TD-ZT3) or dark phase (TD-ZT15). T2DM was induced via high-fat diet plus low-dose streptozotocin. Aerobic training (50–60% Vmax) was performed for 8 weeks. Pancreatic tissues were analyzed for β-cell survival, insulin immunostaining, and p53 expression via qRT-PCR. Data were evaluated using two-way ANOVA. Exercise significantly reduced glucose levels (p < 0.05), increased β-cell survival (p < 0.0001), and decreased p53 expression (p < 0.0001). Light-phase training (ZT3) produced greater improvements than dark-phase training. A significant interaction between training × circadian phase was found for β-cell percentage and p53 expression (p < 0.01). Aerobic exercise improves β-cell viability and reduces apoptotic signaling in diabetic mice, with circadian phase strongly modulating the benefits. Exercise during the light phase showed superior outcomes, suggesting that timing of physical activity may be an important factor in diabetes management.
Circadian Rhythm, Aerobic Exercise, Type 2 Diabetes, p53 Gene Expression, Pancreatic β-Cells, NMRI Mice
Copyright (c) 2025 Fatemeh Sepehrinya (Author); Maryam Janbozorgi (Corresponding Author); Asma Taheri, Masoumeh Hosseinzadeh (Author)
Evaluation of the Effect of Continuous and Interval Aerobic Training on Survivin Gene Expression and Cytochrome C in Myocardial Tissue of Rats Modeled with Myocardial Infarction
This study aimed to investigate the effects of moderate-intensity continuous training (MICT) and high-intensity interval training (MIHIIT) on Survivin gene expression and Cytochrome C levels in myocardial tissue of rats modeled with myocardial infarction. In this experimental study, 30 adult male Wistar rats (10–12 weeks, 275 ± 25 g) were assigned to five groups: healthy control, sham, myocardial infarction (MI), MICT, and MIHIIT. The MI model was induced through left anterior descending coronary artery occlusion and confirmed by echocardiography. Training protocols were performed for 8 weeks, five sessions per week. The MICT group performed continuous running at moderate intensity (15–23 m/min, 50 minutes), while the MIHIIT group completed interval running consisting of 7 sets of high-intensity bouts (20–28 m/min, 4 minutes) with active recovery periods (11–17 m/min, 3 minutes). Survivin gene expression was measured using RT-qPCR, and Cytochrome C levels were quantified using ELISA. Data were analyzed using MANOVA, ANOVA, and Tukey post-hoc tests. Myocardial infarction caused a significant increase in Cytochrome C levels and a reduction in Survivin expression compared to the healthy and sham groups (p < .001). Both types of aerobic training significantly reversed the infarction-induced alterations; Cytochrome C levels were reduced, and Survivin expression returned to levels comparable to the control group. When comparing the two protocols, interval training (MIHIIT) produced a greater increase in Survivin expression (p ≈ .046), while both exercise types demonstrated similar effects on reducing Cytochrome C. Both continuous and interval aerobic training restore the survival/death balance in myocardial tissue following infarction by reducing oxidative stress and enhancing Survivin expression. These findings reinforce the role of aerobic exercise as an effective non-pharmacological intervention in cardiac rehabilitation.
Copyright (c) 2025 Bahareh Mardani (Author); Saeed Keshavarz (Corresponding Author); Hossein Mojtahedi, Leila Sarrami (Author)
The Role of Biotechnology in the Development of Recombinant Drugs
Biotechnology has emerged as a cornerstone of modern pharmaceutical science, providing the foundation for the discovery, design, and production of recombinant drugs that have transformed global healthcare. This narrative review, using a descriptive analytical approach, explores the conceptual, industrial, and clinical dimensions of recombinant drug development. It begins by outlining the molecular foundations of biotechnology, emphasizing recombinant DNA technology, genetic manipulation, and expression systems that enable large-scale synthesis of therapeutic proteins. Industrial advancements in upstream and downstream processing, including cell line optimization, bioreactor engineering, purification, and formulation, are analyzed to illustrate how biotechnology has evolved into a highly controlled and efficient production platform. The study further examines the integration of automation, digitalization, and Good Manufacturing Practice (GMP) standards that ensure product safety, consistency, and regulatory compliance. Clinically, recombinant drugs have achieved remarkable success across multiple disciplines, including endocrinology, oncology, hematology, and immunology. Recombinant insulin, monoclonal antibodies, cytokines, and gene therapy products exemplify the therapeutic versatility of these biopharmaceuticals in managing both chronic and rare diseases. The review also highlights emerging applications in neurodegenerative and genetic disorders, where recombinant enzymes and CRISPR-mediated platforms are redefining the boundaries of precision medicine. Despite challenges related to production cost, ethical considerations, and equitable access, recombinant biotechnology continues to expand its impact through innovation and interdisciplinary collaboration. The findings underscore the role of biotechnology as a transformative force that bridges molecular biology and clinical application, offering solutions that enhance safety, specificity, and therapeutic efficacy. Ultimately, this study concludes that recombinant biotechnology represents not only a scientific revolution but also a paradigm of sustainable innovation, shaping the future of personalized and regenerative medicine.
Biotechnology; Recombinant drugs; Recombinant DNA technology; Biopharmaceuticals; Gene therapy; Monoclonal antibodies.
