Search Results (3,244)

Background: Telemedicine has gained significance, especially during the COVID-19 pandemic, offering remote healthcare solutions. However, its adoption in geriatric medical centers (GMCs) remains limited. Understanding the factors influencing telemedicine acceptance among care teams in geriatric medical centers is crucial for successful implementation. Aim: This study examines behavioral factors influencing telemedicine adoption among care teams in Israeli geriatric medical centers through the lens of the Technology Acceptance Model. Methods: A cross-sectional study was conducted with 406 healthcare professionals from four geriatric medical centers in Israel. Participants completed a self-administered questionnaire measuring self-efficacy, subjective norms, anxiety, resistance to change, perceived usefulness, perceived ease of use, and intention to use telemedicine. Structural equation modeling was used to analyze the data. Results: Perceived ease of use mediated the associations between self-efficacy and perceived usefulness and between subjective norms and perceived usefulness, demonstrating how confidence shapes technology acceptance. Perceived usefulness mediated the association between perceived ease of use and intention to use. Perceived ease of use did not mediate the relationship between anxiety or resistance to technological changes and perceived usefulness. Conclusions: The study highlights the importance of perceived ease of use and usefulness in promoting telemedicine adoption among geriatric medical center care teams, emphasizing the need for targeted interventions to enhance these perceptions. Full article

Background: Physical activity, sedentary behaviour, and sleep are interdependent components of the 24 h movement profile that may influence appetite control. While acute exercise can alter appetite perceptions and food reward, less is known about how reallocating time between daily behaviours affects appetite outcomes under free-living conditions. Methods: We applied isotemporal-substitution modelling in a cross-sectional study of 130 young, healthy, active adults. Accelerometer-derived estimates of sedentary time, light physical activity (LPA), moderate-to-vigorous physical activity (MVPA), and sleep were analysed in relation to energy intake (food diaries, laboratory meals), subjective appetite perceptions, appetite-related hormones (acylated ghrelin, PYY, leptin), and psychological traits, including food reward (Leeds Food Preference Questionnaire, LFPQ), food cravings (Control of Eating Questionnaire, CoEQ), and eating behaviour traits (Three-Factor Eating Questionnaire, TFEQ). Results: Reallocating 30 min/day of sedentary time to MVPA was associated with higher energy intake in free-living (+113 kcal/day, 95% CI: 34–192) and laboratory settings (+120 kcal/day, 95% CI: 55–185), along with greater postprandial hunger and prospective food consumption, reduced fullness, elevated fasting acylated ghrelin, and lower postprandial PYY. No associations were observed for reallocations to LPA or sleep. Furthermore, sedentary time reallocations were unrelated to leptin or psychological eating traits assessed by the LFPQ, CoEQ, or TFEQ. Conclusions: In this population, reallocating sedentary time to MVPA was linked to physiological and behavioural compensation consistent with elevated energy demands, whereas reallocating to LPA or sleep showed no associations. Trait-level eating behaviours were unaffected, suggesting MVPA influences appetite primarily through acute physiological rather than enduring cognitive or hedonic pathways. Full article

