Search Results (393)

Background/Objectives: Childbirth is a natural and joyfully anticipated life event for parents and relatives. Yet, in some cases, it can be a medical emergency requiring immediate intervention, i.e., neonatal resuscitation. The majority of newborns breathe spontaneously; a small number, though, may receive basic life support (assisted transition), and an even smaller but clinically significant number require advanced life support (resuscitation). Within the context of family-centered care, the presence of parents during resuscitation has emerged as a factor with potential implications for emotional adjustment, communication with healthcare providers, and early parent–infant bonding. However, the presence of family members during neonatal resuscitation remains a subject of ongoing debate among healthcare professionals (HCPs). Despite increasing recognition of its potential benefits, HCPs’ views on parental presence during such critical procedures have not been extensively investigated in Greece. This study aims at developing and validating a tool to assess healthcare professionals’ views on parental presence during neonatal resuscitation. Methods: A preliminary questionnaire was developed based on the principles of family-centered care and adapted to the Greek population. The first phase included expert assessment of validity, clarity, and relevance using a modified Delphi method. Item Content Validity Index (I-CVI) and Scale CVI (S-CVI) were calculated. Pilot testing was conducted to assess test–retest reliability. Reliability was assessed using the Intraclass Correlation Coefficient (ICC) and Bland–Altman analyses. The study followed the principles of the Declaration of Helsinki, ensuring anonymity, informed consent, and confidentiality. Results: The questionnaire includes 37–50 items allocated in four sections. It demonstrated excellent content validity (CVI = 1.00) and good test–retest reliability (ICC = 0.86). Qualitative feedback indicated that the tool is user-friendly and comprehensive. Interestingly, participants expressed genuine concerns regarding the implementation of parental presence in neonatal resuscitation. Conclusions: The questionnaire development process led to a comprehensive tool, ready for large-scale testing in order to further establish its validity and internal consistency. Full article

Background: Currently, population aging and the growing incorporation of digital technologies into everyday life highlight the need to ensure the digital inclusion of older adults. This is due to the existence of a significant digital divide that affects this population group, limiting not only their access to services and opportunities but also their emotional well-being and quality of life. The lack of digital skills can generate feelings of exclusion, frustration, and dependence, negatively impacting their mental health and autonomy. Methods: The objective of this study is to assess the level of basic digital competence in 404 older adults using the Scale of Basic Digital Competence in Older Adults (DigCompB_PM) in order to identify existing digital divides and provide empirical evidence for the design of educational interventions that promote the digital inclusion of this population group. To this end, we start with the following research question: Are older adults prepared to face the digital and knowledge society, taking into account personal variables such as age, gender, geographical location, place of residence, and type of cohabitation? Results: The findings reveal that participants scored highest in the dimension related to safety and digital device usage while scoring lowest in online collaboration, indicating a disparity between basic digital skills and collaborative competencies. Cluster analysis further demonstrates that age and previous occupational experience significantly influence digital literacy levels. These results highlight the heterogeneity of digital competence among older adults. Conclusions: The study concludes by emphasising the importance of implementing tailored policies that enhance digital literacy in this population. Key factors such as accessibility, training, and motivation should guide such efforts. Additionally, intergenerational learning emerges as a promising strategy, facilitating the development of digital skills through knowledge exchange and sustained support from younger cohorts. Full article

Background: The increase in life expectancy has led to a higher prevalence of chronic conditions, including widespread pain (WP), which often compromises functional independence and quality of life in older adults. WP is strongly associated with limitations in Basic and Instrumental Activities of Daily Living (BADLs and IADLs). While physical activity (PA) and muscle strength (handgrip) are known to enhance general health, their specific role in preserving functional capacity in individuals with WP remains underexplored. Methods: This cross-sectional study analyzed data from 1154 adults aged 50–80 reporting WP, drawn from the Ninth Wave of The Survey of Health, Ageing and Retirement in Europe (SHARE). Associations between moderate and vigorous PA (MPA and VPA), handgrip strength (HGS), and limitations in BADLs and IADLs were examined using multivariate logistic regression, adjusting for demographic and health-related variables. Results: Lower MPA was significantly associated with greater odds of all BADL and most IADL limitations, while VPA had no significant associations. Higher relative HGS was significantly associated with lower odds of limitations in BADLs and IADLs. Conclusions: Among older adults with WP, MPA and muscular strength appear to reduce the risk of functional limitations. These findings highlight the relevance of promoting sustainable strategies to support independence in aging populations. Full article