Copyright (c) 2025 Alaleh Sattari sobhani (Corresponding Author)
Investigating the User Experience of AI Chatbots in Delivering Mental Health Support to Athletes
This study aimed to explore how athletes experience and perceive the use of artificial intelligence (AI) chatbots as a source of mental health support, focusing on effectiveness, usability, emotional connection, and limitations. A qualitative exploratory design was employed. Twenty-two athletes from diverse sports disciplines in Malaysia were recruited using purposive sampling. Data were collected through semi-structured, in-depth interviews conducted online to allow flexible participation and confidentiality. The sample size was guided by theoretical saturation, reached when no new themes emerged. All interviews were audio-recorded, transcribed verbatim, and analyzed using thematic analysis. NVivo 14 software supported systematic coding, with open, axial, and selective coding applied iteratively to generate categories and subthemes. Rigor and trustworthiness were ensured through member checking, peer debriefing, and an audit trail. Four main themes emerged: perceived effectiveness of AI chatbots, usability and interaction experience, emotional and relational dynamics, and barriers and limitations. Athletes reported improved mental well-being, reduced competition-related anxiety, and personalized coping strategies. They valued intuitive interfaces, empathetic conversational style, and privacy features, which encouraged engagement and disclosure. Chatbots fostered a sense of trust and emotional validation but sometimes lacked depth and produced repetitive responses. Barriers included occasional technical instability, insufficient long-term personalization, cultural mismatches, and data security concerns. Despite these limitations, participants viewed chatbots as valuable early support tools and stigma-free entry points to mental health care. AI chatbots show promise in enhancing access to psychological support for athletes, offering discreet, immediate, and personalized assistance. However, improving cultural sensitivity, personalization, technical reliability, and data transparency is crucial for sustained engagement and safety in sports mental health contexts.
Copyright (c) 2025 Syarifah Maisarah (Corresponding Author); Angel Lee , Nafesa Azzahranisa (Author)
Assessment of Dietary Intake, Nutritional Status, and Cardiovascular Risk in University Students
This study assessed the eating habits, nutritional status, and cardiovascular risk in university students. The sample consisted of 295 new students (188 female, 107 male) who attended the induction week at the Autonomous University of Occident and met the inclusion criteria: being adults, enrolled in any undergraduate degree offered by the university, and agreeing to participate through informed consent. The data collection consisted of two parts: an initial survey to collect general characteristics and self-reported height and weight, and the measurement of waist and hip circumferences according to the ISAK protocol. Then, a short version of the FFQ was applied to collect dietary information. Data was captured on MS Excel, and mean, standard deviation, frequencies, and 95 % confidence intervals were reported. Statistical tests were analyzed using SPSS version 26. Results: 38 % of the students are overweight or obese, being higher in men (42 % vs 35.6 % in women). 7.35 % of women and 10.96 % of men presented high WHR, and 33.09 % of women and 35.62 % of men presented high WHRt. Low weekly consumption was found in dairy products (7.13 CI 95 % 6.71 - 7.56), vegetables (5.83 CI 95 % 5.33 - 6.34), and fruits (6.92 CI 95 % 6.43 – 7.42). Processed foods and junk food are highly consumed (8.77 CI 95 % 8.10 - 9.45, and 14.20 CI 95 % 13.20 – 15.20, respectively). Significant correlations were found on weekly consumption of processed foods and junk food (R = 0.765, p < 0.001), processed foods and dairy products (R = 0.436, p<0.001). The findings indicate a high rate of malnutrition among university students, poor intake of healthy foods, and a high consumption of processed and junk food. These inadequate lifestyle habits could be a risk factor for the development of both cardiovascular diseases and NCDs in the long term. Therefore, it is important to emphasize the need for university-level nutritional interventions.
Copyright (c) 2025 Alejandro Rendon, David Alfonso, Mariela Paz, Lucia Leyva Camacho, Astrid Aimeé Retamoza Rubio (Author)
Comparison of the Effectiveness of Cognitive-Behavioral Therapy and Short-Term Solution-Focused Therapy on Distress Tolerance in Pregnant Women
The present study aimed to compare the effectiveness of cognitive-behavioral therapy (CBT) and short-term solution-focused therapy (SFBT) on distress tolerance in pregnant women in 2024. This applied research employed an experimental design with pretest–posttest and follow-up assessments, including a control group. The study population comprised all pregnant women who visited the Comprehensive Health Service Center and obstetrics specialists in Semnan and who became pregnant either naturally or through assisted reproductive methods in 2021 and 2022. Using a convenience sampling method, 66 pregnant women were selected. Data were collected using the standardized Distress Tolerance Scale (DTS) by Simons and Gaher (2005) and analyzed with SPSS version 27. The CBT intervention group participated in eight weekly sessions of 90 minutes each, while the SFBT intervention group attended six weekly sessions of 90 minutes each. The control group was placed on a waiting list. The results showed that both CBT and short-term SFBT significantly improved distress tolerance in pregnant women, indicating the effectiveness of both therapeutic approaches. Additionally, no statistically significant difference was found between the two intervention groups regarding their impact on increasing distress tolerance. Based on the findings, both CBT and short-term SFBT were effective in enhancing distress tolerance and demonstrated stable effectiveness over time. Therefore, it is recommended that behavioral therapy practitioners incorporate the results of this study into their therapeutic programs
short-term solution-focused therapy (SFBT)
Copyright (c) 2025 Farnoosh Irvani (Author); Mustafa Bolghan-Abadi (Corresponding Author); Ahmad Mansouri (Author) https://creativecommons.org/licenses/by-nc/4.0
The Effect of Eight Weeks of Selected Sensorimotor Exercises and Comprehensive Postural Reeducation on Lumbar Lordosis Angle and Postural Control in Women with Lower Crossed Syndrome
This study aimed to compare the effects of an eight-week program of selected sensorimotor exercises and a comprehensive postural reeducation protocol on lumbar lordosis angle and dynamic postural control in women with lower crossed syndrome. This applied, semi-experimental study employed a pretest–posttest design with two intervention groups and one control group. Thirty-six women aged 35–60 years diagnosed with lower crossed syndrome were recruited through purposive and convenience sampling and randomly assigned into three groups: sensorimotor training, comprehensive postural reeducation, and control. The interventions were conducted three times per week for eight weeks; each sensorimotor session lasted 40 minutes and focused on deep trunk activation and proprioceptive training, while postural reeducation sessions lasted 60 minutes and emphasized global myofascial stretching and sagittal alignment. Lumbar lordosis angle was measured using a flexible ruler, and dynamic postural control was assessed with the Star Excursion Balance Test (SEBT) for both dominant and non-dominant legs. Data were analyzed using analysis of covariance (ANCOVA) to compare post-intervention outcomes across groups. ANCOVA showed a significant group effect on lumbar lordosis angle (F = 22.45, p < 0.001, η² = 0.59), with both sensorimotor and postural reeducation groups achieving significant reductions compared to the control group, and postural reeducation outperforming sensorimotor training (mean difference = −2.01°, p = 0.032). For dynamic postural control, the sensorimotor group demonstrated significantly greater improvements than the control group in SEBT scores for both dominant (mean difference = 9.25%, p = 0.014) and non-dominant legs (mean difference = 12.47%, p = 0.008), while postural reeducation alone showed no significant advantage over control for balance outcomes. Both interventions improved spinal alignment in women with lower crossed syndrome, while sensorimotor training produced superior gains in functional balance.