Background: Globally, uncorrected refractive errors are recognized as the primary cause of visual impairment and blindness. According to a report by the World Health Organization (WHO), providing spectacle lenses at an affordable cost remains a significant challenge, particularly for underprivileged populations in developing countries. This challenge contributes to the low compliance with spectacle wear worldwide. However, the benefits of wearing spectacles are influenced by the perceptions of the population regarding spectacle use. Methods: A quantitative, cross-sectional survey-based study was conducted at a superior educative center in Oman, the University of Buraimi. Participants were recruited from the four major colleges, namely, the College of Health Sciences (COHS), College of Business (COB), College of Engineering (COE), and College of Law (COL), and the Center for Foundation Studies (CFS). This study was conducted over the period from 18 December 2022 to 18 December 2023. Essential data were collected using an electronic questionnaire facilitated by the Google platform. The initial section of the questionnaire outlines this study’s objectives and its benefits to the community. The digital survey comprises three sections: the first section addresses the sociodemographic profile of the participants; the second section explores perceptions related to spectacles; and the third section examines visual symptoms associated with spectacle wear. In this study, a pre-tested survey was administered following consultation with a panel of three subject matter experts who reviewed the clarity and content validity of the test items. Data analyses were performed using descriptive statistics, and linear regression was applied to assess the effect of socioeconomic profile on perceptions of spectacles. Additionally, data entry, processing, and analysis were conducted using SPSS 25 software. The overall mean score for spectacle-related visual symptoms was 2.51 ± 0.75, indicating a moderate level of symptom occurrence. Results: A total of 415 participants (N = 415) were included in this study, comprising 133 males (32.0%) and 282 females (68.0%). The most prominent symptoms related to spectacle perception were “light sensitivity” and “eye pain”, with mean values of 3.03 ± 1.30 and 3.04 ± 1.25, respectively. Additionally, 249 participants (60%) reported moderate concern regarding spectacle-related visual symptoms. Among female participants, 118 (41.8%) exhibited little concern about visual symptoms associated with spectacle wear, whereas this was observed in 25.6% of male participants. Descriptive statistics indicated the mean perceived spectacle-related disadvantages score measured on a scale of 0 to 4 was 2.88 ± 1.16 (57.69% ± 23.15% in percentages), reflecting a moderate perception of such disadvantages. The linear regression model demonstrated statistical significance, as indicated by the likelihood ratio chi-square = 199.194 (df = 15, p < 0.001). The most significant predictor was study major (χ² = 72.922, p < 0.001). Conclusions: The present study indicates that undergraduate students generally exhibit a low perception of the disadvantages associated with wearing spectacles. Randomized sampling should be preferred in future studies to the convenience sampling technique. The most frequently reported visual symptoms include “light sensitivity and eye pain” among spectacle wearers. Therefore, it is imperative to implement health education programs and foundational studies across colleges to address these issues among undergraduate university students. Full article

Background/Objectives: Dance, particularly hip-hop, offers a dynamic means of fostering physical activity (PA) and encouraging movement in health-related initiatives among children and youth in educational environments. Hip-hop offers benefits across motor, physical, social, and mental domains. Given the importance of PA in early development, and the preschool period as a sensitive phase for acquiring motor skills, this study aimed to examine the effects of the “Grow+” hip-hop program on motor competence (MC), perceived motor coordination (PMCoor), and PA levels in preschoolers. Methods: A quasi-experimental within-subjects design was used, including 37 children aged 3 to 4 (M = 4.29 ± 0.58). The intervention included two 4-week hip-hop periods, separated by a 4-week break. Four assessments were conducted using the MCA battery (MC), PA’s pictorial scales, and questionnaires completed by caregivers and educators (PMCoor). Data were analyzed using repeated measures ANOVA and Spearman correlations. Results: MC and PA levels showed a nonsignificant but positive trend across the study. Significant improvements in MC were observed during intervention periods, while no significant changes occurred during the break. Educators’ perceptions of PMCoor remained unchanged, despite improvements in MC. Conclusions: The findings suggest that the “Grow+” hip-hop program contributed meaningfully to improvements in MC and PA levels among children in early childhood. These findings accentuate the potential efficacy of structured rhythmic movement interventions in promoting motor development throughout early childhood, thereby supporting their integration into early childhood education curricula. Full article

Outdoor thermal comfort in tropical cities is increasingly threatened by rapid urbanization, high humidity, and insufficient climate-sensitive planning. Despite numerous studies on urban heat mitigation, there is a lack of empirical and numerical research that evaluates the synergistic application of bioclimatic strategies under humid tropical conditions. This paper addresses this gap by analyzing the combined effect of arborization, dry mist systems, water bodies, and sprinklers on outdoor thermal comfort at the Víctor Levi Sasso Campus of the Technological University of Panama. We hypothesized that synergistic application of these strategies provides greater thermal comfort improvements than isolated interventions. The central research question guiding this study was: To what extent can combined bioclimatic strategies enhance outdoor thermal comfort compared to individual strategies in humid tropical environments? To answer this, a hybrid methodology was employed, integrating ENVI-met dynamic simulations with in situ measurements and thermal comfort surveys based on the physiological equivalent temperature (PET) index and subjective comfort scales. The results demonstrate that combined strategies achieve superior reductions in mean radiant and surface temperatures while improving subjective comfort perceptions, highlighting their potential for context-sensitive urban design in tropical regions. Full article

