Search Results (2,038)

Background: Peritoneal dialysis (PD) depends on patients’ self-management abilities, supported by nursing interventions that extend beyond technical skills to include psychosocial and educational domains. Evidence from Saudi Arabia on how these behaviors relate to clinical and quality-of-life outcomes remains limited. Aim: To assess self-management behaviors among adult PD patients, examine their associations with clinical and quality-of-life outcomes, and explore the mediating role of emotional well-being, with implications for nursing practice. Methods: A descriptive cross-sectional study was conducted among 158 adult PD patients at King Saud University-affiliated centers in Riyadh. Validated Arabic versions of the Chronic Illness Self-Management Scale and KDQOL-SF were administered. Clinical indicators were extracted from medical records. Data were analyzed using descriptive statistics, t-tests, multivariate linear regression, and mediation analysis. Results: Technical skills achieved the highest self-management scores (mean 3.78 ± 0.62), while emotional coping was lowest (mean 2.71 ± 0.69). Participants with higher self-management had fewer hospitalizations (0.9 ± 0.5 vs. 1.6 ± 0.8, p = 0.01), higher serum albumin (3.60 ± 0.56 vs. 3.44 ± 0.61 g/dL, p = 0.04), and better emotional well-being (60.1 ± 14.9 vs. 55.3 ± 12.4, p = 0.03) than their counterparts. Educational level (β = 0.208, p = 0.001) and emotional well-being (β = 0.197, p = 0.001) were independent predictors of self-management, with partial mediation by emotional well-being (indirect β = 0.062, p = 0.004). Conclusions/Clinical Implications: Optimizing nursing support for PD patients requires moving beyond technical instruction to address health literacy, emotional resilience, and culturally sensitive education. Nurse-led interventions integrating psychosocial support with skill-building may enhance self-management, reduce hospitalizations, and improve quality of life in PD populations. Full article

Background/Objectives: There is a growing need for programs addressing perinatal mental health, particularly for new mothers. Postpartum depression (PPD) may occur during pregnancy or within the first year postpartum, with both short- and long-term negative consequences for both mothers and their infants. This study describes the cultural adaptation, implementation, and one-year follow-up of the Mom-to-Mom (M2M) program for minority Bedouin women in Southern Israel. Methods: We conducted a community-based intervention (M2M) emphasizing cultural adaptation. Outreach efforts were conducted in collaboration with healthcare professionals to encourage referral to the M2M program. A total of 111 mothers completed a self-administered questionnaire that included socio-demographic characteristics and PPD symptoms (PPDs) at two time points: prior to the intervention (Time-1) and one year after participating in the program (Time-2). PPD was measured using the Edinburgh Postnatal Depression Scale (EPDS), using a score cutoff of ≥10. Results: There was a significant decrease in PPDs (EPDS ≥ 13) between Time-1 and Time-2 after one year of follow-up in the M2M program (from 45% to 19.8%). Of the participants, 75% were referred to the program by healthcare professionals. Among those with EPDS ≥ 10, 30% were referred to mental health services. This program provided education, professional support, and led to the establishment of the first M2M center within a Bedouin community, located in the Negev (Naqab). Conclusions: The results emphasize the importance of culturally sensitive approaches to increase awareness, early diagnosis, and professional support in addressing PPD, tailored to a cultural context. Culturally adapted programs can be effective in minority populations and contribute to reducing disparities in maternal mental health care. Full article