Soil monitoring is essential for pursuing several sustainable development goals including ‘Zero Hunger’ and ‘Life on Land’. This study examined the status of national soil monitoring laboratories in Mediterranean countries through a multi-country survey to assess strengths and gaps. The results showed that most national soil labs performed basic tests related to soil health and agricultural management, such as texture, pH, and nutrient analysis. However, fewer labs performed more specific tests that are also relevant to these applications such as compaction and biological analysis. Furthermore, tests required for assessing soil pollution, such as heavy metals, were conducted only by few labs. This was mostly due to a lack of equipment like atomic absorption spectrometers. In total, 75% of labs reported good quality of the instruments and frequent calibration. The staff were generally well qualified, with most holding graduate degrees, and women comprised 58% of the staff. Many national services started using electronic reports and provided result interpretation for end users, but not all used lab information systems. The findings highlight the need for better equipment, more advanced testing, and stronger digital management systems. Addressing these issues will help harmonize soil data and support sustainable land management and agriculture in the region. Full article

The increasing prevalence of mental health disorders highlights the need for innovative and accessible interventions. Although existing digital meditation applications offer valuable basic guidance, they often lack interactivity, real-time personalized feedback, and dynamic simulation of real-life scenarios necessary for comprehensive experiential training applicable to daily stressors. To address these limitations, this study developed a novel immersive meditation system specifically designed for deployment within a metaverse environment. The system provides mindfulness practice through two distinct modules within the virtual world. The experience-based module delivers AI-driven social interactions within simulated everyday scenarios, with narrative content dynamically generated by large language models (LLMs), followed by guided inner reflection, thereby forming a scenario–experience–reflection cycle. The breathing-focused module provides real-time feedback through a breath-synchronization interface to enhance respiratory awareness. The feasibility and preliminary effects of this metaverse-based system were explored in a two-week, single-group, pre-test/post-test study involving 31 participants. The participants completed a battery of validated psychological questionnaires assessing psychological distress, mindfulness, acceptance, self-compassion, and self-esteem before and after engaging in the intervention. This study provides exploratory evidence supporting the feasibility and potential of immersive metaverse environments and LLM-based scenario generation for structured mental health interventions, providing initial insights into their psychological impact and user experience. Full article

In the context of Japan’s rapidly aging population, people’s anxiety about life after 65, especially regarding financial sustainability, has become a growing concern. This study examines old age anxiety through the lens of digital financial literacy (DFL), which can significantly impact people’s retirement well-being and long-term financial security in today’s digital environment. Drawing on a large-scale dataset from the “Survey on Life and Money,” jointly conducted by Rakuten Securities and Hiroshima University, we analyze responses from 94,695 individuals aged 40 to 64 who are active bank account holders. Based on ordinal logistic regression, our findings reveal a negative association between DFL and old age anxiety. Further analysis of the five dimensions of DFL demonstrates that several practical components, such as digital financial know-how, decision-making abilities, and self-protection skills, are associated with alleviated old age anxiety. In contrast, a reliance on basic financial knowledge and general awareness alone may exacerbate anxiety. These findings underscore the need to move beyond basic digital awareness and focus on promoting practical skills in digital finance, ultimately supporting better financial decision-making and enhancing overall well-being in older age. Full article

This study demonstrates how mathematical ideas can be developed through genuine applications to problems that are attractive to the learners of mathematics due to consistency with their life experiences. To this end, the paper provides several examples of digital instruments both commonly available and designed by the authors with the goal to prepare schoolchildren of different ages to mathematize basic models of computer science and engineering. The mathematization includes construction and optimization of the models by using big ideas of mathematics at the level of common sense alone as a grade-appropriate prerequisite to their formal description. Also, the paper examines computer systems that can be depicted as the prototypes of artificial intelligence since, in the context of education, they can be used as tools enabling both motivation and support of one’s conceptual development rather than simply a means to carry out thinking for the learners of mathematics. Finally, by referring to a few notable contributors to mathematical, educational, and psychological knowledgebase, this study argues for the merit of intuition in the digital age as a support system in the advancement of computational problem-solving techniques. Full article

A strong sense of school belonging is essential for students’ academic achievement, emotional well-being, and overall development. This study explores the role of emotional intelligence and the social environment in shaping students’ sense of belonging. Adopting a basic qualitative approach, this study analyzes teachers’ perspectives on the contributions of students, teachers, parents, counselors, school principals, and the wider society. Qualitative data which were collected through interviews with 49 teachers (37 female, 12 male; years of experience mean is 12) were analyzed through content analysis to identify the main themes. The findings suggest that students’ sense of belonging improves when they actively participate in school life and are aware of the importance of school. Furthermore, students’ sense of belonging improves when teachers offer academic and emotional support, parents engage actively, counselors foster well-being, and school principals provide strong leadership and relationship management. In addition, increased social involvement enhances student belonging. This study offers valuable insights for educators and policymakers in fostering supportive school environments. It highlights the emotional and social processes underlying school belonging and discusses their implications for future research. Full article