Optimal recovery supports health and enhances performance in soccer players, yet the empirical evidence on various recovery strategies in soccer is complex to interpret. This review aimed to summarize the literature on post-exercise recovery modalities in male and female soccer players of all ages and competition levels. Following PRISMA guidelines, PubMed, SPORTDiscuss, and Web of Science were systematically searched until 17 October 2023. Randomized controlled trials or within-subjects crossover design studies that examined the effects of post-exercise recovery interventions on physical, psychological, or performance outcomes in soccer players were included. A single reviewer extracted data and assessed study quality using the Physiotherapy Evidence Database (PEDro) scale. Overall, 41 studies were included in the final review. The recovery strategies represented in these studies were organized into the following categories: active recovery, blood flow restriction, cold water immersion, contrast water therapy, compression garments, active cool-down, cryotherapy, cold garments, sleep and daytime nap, pneumatic cooling, foam rolling, mindfulness interventions, nutritional intervention, and static stretching. The findings demonstrated that cold-water immersion consistently improved jump performance and perceptions of fatigue, soreness, and overall well-being. Other recovery strategies, such as active recovery, compression therapy, sleep interventions, and nutrition supplementation, also positively impacted recovery, albeit with varying levels of effectiveness and evidence. However, the studies exhibited heterogeneity in methods, outcome measures, and recovery intervention protocols, posing challenges for generalizability. This review summarizes recovery strategies for soccer players, emphasizing the need for practitioners, coaches, and athletes to individualize interventions based on athletes’ needs, preferences, and competition level. Full article

Ambient temperature and thermoregulation influence sleep quality. This study investigated the effects of a temperature-controlled mattress cover on sleep and perceptual outcomes in healthy adults. In a randomised, counterbalanced, crossover design, 34 healthy adults (20 F, 14 M; age, 30 ± 5 y) used a temperature-controlled mattress cover for 14 nights, following ≥3 nights of familiarisation. The temperature feature was on for 7 nights (POD) and off for 7 nights (CON). Sleep was assessed via wrist actigraphy, while heart rate (HR), heart rate variability (HRV), and respiratory rate (RR) were recorded by embedded sensors in the mattress cover. Participants completed daily and weekly questionnaires evaluating sleep quality, thermal comfort, and thermal sensation. Linear mixed models showed significant main effects of condition favouring POD over CON for all daily perceived outcomes (all p < 0.05). A large, significant improvement in perceived sleep quality was observed (p = 0.001, d = 0.92). No significant differences were found in objective sleep metrics or biometric measures (all p ≥ 0.05). A temperature-controlled mattress cover was associated with improved subjective sleep quality and thermal-related perceptions despite minimal changes in objective or biometric outcomes, which may in part reflect expectancy, or placebo effects. Further research is needed to explore whether these perceptual benefits lead to physiological improvements over time. Full article

This study evaluates the impact of using group concept maps in the teaching of Applied Thermodynamics in the Bachelor’s Degree in Industrial Electronics and Automation Engineering. The methodology consisted of selecting topics with a high conceptual load, collaboratively creating concept maps, and subsequently evaluating them by both students and teaching staff. Students achieved average scores above 7/10 in the concept map activity, with teacher and student evaluations averaging 7.8 and 7.3, respectively. Knowledge assessment via pre- and post-tests revealed a 20% increase in concept comprehension. For example, in the topic of Principles of Thermodynamics, the percentage of correct answers on the most complex question increased from 13% in the Pre-Test to 40% in the post-test. In the topic of Refrigeration Cycles, some questions showed an improvement from 18% to 25%. The students’ perception of the activity was positive, with an average satisfaction rating of 6.9 out of 10. Furthermore, most students acknowledged that the activity helped them stay engaged with the subject matter and identify errors in their own learning. The high participation in the activity, despite its low impact on the final grade, demonstrates the students’ strong motivation for this study approach. Therefore, the implementation of concept maps not only facilitated the understanding of key concepts but also promoted critical reflection and collaborative learning, establishing itself as an effective strategy in the teaching of Applied Thermodynamics. Full article

Against the backdrop of China’s large-scale collective forest tenure reform, examining the actual effects of land policies at the household level is crucial for advancing sustainable forestry. This study aims to comprehensively analyze the impacts of tenure formalization (forest tenure certificates) and market-based incentives (bamboo forest certification) on household production inputs and harvesting behavior by disentangling the objective implementation of policies from households’ subjective perceptions. Based on survey data from 1090 households in Fujian Province, China, and employing double-hurdle and Tobit models, this study reveals a central finding: households’ management decisions are driven more strongly by their subjective perceptions than by objectively held policy instruments. Specifically, perceived tenure security serves as a key incentive for increasing production inputs and adopting long-term harvesting plans, whereas the mere possession of forest tenure certificates exhibits limited direct effects. Similarly, households’ positive expectations about the market value enhancement from bamboo forest certification significantly promote investments and sustainable harvesting practices—an effect substantially greater than that of mere participation in certification. Consequently, this study argues that the successful implementation of land governance policies depends not only on the rollout of instruments but, more critically, on fostering households’ trust and positive perceptions of policies’ long-term value. Full article

