Search Results (250)

Objectives: To theorize the work-related dimension involved in the process of reconciling work and personal roles among nurses working in Intensive Care Units. Methods: Constructivist grounded theory was employed to conceptualize the phenomenon of interest from the perspectives of nurses, their families, and administrative staff. Data were derived from 202 h of non-participant observation in two high-complexity hospitals in Chile (one public and one private), 57 institutional documents, and 51 in-depth interviews. Data analysis followed the constant comparative method and multilevel coding. To ensure methodological rigor, the study adhered to the 13 criteria for constructivist grounded theory research proposed by Charmaz and Thornberg and was approved by a scientific ethics committee. Results: Work-related roles are defined as the set of behaviors associated with the professional context, which are shaped by nine sources of interaction: (1) Job content; (2) Workload and pace; (3) Work schedule; (4) Control; (5) Environment and equipment; (6) Organizational culture; (7) Interpersonal relationships; (8) Function within the organization; and (9) Career development. Conclusions: The study presents the theorization process of the work-related dimension involved in the reconciliation of work and personal roles among nurses in Intensive Care Units. Work-related roles are essential to understanding this reconciliation process. The findings provide evidence for the existence of nine sources of interaction, which are influenced by institutional strategic planning and, in turn, by national and international public policies. Full article

Background/Objectives: Ethical challenges in healthcare require awareness and adherence to professional codes of ethics, particularly in interdisciplinary settings such as tertiary hospitals. This study aimed to assess the attitudes and awareness of healthcare professionals regarding codes of ethics at the University Hospital of Split in Croatia, which did not have an institutional code at the time of the study. Methods: A cross-sectional survey using a structured, anonymous questionnaire was distributed both physically across hospital departments and online via email. Welch’s t-test, ANOVA, Kruskal–Wallis, and correlation tests were used to assess associations between favourability scores and participant characteristics. Linear and logistic regression analyses further examined predictors of favourable attitudes. Results: Of 442 returned questionnaires, 377 were complete and included in the analysis, mainly from nurses (56.5%) and physicians (42.7%). The median favourability score was 83.8% (88/105; IQR 78.1–88.6), with 87.0% scoring above the favourable threshold (≥75%). Female gender and higher education were significantly associated with more favourable attitudes. Participants strongly endorsed core principles such as patient confidentiality and autonomy, yet 57.6% considered ethics education during training inadequate, and only 36.3% viewed dual practices as a conflict of interest. Most respondents reported adherence to ethical standards (85.4%), while only over half were familiar with their professional ethics code (64.5%) and the hospital Ethics Committee (56.2%); a total of 66.3% supported introducing a hospital-specific code. Awareness and support for ethical structures were higher among women and those with more education. Conclusions: This study reveals a gap between personal ethical commitment and institutional ethical infrastructure. Strengthening ethics education and implementing a hospital-specific ethics code may enhance organisational ethical culture. Full article

Background/Objectives: In patients with intracranial arteriovenous malformation (AVM), the first diagnostic analysis is often performed in emergency conditions by Computed Tomography (CT) and multiphase CT angiography (CTA). Nevertheless, once ruptured, an AVM might be hardly recognized by an inexperienced neuroradiologist, due to the presence of hematoma or to the destructuring of the lesion. The aim of our study is to outline the utility of color-coded maps derived from multiphase CT angiography in the assessment of cerebral AVMs, evaluating inter-observer agreement between radiologists with different years’ experience and comparing the results with the gold standard, angiography. Methods: The color-coded maps were obtained retrospectively by multiphase CT angiography on a workstation using FastStroke software ColorViz (GE Healthcare, Milwaukee, WI, USA). The color-coded maps were evaluated, independently, by two neuroradiologists, and inter-observer agreement was evaluated. Finally, the AVM’s features (arterial feeders, nidus type, venous drainage type) obtained with color-coded maps were compared with angiographic analysis. The Ethical Committee for Research in Medical Imaging approved this study (Institutional Review Board number 6467). Informed consent was obtained for every patient. Results: A total of 26 patients with intracranial hemorrhage and arteriovenous malformation underwent multiphase CT angiography and were analyzed. Our statistical analysis showed the reproducibility of the color-coded maps and agreement with the angiographic findings, especially in the evaluation of venous drainage type. Conclusions: The ColorViz color-coded maps have proved to be an effective tool in the identification and assessment of AVMs, providing rapid and clear information on intracranial vascular dynamics, even for inexperienced radiologists. Full article