Background: With the growing population requiring palliative care (PC), it is essential to enhance and expand the availability of this care in Portugal. Throughout both pre-graduate and post-graduate training for doctors, there are limited learning opportunities in this area, necessitating further training to improve the knowledge and skills needed to support patients at the end of their lives. Studies conducted on doctors and medical students have demonstrated a clear need for improved training. Additionally, others have noted significant benefits for residents who underwent post-graduate training in this field while caring for patients nearing the end of life. This study aims to evaluate the impact of a basic training program on improving palliative care knowledge among medical doctors. Methods: This was a cross-sectional study, carried out by sharing a questionnaire with the participants enrolled in the “Intensive Palliative Medicine Course” organized by a group of doctors in November 2021. The questionnaire was completed by participants at three moments of training (before, immediately after the course, and 6 months after the course), and it contained questions to assess the theoretical knowledge, skills, and abilities obtained. Results: In total, 93 out of 204 (45.58%) doctors responded before training, 80 (39.21%) immediately after training, and 36 (17.64%) six months after training. After training, an improvement in knowledge was observed (p = 0.014), which did not appear to persist six months after the course (p = 0.574). However, six months after training, an increase in doctors’ confidence in referring patients to Palliative Care Teams or Units (p = 0.009) and medicating patients who may be in the last months of their lives (p = 0.005) was observed. Conclusions: The results regarding theoretical medical knowledge did not seem to stabilize over time, so it may be necessary to create more specific training opportunities for the medical profession. An increase in doctors’ self-confidence in referring and medicating patients with palliative care needs was observed, which may be associated with better medical care provided. It is necessary to carry out more studies to evaluate the impact of combined theoretical and practical training on the knowledge and confidence of doctors in PC. Full article

Integrating generative artificial intelligence (GenAI) into professional practice has become an important topic for professional instructional design practice and training. Accordingly, the purpose of this multiple-case study was to examine six professional instructional designers’ integration of GenAI into their professional practice and the factors affecting this integration. Research data were collected through semi-structured interviews conducted with professional instructional designers working in corporate or higher education settings. The results were as follows: (a) instructional designers mostly integrate GenAI into instructional design and/or development phases and they think that it also has the largest impact on these two phases; and (b) instructional designers’ integration of GenAI into their professional practice is mainly based on their ambivalent attitudes toward it, which is closely linked to the advantages and disadvantages associated with the technology. Specifically, instructional designers’ basic understanding of GenAI, the efficiency of generating instructional content through GenAI, the inaccuracy of GenAI-created products, instructional designers’ use of GenAI in everyday life, and institutional or company support shape their attitudes towards and integration of GenAI into their professional practice. All these findings suggest that instructional design and development phases are especially vulnerable to and can benefit from instructional designers’ attitudes and use of GenAI. Accordingly, it can be useful to address and enhance attitudes toward GenAI technology in instructional design training, which can promote instructional designers’ acceptance of the technology and effective use of it. Full article

The performance evaluation of aqueducts is crucial for the development of water conservancy and the protection of cultural relics. However, there are few effective methods for accurate evaluations of the mechanical performance of aqueducts. To investigate the changes in the concrete microstructure during the service life of aqueducts, this study conducted compressive tests on various parts of an aqueduct that has been in service for 56 years in Hunan Province, China. Additionally, scanning electron microscopy (SEM) scans and mercury intrusion porosimetry (MIP) tests were carried out on concrete samples taken from the side and bottom of the aqueduct tank. The compressive strength of the aqueduct concrete was 28.3–44.1 MPa, and the porosity of concrete was 10.98–17.57%. The pore structure of concrete is deteriorated by carbonation and water flow, which has a negative impact on the impermeability of the aqueduct. For concrete at the bottom of the tank, the internal pore structure was denser than the external one (with lower porosity and smaller average pore diameter). In contrast, the pore structure in other parts was the opposite. This difference was caused by the presence of flowing water. The types of internal pores in the concrete are basically gel pores and capillary pores. Finally, evaluation models considering the relationships between carbonation, compressive strength, porosity and permeation parameters of aqueduct concrete were proposed. The models can provide theoretical support for the performance evaluation and maintenance of aged aqueducts. Full article