Copyright (c) 2025 Hadi Miri (Corresponding Author); Mostafa Soltani , Maryam Nasri (Author) https://creativecommons.org/licenses/by-nc/4.0
The Effect of Neuromuscular Training on Mental Health, Depression, and Quality of Life among Older Women: A Randomized Controlled Trial
The rapid growth of the global aging population has intensified concerns regarding the physical, psychological, and social well-being of older adults, particularly women, as age-related declines in neuromuscular control, balance, and mental health contribute substantially to reduced functional independence and quality of life. Neuromuscular training (NMT) has emerged as a promising multimodal approach to counteract these effects. This study aimed to evaluate the impact of a structured six-week NMT program on mental health, depression, and quality of life in older women. This quasi-experimental study employed a pretest–posttest design with a control group. Thirty women aged 60–70 years were randomly assigned to either an experimental group (n=15) or a control group (n=15). The experimental group participated in an 18-session NMT program over six weeks, while the control group maintained their usual activities. Mental health, depression, and quality of life were measured using the GHQ-28, Beck Depression Inventory-II, and WHOQOL-BREF questionnaires, respectively. Data were analyzed using analysis of covariance (ANCOVA) in SPSS26, with the level of statistical significance set at P<0.05. Preliminary analyses confirmed baseline equivalence between groups (p>0.05), and all ANCOVA assumptions were met. After the intervention, NMT produced significant improvements in mental health (F (1, 27) =7.93, p<0.001, η²=0.38), depression (F (1, 27) =2.29, p=0.004, η²=0.27), and quality of life (F (1, 27) =10.26, p=0.001, η²=0.32). These findings indicate that NMT accounted for a substantial proportion of variance in the measured outcomes. Neuromuscular training significantly improved mental health and quality of life while reducing depressive symptoms among older women. As a safe, low-cost, and accessible form of exercise, NMT may serve as an effective strategy to promote psychological well-being and healthy aging in this population.
Copyright (c) 2025 Pooneh Rahmani, Mahboubeh Ghayour Najafabadi, Hassan Gharayagh Zandi, Ali Nasiri, Amir Pourreza (Author); Isis Kelly dos Santos (Corresponding Author)
Effects of Conventional Exercise versus Functional Training on Physical Performance in AJA Students during the Socialization Course: A Quasi-Experimental Study
This study compared the effects of conventional exercise and functional training, implemented during the AJA socialization course, on multiple dimensions of physical performance. A quasi-experimental pre-test–post-test design was employed. Thirty-four male AJA students were randomly assigned to either a conventional exercise group (n = 17) or a functional training group (n = 17). Physical performance was evaluated using the 1-1-1 Army Physical Fitness Test (one-mile run, push-ups, sit-ups), the Running-based Anaerobic Sprint Test (RAST), and the Y-Balance Test (YBT). Paired-sample t-tests assessed within-group changes, and analysis of covariance (ANCOVA) examined between-group differences while controlling for baseline values. Statistical significance was set at p ≤ 0.05. Between-group comparisons revealed no significant differences for the one-mile run (p = 0.385, η² = 0.06) or the YBT anterior reach (p = 0.093, η² = 0.07). The functional training group showed significantly greater improvements in YBT posteromedial (p = 0.022, η² = 0.16) and posterolateral (p = 0.001, η² = 0.27) reaches, total YBT score (p = 0.031, η² = 0.34), peak anaerobic power (p = 0.001, η² = 0.36), push-ups (p = 0.017, η² = 0.18), and sit-ups (p = 0.028, η² = 0.16). Functional training produced greater improvements in anaerobic power, dynamic balance, and muscular endurance compared to conventional exercise during the AJA socialization course. Given its superior performance outcomes and potential to reduce musculoskeletal injury risk, functional training should be prioritized in military induction programs to better prepare recruits for advanced training and operational demands.