This study aimed to understand, through the voices of patients, the factors that contribute to inequality and inequity in oral healthcare and their implications for patient safety. A qualitative study was performed using a Grounded Theory approach (GT) through 13 in-depth interviews with a flexible design, recorded and transcribed verbatim for study purposes. Open and axial coding and analysis categories were generated, and a conceptual and explicative framework was established. Ethical approval was obtained. The main findings highlighted how individual, social, and contextual factors significantly influence the materialization of risks and failures in oral healthcare, ultimately affecting patient safety in dental practice. These factors include individual factors, the relationship between professionals and patients, and failures in healthcare service provision. Participants’ discourses showed examples of inequities, such as gender, socioeconomic gradient, educative level, type of healthcare system, discrimination, stigmatization, and othering-otherness, and their effect on dental care and dentistry safety. Health inequities should be tackled in a preventive and proactive manner through the effective integration of intersectoral policies and strategies. This approach would enhance oral health, make patient safety a fundamental pillar of dental care, uphold human dignity, and strengthen trust in the healthcare system. Full article

Introduction: Pain represents a significant threat to the physical and psychological well-being of children, negatively affecting their quality of life during hospitalization. Pain is considered the fifth vital sign and must be regularly assessed and managed, as also emphasized by the nursing code of ethics. The interdisciplinary approach to pediatric pain management includes both pharmacological treatments and non-pharmacological techniques (NPTs), taking into account the child’s age and specific needs. NPTs comprise a broad set of methods, ranging from simple to complex, that can be applied to children to help them manage pain. The main objective of this study was to explore and analyze which non-pharmacological methods are adopted by nurses in their clinical practice to relieve pain in school-aged children (6–12 years) undergoing surgery. Materials and Methods: This observational study involved nursing staff from pediatric wards in the Italian provinces of Ravenna, Forlì-Cesena, and Rimini, and used a validated online questionnaire. The study focused on school-aged children (6–12 years) who had undergone surgical procedures. The questionnaire included items on which NPTs nurses used to relieve pain in pediatric patients. Participants responded using a Likert scale from 1 (never) to 5 (always), and anonymity and voluntary participation were guaranteed. Data were collected between February and October 2024, involving the pediatric units of three hospitals in the provinces of Ravenna, Forlì-Cesena, and Rimini. Statistical analyses included t-tests, ANOVA, and Kruskal–Wallis tests to identify significant differences. Results: A total of 46 nurses completed the questionnaire. No significant differences were found between nurses’ backgrounds and the use of NPTs. Overall, nurses did report using NPTs, although there was limited use of such techniques in the preoperative phase. The study also highlighted a discrepancy in the information provided to children versus parents, with nurses tending to give more information to parents during the preoperative period. Notably, nurses who reported effective multidisciplinary collaboration were also those who better prepared children using NPTs. Conclusions: This study emphasizes the importance of NPTs in pediatric pain management and highlights the need to improve direct communication with children. Adopting an effective multidisciplinary approach is essential to ensuring a less traumatic surgical experience for young patients. Full article

This systematic literature review explores the socio-ethical implications of Artificial Intelligence (AI) in contemporary media content generation. Drawing from 44 peer-reviewed sources, policy documents, and industry reports, the study synthesizes findings across three core domains: bias detection, storytelling transformation, and ethical governance frameworks. Through thematic coding and structured analysis, the review identifies recurring tensions between automation and authenticity, efficiency and editorial integrity, and innovation and institutional oversight. It introduces the Human–AI Co-Creation Continuum as a conceptual model for understanding hybrid narrative production and proposes practical recommendations for ethical AI adoption in journalism. The review concludes with a future research agenda emphasizing empirical studies, cross-cultural governance models, and audience perceptions of AI-generated content. This aligns with prior studies on algorithmic journalism. Full article

