Search Results (320)

This study investigates the challenges of promoting accessibility for deaf teachers and students in higher education, focusing on the development of inclusive teaching materials. A qualitative case study was conducted in ten teacher training programmes at the Federal University of Alagoas (Brazil), including nine distance learning courses and one face-to-face LIBRAS programme. Analysis of the Virtual Learning Environment revealed a predominance of text-based content, with limited use of Libras videos, visual resources, or assistive technologies. The integration of Brazilian Sign Language into teaching practices was minimal, and digital translation tools were rarely used or contextually appropriate. Educators reported limited training, technical support, and institutional guidance for the creation of accessible materials. Time constraints and resource scarcity further hampered inclusive practices. The results highlight the urgent need for institutional policies, continuous teacher training, multidisciplinary support teams, and the strategic use of digital technologies and Artificial Intelligence (AI). Compared with previous studies, significant progress has been made. The present study highlights the establishment of an Accessibility Centre (NAC) and an Accessibility Laboratory (LAB) at the university. These facilities are designed to support the development of policies for the inclusion of people with disabilities, including deaf students, and to assist teachers in designing educational resources, which is essential for enhancing accessibility and learning outcomes. Artificial intelligence tools—such as sign language translators including Hand Talk, VLibras, SignSpeak, Glove-Based Systems, the LIBRAS Online Dictionary, and the Spreadthesign Dictionary—can serve as valuable resources in the teaching and learning process. Full article

In this paper, we propose a distributed prescribed performance formation tracking control method for unknown Euler–Lagrange systems subject to input amplitude constraints. We address the challenge of maintaining formation tracking within predefined performance bounds when the agents’ inputs are subject to saturation. This is achieved by designing a distributed virtual velocity reference modification mechanism, which modifies the desired velocity reference of each agent whenever saturation occurs. We establish sufficient feasibility conditions for the input constraints that ensure prescribed performance formation tracking of the desired trajectory and guarantee the boundedness of all closed-loop signals. Simulations on a team of underwater vehicles validate the method’s effectiveness. Full article

Background: Transitions from hospital to long-term care (LTC) facilities are critical periods for older adults living with dementia, often involving complex medical, cognitive, and psychosocial needs. Virtual team-based care has emerged as a promising strategy to improve communication, coordination, and continuity of care during these transitions. However, there is limited evidence on how such approaches are implemented in practice, particularly with respect to inclusion, equity, and engagement of older adults and families. Objective: This study aimed to identify the enablers and barriers to delivering virtual team-based care to support older adults with dementia in transitioning from hospital to LTC. Methods: We conducted a qualitative study using semi-structured interviews, focus groups, and a policy review. Data were collected from 60 participants, including healthcare providers, older adults, and family care partners across hospital and LTC settings in British Columbia, Canada. Thematic analysis was conducted using a hybrid inductive and deductive approach. Eighteen institutional policies and guidelines on virtual care and dementia transitions were reviewed to contextualize findings. Results: Four themes were identified: (1) enhancing communication and collaboration, (2) engaging families in care planning, (3) digital access and literacy, and (4) organizational readiness and infrastructure. While virtual huddles and secure messaging platforms supported timely coordination, implementation was inconsistent due to infrastructure limitations, unclear protocols, and staffing pressures. Institutional policies emphasized privacy and security but lacked guidance for inclusive engagement of older adults and families. Many participants described limited access to reliable technology, a lack of training, and the absence of tools tailored for individuals with cognitive impairment. Conclusions: Virtual care has the potential to support more coordinated and inclusive transitions for people with dementia, but its success depends on more than technology. Structured protocols, inclusive policies, and leadership commitment are essential to ensure equitable access and meaningful engagement. The proposed VIRTUAL framework offers practical tips for strengthening virtual team-based care by embedding ethical, relational, and infrastructural readiness across settings. Full article

Background/Objectives: Novice nurses often struggle to assertively voice patient safety concerns due to limited clinical experience and hierarchical healthcare environments. Immersive virtual reality simulation (IVRS) may provide opportunities to practice assertive communication skills essential for interprofessional collaboration in a psychologically safe environment. This study aimed to evaluate the short- and long-term effectiveness of an IVRS speak-up training program in enhancing communication clarity and collaborative attitudes, as well as reducing experiences of nursing malpractice among novice nurses. Methods: A quasi-experimental study was conducted with 36 novice nurses (18 participants each in control and experimental groups). The experimental group received a 200 min IVRS speak-up training program incorporating TeamSTEPPS communication strategies through four virtual reality scenarios. The control group received a 110 min conventional group lectures and discussions on communication training covering the same TeamSTEPPS strategies. Communication clarity and collaborative attitudes were measured at baseline, immediately post-intervention, and 6 weeks post-intervention. Nursing malpractice experiences were assessed at 6 weeks post-intervention. Results: Communication clarity showed no significant interaction effect between groups and time points (F = 0.84, p = 0.437), though both groups demonstrated immediate post-intervention improvements. Collaborative attitudes showed a significant interaction effect (F = 4.23, p = 0.020), with the experimental group exhibiting significantly greater and sustained improvements at immediate and 6-week follow-up compared with the control group. No significant difference in nursing malpractice experiences was observed between groups (Z = 0.16, p = 0.872). Conclusions: The IVRS speak-up training program effectively enhanced novice nurses’ assertive communication skills in immersive, interactive environments tailored for realistic practice compared to conventional group discussion-based training. This program improved communication clarity in the short term and enhanced collaborative attitudes up to 6 weeks. Integrating or boosting IVRS training into novice nurses’ communication education may foster interprofessional collaboration and advance patient safety in clinical practice. Full article