Copyright (c) 2025 Amir Shamlou kazemi (Author); Hamid Omidi (Corresponding Author); Reza Sabzevari Rad (Author) https://creativecommons.org/licenses/by-nc/4.0
Career Termination in Athletes: Identity Loss and Mental Health Strategies
This study examines the psychological and physiological impacts of athletic career termination, focusing on identity loss and mental health trajectories among elite athletes. It evaluates the effectiveness of a multimodal intervention program designed to facilitate post-retirement adjustment through identity reconstruction and lifestyle adaptation strategies. A mixed-methods longitudinal design was employed with 138 retiring elite athletes (72 male, 66 female) across 28 sports disciplines. Participants were assessed at three timepoints (pre-retirement, 3-month, and 12-month post-retirement) using validated measures including the Athletic Identity Measurement Scale (AIMS-7), Depression Anxiety Stress Scales (DASS-21), and physiological markers (cortisol, heart rate variability). The intervention group (n=69) received 18 sessions combining cognitive-behavioral therapy, narrative identity exercises, and lifestyle redesign, while controls (n=69) received standard transition services. Qualitative interviews with 32 participants provided in-depth experiential data. Athletic identity showed a 32% mean reduction (d=1.2) with steepest decline at 3 months post-retirement. Mental health symptoms followed a U-shaped trajectory, peaking at 3 months (depression M=8.7; anxiety M=7.5) before improving. The intervention group demonstrated superior outcomes: 41% lower depression scores among physically active participants (p<0.001) and greater psychological integration (d=0.73). Physiological markers correlated with psychological distress (r=0.47), with faster cortisol normalization (-23% vs -14%) in the intervention group. Individual sport athletes showed 38% identity reduction versus 27% in team sports. Athletic retirement triggers significant identity disruption and mental health challenges, particularly during early transition. Structured interventions addressing identity continuity and lifestyle adaptation effectively mitigate these effects. Sports organizations should implement proactive transition programs combining psychological support with physiological monitoring.
Copyright (c) 2025 Dr Razvan Sandu Enoiu (Corresponding Author); Dr Felipe J. Aidar (Author) https://creativecommons.org/licenses/by-nc/4.0
Neurofeedback Training for Sharpening Focus in Precision Sports: A Pilot Study
This study investigates the efficacy of neurofeedback training in enhancing focus and attentional control among athletes in precision sports, examining both neural and behavioral outcomes. A pilot intervention was conducted with [X] competitive athletes (e.g., archers, shooters) who underwent [Y] sessions of EEG-based neurofeedback targeting sensorimotor rhythm (SMR) or theta/beta ratio modulation. Pre- and post-training assessments included quantitative EEG analysis, standardized attention tests (e.g., TOVA), and self-reported focus metrics during simulated competition. A control group engaged in sham neurofeedback to account for placebo effects. Participants receiving active neurofeedback demonstrated significant improvements in SMR amplitude (p<0.05) and theta/beta ratio reduction (p<0.01), correlating with enhanced performance accuracy (15% increase, p<0.05) and faster reaction times. Subjective reports confirmed heightened concentration during high-pressure tasks, whereas the control group showed no statistically meaningful changes. EEG coherence analysis revealed strengthened frontoparietal connectivity, suggesting neuroplastic adaptations underlying cognitive gains. Neurofeedback appears effective in sharpening attentional regulation for precision sports, though individual variability and the need for protocol optimization warrant further investigation. These preliminary findings support integrating neurofeedback into athletic training regimens while highlighting the necessity for larger randomized trials to establish standardized protocols.
Copyright (c) 2025 Dr Matheus Santos de Sousa Fernandes (Corresponding Author); Dr Eduardo Melguizo-Ibáñez (Author) https://creativecommons.org/licenses/by-nc/4.0
Fear of Re-Injury Post-ACL Reconstruction: Cognitive-Behavioral Interventions
This study evaluated the efficacy of cognitive-behavioral interventions, particularly graded exposure therapy, in addressing fear of re-injury among athletes following anterior cruciate ligament (ACL) reconstruction, comparing outcomes with traditional cognitive restructuring and standard rehabilitation approaches. A randomized controlled trial was conducted with 120 athletes (ages 16-25) at 3-6 months post-ACL reconstruction, randomly assigned to graded exposure (GE), cognitive restructuring (CR), or standard care (SC) groups. The GE protocol incorporated systematic desensitization through sport-specific movements, while CR focused on modifying maladaptive beliefs about re-injury. Primary outcomes included changes in Tampa Scale for Kinesiophobia (TSK-11) scores, biomechanical assessments during drop-jump tasks, and return-to-sport rates, measured at baseline, 6, 12, and 24 weeks. The GE group demonstrated superior outcomes, with a 35.3% reduction in fear scores (TSK-11) compared to 33.1% in CR and 22.7% in SC (p < 0.001). Biomechanical improvements, including knee flexion angle and limb symmetry, were significantly greater in GE (p < 0.001). Qualitative findings highlighted enhanced movement confidence and reduced somatic fear in GE participants. Return-to-sport rates were highest in GE (68.9%) versus CR (62.5%) and SC (45.0%) (p = 0.007). Graded exposure therapy emerges as the most effective intervention for reducing fear of re-injury post-ACLR, combining psychological and neuromuscular benefits. These findings support integrating exposure-based protocols into standard rehabilitation programs during early-to-mid recovery phases to optimize both physical and psychological readiness for return to sport.