With a history spanning over two thousand years, the Beijing Road historic and cultural zone marks the origin of Guangzhou’s traditional central axis and serves as one of the earliest commercial centers in the Lingnan region, characterized by a rich historical and cultural heritage and unique Lingnan features. Through a combination of literature collection and review, field observation, and photographic documentation, the research examines the historical natural, artificial, and folk lightscapes of the Beijing Road zone, highlighting the diversity of its lightscape features from past to present. As the city developed and modern technology advanced, the representative lightscapes in the Beijing Road zone have evolved from traditional forms to modern expressions, including 3D projection, multimedia interaction, and LED lighting. These advancements breathe new life into the pedestrian street and enhance its cultural significance within the contemporary commercial environment. By comparing the characteristics and categories of historical and contemporary lightscapes, the paper reveals the transformation of historical lightscapes, the innovation in modern lightscape techniques, and the remnants of vanished lightscapes. It also proposes strategies for the restoration and preservation of historical lightscapes, the innovation and integration of contemporary lightscapes, and the development of sustainable lighting design, while it discusses the direction of work for future research. It underscores the need for further protection and optimization of lightscape resources in the Beijing Road historic and cultural zone, to enhance cultural heritage and commercial appeal, providing valuable insights for the preservation of historic zones and the development of cultural tourism in Guangzhou and the Lingnan region. Full article

Deep-learning generative AI promises to transform architectural design, yet its potential employment and ready-to-use capacity for professional workflows are unclear. This study presents a systematic review conducted in accordance with PRISMA 2020 guidelines, synthesizing peer-reviewed work from 2015 to 2025 to assess how GenAI methods align with architectural practice. A total of 1566 records were initially retrieved across databases, of which 42 studies met eligibility criteria after structured screening and selection. Each was evaluated using five indicators with a three-tier rubric: Output Representation Type, Pipeline Integration, Workflow Standardization, Tool Readiness, and Technical Skillset. Results show that most outputs are raster images or non-editable objects, with only a minority producing CAD/BIM-ready geometry. Workflow pipelines are often fragmented with manual hand-offs and most GenAI methods map only onto the early conceptual design stage. Prototypes frequently require bespoke coding and advanced expertise. These findings indicate a persistent gap between experimentation with ideation-oriented GenAI and the pragmatism of CAD/BIM-centered delivery. By framing the proposed rubric as a workflow maturity model, this review contributes a replicable benchmark for assessing practice readiness and identifying pathways toward mainstream adoption. For GenAI to move from prototypes to mainstream architectural design practice, it is essential to address not only technical barriers, but also cultural issues such as professional skepticism and reliability concerns, as well as ecosystem challenges of data sharing, authorship, and liability. Full article

This study reports on a Design-Based Research (DBR) project that implemented Project-Based Learning (PjBL) in an undergraduate psychology course on Human Resource Development (HRD). The purpose was to move beyond lecture-based instruction and explore how open pedagogy can create authentic, student-centered learning experiences that bridge theory and practice. Over two course iterations (n = 31), students co-designed, implemented, and evaluated HRD interventions for their peers, supported by peer and instructor feedback and complemented by a co-created open-book exam. Quantitative pre- and post-tests revealed significant improvements in students’ knowledge of HRD methods, learning theories, and application competencies, as well as enhanced confidence in their professional qualifications. Students valued the openness of the design, its practical orientation, and the error-friendly learning environment, though challenges emerged regarding workload, communication, and intrinsic motivation. Educators reported a transformation of their role from knowledge transmitter to facilitator and co-learner, while also identifying opportunities to use AI for generating authentic case tasks. The findings suggest that PjBL, combined with open pedagogy, fosters self-directed learning, transparency, and collaboration, thereby contributing to cultural change in higher education toward openness, participation, and innovation. Full article

As universities become increasingly open, campuses are no longer only places for study and daily life for students and faculty, but also essential spaces for public visits and cultural identity. Traditional perception evaluation methods that rely on manual surveys are limited by sample size and subjective bias, making it challenging to reveal differences in experiences between groups (students/visitors) and the complex relationships between spatial elements and perceptions. This study uses a comprehensive open university in China as a case study to address this. It proposes a research framework that combines street-view image semantic segmentation, perception survey scores, and interpretable machine learning with sample augmentation. First, full-sample modeling is used to identify key image semantic features influencing perception indicators (nature, culture, aesthetics), and then to compare how students and visitors differ in their perceptions and preferences across campus spaces. To overcome the imbalance in survey data caused by group–space interactions, the study applies the CTGAN method, which expands minority samples through conditional generation while preserving distribution authenticity, thereby improving the robustness and interpretability of the model. Based on this, attribution analysis with an interpretable decision tree algorithm further quantifies semantic features’ contribution, direction, and thresholds to perceptions, uncovering heterogeneity in perception mechanisms across groups. The results provide methodological support for perception evaluation of campus functional zones and offer data-driven, human-centered references for campus planning and design optimization. Full article

