Search Results (38)

Background: Group Care (GC) is an antenatal/postnatal care model comprised of a stable group of pregnant people or parent–child dyads receiving care in two-hour group sessions that combine clinical care with interactive discussion and learning. Integrating GC into healthcare systems organised for individual care poses challenges at both site and system levels. This study identified scheduling-related modifications across contexts to understand modification processes. Methods: We used an explanatory sequential design with mixed qualitative methods across seven GC implementation sites in Belgium, Kosovo, and the United Kingdom. A qualitative survey based on the Framework for Reporting Adaptations and Modifications to Evidence-based interventions (FRAME) was completed at each site by multiple stakeholders. Subsequently, in-depth interviews were conducted to further explore modification processes and examine whether changes were sustained or discontinued up to three years post-implementation initiation. Results: Two modifications were identified across countries: (1) combining GC sessions with individual consultations, and (2) integrating GC into digital booking and medical record systems. Guided by FRAME, we identified similarities and differences in the goals, drivers, and impact of these modifications. The dominant one-to-one antenatal care model strongly influenced modifications, making it more difficult to implement GC as a stand-alone model in obstetrician-led systems (Belgium and Kosovo) compared to a midwifery-led system (UK). In both contexts, the dominant model negatively influenced the perceived value of GC, with GC sessions viewed only as education and individual consultations seen as the actual care. Integration in the booking system appeared essential for payment and scheduling arrangements. Conclusions: Integrating GC scheduling into existing care pathways is challenging in systems where one-to-one care is the predominant model. Sustainable integration of GC requires early coordination and shared ownership across areas, including clinical, administrative, and IT. Full article

Understanding the effects of light on the body at different times of the 24 h solar day is a topic of increasing interest. In this paper, we use a mathematical model from the literature to simulate what would be expected of the human circadian clock on different light schedules. We first reproduce an influential experiment which found eBooks, when compared to a paper book, delayed sleep by roughly 10 min and melatonin onset by 1.5 h. The model is able to match the delay in sleep onset but struggles to reproduce the melatonin phase delay. However, certain initial conditions and parameters are capable of phase shifts consistent with the original study’s magnitude, suggesting that the original study’s finding may have been influenced by the pre-study entrainment or variability among the participants. We next simulate the same protocol under higher daytime light levels (increasing baseline illumination from 90 to 500 lux) and find that brighter daytime exposure reduces both sleep onset latency and the variability in phase delay attributable to evening eBook light. Finally, we explore how the timing of a bright light pulse during the day changes outcomes, such as sleep onset and circadian amplitude, and how these effects interact with light during the other hours of the 24 h day. Together, these modeling results suggest robust daytime light exposure confers resilience against the circadian-disruptive effects of evening light, generating testable predictions regarding the timing and intensity of beneficial light interventions for maintaining circadian alignment. Full article

Background: During the flu season, there is an increase in absenteeism due to illness, a drop in productivity, and a greater risk of the virus spreading among workers. Thus, the Italian Ministry of Health recommends vaccination for essential service workers. The University of Salerno, in collaboration with the local health authority of Salerno, offers free vaccination to its employees. Methods: A public health methodology for seasonal influenza vaccination in the workplace is presented—specifically in the university setting—with the aim of identifying individual, contextual, and organizational elements of the model that have promoted vaccination uptake. An ad hoc questionnaire was used (October–December 2025) to survey 399 academic employees, investigating seasonal influenza vaccination in the following aspects: recent personal experiences, motivations, vaccination experiences at university, sources of information, considerations regarding national and local vaccination campaigns, and level of vaccine confidence (VCI). Results: Seasonal influenza vaccination at the University is appreciated for its compatibility with working hours (66.1%), the availability of a platform that allows flexible booking (56.9%), the perception of safety in the environment (31.6%), the fact that the vaccine is free (17.4%), and the involvement of office/laboratory colleagues (5%). Participants appreciate the model and would apply it to other vaccinations at the University and in other institutional settings. A significant relationship (F = 7.24; df = 1; p < 0.05) exists between confidence in the vaccine and the sense of security experienced when receiving the vaccine in the workplace. Data analysis was performed using the IBM SPSS v.28 software. Conclusions: The model proposed can be applied to other institutional contexts, simplifying and facilitating access to vaccines by implementing vaccination campaigns tailored to specific work environments. Full article

By examining historical recipes from the medieval treatise The Montpellier Liber Diversarum Arcium, the creation of bottle green and verdigris pigments involved various types of tempera, such as parchment glue and gum arabic. Malachite was also prepared. These references and paints were analysed using infrared spectroscopy and visible spectroscopy techniques, such as micro-Infrared Spectroscopy (microFTIR) and Fibre Optic Reflectance Spectroscopy, (FORS) over the 350–1000 nm range. This research provided new insights into the pigments used in monastic manuscripts and Books of Hours, supported by valuable data from the Soleil synchrotron. Producing historically accurate reproductions and applying spectroscopy to analyse them promotes sustainable cultural heritage preservation by maintaining ancient artefacts, detecting early signs of degradation, and enabling the development of compatible restoration materials. Full article