Background: The COVID-19 pandemic placed unprecedented strain on long-term care facilities (LTCFs), disproportionately affecting care aides who provide essential frontline support. This study explored the impact of the pandemic on care aides’ job satisfaction in LTCFs across Northern British Columbia, a geographically and structurally underserved region. Methods: Eight care aides participated in semi-structured virtual interviews, and data were analyzed using Braun and Clarke’s thematic analysis. Results: Five key themes emerged: (1) work environment and staffing conditions, (2) emotional and psychological burden, (3) communication and team dynamics, (4) resident care and safety, and (5) effects of evolving COVID-19-related policies. Participants consistently described emotional exhaustion, policy fatigue, grief from resident deaths, communication breakdowns, and uncertainty stemming from frequent procedural changes. These stressors were compounded by staffing shortages and limited access to mental health support, especially in rural settings. Conclusion: The findings highlight the urgent need for structural and psychological supports, including responsive leadership, accessible mental health resources, and stable employment policies, to protect care aides’ well-being and ensure quality of care in future public health emergencies. Full article

Virtual reality (VR) is becoming an increasingly popular tool across a range of domains, from education and healthcare to entertainment and workforce development. Organizations are now beginning to adopt VR for personnel management purposes, including training, evaluation, and decision-making. However, little is known about how such uses influence public perceptions of the organizations themselves. To address this gap, we conducted a three-study investigation examining how individuals perceive organizations that implement VR for various workplace applications. Across the studies, participants were presented with scenarios involving fictitious companies using VR in either low-stakes (e.g., team meeting) or high-stakes (e.g., job interview) contexts. Our findings suggest that people generally view VR technology and the organizations who use the technology positively. However, the context of use significantly shapes perceptions, where organizations that used VR in high-stakes applications were evaluated more negatively than those using it in low-stakes settings. This pattern suggests that while VR carries a general technological appeal, its application in high-stakes contexts may lead to skepticism or concern. We discuss the implications of these findings for organizations considering the integration of VR into personnel practices, highlighting the importance of context and transparency in shaping stakeholder perceptions. Full article

Background/Objectives: Auricular epitheses play a vital role in restoring facial symmetry and patient confidence following congenital or acquired defects. Traditional wax-based fabrication is labor-intensive and lacks reproducibility. This study proposes and evaluates a simplified, digitally driven workflow for auricular prosthesis manufacturing, integrating virtual patient creation, mirrored ear design, and three-part mold fabrication using two design platforms—CATIA V5R21 (industrial CAD) and Blender (open-source graphics software). Key outcomes include mold reusability, patient-centered evaluation, and workflow feasibility. Methods: A 28-year-old female patient with right-sided microtia was selected. A light-based 3D facial scan was performed, and the intact contralateral ear was mirrored and adapted virtually to the defect site. Molds were designed in both CATIA and Blender using a standardized three-parallelepiped approach and printed using FDM technology (Elegoo Neptune 4 Plus). Five silicone epitheses were carefully fabricated with each mold. Surface trueness was evaluated with Geomagic Control X, while subjective assessments were conducted by an independent prosthetic team and the patient using Visual Analogue Scales (VAS). Results: Both design workflows resulted in clinically usable prostheses. No statistically significant difference in RMS deviation was observed (p = 0.53), although CATIA-derived epitheses achieved higher subjective scores (mean 9.22/10) compared to Blender (mean 7.67/10). The preferred prosthesis (CATIA #4) was selected for final pigmentation and delivery to the patient. All molds were reused five times without any structural damage or significant signs of wear. Conclusions: This study demonstrates that both CATIA and Blender can support an effective, patient-centered digital workflow for auricular prosthesis fabrication. The methodology enables reproducibility, mold reusability, and improved clinical accessibility of custom prosthetics. Full article

