Search Results (344)

This study examines journalists’ perceptions of the impact of artificial intelligence (AI) on disinformation, a growing concern in journalism due to the rapid expansion of generative AI and its influence on news production and media organizations. Using a quantitative approach, a structured survey was administered to 504 journalists in the Basque Country, identified through official media directories and with the support of the Basque Association of Journalists. This survey, conducted online and via telephone between May and June 2024, included questions on sociodemographic and professional variables, as well as attitudes toward AI’s impact on journalism. The results indicate that a large majority of journalists (89.88%) believe AI will considerably or significantly increase the risks of disinformation, and this perception is consistent across genders and media types, but more pronounced among those with greater professional experience. Statistical analyses reveal a significant association between years of experience and perceived risk, and between AI use and risk perception. The main risks identified are the difficulty in detecting false content and deepfakes, and the risk of obtaining inaccurate or erroneous data. Co-occurrence analysis shows that these risks are often perceived as interconnected. These findings highlight the complex and multifaceted concerns of journalists regarding AI’s role in the information ecosystem. Full article

Background: The World Health Organization defined specific recommendations about digital tobacco cessation modalities as a self-management tool or as an adjunct to other support for adults. Objectives: The present umbrella review primarily aimed to assess the long-term (≥6 months) effectiveness and adherence of the different standalone digital tobacco cessation modalities (mobile text messaging, smartphone apps, Internet-based websites and programs, AI-based), administered individually or in combination; secondarily, the study aimed to assess the effect on smokers’ health. Methods: The present study (PROSPERO number: CRD42024601824) followed the PRISMA guidelines. The included studies were qualitatively synthesized and evaluated through the AMSTAR-2 tool. Results: Forty-five systematic reviews were included, encompassing 164,010 adult daily smokers of combustible tobacco. At 6 months, highly interactive or human-centered digital tools showed higher effectiveness (biochemically verified continuous abstinence rates (CARs) were 11.48% for smartphone apps and 11.76% for video/telephone counseling). In contrast, at 12 months, simpler, less interactive tools demonstrated higher effectiveness (self-reported CARs was 24.38% for mobile text messaging and 18.98% for Internet-based). Adherence rates were generally high, particularly with human-centered digital tools, amounting to 94.12% at 6 months and 64.08% at 12 months. Compared with individually administered digital tobacco cessation modalities, at 12 months, combined ones registered slightly higher effectiveness (self-reported CARs were 13.12% vs. 13.94%) and adherence (62.36% vs. 63.70%), potentially attributed to the multi-component nature and longer durations. Conclusions: Clinicians should prioritize combined digital tobacco cessation interventions that incorporate human-centered engagement initially, alongside simpler, sustained digital support to enhance long-term effectiveness and adherence. Future research should explore long-term medical and oral health benefits to assess the impact on overall health and well-being. Full article

Background/Objectives: Family caregivers in palliative care often face complex physical, emotional, and logistical challenges, which can result in a significant caregiving burden. Dyadic interventions—designed to support both the patient and the caregiver simultaneously—have emerged as a promising holistic approach to enhancing well-being and quality of life. This systematic review aimed to evaluate the effects of dyadic support interventions in reducing caregiver burden among middle-aged and older adults receiving palliative care. Methods: A systematic literature search was conducted following PRISMA guidelines across five databases (CINAHL, MEDLINE, Web of Science, Scopus, and Google Scholar for grey literature) covering the period from 2019 to January 2025. Results: Of 653 records identified, 8 studies met the inclusion criteria. Interventions were typically delivered by multidisciplinary teams and included weekly in-person consultations, telephone follow-up, telemedicine, physical exercise sessions, laughter therapy, and music therapy over durations ranging from 16 weeks to 6 months. These programs resulted in reduced anxiety and depressive symptoms (PHQ-4, HADS, SDS, BAI, SAS), improved functional and social performance (SF-36), and/or enhanced quality of life (MQLQ, QOL-AD, KCCQ-12, EORTC QLQ-C30). In patients, they contributed to better symptom control (ESAS, CFS), while in caregivers, they effectively reduced burden (ZBI-12, FCBSI, CBI) and/or supported the anticipatory grief process (PGQ, AGS). However, not all studies reported consistently positive outcomes. Conclusions: Structured dyadic interventions that involve both patients and caregivers significantly improve outcomes in palliative care for middle-aged and older adults. Future research should examine their long-term impact and explore the integration of artificial intelligence to optimize intervention delivery. Full article

