Search Results (2,351)

Pragmatics concerns how people use language and other expressive means, such as nonverbal and paralinguistic cues, to convey intended meaning in the context. Difficulties in pragmatics are common across distinct clinical conditions, motivating validated assessments such as the Assessment Battery for Communication (ABaCo); whether Large Language Models (LLMs) can serve as reliable coders remains uncertain. In this exploratory study, we used Generative Pre-trained Transformer (GPT)-4o as a rater on 2025 item × dimension units drawn from the responses given by 10 healthy older adults (M = 69.8) to selected ABaCo items. Expert human coders served as the reference standard to compare GPT-4o scores. Agreement metrics included exact agreement, Cohen’s κ, and a discrepancy audit by pragmatic act. Agreement was 89.1% with κ = 0.491. Errors were non-random across acts (χ²(12) = 69.4, p < 0.001). After Benjamini–Hochberg False Discovery Rate correction across 26 cells, only two categories remained significant: false positives concentrated in Command and false negatives in Deceit. Missing prosodic and gestural cues likely exacerbate command-specific failures. In conclusion, in text-only settings, GPT-4o can serve as a supervised second coder for healthy-aging assessments of pragmatic competence, under human oversight. Safe clinical deployment requires population-specific validation and multimodal inputs that recover nonverbal cues. Full article

Heterogeneous unmanned aerial vehicle (UAV) swarms are becoming critical components of next-generation non-terrestrial networks, enabling tasks such as communication relay, spectrum monitoring, cooperative sensing, and navigation. Yet, their heterogeneity and multifunctionality bring severe challenges in task allocation and resource scheduling, where traditional multi-agent reinforcement learning methods often suffer from high algorithmic complexity, lengthy training times, and deployment difficulties on resource-constrained nodes. To address these issues, this paper proposes a low-complexity multi-agent soft actor–critic (MASAC) framework that combines parameter sharing (shared actor with device embeddings and shared-backbone twin critics), lightweight network design (fixed-width residual MLP with normalization), and robust training mechanisms (minimum-bias twin-critic updates and entropy scheduling) within the CTDE paradigm. Simulation results show that the proposed framework achieves more than 14-fold parameter compression and over a 93% reduction in training time, while maintaining or improving performance in terms of the delay–energy utility function. These advances substantially reduce computational overhead and accelerate convergence, providing a practical pathway for deploying multi-agent reinforcement learning in large-scale heterogeneous UAV clusters and supporting diverse mission scenarios under stringent resource and latency constraints. Full article

In the field of material micro-/nano-analysis, the lack of an efficient method for characterizing the same microregion has been an obstacle in scientific research. This not only severely affects the efficiency and depth of academic communication, but also creates loopholes for data manipulation. To address these challenges, it is essential to develop microscale repositioning techniques to achieve repeatable characterization. However, microscale localization techniques based on Transmission Electron Microscopy (TEM) remain underdeveloped, facing issues such as poor localization accuracy, high costs, and cumbersome procedures in practical applications. This paper proposes a positioning method for nanoscale samples that utilizes coordinate grids and artificially added micron-scale markers as references. Accurate localization and retrieval of micro- and nanoscale targets in TEM were achieved using a confined comparison approach. This method is simple, cost-effective, and universally applicable to Inter-instrument correlative operation, enabling repeated characterization of the same microregion. It is also effective in Scanning Electron Microscopy (SEM) and Atomic Force Microscopy (AFM). By enhancing the integration efficiency between TEM, SEM, and AFM, this method will yield more meaningful data and address challenges such as target localization difficulties and poor data reproducibility. It will mitigate issues related to data fabrication and experimental irreproducibility, thereby offering technical support for the smooth progress of research and academic exchange activities. Full article