Paper-based heritage objects are commonly stored in archival boxes, books, and paper stacks, creating confined microclimates that may differ from the surrounding environment. While room-level climate control is central to preventive conservation, object-level conditions are shaped by enclosure permeability, hygroscopic buffering, ventilation, and internal emissions. This study investigates temperature, relative humidity, air exchange, and gaseous pollutants inside archival boxes, bound books, and paper stacks under laboratory and real storage conditions. Air exchange rates were determined using CO₂ tracer decay, while climates were monitored over periods from hours to one year. Chemical conditions were assessed using passive sampling of air pollutants, oxygen measurements, and dosimetric methods. The results show that boxes, books, and paper stacks behave as semi-permeable rather than sealed systems. Hygroscopic buffering attenuated short-term RH fluctuations, especially within books and paper stacks, while long-term internal conditions followed ambient trends with pronounced time lags. Restricted ventilation limited the ingress of external pollutants but could allow for internally generated gases to accumulate. Experiments using acid-sensitive indicator paper demonstrated the slow penetration of acetic acid into paper stacks. Overall, enclosure performance reflected a balance between buffering capacity, permeability, and chemical reactivity rather than airtightness alone, highlighting the importance of object-level microclimate assessment in preventive conservation. Full article

The article presents a blockchain-based architecture for decentralized electricity trading that tokenizes energy delivery rights and cash-flows. Energy Attribute Certificates (EACs) are implemented as NFTs, while buy/sell orders are encoded as ERC-1155 tokens whose tokenId packs a time slot and price, enabling precise matching across hours. A clearing smart contract (Matcher) burns filled orders, mints an NFT option, and issues two ERC-20 assets: PT, the right to consume kWh within a specified interval, and YT, the producer’s claim on revenue. We propose a simple, linearly increasing discounted buyback for YT within the slot and introduce an aggregating token, IndexYT, which accumulates YTs across slots, redeems them at par at maturity, and gradually builds on-chain reserves—turning IndexYT into a liquid, yield-bearing instrument. We outline the PT/YY lifecycle, oracle-driven policy controls for DSO (e.g., transfer/splitting constraints), and discuss transparency, resilience, and capital efficiency. The contribution is a Pendle-inspired split of electricity into Principal/Yield tokens combined with a time-stamped on-chain order book and IndexYT, forming a programmable market for short-term delivery rights and yield derivatives with deterministic settlement. Full article

Holy Week, the most significant period of the Christian liturgical year, was marked by solemn and complex rituals enacted within the sacred spaces of medieval religious communities. In the case of Cistercian female monasteries, scholarly attention has largely centered on Easter dramatic representations such as the Depositio or the Visitatio Sepulchri, while the official liturgy—Hours, Masses, processions, and the official rituals of the Easter Triduum—has remained comparatively understudied. This article addresses that gap by examining the Holy Week liturgy as performed by the Cistercian nuns of Lichtenthal (Baden-Baden, Germany), on the basis of an exceptional and understudied source: the original Ecclesiastica Officia (mid-13th century, Karlsruhe, Badisches Generallandesarchiv, 65/323). Containing comprehensive normative prescriptions for the Easter liturgy adapted for the Lichtenthal community, this manuscript enables a detailed reconstruction of the nuns’ primary collective experiences during these days. The study brings together evidence from architecture, works of art, and liturgical books, while integrating insights from sensory studies, in order to underscore the bodily and multi-sensory dimensions of the rituals. In doing so, it highlights the implications of the nuns’ active participation in Holy Week ceremonies and contributes to a deeper understanding of medieval female religious ritual experience, challenging conventional notions of enclosure and liturgical practice. Full article

Background: Antimicrobial resistance (AMR) is a critical global health issue. Like other low- and middle-income countries, the misuse of antimicrobial medicine, including widespread self-medication, exacerbates AMR in Bangladesh. Making future generations aware of AMR through educational interventions is an effective tool in combating AMR. This research focuses on understanding the effects of AMR awareness interventions on the knowledge, attitudes, and behaviors of the schoolchildren in the selected district of Bangladesh. Methods: In this study, 241 students of the 12- to 16-year-old age group participated in a two-day program. The programs include four hours of activities, including reading comics and coloring books, presentations, quizzes, and watching an animation about AMR on the first day, followed by an art competition on the second day. To assess changes in knowledge earlier and after the intervention, pre- and post-tests were conducted. Results: This pilot study demonstrates that using age-appropriate interactive educational tools can significantly improve students’ knowledge about AMR, showing a mean difference of 1.28 (p < 0.001). The regulatory step of the Directorate General of Drug Administration, incorporating red identification marks on antibiotic packaging, makes it easier and shows that 93.36% of students could identify antibiotics, which helps them to be aware of these types of medicines. Interventions were equally effective for boys and girls and science and commerce students, and these helped participants recognize the inappropriate practices of antibiotic use in their daily lives. Conclusions: This study identified the importance of incorporating AMR issues into the educational curriculum to address AMR for future generations. Full article