This review examines the clinical data and basic science research to evaluate the potential of the Selective Cytopheretic Device (SCD) in mitigating Extracorporeal Membrane Oxygenation (ECMO)-associated inflammation. In brief, SCD is an immunomodulatory device used within extracorporeal blood circuits along with the use of citrate anticoagulation. SCD has been shown to be a novel, first-in-its-class device (being marketed as QUELimmune by SeaStar Medical), which is capable of the autologous processing of hyper-inflamed leukocytes to reduce systemic inflammation. Strong preclinical data gathered for SCD in the context of both Cardio-Pulmonary Bypass (CPB) as well as ECMO set the stage for SCD to be used in these life support circuits. ECMO played a crucial role during the COVID-19 pandemic, during a time period when SCD therapy was being evaluated in clinical trials, generating initial clinical data in this setting. SCD has also been utilized in the setting of pediatric acute kidney injury (AKI) and multiorgan dysfunction (MOD), where ECMO can be common. Full article

This concept paper outlines an implementation strategy for a mandatory training programme using the ADDIE instructional design model for delivery to nurses and other health professionals in an interprofessional education (IPE) environment). Background: Competence in Basic Life Support (BLS) is a lifesaving requirement for health professionals in clinical settings to ensure patient safety and accreditation outcomes. It is essential that health professionals are supported in attending mandatory training, including BLS. To inform learning and teaching strategies, it is useful to apply theoretical perspectives to the development of mandatory staff training methods. However, various training models exist, and few are grounded in instructional design theory to the unique environment for BLS in IPE. Method: A theory-based implementation strategy is outlined for a mandatory interprofessional training programme including BLS, using the ADDIE model to enhance patient outcomes. ADDIE is an instructional design framework comprising five elements: Assess, Design, Develop, Implement and Evaluate; describing a learning methodology that can be readily applied to mandatory training in IPE. Results: Through its iterative capability, the ADDIE model promotes learner needs and rapid acquisition of clinical skills that improve training accessibility. The strategy can equip educators with teaching skills based on a robust theoretical model, with potential to promote nursing and health professional attendance for mandatory training. Conclusions: Mandatory health professional training that addresses a theory informed strategy framed by the ADDIE model can support interprofessional collaboration and consistent competency across healthcare teams. This strategy has potential to contribute by demonstrating how instructional design can be operationalised to improve the effectiveness and engaging approach to BLS training and education to the unique dynamics of an interprofessional environment. Full article

Assessing a city’s level of smartness according to global indices is a relatively new area of investigation. It is useful in encouraging a rethinking of urban digital strategies, although the different approaches to global smart city rankings have been subject to criticism. This paper highlights the methodological features of constructing the Smart City Index (SCI) from the IMD (International Institute for Management Development) based on residents’ assessments, their satisfaction with electronic services, and their perception of the priority of urban infrastructure areas. The Central European cities of the Visegrad region (Prague/Czech Republic, Budapest/Hungary, Bratislava/Slovakia, Warsaw and Krakow/Poland) were chosen as the basis for an in-depth analysis. The architectonics, i.e., the internal system of constructing and calculating city rankings by SCI, is analyzed. A comparative analysis of the technology indicators (e-services) in five cities of the Visegrad region, presented in the SCI, showed the smart features of each city. The progressive and regressive trends in the dynamics of smartness in the cities in the Visegrad region were identified in five urban spheres indicated in the Index: Government, Activity, Health and Safety, Mobility, and Opportunities. This also made it possible to identify certain methodological gaps in the SCI in establishing interdependencies between the data on the residents’ perception of the priority of areas of life in a particular city and the residents’ level of satisfaction with electronic services. In particular, the structural indicators “Affordable housing” and “Green spaces” are not supported by e-services. This research aims to bridge this methodological gap by proposing a model for evaluating the e-service according to the degree of coverage of different spheres of life in the city. The application of the project, as well as cross-sectoral and systemic approaches, made it possible to develop basic models for assessing the value of e-services. These models can be implemented by municipalities to assess and monitor e-services, as well as to select IT projects and elaborate strategies for smart sustainable city development. Full article

With global population aging, muscle atrophy and functional decline—hallmarks of sarcopenia—pose growing challenges to public health and significantly impact the quality of life in older adults. The goal of this review is to present a thorough examination of the most recent developments in the study of sarcopenia, including the development of its pathophysiological mechanisms, diagnostic techniques, and multimodal intervention strategies. Particular attention is given to the role of declining sex hormones, such as testosterone and estrogen, as key drivers of anabolic resistance and muscle loss during aging. The review also addresses the current opportunities and challenges in translating basic research into effective clinical applications. Key focus areas include protein metabolism, mitochondrial dysfunction, chronic inflammation, and neuromuscular junction degeneration. Finally, it outlines future directions for precision classification, early detection, and personalized treatment, aiming to support interdisciplinary collaboration and shift sarcopenia management from reactive care to proactive, targeted intervention. Full article