As cities strive for human-centered and fine-tuned development, Agent-Based Modeling (ABM) has emerged as a powerful tool for simulating pedestrian behavior and optimizing walkable neighborhood design. This study presents a comparative bibliometric analysis of ABM applications in block-scale walkability research from 2015 to 2024, drawing on both Chinese- and English-language literature. Using visualization tools such as VOSviewer, the analysis reveals divergences in national trajectories, methodological approaches, and institutional logics. Chinese research demonstrates a policy-driven growth pattern, particularly following the introduction of the “15-Minute Community Life Circle” initiative, with an emphasis on neighborhood renewal, age-friendly design, and transit-oriented planning. In contrast, international studies show a steady output driven by technological innovation, integrating methods such as deep learning, semantic segmentation, and behavioral simulation to address climate resilience, equity, and mobility complexity. The study also classifies ABM applications into five key application domains, highlighting how Chinese and international studies differ in focus, data inputs, and implementation strategies. Despite these differences, both research streams recognize the value of ABM in transport planning, public health, and low-carbon urbanism. Key challenges identified include data scarcity, algorithmic limitations, and ethical concerns. The study concludes with future research directions, including multimodal data fusion, integration with extended reality, and the development of privacy-aware, cross-cultural modeling standards. These findings reinforce ABM’s potential as a smart urban simulation tool for advancing adaptive, human-centered, and sustainable neighborhood planning. Full article

Background: Authentic leadership is characterized by the authenticity and self-awareness of the leader, who acts with transparency and promotes positive outcomes in clinical practice and team management. In Portugal, there isn’t a tool available to assess nurses’ perceptions of authentic leadership in nursing. This study aimed to translate and cross-culturally adapt the Authentic Nurse Leadership Questionnaire (ANLQ) for the Portuguese context and to evaluate its psychometric properties. This instrument assesses nurses’ perceptions of the authentic leadership exercised by their leader. Methods: A methodological, descriptive, cross-sectional study with a quantitative approach was conducted. The translation and cross-cultural adaptation process followed the recommendations of internationally recognized guidelines. The Authentic Nurse Leadership Scale—Portuguese version (ANLS-PT) was administered to a sample of 406 nurses from various functional units in three primary healthcare centers. Exploratory and confirmatory factor analysis techniques were used. Reliability was established through a test–retest administration to 22 nurses at two different times, with a two-week interval. The internal consistency of the scale was assessed using Cronbach’s Alpha. Results: An instrument with 29 items and 3 dimensions was obtained, explaining 68.3% of the total variance. The identified dimensions were Caring and Decision-Making, Self-Awareness, and Relational Integrity and Ethics. The overall instrument showed an internal consistency of 0.97. Conclusions: The ANLS-PT proved to be a valid, reliable, and robust tool for assessing authentic leadership in the Portuguese cultural context and can be used in various nursing practice contexts. Full article