Artificial intelligence has taken a seat at the executive table and is threatening the fact that human beings are the only ones who should be in a position of power. This article gives conjectures on the future of leadership in which managers will collaborate with learning algorithms in the Neural Adaptive Artificial Intelligence Leadership Model, which is informed by the transformational literature on leadership and socio-technical systems, as well as the literature on algorithmic governance. We assessed the model with thirty in-depth interviews, system-level traces of behavior, and a verified survey, and we explored six hypotheses that relate to algorithmic delegation and ethical oversight, as well as human judgment versus machine insight in terms of agility and performance. We discovered that decisions are made quicker, change is more effective, and interaction is more vivid where agile practices and good digital understanding exist, and statistical tests propose that human flexibility and definite governance augment those benefits as well. It is single-industry research that contains self-reported measures, which causes research to be limited to other industries that contain more objective measures. Practitioners are provided with a practical playbook on how to make algorithmic jobs meaningful, introduce moral fail-safes, and build learning feedback to ensure people and machines are kept in line. Socially, the practice is capable of minimizing bias and establishing inclusion by visualizing accountability in the code and practice. Filling the gap between the theory of leadership and the reality of algorithms, the study provides a model of intelligent systems leading in organizations that can be reproduced. Full article

Endometrial cancer (EC) is the most common gynecological malignancy in developed countries. Risk factors for EC include metabolic alterations (obesity, metabolic syndrome, insulin resistance), hormonal imbalance, age at menopause, reproductive factors, and inherited conditions, such as Lynch syndrome. For the inherited forms, several genes had been implicated in EC occurrence and development, such as POLE, MLH1, TP53, PTEN, PIK3CA, PIK3R1, CTNNB1, ARID1A, PPP2R1A, and FBXW7, all mutated at high frequency in EC patients. However, gene function impairment is not necessarily caused by mutations in the coding sequence of these and other genes. Gene function alteration may also occur through post-transcriptional control of messenger RNA translation, frequently caused by microRNA action, but transcriptional impairment also has a profound impact. Here, we review how chromatin modifications change the expression of genes whose impaired function is directly related to EC etiopathogenesis. Chromatin modification plays a central role in EC. The modification of chromatin structure alters the accessibility of genes to transcription factors and other regulatory proteins, thus altering the intracellular protein amount. Thus, DNA structural alterations may impair gene function as profoundly as mutations in the coding sequences. Hence, its central importance is in the diagnostic and prognostic evaluation of EC patients, with the caveat that chromatin alteration is often difficult to identify and needs investigations that are specific and not broadly used in common clinical practice. The different phases of the healthy endometrium menstrual cycle are characterized by differential gene expression, which, in turn, is also regulated through epigenetic mechanisms involving DNA methylation, histone post-translational modifications, and non-coding RNA action. From a medicolegal and policy-making perspective, the implications of using epigenetics in cancer care are briefly explored as well. Epigenetics in endometrial cancer is not only a topic of biomedical interest but also a crossroads between science, ethics, law, and public health, requiring integrated approaches and careful regulation. Full article

Wharton’s jelly mesenchymal stem cells (WJ-SCs) are a promising source for regenerative medicine due to their multipotency, low immunogenicity, and ethical acceptability. Epigenetic regulation plays a crucial role in modulating their proliferation, differentiation, and therapeutic potential. Key mechanisms, including DNA methylation, histone modifications, and non-coding RNAs (e.g., miRNAs and lncRNAs), influence WJ-SC behavior by dynamically altering gene expression without changing the DNA sequence. DNA methylation often silences genes involved in differentiation, while histone acetylation/methylation can activate or repress lineage-specific pathways. Non-coding RNAs further fine-tune these processes by post-transcriptional regulation. Understanding these mechanisms could optimize WJ-SC-based therapies for tissue repair and immune modulation. This review summarizes current insights into epigenetic regulation in WJ-SCs and its implications for regenerative applications. Full article