Copyright (c) 2025 Dr Sameer Badri Al-Mhanna (Corresponding Author); Dr Moazzam Tanveer (Author) https://creativecommons.org/licenses/by-nc/4.0
Eating Disorders in Female Gymnasts: Cultural Pressures and Psychological Interventions
Copyright (c) 2025 Luca Paolo Ardigò (Author); Mahdi Fahimi (Corresponding Author) https://creativecommons.org/licenses/by-nc/4.0
Paralympic Science in the Genomic and Post-Genomic Era: A Historical and Critical Literature Review
Exercise physiology has evolved from exercise biochemistry to sports and exercise genetics and, more recently, to network physiology and complex systems science of exercise: if the former was mostly reductionist, by incorporating cellular and molecular aspects, the latter leverages an integrative approach. Even though exercise physiology has been able to provide impressive insights into the genomic and post-genomic landscape that shapes the human response and adaptation to exercise and training, it has studied mostly able-bodied subjects, failing to include diverse, heterogeneous athletic populations. Only by diversifying athlete cohorts and testing them is it possible to better understand the profound interrelations and interconnections of health status, susceptibility towards injuries and diseases, underlying diseases/impairments, exercise physiology, response and adaptation to exercise, performance traits, and performance-related outcomes. Only by fully embracing pluralism and combining precision with equity, diversity, and inclusion, the “challenge of genomics” for people living with disabilities can be properly addressed and the “historic trauma” between (post-)genomic science and disability can be effectively solved and reconciled, providing the outlook necessary to decipher the molecular foundation of physical performance. In the present review, we will explore the historical evolution of sports genetics/genomics and post-genomics, utilizing a critical approach. More specifically, we will adopt a “critical disability perspective”, according to which disability is conceived as a series of lived, meaningful experiences of people with disabilities, and as social and political constructs and interpretations.
Copyright (c) 2025 Luca Puce, Kayvan Khoramipour (Author); Nichola Luiggi Braggazi (Corresponding Author) https://creativecommons.org/licenses/by-nc/4.0
Effect of an Aerobic Exercise Program and Gymnema Supplementation on Plasma Ghrelin Levels and Sweet Taste Preference in Obese Women
Obesity is associated with dysregulation of appetite control and a preference for sweet taste. Ghrelin is recognized as a key hormone in appetite stimulation and sweet taste preference. The aim of this study was to examine the effect of aerobic exercise and Gymnema supplementation on plasma ghrelin levels and sweet taste preference in obese women. In this quasi-experimental study, 45 obese women aged 20 to 45 were randomly assigned into three groups: aerobic training, aerobic training plus Gymnema supplementation, and a control group (15 participants per group). The intervention groups engaged in aerobic exercise for 8 weeks. The second group additionally received 400 mg of Gymnema supplement daily. Plasma ghrelin levels were measured using the ELISA method, and sweet taste preference was assessed via a questionnaire. Post-intervention, plasma ghrelin levels significantly increased in both the aerobic and combined intervention groups (P < 0.001), while no change was observed in the control group. The intensity and frequency of sweet cravings significantly decreased in both intervention groups (P < 0.001), although no significant difference was found between the two. Furthermore, anthropometric indices including weight, waist-to-hip ratio (WHR), and body mass index (BMI) were significantly reduced in the intervention groups. Aerobic exercise, whether alone or combined with Gymnema supplementation, can contribute to modulating ghrelin levels, reducing sweet cravings, and improving body composition in obese women. Gymnema supplementation may be considered a complementary strategy for managing unhealthy eating behaviors.
Copyright (c) 2025 Roya Azadi (Author); Khadijeh Irandoust (Corresponding Author); Morteza Taheri (Author) https://creativecommons.org/licenses/by-nc/4.0
Understanding User Perceptions of Personalized Feedback in Digital Health Tools
This study aimed to explore how users perceive and emotionally respond to personalized feedback in digital health tools. A qualitative research design was employed using semi-structured interviews with 20 adult participants from Mexico who had experience using digital health tools with personalized feedback features. Participants were selected through purposive sampling, and data collection continued until theoretical saturation was achieved. Interviews were audio-recorded, transcribed, and thematically analyzed using NVivo 14. The coding process followed three stages: open coding, axial coding, and selective coding, ensuring a comprehensive understanding of user experiences and interpretive patterns. Analysis revealed four core themes: perceived effectiveness of feedback, personal relevance and cultural fit, communication and design quality, and trust, privacy, and emotional resonance. Participants valued motivational and positively framed feedback that aligned with their health goals, but criticized messages that were overly generic, intrusive, or lacking emotional intelligence. Users expressed a preference for customizable settings, culturally and linguistically appropriate messages, and visual formats such as graphs or summaries. Trust in the system was strongly influenced by the tone, clarity, and perceived transparency of the feedback, while overly frequent or robotic messages sometimes triggered negative emotional reactions or disengagement. User perceptions of personalized feedback in digital health tools are multifaceted and shaped by emotional, cultural, cognitive, and technological factors. For feedback systems to be effective and engaging, they must be adaptive, empathetic, and contextually relevant. Incorporating user control, emotional intelligence, and cultural sensitivity into feedback design can enhance trust, increase adherence, and ultimately improve digital health outcomes.
Copyright (c) 2025 Oriana Piskorz-Ryń (Author); Rafael Ballester-Ripoll (Corresponding Author); Daniela Gottschlich , Mehdi Rostami, Sefa Bulut (Author) https://creativecommons.org/licenses/by-nc/4.0
Examining the Relationship Between Mental Toughness and Anxiety Levels of Professional Volleyball Players
The main objective of this research is to reveal the relationship between anxiety levels and mental toughness among professional volleyball players and to determine how these constructs differ according to demographic variables. The study group consisted of 139 voluntary athletes (86 female. 53 male) who are licensed and actively competing in volleyball in the Eastern Anatolia Region. The data collection tool used in the study consisted of two parts: the first part was the “Personal Information Form” used to identify the demographic characteristics of the athletes; the second part included the “Sport Anxiety Scale” to measure the anxiety levels of the athletes and the “Sports Mental Toughness Questionnaire” to assess their mental toughness levels. The data were analyzed using the SPSS statistical software. and the level of significance was set at p<0.05. According to the results of the study. significant differences were found in the Sport Anxiety Scale scores based on gender. age. education level. province of residence. years of sports experience. and number of weekly training sessions (p<0.05). while no significant difference was found based on income level and league level (p>0.05). Regarding mental toughness. significant differences were observed based on gender. education level. province of residence. and number of weekly training sessions (p<0.05). whereas no significant differences were found in relation to age. income level. league level. and years of sports experience (p>0.05). It was observed that female athletes had higher levels of anxiety compared to male athletes. while male athletes exhibited higher levels of mental toughness than female athletes. Additionally. athletes with lower income levels and those with high school education had higher levels of anxiety and mental toughness compared to those with middle income and university education. In terms of league participation. athletes playing in the regional league exhibited higher anxiety levels than those in the 2nd league. whereas athletes in the 2nd league demonstrated greater mental toughness than those in the regional league. In conclusion. it was found that the athletes included in the study had moderate levels of anxiety and mental toughness. and that education level and league participation significantly affected both constructs. In this context. it is believed that implementing activities aimed at developing both anxiety management and mental toughness. especially from an early age. may positively impact athletic performance.