Color grading of boiled shrimp is a critical factor influencing market price, yet the process is usually conducted visually by buyers such as middlemen and processing plants. This subjective practice raises concerns about accuracy, impartiality, and fairness, often resulting in disputes with farmers. To address this issue, this study proposes a standardized and automated grading approach based on image processing and artificial intelligence. The method requires only a photograph of boiled shrimp placed alongside a color grading ruler. The grading process involves two stages: segmentation of shrimp and ruler regions in the image, followed by color comparison. For segmentation, deep learning models based on Mask R-CNN with a Feature Pyramid Network backbone were employed. Four model configurations were tested, using ResNet and ResNeXt backbones with and without a Boundary Loss function. Results show that the ResNet + Boundary Loss model achieved the highest segmentation performance, with IoU scores of 91.2% for shrimp and 87.8% for the color ruler. In the grading step, color similarity was evaluated in the CIELAB color space by computing Euclidean distances in the L (lightness) and a (red–green) channels, which align closely with human perception of shrimp coloration. The system achieved grading accuracy comparable to human experts, with a mean absolute error of 1.2, demonstrating its potential to provide consistent, objective, and transparent shrimp quality assessment. Full article

This study investigates how perceptions of economic inequality are associated with confidence in elections through the mechanism of subjective class identification. Whereas much existing research relies on objective indicators of inequality, this analysis emphasizes the importance of subjective perceptions for understanding political trust. Using cross-national survey data from the International Social Survey Programme, the findings showed that individuals who perceive greater inequality are more likely to identify with a lower social class, and this self-placement is, in turn, associated with lower trust in electoral outcomes. These results highlight a pathway through which inequality influences democratic legitimacy, operating not only through structural conditions but also through how individuals interpret their relative social position. By identifying this association, this study contributes to debates on inequality and democratic resilience and calls for greater attention to the subjective dimensions of inequality in efforts to safeguard electoral legitimacy. Full article

Background/Objectives: Adult cochlear implant (CI) users exhibit broad variability in speech perception and production outcomes. Cochlear implantation improves the intelligibility (comprehensibility) of CI users’ speech, but the degraded auditory signal delivered by the CI may attenuate this benefit. Among other effects, degraded auditory feedback can lead to compression of the acoustic–phonetic vowel space, which makes vowel productions confusable, decreasing intelligibility. Sustained exposure to degraded auditory feedback may also weaken phonological representations. The current study examined the relationship between subjective ratings and acoustic measures of speech production, speech recognition accuracy, and phonological processing (cognitive processing of speech sounds) in adult CI users. Methods: Fifteen adult CI users read aloud a series of short words, which were analyzed in two ways. First, acoustic measures of vowel distinctiveness (i.e., vowel dispersion) were calculated. Second, thirty-seven normal-hearing (NH) participants listened to the words produced by the CI users and rated the subjective intelligibility of each word from 1 (least understandable) to 100 (most understandable). CI users also completed an auditory sentence recognition task and a nonauditory cognitive test of phonological processing. Results: CI users rated as having more understandable speech demonstrated more accurate sentence recognition than those rated as having less understandable speech, but intelligibility ratings were only marginally related to phonological processing. Further, vowel distinctiveness was marginally associated with sentence recognition but not related to phonological processing or subjective ratings of intelligibility. Conclusions: The results suggest that speech intelligibility ratings are related to speech recognition accuracy in adult CI users, and future investigation is needed to identify the extent to which this relationship is mediated by individual differences in phonological processing. Full article