The COVID-19 pandemic exacerbated mental illness, accelerated cognitive decline, and deepened social inequalities. In low and middle-income countries (LMIC) such as Panama, it is unclear as to whether, and to what extent, the pandemic lockdowns affected cognitive, mental, and physical health of older adults. This study investigated changes in cognitive function, mental health, and physical health in a sample of Panamanian older adults assessed before and during the pandemic, and examined whether sociodemographic variables were associated with cognition and mental health. Participants completed in-person interviews between 2018 and early 2020 and a follow-up telephone interview between February and May 2021. Repeated measures analyses showed no significant changes in cognitive function or depression; however, participants reported fewer chronic illnesses. Linear regression analysis indicated that higher cognitive function during the pandemic was associated with younger age, higher education, and having sufficient income. An attrition analysis compared participants who completed both interviews to those who were lost to follow-up, revealing that participants who dropped out of the study had lower socioeconomic status and greater impairment at baseline. These findings highlight the need for targeted support for vulnerable older adults during public health crises. Full article

Background/Objectives: Feigning spectrum behavior (FSB) is the exaggeration, fabrication, or false imputation of symptoms. It occurs in compensable injury with great cost to society by way of loss of productivity and excessive costs. The aim of this study is to identify feigning by developing cut scores on the long and short forms (SF) of the Orebro Musculoskeletal Pain Screening Questionnaire (OMPSQ and OMPSQ-SF) and the Perceived Stress Scale (PSS and PSS-4). Methods: As part of pre-screening for a support program, 40 injured workers who had been certified unfit for work for more than 2 weeks were screened once with the OMPSQ and PSS by telephone by a mental health professional. A control sample comprised of 40 non-injured community members were screened by a mental health professional on four occasions under different aliases, twice responding genuinely and twice simulating an injury. Results: Differences between the workplace injured people and the community sample were compared using ANCOVA with age and gender as covariates, and then receiver operator characteristics (ROCs) were calculated. The OMPSQ and OMPSQ-SF discriminated (ρ < 0.001) between all conditions. All measures discriminated between the simulation condition and workplace injured people (ρ < 0.001). Intraclass correlation demonstrated the PSS, PSS-4, OMPSQ, and OMPSQ-SF were reliable (ρ < 0.001). Area Under the Curve (AUC) was 0.750 for OMPSQ and 0.835 for OMPSQ-SF for work-injured versus simulators. Conclusions: The measures discriminated between injured and non-injured people and non-injured people instructed to simulate injury. Non-injured simulators produced similar scores when they had multiple exposures to the test materials, showing the uniformity of feigning spectrum behavior on these measures. The OMPSQ-SF has adequate discriminant validity and sensitivity to feigning spectrum behavior, making it optimal for telephone screening in clinical practice. Full article

Background/Objectives: Obstructive sleep apnea (OSA) is a highly prevalent disorder that significantly impacts quality of life and daily functioning. While continuous positive airway pressure (CPAP) therapy is effective, long-term adherence remains a challenge. This single-arm observational study aimed to evaluate clinical outcomes and adherence patterns during telemedicine-supported CPAP therapy and identify distinct phenotypic response clusters in Romanian patients with OSA. Methods: This prospective observational study included 86 adults diagnosed with OSA, treated with ResMed Auto CPAP devices at “Victor Babeș” University Hospital in Timișoara, Romania. All patients were remotely monitored via the AirView™ platform and received monthly telephone interventions to promote adherence when necessary. Clinical outcomes were assessed through objective telemonitoring data. K-means clustering and t-distributed stochastic neighbor embedding (t-SNE) were employed to explore phenotypic response patterns. Results: During telemedicine-supported CPAP therapy, significant clinical improvements were observed. The apnea–hypopnea index (AHI) decreased from 42.0 ± 21.1 to 1.9 ± 1.3 events/hour. CPAP adherence improved from 75.5% to 90.5% over six months. Average daily usage increased from 348.4 ± 85.8 to 384.2 ± 65.2 min. However, post hoc analysis revealed significant concerns about the validity of self-reported psychological improvements. Self-esteem changes showed negligible correlation with objective clinical measures (r < 0.2, all p > 0.1), with only 3.3% of variance being explained by measurable therapeutic factors (R² = 0.033). Clustering analysis identified four distinct adherence and outcome profiles, yet paradoxically, patients with lower adherence showed greater self-esteem improvements, contradicting therapeutic causation. Conclusions: Telemedicine-supported CPAP therapy with structured monthly interventions was associated with substantial clinical improvements, including excellent AHI reduction (22-fold) and high adherence rates (+15% after 6 months). Data-driven phenotyping successfully identified distinct patient response profiles, supporting personalized management approaches. However, the single-arm design prevents definitive attribution of improvements to telemonitoring versus natural adaptation or placebo effects. Self-reported psychological outcomes showed concerning patterns suggesting predominant placebo responses rather than therapeutic benefits. While the overall findings demonstrate the potential value of structured telemonitoring for objective CPAP outcomes, controlled trials are essential to establishing true therapeutic efficacy and distinguishing intervention effects from measurement bias. Full article