Copyright (c) 2025 Ramazan Erdoğan, Korhan Kavuran, Ayşegül Şimşek (Author) https://creativecommons.org/licenses/by-nc/4.0
Application of Inner Speech in the Motor Learning Context: A Validation Study
This study addresses the absence of suitable tools for evaluating the frequency and content of inner speech during the acquisition of new motor skills by adapting the Learning-Specific Inner Speech Scale (Xiang et al., 2020) for a motor learning context. We assessed the modified scale, termed the Motor Learning-Specific Inner Speech Scale (MLISS), focusing on its factor structure, internal consistency, and content validity among young adults in Study 1. A total of 325 university students (145 females) participated, completing the MLISS, which comprises 16 items across four dimensions of inner speech: self-criticism, self-reinforcement, self-management, and social assessment. In Study 2, 149 university students (58 females) completed the MLISS and executed three basketball skills: shooting, passing, and dribbling. Data analysis employed confirmatory factor analyses and structural equation modeling, which confirmed the proposed scale structure. Notably, the self-reinforcement and self-management dimensions of the MLISS showed significant correlations with basketball performance, affirming the measure's construct validity. These findings indicate that the MLISS is a valid tool for assessing inner speech frequency in motor learning, marking the first extension of an existing inner speech measure into this domain.
Copyright (c) 2025 Amir Dana, Thomas M. Brinthaupt (Author) https://creativecommons.org/licenses/by-nc/4.0
Development and Validation of the Psychological Readiness Scale after Serious Injury (PRS-SI): A Study on Young Football Players
This study aimed to develop and validate a culturally adapted instrument—the Psychological Readiness Scale after Serious Injury (PRS-SI)—for assessing the psychological readiness of young football players to return to sport following a serious injury. A total of 265 male football players aged 17–25 from Mashhad, Iran, who had sustained at least one serious sports injury requiring a minimum of three months of recovery, participated in this psychometric study. The PRS-SI was constructed by integrating key elements from two established tools: the Psychological Readiness of Injured Athlete to Return to Sport (PRIA-RS), tailored to football contexts, and the Anterior Cruciate Ligament Return to Sport After Injury (ACL-RSI), which focuses on emotional, cognitive, and behavioral dimensions. Using Partial Least Squares Structural Equation Modeling (PLS-SEM), the measurement model demonstrated strong internal consistency, convergent and discriminant validity, and an excellent model fit. The final 21-item scale included four components: post-traumatic readiness, emotions, risk assessment, and confidence in performance. Structural analysis revealed that all four dimensions significantly and positively contribute to psychological readiness (R² = 0.99), with self-confidence in performance being the strongest predictor. The results underscore the importance of addressing emotional, cognitive, and confidence-related factors in rehabilitation, beyond physical recovery alone. The PRS-SI offers a reliable, valid, and contextually appropriate tool for evaluating athletes’ psychological states post-injury and can assist clinical decisions, psychological interventions, and return-to-sport protocols. Its application may enhance individualized rehabilitation strategies and promote safer, more effective returns to competition among young athletes.
Copyright (c) 2025 Martin Hofmeister, Karolina Gołębieska Gołębieska, Reza Aminzadeh, Mojtaba Amiri, Agnieszka Sikorska-Szyplińska, Mohammad Khazaei, Katarzyna Dzioban (Author); Bahador Azizi (Corresponding Author) https://creativecommons.org/licenses/by-nc/4.0
Understanding Emotional Engagement in Immersive VR Stress Management Programs
This study aimed to explore the dimensions of emotional engagement experienced by users participating in immersive virtual reality (VR) stress management programs. A qualitative phenomenological approach was employed to investigate how individuals emotionally interact with immersive VR environments designed for stress reduction. Nineteen participants from Turkey, who had completed VR-based stress management sessions within the past six months, were selected using purposive sampling. Data were collected through semi-structured, in-depth interviews and analyzed using a grounded theory approach across three stages: open coding, axial coding, and selective coding. NVivo 14 software was used for data management and coding. Theoretical saturation determined the final sample size. Thematic analysis revealed five core categories of emotional engagement: (1) emotional regulation and relief, characterized by feelings of calm, reduced anxiety, and emotional release; (2) immersive escape and containment, reflecting temporary psychological withdrawal and emotional safety; (3) reflective self-awareness, involving increased emotional insight and self-perception; (4) psychological safety and comfort, supported by sensory design and environmental predictability; and (5) affective transformation, encompassing mood elevation and deeper emotional shifts. Participants described immersive VR not only as a relaxation tool but as an emotionally rich environment capable of triggering introspection, affective balance, and transformation. Immersive VR stress management programs engage users across multiple emotional dimensions—physiological, cognitive, and affective. Emotional engagement is not a passive outcome but a dynamic and layered process shaped by presence, design features, and individual psychological factors. These findings underscore the importance of affect-sensitive design and implementation strategies in therapeutic VR, emphasizing the potential of immersive environments for promoting emotional resilience and mental well-being.