Background/Objectives: Maintaining independent mobility among older adults requires complex cognitive and physical health and is influenced by various health-related factors. This study sought to examine the relationship between health-related factors and driving among community-dwelling older adults by comparing the health status of currently driving individuals and those who have ceased driving. Methods: A secondary data analysis was conducted using the 2023 Korean Elderly Survey, collected between 4 September and 12 November 2023. A total of 4114 individuals aged 65 years or older were included. Statistical analyses were performed using chi-square tests, independent t-tests, and weighted binary logistic regressions via IBM SPSS for Windows. Results: Significant health-related factors for driving cessation included having ≥2 chronic diseases (OR = 1.22, p = 0.041), diagnosed depression (OR = 3.64, p = 0.030), Instrumental Activities of Daily Living dependency (OR = 1.67, p = 0.001), visual discomfort (OR = 1.18, p = 0.048), depression risk (OR = 1.34, p = 0.015), suspected cognitive impairment (OR = 1.73, p < 0.001), and poor self-rated health (OR = 1.21, p = 0.029). None of the participants with Parkinson’s were currently driving, whereas polypharmacy (≥5 medications) was not statistically significant (OR = 0.77, p = 0.222). Chronic diseases that may affect driving were also not statistically significant. Conclusions: This study highlights the fact that older drivers may have difficulty recognizing health-related risks that affect driving. To support safe mobility, it is essential to implement a health-centered assessment of driving fitness, including an appropriate evaluation cycle, and promote continuous education to raise awareness among older adults. Full article

Background: Social media has emerged as a powerful communication tool for healthcare professionals, including nutritionists and dietitians, particularly since the COVID-19 pandemic. Evidence suggests that their online presence can enhance nutritional literacy and play a crucial role in countering misinformation. Objective: This systematic review aims to investigate how and why Registered Nutritionists and Dietitians (RNDs) use social media in their professional practice, focusing on benefits, challenges, and impact. Methods: A systematic literature search was conducted between 1 January 2019 and 28 February 2024, in PubMed, Scopus, Scholar, and SciELO databases using terms such as ‘nutritionist’, ‘dietitian’, and ‘social media’. Quality was assessed using the MMAT tool. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The included studies were analysed with respect to their content, professional practices, and patterns of social media use. Results: Of the 359 articles identified through the systematic search, 10 cross-sectional studies conducted using questionnaires were included in this review. Sample sizes ranged from 10 to 2542 participants across nine countries. Instagram and Twitter were the most frequently used platforms among RDNs, primarily for sharing evidence-based nutritional information, counselling content, and professional promotion. Reported usage ranged from 37.5% to 100%, with a marked increase during the COVID-19 pandemic, especially among younger professionals. Key enablers included enhanced communication, professional visibility, and cost-effective outreach, while main challenges involved limited digital literacy and difficulties replicating face-to-face counselling online. Although ethical concerns were reported, many RNDs maintained compliance with professional standards, particularly in regions with strict marketing regulations. Conclusions: This systematic review provides evidence that social media is a valuable tool for RNDs, particularly in the context of food and/or nutritional education. RNDs would benefit from training in content creation, knowledge dissemination and ethical digital communication. However, clearer guidelines from professional organisations are also recommended. Full article

Background/Objectives: The COVID-19 pandemic profoundly disrupted the daily lives of children with neurodevelopmental disorders, particularly Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD). Lockdowns, therapy interruptions, and reduced access to educational and healthcare services significantly affected developmental progress and family functioning. This pilot study aimed to assess the long-term impact of the pandemic on children with ASD and ADHD in Northern Greece and to explore consequences for their families in the post-pandemic period. Methods: Parents or legal guardians of 72 children (ages 2–17 years) with confirmed diagnoses of ASD (n = 57) or ADHD (n = 15) participated. A structured 25-item questionnaire captured information on developmental, psychological, and social functioning, family well-being, therapy disruption, screen use, and access to online support. Data were collected across urban, semi-urban, and rural areas of Northern Greece over six months. Descriptive and inferential analyses were performed. Results: Most participants were boys (77.8%) and in primary school (73.6%). Common co-occurring conditions included learning difficulties (33.3%), anxiety (8.3%), and epilepsy (6.9%). Nearly half of families (45.8%) reported therapy reductions exceeding 70%, while 29.2% accessed online therapy, often with limited perceived effectiveness. New behavioral symptoms emerged in 45.8% of children, including irritability, anxiety, and emotional instability. Parental psychological distress was reported by 29.2% of caregivers. Screen time increased in over 90% of cases, and 87.5% of parents perceived the pandemic as negatively affecting their child. Financial strain was noted by 37.5% of families. Conclusions: The findings highlight the significant developmental, psychological, and social consequences of the COVID-19 pandemic for children with ASD and ADHD and their families. Service disruptions, unmet therapeutic needs, and increased caregiver burden emphasize the urgency of sustainable, flexible care models. Strengthening telehealth, integrating community-based interventions, and enhancing educational accommodations are essential for resilience in the post-pandemic era. Full article