Jaw in a Day (JIAD) reconstruction provides immediate restoration of mandibular form and function through a single-stage procedure that integrates fibula free flap reconstruction, virtual surgical planning (VSP), immediate dental implant placement, and delivery of a prefabricated prosthesis. Although the technique provides significant benefits in reducing rehabilitation time and improving patient outcomes, its adoption has been limited due to perceived technical complexity and unfamiliarity with dental workflow. This manuscript provides a detailed, step-by-step protocol to guide surgeons through their first JIAD case, from patient selection and data acquisition to VSP execution, intraoperative coordination, and implant positioning. Emphasis is placed on accurate osteotomy design, implant placement using guided protocols, fabrication of patient-specific hardware, and precise prosthesis pickup techniques. This guide also addresses essential OR team preparation and sterile handling of non-sterile components. By breaking down the process into actionable stages and highlighting common pitfalls and technical tips, this resource aims to lower the barrier for early adopters and enhance the success of initial JIAD cases. Full article

This study investigates the complex interaction between in-game behaviors, post-game emotional expressions, and Game Transfer Phenomena (GTP) among MOBA players. A multidimensional framework is adopted to examine how gaming experiences shape real-world cognition, perception, and behavior through the integration of objective behavioral metrics and affective computing-based emotion recognition. The results indicate that in-game Deaths are negatively associated with altered sensory perceptions—specifically Altered Visual and Auditory Perceptions (AVP and AAP)—suggesting that performance failures may disrupt immersive engagement. In contrast, Assists, as indicators of team-based collaboration, are positively associated with Automatic Mental Processes (AMP), highlighting the cognitive impact of cooperative gameplay. Although no significant mediating effects were observed, emotional dimensions, such as Social Discomfort and Cognitive Focus, offered additional insights into the transfer between in-game and post-game experiences. These findings bridge the gap between virtual and real-world experiences, offering theoretical advancements in GTP research and practical implications for game design, emotional regulation, and psychological interventions. Full article

Background/Objectives: Workplace conflict and aggression pose significant psychosocial risks across diverse professional sectors. This protocol outlines a novel, university-based educational intervention. Developed by a multidisciplinary team from the University Hospital of Pisa, Italy, including occupational physicians and a psychiatrist specializing in work and organizational psychology, its primary purpose is to enhance conflict prevention and crisis management skills. While initially developed and tested within the veterinary sector due to its identified vulnerabilities, the intervention is inherently generalizable to any high-stress professional environment characterized by intense client, customer, or public interactions. Methods: The intervention integrates didactic instruction with active, immersive learning through tailored role-playing scenarios simulating real-world challenging encounters. This study protocol details the structured methodology for evaluating the immediate effectiveness of this training. We are using a specifically developed efficacy scale to assess outcomes. Results: The results demonstrate a significant improvement in all assessed skills from the pre-training to the post-training evaluation. For every item on the scale, the median scores increased, indicating a positive shift in overall group performance. The p-value for each item was <0.001, confirming that the observed improvements were statistically significant. These results demonstrate enhanced conflict resolution skills, improved communication, and an increased sense of self-efficacy among participants. Conclusions: This protocol offers a comprehensive and generalizable approach to addressing workplace psychosocial risks through an innovative educational intervention. A key future goal involves advancing this training methodology by integrating virtual reality (VR) environments with AI-driven avatars for role-playing, aiming to achieve a more realistic and impactful learning experience and sustained behavioral change. Full article

The Maxillary Skeletal Expander (MSE) is used for maxillary expansion in adolescents and young adults. Virtual planning using 3D models, CBCT and 3D printers help in case selection, appliance design and fabrication. Using the proposed digital workflow, the accuracy of the patient selection phase and appliance delivery are increased, and the required number of visits to the clinic is decreased. The MSE serves as a guide for the insertion of mini-implants, reducing the number of appointments needed for installation. (1) Introduction: Mini-Implant-Assisted Rapid Palatal Expansion (MARPE) appliances, like the MSE, decrease the side effects that regular tooth-anchored appliances have on dental and periodontal structures, especially for skeletally mature patients, combining palatal anchorage with dental support for guidance. The digital planning of the insertion sites, length and angulation of the mini screws, and the fabrication of the 3D-printed appliance that stands as a mini-implant insertion guide give an undeniable precision. (2) Materials and methods: The laboratory steps used in the digital design and fabrication, and clinical steps needed for the insertion protocol are described. (3) Discussions: The individual assessment of the anatomical structures and the use of virtual integrated dental impressions and CBCT increase the accuracy of diagnosis, appliance fabrication and treatment progress. Implementing a digital workflow for mini-implant-supported expansion is a real advantage for both dental teams and patients. (4) Conclusions: The wide range of advantages and the ease of the process support the introduction of this digital workflow in every orthodontic practice. Full article