Copyright (c) 2025 Ahmet Kutsal (Corresponding Author); Selva Turan (Author) https://creativecommons.org/licenses/by-nc/4.0
Identifying Barriers and Enablers to the Adoption of AI-Based Triage Tools in Emergency Departments
This study aimed to explore the perceived barriers and enablers influencing the adoption of artificial intelligence (AI)-based triage tools in emergency departments (EDs) from the perspective of frontline healthcare professionals. A qualitative research design was employed, utilizing semi-structured interviews with 19 participants—including emergency physicians, triage nurses, department managers, clinical administrators, and health informatics experts—working in emergency departments across Canada. Participants were selected using purposive sampling to ensure diversity in professional roles and institutional settings. Data collection continued until theoretical saturation was reached. Interviews were transcribed verbatim and analyzed using grounded theory methodology. Open, axial, and selective coding were conducted with the assistance of NVivo software to identify emerging themes and construct a conceptual model of AI adoption dynamics. The analysis revealed five core categories shaping AI-based triage adoption: (1) perceived risk and uncertainty, including lack of trust in AI outputs and concerns over legal liability; (2) institutional and organizational readiness, such as infrastructure limitations and workflow misalignment; (3) human capital and knowledge systems, including digital literacy gaps and lack of training; (4) system-level support and governance, highlighting the role of managerial commitment and national policy frameworks; and (5) value proposition and practical benefits, including efficiency gains, clinical decision support, and user-friendly integration. These categories reflected the interplay of technical, organizational, and human factors that either hindered or enabled AI integration in emergency care settings. Adopting AI-based triage tools in emergency departments requires addressing a complex ecosystem of trust, readiness, training, infrastructure, and systemic support. The findings underscore the importance of clinician engagement, targeted education, transparent design, and multi-level policy alignment to ensure effective and sustainable implementation.
Copyright (c) 2025 Seyed Milad Saadati (Corresponding Author); Armin Khadem Fini (Author) https://creativecommons.org/licenses/by-nc/4.0
200 Meters Freestyle Responses and Strategy Differences During Different Competition Rounds in Youth Competitive Swimmers
The aims of the study were to analyze the physiological and perceptual responses, performances and strategy differences between competition rounds in youth competitive swimmers by examining possible differences between heats and semi-finals within the same competition day during the 200 meters freestyle event. Twenty-Two male swimmers volunteered to participate in this study. Only thirteen out of the sixteen qualified semi-finalists (age 16.8±0.6 years; weight 69.8±2.2 kg; height 178.3±3.9 cm) were taken into account for data analysis. Significant differences within and between groups were found for T200, HR, RPE and BLa (p < 0.001). From heats to semi-finals, Top 8 swimmers improved their performance by 5.72% with an increased value of HR (10.20%), RPE (35.56%) and BLa (67.30%), However, the remaining semi-finalists only saw a 2.92% improvement in timing and with an increased value of HR (5.17%), RPE (16.13%) and BLa (20.25%). These findings demonstrated that while the Top 8 swimmers swam more slowly in the heats, they exerted more effort in the semi-finals. This might be a tactic to conserve energy in order to provide their best effort in the semi-finals and rank in top to advance to the finals.
Copyright (c) 2025 Jed mohamed Tijani, Ali Aloui, Ahmed Said Hammed, Amal Salhi (Author); Abderraouf Ben Abderrahman (Corresponding Author) https://creativecommons.org/licenses/by-nc/4.0
Exploring the Factors Influencing AI Integration in Clinical Diagnostic Decision-Making
This study aimed to explore the key factors influencing the integration of artificial intelligence (AI) into clinical diagnostic decision-making from the perspective of healthcare professionals. This research employed a qualitative design based on semi-structured interviews with 23 healthcare professionals in Canada, including physicians, radiologists, clinical informaticians, nurse practitioners, and administrators. Participants were selected through purposive sampling to ensure diverse perspectives, and data collection continued until theoretical saturation was achieved. Interviews were transcribed verbatim and analyzed thematically using NVivo software, with codes and themes developed iteratively through inductive analysis and constant comparison. Four major themes emerged from the data: (1) technological infrastructure and readiness, (2) human and professional factors, (3) organizational culture and leadership, and (4) perceived value and impact of AI. Participants reported that outdated systems, poor interoperability, and insufficient technical support limited integration. Attitudes toward AI varied, with concerns about trust, autonomy, and training gaps. Organizational barriers included lack of leadership strategy and unclear implementation policies. While AI was recognized for enhancing diagnostic accuracy and efficiency, concerns about alert fatigue, liability, and ethical issues were prevalent. Patient trust, professional identity, and collaborative workflows also influenced AI adoption outcomes. Integrating AI into clinical diagnostics is a complex, multidimensional process shaped by technological, professional, organizational, and ethical factors. Beyond technical improvements, successful implementation requires a holistic, sociotechnical approach that addresses infrastructure, education, workflow design, and patient-clinician communication. Institutional strategies should prioritize clinician engagement, interdisciplinary collaboration, and transparent governance to foster responsible and effective AI adoption in healthcare settings.