This study examines community-based wellness tourism (CBWT) in Ubud, Bali, focusing on ownership structures, community participation, and the role of local traditions. Using a qualitative design, the data were collected through semi-structured interviews with wellness stakeholders and field observations of spas and yoga centers. The findings reveal that spas are predominantly locally owned and staffed, ensuring value retention and skill development, while flagship yoga and retreat centers are dominated by non-local actors, creating risks of economic leakage and weaker cultural stewardship. Community involvement is strong in operations but limited in planning and governance, highlighting a policy–practice gap. Integrating Balinese traditions, such as Usada Bali and Melukat, could enhance authenticity but requires careful protection against commodification. The findings reveal that locally owned spas contribute to SDG 1 (No Poverty) and SDG 8 (Decent Work and Economic Growth) through local value retention, employment creation, and skill development, while non-local dominance of yoga and retreat centers risks economic leakage and weakened cultural guardianship. The study also identifies gaps in governance and planning, underscoring the need for inclusive participation and capacity building to align with SDG 11 (Sustainable Cities and Communities). Integrating Balinese traditions, such as Usada Bali and Melukat, highlights the opportunities for safeguarding cultural heritage, provided that protocols against commodification are enforced. To address these challenges, the study proposes a strategic framework emphasizing governance reform through a quadruple-helix model, shared-equity ownership, standardized human capital development, and protocol-based cultural guardianship. Despite the limitations of this being a single-case, cross-sectional study, the findings contribute to wellness tourism research by shifting attention from visitor demands to governance and equity. The study offers practical strategies for institutionalizing CBWT in Ubud while providing a transferable model for destinations seeking to balance growth with tradition. Full article

Not enough attention has been paid to the artistic approach of depicting human figures at the center of double-scroll patterns in Chinese Buddhist art. Originating from Greco-Roman culture, this motif entered China from the overland Silk Road around the late 5th century, evolving into two systems. The Hexi Corridor system, centered on Dunhuang, predominantly features lotus-born beings holding vines. The figural types evolved from lotus-born beings to celestial beings, bodhisattvas, and buddhas, with postures ranging from vine-holding to mudra-forming, lotus-tray-lifting, music-playing, and dancing, demonstrating a clear trajectory of development. The Northern Central Plains system, successively centered in Pingcheng, Qingzhou, and Yecheng, developed a relatively complete sequence only in buddha figures. The motif first spread through the Hexi Corridor before influencing the Northern Central Plains. It was adapted from its original Mediterranean context of mythological themes and funerary or temple use to illustrate Buddhist doctrines in China, absorbing elements of Han, Western Regions, and Central Asian cultures. By clarifying the motif’s origin, spread, evolution, and adaptation through systematic analysis of material evidence, this article reveals an intrinsic connection between Greco-Roman culture and Chinese Buddhist art, enriches the history of Sino-foreign cultural exchange, and reflects how Buddhism absorbed diverse cultural elements to achieve Sinicization. Full article

This article explores how Afro-Colombian rural communities in the Caribbean region reclaim their territorial rights through the social construction of habitat. Drawing on four years of participatory action research with the Ma-Majarí Community Council in El Níspero, Montes de María, the study analyzes how traditional housing practices—rooted in ancestral knowledge, oral traditions, and collective memory—function as tools of cultural affirmation, political resistance, and re-peasantization in a post-conflict context. The research highlights the strategic role of Life Plans (Planes de Vida) as instruments of self-governance and territorial justice, challenging extractive development models and institutional neglect. Through visual ethnography, architectural surveys, and community-led housing initiatives, the study reveals how Afro-rural architecture embodies autonomy, resilience, and the right to remain in territory. Housing is not merely a physical structure but a living system of identity, memory, and future-making. This work contributes to broader debates on rural social movements, ethnodevelopment, and post-conflict reconstruction, proposing an architecture of recognition that centers cultural specificity and community agency. Full article

Conventional academic warning systems in higher education often rely on end-of-semester grades, which severely limits opportunities for timely intervention. To address this, our interdisciplinary study developed and validated a comprehensive socio-technical framework that integrates social-cognitive theory with learning analytics. The framework combines educational data mining with culturally responsive, personalized interventions tailored to a non-Western context. A two-phase mixed-methods design was employed: first, predictive models were built using Learning Management System (LMS) data from 2,856 students across 64 courses. Second, a quasi-experimental trial (n = 48) was conducted to evaluate intervention efficacy. Historical academic performance, attendance, and assignment submission patterns were the strongest predictors, achieving a Balanced Area Under the Curve (AUC) of 0.85. The intervention, specifically adapted to Confucian educational values, yielded remarkable results: 73% of at-risk students achieved passing grades, with a large effect size for academic improvement (Cohen’s d = 0.91). These findings empirically validate a complete prediction–intervention–evaluation cycle, demonstrating how algorithmic predictions can be effectively integrated with culturally informed human support networks. This study advances socio-technical systems theory in education by bridging computer science, psychology, and educational research. It offers an actionable model for designing ethical and effective early warning systems that balance technological innovation with human-centered pedagogical values. Full article