Immersive technologies such as augmented reality (AR) and virtual reality (VR) have emerged as powerful tools in cultural heritage education and preservation. Building on prior work that demonstrated the effectiveness of gamified XR applications in engaging users with heritage content and drawing on existing studies in neuroscience and cognitive psychology, this study explores how immersive experiences support multisensory integration, emotional engagement, and spatial presence—all of which contribute to the deeper encoding and recall of heritage narratives. Through a theoretical lens supported by the empirical literature, we argue that the interactive and embodied nature of AR/VR aligns with principles of cognitive load theory, dual coding theory, and affective neuroscience, supporting enhanced learning and memory consolidation. This paper aims to bridge the gap between technological innovation and cognitive understanding in cultural heritage dissemination, identifying concrete design principles for memory-driven digital heritage experiences. While promising, these approaches also raise important ethical considerations, including accessibility, cultural representation, and inclusivity—factors essential for equitable digital heritage dissemination. Full article

Objective: This cross-sectional content analysis aimed to investigate how oil pulling is portrayed on YouTube Shorts, focusing on the types of speakers, claims made, and alignment with scientific evidence. The study further explored how the content may influence viewer perception, health behaviors, and the potential spread of misinformation. Methods: On 28 January 2025, a systematic search of YouTube Shorts was performed using the term “oil pulling” in incognito mode to reduce algorithmic bias. English language videos with at least 1000 views were included through purposive sampling. A total of 47 Shorts met the inclusion criteria. Data were extracted using a structured coding framework that recorded speaker type (e.g., dentist, hygienist, influencer), engagement metrics, stated benefits, oil type and regimen, the use of disclaimers or citations, and stance toward oil pulling rated on a 5-point Likert scale. Speaker background and nationality were determined through publicly available channel descriptions or linked websites, with user identities anonymized and ethical approval deemed unnecessary due to the use of publicly available content. In total, 47 videos met the inclusion criteria. Results: Of the 47 YouTube Shorts that met the inclusion criteria, most were posted by influencers rather than dental professionals. These videos predominantly encouraged oil pulling, often recommending coconut oil for 10–15 min daily and citing benefits such as reduced halitosis and improved gum health. However, a smaller subset advanced more extreme claims, including reversing cavities and remineralizing enamel. Notably, US-licensed dentists and dental hygienists tended to discourage or express skepticism toward oil pulling, assigning lower Likert scores (1 or 2) to influencers and alternative health practitioners (often 4 or 5). Conclusions: YouTube Shorts largely promote oil pulling through anecdotal and testimonial-driven content, often diverging from evidence-based dental recommendations. The findings reveal a disconnect between professional dental guidance and popular social media narratives. While some benefits like halitosis reduction may have limited support, exaggerated or misleading claims may result in improper oral hygiene practices. Greater engagement from dental professionals and improved health communication strategies are needed to counteract misinformation and reinforce oil pulling’s role, if any, as an adjunct—not a replacement—for standard oral care. Future studies should explore viewer interpretation, behavioral influence, and cross-platform content patterns to better understand the impact of short-form health videos. Full article

The rapid advancements in healthcare technologies are reshaping the medical landscape, prompting a reconsideration of clinical methodologies and their ethical foundations. This article explores the need for an updated approach to medical deontology, emphasizing the transition from traditional practices to a hybrid clinical methodology that integrates both human expertise and technological innovations. With the increasing use of Artificial Intelligence, data analytics, and advanced medical tools, healthcare professionals are presented with new ethical and professional challenges. These challenges demand a reevaluation of professional responsibility, highlighting the importance of scientific evidence in decision-making while mitigating the influence of economic and ideological factors. By framing medical practice within a systemic and integrated perspective, this article proposes a model that moves beyond the reductionist and anti-reductionist dualism, fostering a more realistic understanding of healthcare. This new paradigm necessitates the evolution of the Medical Code of Ethics, integrating the concept of “medical intelligence” to address the complexities of data management and its ethical implications. The article ultimately advocates for a dynamic and adaptive approach that aligns medical practice with emerging technologies, ensuring that patient care remains person-centered and ethically grounded in a rapidly changing healthcare environment. Full article