Aim: To explore the experiences, beliefs, and values of patients who participated in a two-arm randomized clinical trial assessing a nurse-led intervention program for chronic pain self-management, which demonstrated positive effects on pain reduction, depression, and anxiety, and on health-related quality of life 24 months after completion of the program. Design: Descriptive phenomenological qualitative study. Methods: Patients were recruited via telephone, informed about the study, and invited to participate in an individual interview at a place of their choice (hospital or home). All interviews were audiotaped, and an inductive thematic analysis was performed. Results: Seven interviews were carried out between both groups. Six emerging categories were found: effective relationship with the healthcare system, learning to live with pain, family and social support, behaviors regarding pain, resources for self-management, and concomitant determinants. Conclusions: Patients report key aspects that help us to understand the impact of this type of nurse-led group intervention: the intrinsic therapeutic effect of participating in the program itself, the ability to learn to live with pain, the importance of family and social support, the modification of pain-related behaviors, and the identification of resources for self-care. The findings highlight the need for gender-sensitive, individualized care approaches to chronic pain, addressing stigma and social context. Expanding community-based programs and supporting caregivers is essential, as is further research into gender roles, family dynamics, and work-related factors. Full article

Pharmacist-led transitions of care (TOC) services decrease preventable hospital readmission. TOC service implementation assessment can inform translation to real-world settings. The purpose of this study was to evaluate the implementation of a TOC service for patients with multiple admissions at a regional hospital using the RE-AIM framework. In this quasi-experimental, non-randomized study, individuals with ≥2 recent hospitalizations received pharmacist-led discharge medication reconciliation and counseling, management of drug-related problems, post-discharge telephonic visits, and social support. The reach, effectiveness, implementation, and maintenance RE-AIM dimensions were assessed using patient and service records. Outcomes included 30-day readmission rates for individuals completing ≥1 outpatient pharmacist visit (intervention) versus those unreachable in the outpatient setting (comparison), completed interventions, implementation features, and service adaptations. Chi-square and Fisher’s exact tests were used for comparison of categorical variables and the t-test was used for continuous variables. From February 2022 to August 2023, 72.7% of the 66 service participants participated in the intervention (reach). Additionally, 30-day readmission was 22.9% (intervention) versus 55.6% (comparison; p = 0.01). In total, 2279 interventions were documented (effectiveness). The service was adapted (implementation) and expanded to include additional populations (maintenance) to enhance sustainability. Based on RE-AIM evaluation, the pharmacist-led TOC intervention appears to be a sustainable solution for addressing readmission in multivisit patients. Full article

Background/Objectives: In Germany, the provision of healthcare for post-COVID patients primarily lies with general practitioners (GPs), who often lack the necessary knowledge and skills. As part of the PostCovidCare pilot study (PCC), case management software incorporating a symptom diary was introduced and piloted in n = 10 GP practices with n = 33 included patients involved (September 2022–March 2023). This study aimed to explore patients’ experiences. Methods: Semi-structured telephone interviews were transcribed and analyzed using qualitative content analysis. A total of n = 10 patient interviews were conducted (July–September 2023). Results: Patients’ experiences were heterogeneous. The service was largely structured, involving an extensive initial assessment, follow-up appointments, questionnaires, and support from medical assistants, but technical problems with the symptom diary occurred. The GP consultation played a prominent role. Positive aspects included being actively asked about their symptoms, being given a lot of time, initiating diagnostic and therapeutic measures, and having a closer relationship with their GP. Negative aspects included the time taken, resulting exhaustion, duplication of efforts, and insufficient involvement in the consultation process. Conclusions: The pilot study conducted at an early stage of the post-COVID era demonstrated the basic feasibility of case management in primary care from patients’ perspectives. In addition, for future projects, it is important to integrate patients into the design from the outset, adapt the software to users’ needs, and consider care providers’ perspectives. Full article