Copyright (c) 2025 Seyed Amir Saadati (Corresponding Author); James Ma (Author) https://creativecommons.org/licenses/by-nc/4.0
Exploring Lifestyle Pressures and Expectations Induced by Continuous Health Monitoring
This study aimed to explore the lived experiences of individuals using continuous health monitoring technologies, with a focus on how these tools shape lifestyle pressures, behavioral expectations, and psychological responses. A qualitative exploratory design was employed, utilizing semi-structured interviews with 24 adult participants residing in Hungary who had used wearable or app-based health monitoring tools for at least six months. Participants were selected through purposive sampling to ensure diversity in age, gender, and health status. Data were collected until theoretical saturation was reached. Interviews were transcribed verbatim and analyzed thematically using NVivo 12 Plus software. The analysis followed a three-phase coding process: open coding to generate initial concepts, axial coding to identify thematic relationships, and selective coding to consolidate core categories. Five central themes emerged from the data: (1) data-driven identity and self-worth, in which participants linked their personal value to metrics and digital achievements; (2) emotional consequences of health surveillance, including anxiety, guilt, and frustration tied to device feedback; (3) behavioral conformity and goal obsession, reflecting compulsive engagement with digital targets; (4) loss of autonomy and bodily intuition, where users reported diminished reliance on internal cues; and (5) social surveillance and self-regulation fatigue, marked by perceived peer judgment and performance pressure. These findings suggest that continuous monitoring, while intended to promote health, may also contribute to psychological burden and lifestyle rigidity. Continuous health monitoring technologies have the potential to enhance preventive care but may simultaneously induce emotional distress and behavioral dependency. To support well-being, future designs must integrate adaptive feedback, contextual sensitivity, and emotional support mechanisms to mitigate unintended psychosocial consequences.
Copyright (c) 2025 Orsolya Demetrovics , Rafael Ballester-Ripoll , Joel Billieux (Author) https://creativecommons.org/licenses/by-nc/4.0
Perceived Effects of Technology-Based Goal Setting on Lifestyle Behavior Change in Athletes
This study aimed to explore athletes' perceptions of how technology-based goal-setting tools influence their lifestyle behavior change. A qualitative exploratory design was employed using semi-structured interviews with 27 athletes from various sports disciplines in Peru. Participants were selected through purposeful sampling based on their experience with technology-assisted goal-setting tools such as fitness apps, wearables, and performance dashboards. Data collection continued until theoretical saturation was reached. All interviews were transcribed, translated into English, and analyzed thematically using NVivo 12 software, following Braun and Clarke’s six-phase framework. Rigor was ensured through independent coding, member checking, and peer debriefing. Analysis revealed four main themes: (1) Motivational Enhancement (e.g., increased accountability, gamification appeal, goal commitment), (2) Behavioral Regulation (e.g., habit formation, sleep pattern control, diet monitoring), (3) Psychological and Emotional Impact (e.g., reduced stress, confidence improvement, emotional engagement), and (4) Contextual and Environmental Influences (e.g., technological accessibility, coach endorsement, institutional support). Athletes reported that digital tools not only improved their commitment and consistency but also positively affected emotional regulation and lifestyle structure. However, some participants noted barriers such as limited digital literacy and overdependence on metrics. Technology-based goal-setting tools are perceived by athletes as effective instruments for promoting healthy lifestyle behaviors by enhancing motivation, structure, and emotional resilience. However, their effectiveness depends on individual readiness, environmental support, and mindful integration into training culture. These tools can be leveraged in athlete development programs but require culturally sensitive, user-centered implementation to avoid unintended psychological pressures.
Copyright (c) 2025 Bridget Abalorio (Author); Nayelli Muñoz (Corresponding Author) https://creativecommons.org/licenses/by-nc/4.0
Institutionalizing Public Health Lessons from COVID-19
The COVID-19 pandemic revealed critical vulnerabilities in global and national public health systems, underscoring the urgent need to institutionalize lessons learned to enhance preparedness, equity, and resilience. This letter highlights key domains where reactive measures during the pandemic should now evolve into permanent, structured policy frameworks. These include embedding transparent communication protocols, formalizing community-level health governance, integrating mental health and equity considerations, and ensuring sustained global cooperation. Case examples demonstrate that institutional memory and participatory governance significantly enhance responsiveness during crises. Furthermore, the necessity of legal and structural mechanisms—such as mandatory After-Action Reviews (AARs), health security integration into development planning, and codified global vaccine equity frameworks—is emphasized as essential for long-term pandemic resilience. Rather than treating COVID-19 as an isolated event, policymakers must seize the opportunity to create enduring reforms that institutionalize best practices and protect populations from future public health emergencies.
Copyright (c) 2025 Bahram Sarmast (Author) https://creativecommons.org/licenses/by-nc/4.0
The Effectiveness of Acceptance and Commitment Therapy on Social Anxiety, Academic Performance, and Homesickness among International Students at Imam Khomeini International University
The present study aimed to investigate the effectiveness of Acceptance and Commitment Therapy (ACT) in reducing social anxiety, improving academic performance, and alleviating homesickness among students. This research employed a quasi-experimental design with pre-test and post-test and a control group. The statistical population consisted of students at Imam Khomeini International University. Using purposive sampling, 30 students with high levels of social anxiety and homesickness were selected and randomly assigned to experimental and control groups. The experimental group received ACT-based intervention in eight 90-minute sessions, while the control group did not receive any intervention. The findings, analyzed using analysis of covariance, indicated that Acceptance and Commitment Therapy significantly reduced social anxiety and homesickness and improved the academic performance of students in the experimental group compared to the control group (p<0.05). The results of this study demonstrate the efficacy of the Acceptance and Commitment Therapy approach in enhancing students’ mental health and academic adjustment, particularly in facing the psychological challenges of university life. Accordingly, the use of ACT is recommended as an effective intervention in student counseling centers.
Copyright (c) 2025 Somayeh Keshavarz (Corresponding Author) https://creativecommons.org/licenses/by-nc/4.0