Background: The study aimed to assess the diagnostic and therapeutic management of infectious keratitis at a tertiary referral center, focusing on how microbiological analysis influences clinical outcomes. Methods: A retrospective review was conducted on 220 patients (221 eyes) with infectious keratitis treated between November 2021 and January 2025. Data collected included clinical presentation, microbiological findings, treatment approaches, and outcomes. Statistical analyses examined the relationships between microbiological results, improvements in visual acuity, and the need for rescue surgery. Results: Bacterial keratitis accounted for 64% of cases, followed by viral (20%), fungal (13%), and Acanthamoeba (3%). Microbiological testing was performed in 107 cases, with a culture positivity rate of 75.7%. Positive microbiological findings were significantly associated with better visual acuity (p = 0.019) and a reduced, though not statistically significant, need for rescue surgery. Use of contact lenses and ocular trauma were independent risk factors for culture positivity. Delayed referral (more than 15 days) was linked to longer treatment durations and a higher likelihood of surgical intervention (p < 0.001). Microbiological diagnosis correlates with improved visual outcomes and a decreased need for surgical procedures. Conclusion: Early referral and targeted therapy are essential for optimizing prognosis. The use of contact lenses and cases of ocular trauma should prompt early diagnostic sampling. Full article

Quality-of-life (QoL) needs among gynecologic cancer survivors are multifaceted and culturally mediated, yet limited research has examined how survivors in the Middle East prioritize key domains such as sexual function, emotional well-being, and relational quality. This study aimed to identify subgroups of survivors based on the perceived importance of these domains and to explore demographic and clinical predictors of subgroups within the Saudi Arabian context. We conducted a cross-sectional, survey-based study among 129 women with a history of breast or cervical cancer attending a tertiary oncology center in Jeddah, Saudi Arabia. Participants rated the importance of sexual, emotional, and relational QoL domains using a 4-point Likert scale. Latent class analysis (LCA) was used to segment survivors based on their perceived domain importance. Differences in demographic and clinical characteristics across classes were assessed using chi-square tests. A decision tree classifier was employed. Three latent classes emerged: Class 0 (48.8%) prioritized all domains highly; Class 1 (17.8%) reported low importance across domains; and Class 2 (33.3%) emphasized emotional and relational domains while downplaying sexual function. Class group was significantly associated with age (p = 0.001), education (p = 0.04), nationality (p = 0.03), and number of children (p < 0.001). Decision tree analysis identified number of children, age, and marital status as the strongest predictors of high-importance class group. Gynecologic cancer survivors in Saudi Arabia hold diverse priorities regarding QoL domains, primarily shaped by sociocultural context than clinical variables. Tailored survivorship interventions that reflect survivors’ lived values, particularly in relation to age, family structure, and cultural norms, are critical for person-centered oncology care in the region. Full article

This study examined the psychometric properties of the Family Empowerment Scale (FES) among Latinx parents of children with intellectual and developmental disabilities (IDDs), a population historically underrepresented in empowerment research. Given the cultural and contextual factors that may shape empowerment experiences, Exploratory Structural Equation Modeling (ESEM) was utilized to assess the scale’s structural validity. ESEM supports a four-factor model that aligns with, but also refines, the original structure of the FES. The lack of loading for several items indicates the need for revisions that better reflect the lived experiences of Latinx parents. ESEM provided a more nuanced view of the scale’s dimensional structure, reinforcing the value of culturally informed psychometric evaluation. These results underscore the importance of validating empowerment measures within diverse populations to inform equitable family-centered practices. Full article