This paper reviews social science studies of emergency evacuations to point to the difficulties in associating them with panic formulations stressing irrationality and to show how the misunderstandings that how the conceptualization of one of these approaches on panic flight, which assumes the prevalence of nonsocial and self-centered behaviors and movements, has been transformed by recent studies of emergency evacuations from buildings, which show that the evacuation is best understood as social behavior in which people exhibit means-end rationality and social solidarity and act as socialized individuals moving towards sources of actual or perceived safety. The conclusion suggests first that the continued usage of the irrationality formulation by a minority of engineers and computer scientists writing on the topic of emergency evacuation and their use of “herding,” or the notion that during dangerous conditions, people follow the actions of others, leading to conformity, is not supported by a majority of findings in the social sciences, and second, that a likely solution to the disconnect between the two science communities is the adoption of transdisciplinary collaborative efforts. Full article

Impairments of executive function following acquired brain injury including stroke (ABI) contribute significantly to long-lasting everyday difficulties in life. Pilot work on the CO-OP Approach^TM (Cognitive Orientation to daily Occupational Performance Approach), a contextualized strategy training intervention, with ABI adults with executive dysfunction showed improved performance on untrained everyday life tasks and cognitive flexibility. Objective: Our objective was to determine the efficacy of the CO-OP Approach relative to usual occupational therapy (UOT) for community-dwelling adult survivors of ABI with executive dysfunction. Methods: Eighty-seven participants were randomized to receive CO-OP (n = 45) or UOT (n = 42) in their homes. All participants identified five personally meaningful, everyday life goals (using the Canadian Occupational Performance Measure (COPM)) and received up to 15 one-hour treatment sessions twice per week. Three goals were trained, and two were untrained. Interventions were provided by occupational therapists registered with their regulatory college. The CO-OP group was trained to apply a meta-cognitive strategy to three goals. The UOT group received therapy based on the clinicians’ (experienced in community settings) determination. Testers were masked to the participants’ group. Analysis at the primary outcome (Post-test, ~10 weeks following baseline) was on an intent-to-treat basis. Results: Participants in the CO-OP group had a mean age of 57.5 years, a mean time post-ABI of 5.3 years, and were 57.8% men. Those in the usual OT group had a mean age of 54.7 years, a mean time post-ABI of 6.2 years, and were 69.0% men. The CO-OP group reported statistically significant higher improvements on COPM performance and satisfaction scores post-test for untrained and trained goals. However, these benefits were not retained at follow-up (three months post-baseline). Conclusions: The CO-OP Approach^TM shows promise for improving performance in everyday life goals for individuals with chronic ABI relative to usual community occupational therapy. Achieving retention of these benefits remains a challenge. Full article

Background/Objectives: People living with MND (plwMND) commonly develop difficulty swallowing and subsequent difficulty clearing saliva from the airway. Medical saliva interventions include pharmacological agents, botulinum toxin injections, and radiation to salivary glands, with associated side effects. Non-invasive behavioural strategies and natural remedies are also recommended. Saliva symptom management is guided by the multidisciplinary MND team (typically through a three-monthly clinic) alongside community clinicians. Some plwMND report difficulty recalling and implementing treatments between clinics. This study aimed to enhance the content and method of providing recommendations for self-management of saliva symptoms by (i) developing MND-specific resources and (ii) evaluating resource use and preliminary clinical benefit. Methods: In Phase 1 plwMND, caregivers, and clinicians co-designed saliva management resources. Phase 2 examined the use of these resources via a hospital-based MND clinic with 28 plwMND, their caregivers, and community clinicians. In the clinic, plwMND were given a written treatment plan and relevant resources. During reviews at weeks 2, 6, and 12 saliva treatment was adjusted and clinical outcomes evaluated using the Clinical Saliva Scale for MND (CSS-MND). Community clinicians, plwMND, and caregivers were surveyed regarding the resource utility. Results: People living with MND reported the resources assisted saliva symptom self-management. Community clinicians found the resources informative and beneficial in supporting patient care. All plwMND required multiple treatment strategies and adjustments to manage symptoms. Of the treatments prescribed, 91% were non-invasive and 9% were medical interventions. For 54% (n = 15) of plwMND, improved CSS-MND scores were sustained over the three-month evaluation. Conclusions: Co-designed saliva resources and regular reviews assisted plwMND to implement their individualised saliva treatment, to self-manage saliva symptoms between clinics. Full article