Background/Objectives: Air embolism on contrast-enhanced computed tomography (CECT) scans may have significant consequences, particularly if a right-to-left shunt is present, as seen in hereditary hemorrhagic telangiectasia. We sought to evaluate the frequency of CECT-associated air emboli in a single tertiary care referral center. Methods: Consecutive non-enhanced and contrast-enhanced cardiac CT studies (NECCT and CECCT, respectively) were evaluated prospectively over a 6-month period. Following the University of Alberta’s Health Research Ethics Board approval (code: Pro00042313; date: 1 May 2014), two experts reviewed all studies independently to assess for the presence and location of air emboli. The control group consisted of only NECCTs. All patients, except for the control group in this study, had an IV cannula placed. When present, the number, volume, and location of air emboli were recorded. Results: In this study, 110 subjects underwent intravenous cannula placement and both NECCT and CECCT. Of these, 27 of the NECCT studies (24.5%) and 36 of the CECCT studies (32.7%) demonstrated intravascular air emboli. Of those with air emboli, the average volume of intravascular gas was 19.22 ± 25.35 µL in the NECCT studies, with most of the intravascular air (70.4%) seen in the right atrial appendage (RAA). The average volume of intravascular air was 14.81 ± 26.54 µL in the CECCT studies, with most of the intravascular air also located within the RAA (72.2%). The incidence of intravascular air was higher in the CECCT group (28.6% increase), with lower volumes of intravascular air. None of the subjects in the control group (n = 28), who underwent NECCT without intravenous cannulation, demonstrated air emboli. Conclusions: Air emboli were present in a significant proportion of subjects undergoing intravenous cannulation and subsequent CECT. The use of CECT should be carefully considered in high-risk populations. Full article

We propose Observer-Linked Branching (OLB), a mathematically rigorous extension of quantum theory in which an observer’s cognitive commitment actively modulates collapse dynamics at macroscopic scales. The OLB framework rests on four axioms, employing a norm-preserving nonlinear Schrödinger evolution and Lüders-type projection triggered by crossing a cognitive commitment threshold. Our expanded formalism provides five main contributions: (1) deriving Lie symmetries of the observer–environment interaction Hamiltonian; (2) embedding OLB into the Consistent Histories and path-integral formalisms; (3) multi-agent network simulations demonstrating intentional synchronisation toward shared macroscopic outcomes; (4) detailed statistical power analyses predicting measurable biases (up to ~5%) in practical experiments involving traffic delays, quantum random number generators, and financial market sentiment; and (5) examining the conceptual, ethical, and neuromorphic implications of intent-driven reality selection. Full reproducibility is ensured via the provided code notebooks and raw data tables in the appendices. While the theoretical predictions are precisely formulated, empirical validation is ongoing, and no definitive field results are claimed at this stage. OLB thus offers a rigorous, norm-preserving and falsifiable framework to empirically test whether cognitive engagement modulates macroscopic quantum outcomes in ways consistent with—but extending—standard quantum predictions. Full article

There is limited empirical literature on the study of LGBTQ books, and even less on the perspective of early childhood center administrators on these books. Hence, a mixed methods study surveying the administrators of high-quality early childhood centers across the state of North Carolina was implemented. Sixty-five participants completed the survey, and both quantitative and qualitative data were gathered and analyzed. The findings indicated that the majority (64%) of the administrators had read at least one book from the listed LGBTQ books, while the rest had never read a single book from the listing. Their familiarity with the book content was based on reading the book only once, and they only “somewhat” recalled the content of the book. These findings indicate a lack of regular use of LGBTQ books in the centers. The administrators made both negative and positive comments on the survey administered and the books in general. The results indicate a need for education and training to focus on the connection of LGBTQ topics and how they are developmentally appropriate, as well as the connection to the NAEYC Code of Ethics. Full article