Background: Few studies have investigated the impact of parental bonding on the quality of life and psychological health in kidney transplant recipients. Exploring these factors could provide valuable insights into the development of psychosocial interventions aimed at improving patients’ psychological adjustment and their overall quality of life. In this perspective, our study aimed to explore how dimensions of parental bonding, particularly maternal care and overprotection, may influence the quality of life and psychological well-being in kidney transplant recipients. By investigating these relationships, the study seeks to understand whether early maternal attachment experiences can predict psychological outcomes in adult transplant recipients. Methods: A cross-sectional study involving a sample of 99 kidney transplant recipients (69.7% males, mean age  =  52  ±  9.93 years) was conducted. Participants were recruited from the outpatient clinic of an Italian transplant center between May 2022 and July 2024. After an initial telephone interview, 1-2 interviews were performed in person to administer the questionnaires of the established protocol: the Parental Bonding Instrument (PBI) to identify the type of parental bond and the Short Form-36 (SF-36) Health Survey to evaluate the quality of life perceived by the patients. Results: Regression analyses revealed that higher perceived maternal care during childhood was positively associated with better psychological health during adulthood (β = 0.290; p < 0.05). Conversely, higher levels of perceived maternal overprotection were negatively associated with psychological health in this population (β = −0.286; p < 0.05). Conclusions: The results suggest that maternal affection and support may serve as a protective factor, while excessive maternal protection could impair the development of emotional coping mechanisms necessary for dealing with the stresses of adult life. Full article

Background: Colonoscopy is an important and essential diagnostic and screening tool for colorectal cancer and other pathologies in the colon. High-quality bowel preparation (BP) is a key quality measure of colonoscopy and is critical for maximizing its effectiveness, including enhancing adenoma detection rates. However, inadequate bowel preparation (IBP) remains a frequent challenge and is influenced by multiple factors. This review aims to summarize and evaluate educational and technological interventions implemented before colonoscopy to improve BP quality. Methods: The methodology comprised a structured narrative review of studies published in English, including randomized controlled trials, prospective studies, observational cohorts, and meta-analyses. Interventions were categorized by their delivery mode and impact on BP adequacy. Interventions included written materials, internet-based education modules, short message service (SMS) reminders, visual aids, instructional videos, verbal communication, telephone support, smartphone applications, and virtual reality (VR) platforms. Results: Most studies reported significant improvements in BP quality with enhanced patient education, particularly with the use of instructional videos and smartphone applications. Verbal communication and telephone support also demonstrated positive outcomes but were limited by resource availability. VR represents a promising emerging technology, though its implementation remains costly and complex. Conclusions: Enhanced educational interventions are proven methods to optimize BP quality. The selection of an appropriate modality should consider patient characteristics, technological accessibility, and institutional resources. Personalized strategies targeting high-risk populations can further reduce IBP rates and improve overall colonoscopy outcomes. Full article

The COVID-19 pandemic has resulted in countless losses around the world, profoundly affecting the lives of many people, especially those who faced the death of family members, bringing several negative repercussions to these families and constraining the experience of grief. This study aimed to understand the experience of loss and grief among bereaved individuals who lost family members during the COVID-19 pandemic. This qualitative study was guided by Charmaz’s constructivist grounded theory as a methodological framework. The study adhered to the Criteria for REporting Qualitative research (COREQ) checklist. Data collection took place between May and November 2023 through telephone interviews that were audio-recorded and later transcribed in full. The purposive sample consisted of 21 bereaved family members who had lost their loved ones during the COVID-19 pandemic. Participants were mainly female (n = 16) with a mean age of 55.5 (SD = 16.2). The loss of their family members occurred 12 to 24 months before data collection. The following central phenomenon was identified through the analytical process: “Family experience of loss and grief: between the unspoken goodbye and post-loss adjustment”. This was anchored in the following three categories: (1) Anguish and fear of the unknown; (2) Death by COVID-19—communication of death and lack of goodbyes; and (3) (Re)construction of meaning—support networks and the grieving process. Our findings recommend that policymakers allocate additional resources to grief support services to better prepare for future pandemic events. Furthermore, it is necessary to invest in the implementation of relevant training programs for healthcare professionals, with a family centered approach. Full article