Infrastructure as code (IaC) is essential for modern cloud development, enabling teams to define, deploy, and manage infrastructure in a consistent and repeatable manner. As organizations migrate to Azure, selecting the right approach is crucial for managing complexity, minimizing errors, and supporting DevOps practices. This paper examines the use of Azure Bicep with GitHub Actions to automate infrastructure deployment for an application in the Azure cloud. It explains how Bicep improves readability, modularity, and integration compared to traditional ARM templates and other automation tools. The solution utilizes a modular Bicep design to deploy resources, including virtual networks, managed identities, container apps, databases, and AI services, with environment-specific parameters for development, QA, and production. GitHub Actions workflows automate the building, deployment, and tearing down of infrastructure, ensuring consistent deployments across environments. Security considerations include managed identities, private networking, and secret management in continuous integration (CI) and continuous delivery (CD) pipelines. This paper provides a detailed architectural overview, workflow analysis, and implementation guidance to help teams adopt a robust, automated approach to Azure infrastructure deployment. By leveraging automation tooling and modern DevOps practices, organizations can streamline delivery and maintain secure, maintainable cloud environments. Full article

Hospital in the Home (HITH) programs are emerging as a key pillar of smart city healthcare infrastructure, leveraging technology to extend care beyond traditional hospital walls. The global healthcare sector has been conceptualizing the notion of a care without walls hospital, also called HITH, where virtual care takes precedence to address the multifaceted needs of an increasingly aging population grappling with a substantial burden of chronic disease. HITH programs have the potential to significantly reduce hospital bed occupancy, enabling hospitals to better manage the ever-increasing demand for inpatient care. Although many health providers and hospitals have established their own HITH programs, there is a lack of research that provides healthcare executives and HITH program managers with management models and frameworks for such initiatives. There is also a lack of research that provides strategies for improving HITH management in the health sector. To fill this gap, the current study ran a systematic literature review to explore state-of-the-art with regard to this topic. Out of 2631 articles in the pool of this systematic review, 20 articles were deemed to meet the eligibility criteria for the study. After analyzing these studies, nine management models were extracted, which were then categorized into three categories, namely, governance models, general models, and virtual models. Moreover, this study found 23 strategies and categorized them into five groups, namely, referral support, external support, care model support, technical support, and clinical team support. Finally, implications of findings for practitioners are carefully provided. These findings provide healthcare executives and HITH managers with practical frameworks for selecting appropriate management models and implementing evidence-based strategies to optimize program effectiveness, reduce costs, and improve patient outcomes while addressing the growing demand for home-based care. Full article

Background and Aim: Artificial intelligence (AI) is among the most promising innovations for transforming nursing education, making it more interactive, personalized, and competency-based. However, its integration also raises significant ethical and practical concerns. This scoping review aims to analyze and summarize key studies on the application of AI in university-level nursing education, focusing on its benefits, challenges, and future prospects. Methods: A scoping review was conducted using the Population, Concept, and Context (PCC) framework, targeting nursing students and educators in academic settings. A comprehensive search was carried out across the PubMed, Scopus, and Web of Science databases. Only peer-reviewed original studies published in English were included. Two researchers independently screened the studies, resolving any disagreements through team discussion. Data were synthesized narratively. Results: Of the 569 articles initially identified, 11 original studies met the inclusion criteria. The findings indicate that AI-based tools—such as virtual simulators and ChatGPT—can enhance students’ learning experiences, communication skills, and clinical preparedness. Nonetheless, several challenges were identified, including increased simulation-related anxiety, potential misuse, and ethical concerns related to data quality, privacy, and academic integrity. Conclusions: AI offers significant opportunities to enhance nursing education; however, its implementation must be approached with critical awareness and responsibility. It is essential that students develop both digital competencies and ethical sensitivity to fully leverage AI’s potential while ensuring high-quality education and responsible nursing practice. Full article

This paper introduces a unified and systematic design methodology for robotic systems that is generalizable across a wide range of applications. It integrates rigorous mathematical formalisms such as kinematics, dynamics, control theory, and optimization with advanced simulation tools, ensuring that each design decision is grounded in provable theory. The approach defines clear phases, including mathematical modeling, virtual prototyping, parameter optimization, and theoretical validation. Each phase builds on the previous one to reduce unforeseen integration issues. Spanning from conceptualization to deployment, it offers a blueprint for developing mathematically valid and robust robotic solutions while streamlining the transition from design intent to functional prototype. By standardizing the design workflow, this framework reduces development time and cost, improves reproducibility across projects, and enhances collaboration among multidisciplinary teams. Such a generalized approach is essential in today’s fast-evolving robotics landscape where rapid innovation and cross-domain applicability demand flexible yet reliable methodologies. Moreover, it provides a common language and set of benchmarks that both novice and experienced engineers can use to evaluate performance, facilitate knowledge transfer, and future-proof systems against emerging application requirements. Full article