Background/Objectives: Healthcare accounts for approximately 4.4% of global carbon emissions. Gastroenterology is a particularly heavy producer, with professional organisations outlining targets to move towards carbon neutrality. Missed hospital appointments, associated with poor medical outcomes, also represent physical and economic waste to the sector. COVID-19 expedited the shift toward virtual clinics, but tele-diagnostics have not expanded similarly. We aimed to assess the feasibility of a virtual C13 urea breath test clinic for H. pylori in Ireland. Methods: C13 urea breath test kits were provided to patients in the community, who were subsequently invited to book an online video appointment with a GI lab technician to assist them in performing the test at home. Completed tests were returned to the hospital via local GP, by post, or a specified hospital drop-off point, and analysed using our standard protocol. Results: 423 virtual appointments were reviewed. 135 (32%) were male, and the mean age was 42 years. The test positivity rate was 22%, similar to a matched in-person testing cohort (21%). In all, there were no non-attenders, and two cancellations. Virtual patients were more likely to attend their appointments (OR = 153.9, p = 0.0004) than in-person patients. Virtual UBT appointments saved 9943.5 Km of road journeys, equivalent to 254 person-hours of travel time and 1.24 metric tonnes of CO₂. Additionally, 300 (71%) patients returned a feedback questionnaire, of which 276 (92%) rated the overall home breath test experience as ‘good’ or ‘excellent’. Conclusions: Home testing for H. pylori is effective, acceptable, and reduces both reliance on invasive procedures such as endoscopy and carbon emissions. Full article

Under a 2021 amendment to German law, the KelRide project became the first public on-demand service operating electric autonomous vehicles (AVs) without fixed routes on public roads. This paper addresses two notable gaps in the literature by (1) conducting an ex post evaluation of demand predictions for a non-infrastructure (Mobility-on-Demand (MoD)) project and (2) using real-world data to analyze how demand responds to key Autonomous Mobility-on-Demand (AMoD) system parameters in a rural context. Earlier simulation-based demand forecasts are compared to observed booking data, and the recalibrated model is used to investigate the sensitivity of passenger numbers to vehicle speed, fleet size, service area, operating hours, and idle vehicle positioning. Results show that increasing vehicle speed leads to a superlinear rise in passenger numbers—especially at small fleet sizes—while demand saturates at large fleet sizes. A linear increase in demand is observed with expanding service areas, provided fleet size is sufficient. Extending operating hours from 9 a.m.–4 p.m. to full-day service increases demand by a factor of two to four. Passengers numbers also vary notably depending on the positioning of idle vehicles. Consistent with empirical findings, the analysis underscores that raising AV speed is essential for ensuring the long-term viability of autonomous mobility services. Full article

Ride-pooling (RP) services, in which passengers with similar destinations share a ride, offer considerable potential for enhancing urban mobility by bridging gaps in public transportation (PT) networks and providing a convenient alternative to private car use. For the effective design and operation of such services, a detailed understanding of user preferences and usage patterns is essential. This study investigates differences in RP preferences and usage between day and night (with nighttime defined as 10:00 p.m. to 5:00 a.m.), drawing on both a stated choice experiment (SCE) and revealed preference data collected in Mannheim, Germany. The focus lies on the local RP service fips, which is integrated into the PT system. The SCE, conducted in 2024 with 566 participants, was analyzed using a nested logit model. The analysis of the SCE reveals that nighttime preferences for RP are characterized by reduced sensitivity to travel time and cost, creating an opportunity for RP operators to optimize stop network designs during nighttime hours by increasing pooling rates. In addition, it indicates a greater likelihood of private car usage at night, especially among women, likely due to safety concerns and limited PT availability. The analysis of revealed preference data provides a complementary perspective. It shows that the RP nighttime service primarily attracts younger users, while many respondents report not being active on weekend nights. However, the combination of low public awareness and limited service availability, evidenced by rejected booking requests, suggests that existing demand is not being fully captured. This implies that low usage is not merely the result of low demand, but also of structural barriers on both the supply and information side. Overcoming these barriers through targeted information campaigns and expansion of nighttime service capacity could substantially enhance sustainable urban travel options during nighttime. Full article