Background/Objectives: Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition characterized by persistent social communication difficulties and restricted, repetitive behaviors, with prevalence estimates continuing to rise worldwide. The gut–brain axis has been proposed as a potential contributor to ASD, yet human studies yield inconsistent findings, partly due to confounding effects of diet and behavior. Methods: Here, we investigated the gut bacteriome and mycobiome of children with ASD (n = 17) compared with their non-ASD siblings (n = 9) and parents without ASD (n = 27), alongside detailed assessment of dietary intake (n = 79) using 7-day food diaries. Results: Multi-kingdom microbiome profiling revealed no significant differences in α- or β- diversity across ASD, sibling, and parental groups, with only minor taxonomic variation observed. Similarly, fungal community composition showed negligible group-level differences. By contrast, dietary patterns strongly differentiated ASD from non-ASD participants: children with ASD consumed higher levels of sweets and sugary foods, lower portions of vegetables, and exhibited reduced overall dietary diversity. Statistical analyses confirmed that dietary factors, rather than microbial composition, explained variation in ASD diagnosis. Conclusions: These findings suggest that selective and repetitive eating behaviors are characteristic of ASD shape dietary intake, which in turn influences gut microbial diversity. Thus, in humans, the directionality may run primarily from behavior to diet to microbiome, rather than from microbiome to behavior. Our results underscore the importance of incorporating dietary variables into microbiome research and highlight the need for targeted nutritional interventions to improve health outcomes in individuals with ASD. Full article

Background/Objectives: Chronic pain conditions are common among older residents in long-term care facilities (LTCFs), often leading to increased demand for analgesic drugs. Despite this, pain is frequently underdiagnosed and undertreated, especially in individuals with cognitive impairments such as dementia. Both underuse and overuse of analgesics remain a challenge in LTCFs, affecting patient outcomes and quality of life. This systematic review aimed to identify patient- and facility-level factors associated with variation in analgesic use in LTCFs. Methods: This review followed PRISMA guidelines. A comprehensive literature search was conducted in PubMed, CINAHL, Cochrane Library, and Scopus for studies published between 2013 and 2024. Eligible studies were focused on adults aged ≥ 60 years in LTCFs and examined patient and facility factors related to analgesic prescription. Risk of bias was assessed independently by two reviewers using STROBE, JBI, and MMAT tools. Disagreements were resolved by a third reviewer. Results: A total of 6266 studies were retrieved; 13 papers met the eligibility criteria after screening. Dementia was the most frequently reported factor associated with lower analgesic prescribing, largely due to difficulties in assessing pain and communication barriers. Other patient-related factors included pain severity and comorbidities. Facility-level factors such as staffing levels, staff qualifications, and facility size were also associated with variation in prescribing practices. Conclusions: Dementia highly impacts pain management due to assessment and communication challenges. Improved pain assessment tools and staff training are needed to recognize pain in cognitively impaired residents and ensure appropriate analgesic use in LTCFs. Full article