The pursuit of a comprehensive understanding of human consciousness, which includes the subjective experience of perception, is a long-standing endeavor. A multitude of disciplines have sought to elucidate and define consciousness, with a particular emphasis on its etiology. What is the cause of consciousness? One particularly eye-opening idea is that humans attempt to identify the source of consciousness by leveraging their own consciousness, as if something is attempting to elucidate itself. Strikingly, the results of brain-imaging experiments indicate that the brain processes a considerable amount of information outside conscious awareness of the organism in question. Perhaps, the vast majority of decision making, thinking, and planning processes originate from non-conscious brain processes. Nevertheless, consciousness is a fascinating phenomenon, and its intrinsic nature is both intriguing and challenging to ascertain. In the end, it is not necessarily given that consciousness, in particular the phenomenon of perception as the subjective experience it is, is a tangible function or process in the first place. This is why it must be acknowledged that this theoretical paper is not in a position to offer a definitive solution. However, it does present an interesting new concept that may at least assist future research and potential investigations in achieving a greater degree of elucidation. The concept is founded upon a physical (mathematical) phenomenon known as stochastic resonance. Without delving into the specifics, it is relatively straightforward to grasp one of its implications, which is employed here to introduce a novel direction regarding the potential for non-conscious information within the human brain to become conscious through the introduction of noise. It is noteworthy that this phenomenon can be visualized through a relatively simple approach that is provided in the frame of this paper. It is demonstrated that a completely white image is transformed into an image depicting clearly recognizable content by the introduction of noise. Similarly, information in the human brain that is processed below the threshold of consciousness could become conscious within a neural network by the introduction of noise. Thereby, the noise (neurophysiological energy) could originate from one or more of the well-known activating neural networks, with their nuclei being located in the brainstem and their axons connecting to various cortical regions. Even though stochastic resonance has already been introduced to neuroscience, the innovative nature of this paper is a formal introduction of this concept within the framework of consciousness, including higher-order perception phenomena. As such, it may assist in exploring novel avenues in the search for the origins of consciousness and perception in particular. Full article

Background: Shared Decision-Making (SDM) is important for patient-centred care, especially in areas such as gynaecological oncology where treatment decisions are often multifaceted. This study aimed to implement and measure SDM in a gynaecological oncology outpatient clinic, specifically assessing the impact of the BRAN (Benefits, Risks, Alternatives, Nothing) tool on patient and physician perceptions. Methods: A two-phased prospective observational and survey mixed-methodology study was conducted at the tertiary Northern Gynaecological Oncology Centre (NGOC) outpatient clinic in Gateshead, United Kingdom, from October 2023 to November 2024. SDM champions provided staff training. Patient and physician perspectives were measured using the nine-item Shared Decision Making Questionnaire (SDM-Q-9). Phase one was a baseline assessment; phase two involved the implementation of BRAN posters and leaflets. Statistical analyses included the Mann–Whitney U Test and Fisher’s Exact Test. A post-implementation online staff survey was conducted. Results: A total of 207 patients and 13 physicians participated: 107 patients and 13 physicians in phase one and 100 patients and 12 physicians in phase two. Whilst no statistically significant difference in patients’ perceptions of SDM was found between phases (p = 0.73), physicians’ perceptions showed a statistically significant improvement after BRAN tool implementation (p < 0.01). The staff survey results indicated that 84% observed increased patient involvement, and 92% agreed that SDM helped achieve consultation goals. Conclusions: The implementation of SDM at the NGOC led to a statistically significant improvement in the subjective use of SDM by physicians’, despite no significant change in patients’ perceptions, possibly due to high baseline levels. Staff reported increased patient engagement and improved consultation styles. These findings support implementing SDM in gynaecological oncology outpatient settings Full article

The growing complexity of distribution-level virtual power plants (VPPs) demands a rethinking of how flexible demand is modeled, aggregated, and dispatched under uncertainty. Traditional optimization frameworks often rely on deterministic or homogeneous assumptions about end-user behavior, thereby overestimating controllability and underestimating risk. In this paper, we propose a behavior-aware, two-stage stochastic dispatch framework for VPPs that explicitly models heterogeneous user participation via integrated behavioral economics and social interaction structures. At the behavioral layer, user responses to demand response (DR) incentives are captured using a Prospect Theory-based utility function, parameterized by loss aversion, nonlinear gain perception, and subjective probability weighting. In parallel, social influence dynamics are modeled using a peer interaction network that modulates individual participation probabilities through local contagion effects. These two mechanisms are combined to produce a high-dimensional, time-varying participation map across user classes, including residential, commercial, and industrial actors. This probabilistic behavioral landscape is embedded within a scenario-based two-stage stochastic optimization model. The first stage determines pre-committed dispatch quantities across flexible loads, electric vehicles, and distributed storage systems, while the second stage executes real-time recourse based on realized participation trajectories. The dispatch model includes physical constraints (e.g., energy balance, network limits), behavioral fatigue, and the intertemporal coupling of flexible resources. A scenario reduction technique and the Conditional Value-at-Risk (CVaR) metric are used to ensure computational tractability and robustness against extreme behavior deviations. Full article