Participation in science, technology, engineering, and mathematics (STEM) fields is crucial, as these fields present an opportunity for individuals to overcome socio-economic adversities such as unemployment and poverty. In South Africa, access to STEM education has improved in recent years, partly due to the availability of study grants for learners interested in these fields. However, evidence shows that women remain underrepresented in STEM fields. Gender stereotypes, bullying, and pay disparities are cited as some of the contributing factors. Despite these overwhelming challenges, female learners are increasingly pursuing STEM education. Guided by the resilience theory, we explored the factors motivating female learners to enroll in STEM fields at a public secondary school level in South Africa. The research adopted the snowball sampling technique to recruit learners attending a public secondary school in South Africa. Due to COVID-19-related restrictions in 2022, the research data was collected through telephonic one-on-one interviews. The findings revealed that access to competitive employment opportunities, impactful careers, personal growth, and financial independence were some factors sparking the female learners’ interest in STEM. However, the learners experienced gender stereotypes and discrimination, which made them doubt their abilities to thrive in STEM education/fields. To cope with the complexities of STEM, the learners relied on their caregivers for emotional support, and they attended extra lessons and tutorials offered by the education system. The findings highlight the need for the government to prioritize support programs for female learners who must continuously fight rejection in STEM fields. Full article

Objectives: This study aimed to evaluate exclusive breastfeeding (EBF) rates and the duration of breastfeeding among mothers of twins and to identify the maternal, neonatal, and social factors associated with these outcomes. Methods: This retrospective cross-sectional study included 153 mothers of twin infants who were delivered at a tertiary hospital. Data were obtained from medical records and postnatal telephone interviews. Univariate analyses were performed to assess associations with EBF and breastfeeding duration, while multiple linear regression was performed to identify the independent predictors of breastfeeding. Results: The EBF rate within the first six months was 15%, and the mean breastfeeding duration was 10.5 ± 8.3 months. Tandem breastfeeding was positively associated with breastfeeding duration (β = 5.80; 95% CI: 3.51 to 8.10; p < 0.001), whereas bottle feeding showed a strong negative association (β = −9.49; 95% CI: −12.88 to −6.10; p < 0.001). Infants born before 34 weeks had significantly shorter breastfeeding durations, higher rates of NICU admission and respiratory support, and received less skin-to-skin contact and breastfeeding counselling compared to term infants (p < 0.05). Conclusions: Exclusive breastfeeding rates among mothers of twins remain low. Encouraging tandem breastfeeding, reducing bottle use, and providing tailored lactation support—particularly for mothers of preterm infants—may improve breastfeeding outcomes. Breastfeeding support should be adapted according to gestational age in neonatal care. Full article

Background/Objectives: The physical and psychosocial impacts of cancer treatment can be distressing and profound for many patients, but little is known about the specific impacts of undergoing radiotherapy and proton beam therapy (PBT). This study explores the hidden burdens of treatment and aims to identify the gaps in our current understanding of patients’ experience when attending a large radiotherapy and PBT service. Methods: A qualitative study using semi-structured interviews was conducted with patients undergoing treatment. A purposive sample of participants were recruited, reflecting the main indications for radiotherapy and PBT. Semi-structured interviews were conducted between August 2023 and January 2024 either in person, virtually, or by telephone. Data were analysed using Framework Analysis. Results: In total, 20 patients were interviewed. Five themes were identified: informational needs, emotional wellbeing, logistical concerns, physical impacts, and interpersonal impacts. Patients reported additional financial burdens such as transport and staying away from home, difficulty carrying out normal responsibilities, caregiver burden, and increased anxiety. Many patients reported the post-treatment drop in healthcare interaction, which resulted in distress and isolation, difficult. Conclusions: This study indicates that there are many burdens of radiotherapy and PBT outside of the physical symptoms and side-effects of cancer treatment. Tailored support is needed to address treatment-specific concerns within the radiotherapy and PBT service, but this study also suggests that supportive interventions developed for broader cancer populations may be helpful for this patient cohort. Full article