The increasing number of international students choosing a non-traditional study destination, such as Hungary, underscores the country’s growing appeal in the global higher education landscape. This trend is driven by Hungary’s competitive and quality educational programmes, supportive policies, and rich cultural and historical heritage. This exploratory study examines the cross-cultural experiences of international students studying in the country, drawing on data from a cross-sectional online survey conducted in 2024. Through descriptive and thematic analyses, three principal findings emerged. First, students are attracted to study in Hungary by a combination of instrumental and cultural factors, including the quality and affordability of education, the country’s cultural heritage, and its strategic location in Central Europe. Second, the most significant challenges involve adapting to a different academic culture and overcoming language barriers, both of which hinder everyday communication. Third, difficulties in establishing meaningful connections with Hungarian peers often exacerbate feelings of social distance, thereby limiting the integration of international students. By foregrounding student perspectives in an under-researched, non-traditional study destination context, this study contributes to a deeper understanding of international student mobility beyond the traditional study destinations of Anglophone and Western European settings. The findings offer valuable insights for higher education institutions and policymakers to improve the integration of international students, enhance support structures, and further strengthen Hungary’s position as an attractive and inclusive study destination for global talent. Full article

High-quality early care and education (ECE) programs, characterized by safe environments, emotionally supportive communication, proactive behavior supports, and teacher self-care practices, play a pivotal role in healthy child development. Early Childhood Mental Health Consultation (ECMHC) is an evidence-based approach designed to strengthen these environments and support young children’s social–emotional outcomes. However, the long-term impacts of ECMHC models remain understudied. Grounded in ECMHC, the purpose of this study is to evaluate the effectiveness of Jump Start Plus COVID Support (JS+CS) in supporting child psychosocial outcomes (prosocial behaviors and reduced externalizing/internalizing behaviors) over two school years. In a cluster-randomized trial, 12 ECE centers received the 14-week JS+CS intervention, and 12 attention control centers received a 14-week obesity prevention program. Children were followed over two school years to determine long-term impacts on behavior, measured by the Devereux Early Childhood Assessment (DECA) and the Strengths and Difficulties Questionnaire (SDQ). Over two school years, significant time-by-group interactions emerged for primary child outcomes. The JS+CS group showed greater improvements in DECA Initiative and Self-Regulation (p = 0.01 and p = 0.02, respectively) compared to controls. JS+CS significantly enhanced child psychosocial functioning, supporting its potential as an effective model for a scalable mental health consultation in ECE settings. Full article

This article examines the level of public knowledge regarding the development of a network of climate shelters in Barcelona and the degree of acceptance by city residents (use and rating of the network) of this strategy of adaptation to extreme temperatures. This question is of interest due to the information deficit in communication about climate adaptation processes and the relatively minor role attributed to communication in climate governance, could be a barrier to public participation in these processes. The research used the survey technique. A total of 300 surveys were carried out face-to-face at 30 points in the network. The results show that the mere existence of these facilities in the city does not guarantee that they can be used effectively by residents. Their use depends on the level of knowledge, which is the result in part of the information provided to potential users and the communication strategies applied to this end. The study highlights that although general information about the existence of a network has reached the residents, more specific information about the rollout of the network at city and district level has been clearly insufficient. The people of Barcelona have serious difficulties in identifying the nodes in this network so as to be able to use them in times of need. This research provides ideas that could contribute to the better design of an information and communication strategy that would improve knowledge of the city’s climate shelters. The planning and implementation of climate shelter networks must take the information and communication variable into account, in order to promote the use of these facilities and improve effective climate-related action. Full article

Israeli higher education institutes are challenged by the growing number of ultra-orthodox students. This requires coping with novel aspects unfamiliar to participants, as students and as teachers in the education system, utilizing online learning as a lever for empowering this marginalized population. The aim of the proposed research was to explore perceptions of ultra-orthodox students studying in B.Ed. programs within a secular college of education towards online courses. Data included transcriptions from 68 narratives of interviews, which were analyzed using a mixed-methods approach, which helped us achieve an in-depth understanding of the difficulties and challenges of these higher education students. Altogether, five themes were identified, namely: technical challenges, ethical/religious challenges, academic challenges, engagement challenges, and aspects of availability. Statements referring to academic challenges and engagement challenges were the most frequent. The number of positive and negative statements was balanced. Also, distinct patterns of responses were identified for married vs. single ultra-orthodox women. Findings demonstrate the complexity of utilizing online learning among ultra-orthodox B.Ed. students, in a twofold manner: personally and community-wise. The study may shed light on online learning in additional marginal communities worldwide that are traditional in nature, and that may benefit from online courses. Full article