Typically developing peers are the key factor for children with disabilities to participate in inclusive settings. Good peer relationships can improve the social communication and language expression of children with disabilities, and typically developing children play a role as “gatekeepers” in the social activities of children with disabilities in the schools. In this study, 36 primary school students from grades 1 to 3 received online picture book teaching for 3 weeks, 6 units, 12 class hours, and 40 min per class hour with six volumes of disability picture books (including physical disability, deaf and hard of hearing, visual impairment, intellectual disability, learning disability and autism spectrum disorder) selected by experts in summer vocation. The attitudes of typically developing children toward peers with disabilities of participants were tested before and after attending the online picture book course. The teaching of disability-themed picture books online has significantly improved the attitudes of typically developing children in lower grades toward peers with disabilities. Specifically, there are significant differences in the sub-dimensions of emotion and positive behavior and negative behavior before and after the intervention. The results showed that online picture book teaching activities with disability themes can effectively improve the attitudes of typically developing children in primary schools toward children with disabilities in terms of cognition, emotion, and behavior, and they can be used in schools to create an inclusive climate for students with disabilities. Full article

With the recent increase in retail investor participation led by commission-less fintech trading applications and new features like fractional trading, we now have higher volatility and significantly quicker price changes. This makes it hard to make informed trading decisions. Moreover, these effects are exacerbated even further around earnings announcements days. In this paper, we use Nasdaq data feed at a minute frequency and show that there is a significant increase in the slope of the price–volume structure during extended hours (after-hours, or pre-market hours) as compared with the ones observed during regular market times. Our analysis shows that the liquidity is much less during the extended market hours. As such, earnings announcements of stocks during these times have a significantly larger price impact than those stocks that have their earnings announced during regular trading hours. This significant difference can be explained by observing the limit order book structures during these different trading periods. We suggest that the earnings announcements should not be made during extended hours given the significantly lower liquidity and thus, the significantly larger price impact that not only determines the prices for the next trading session but also sets the new “fundamental” price signals for the stocks. Full article

Warhammer 40,000 (40k) is the world’s most popular miniature wargame. The game is played with miniatures (small-scale figures made of hard plastic or other materials), which have usually been painted by each individual player. These player–painters typically spend hours in deep concentration painting the models. Drawing on interviews and journal entries from a six-month participant study of 14 painters, this paper explores whether miniature painters achieve a flow state, whether this creates a greater feeling of mindfulness, and how painting impacts their overall mental health. Results from this study indicate that miniature painting is meditative, meaningful, and positive for the participants’ mental health. Using the definition of flow outlined in Mihaly Csikszentmihalyi’s book Optimal Experience: Psychological Studies of Flow in Consciousness (1988), flow is a state of pleasure had when an individual concentrates on a specific task. Csikszentmihalyi, from his research on flow, notes that this state of mind involves both immersion and a sense of transcendence, where the individual temporarily loses a sense of self. This sense of loss of self was explored with an increased attention to the feeling of the body, and situated cognition has been further explored to understand how this connects to painting. While flow is regularly applied to videogame studies, less work has been carried out on this flow state during activities like miniature painting. Full article

Background: Approximately two to three children die from pneumonia every hour, and pneumonia is the leading cause of hospitalization for children under five in Bangladesh. Bangladesh has adopted the Pocket Book guidelines by the World Health Organization (WHO) for hospital management of childhood pneumonia. These guidelines recommend the proper use of injectable antibiotic administration. Objectives: We assessed and compared the prescription drugs for treating childhood pneumonia following WHO guidelines in a secondary and tertiary hospital in Bangladesh. Methods: We conducted a cross-sectional comparative study among children under five years who were admitted to a tertiary hospital, Dhaka Medical College Hospital (DMCH), and a secondary-level hospital, Kushtia District Hospital (KDH), with pneumonia between May 2021 and May 2022. A structured questionnaire was administered to the eligible participants. Additionally, we reviewed the hospital records related to the patient’s treatment. SPSS (Version 28) was used to conduct statistical analysis. Results: 316 children were enrolled during the study period, of whom 66.4% were collected from DMCH. There were 65.8% and 24.6% of patients who were classified with severe pneumonia and very severe pneumonia, respectively. In DMCH, the severity of pneumonia percentage was 57.6%, while in KDH, the percentage was 82%. A significant difference was found between the two facilities in diagnosing complicated pneumonia, prescribing the appropriate antibiotics, and ensuring oxygen availability. Amoxicillin was prescribed to 83.5% of the participants, and ceftriaxone was used at a high rate (64.5–70.9%). Combining injections of ceftriaxone with oral amoxicillin or other combinations of antibiotics, both facilities used high frequencies of non-antibiotic corticosteroids. Conclusions: Antibiotics were overprescribed, and injections were prescribed at higher levels than WHO recommended. This could pose a threat to antibiotic resistance. There is a need to enforce standard prescribing policies and treatment guidelines to reduce morbidity and mortality among hospitalized children with pneumonia. Full article