Search Results (1,738)

Background: Clínica Esperanza/Hope Clinic (CEHC), a free clinic for low-income, uninsured, Spanish-speaking patients, located in Providence, RI, piloted an intervention to improve vaccination rates. This program, named “Oportuna Vacuna” (OV) aimed to assess vaccine hesitancy in the post-pandemic period and measure improvements to vaccine uptake after integrating healthcare provider (HCP) and patient education with vaccine workflow adjustments. Methods: OV was initiated in January 2023. Culturally attuned and linguistically appropriate vaccine-focused educational programs were developed and provided to patients and HCPs, while workflow modifications to streamline vaccine administration were implemented during clinic visits. Structured pre- and post-intervention chart reviews were conducted and (oral- and) paper-based knowledge, attitudes, and practices surveys were administered to selected staff and patients to assess knowledge, attitudes, and vaccine confidence before and after the interventions. A total of 816 charts were reviewed prior to the intervention; 709 charts were reviewed post-intervention. A total of 72 patient and 10 HCP pre- and post- intervention surveys were completed. Vaccine uptake was compared to the uptake in 2022. Results: Overall vaccination rates at the clinic increased by more than 400% compared to the prior year. Patients and HCPs demonstrated increased vaccine knowledge and confidence, particularly with respect to COVID-19 and HPV vaccines. In contrast, chart reviews of individual patients revealed only a slight improvement in vaccination completion rates for patients over the 1-year period. Conclusion: Substantial increases in vaccine administration rates across multiple vaccine types highlight the effectiveness of OV, mainly for first time patients, at CEHC. Clinic workflow modifications improved vaccination efficiency and increased vaccine uptake. Educational sessions on vaccines were well received by patients and staff. Overall knowledge about vaccines improved during the intervention among staff and HCPs. Patients reported higher trust in HCPs compared to other sources for vaccine information. Full article

With the substantial expansion of technology in education during the COVID-19 pandemic, with certain practices even demonstrating a positive impact on environmental sustainability, five years later, it has become pertinent to examine the current perceptions of teachers and students regarding its utilization. This work explores how students and teachers from different countries and academic cultures perceive and incorporate sustainable habits into their daily lives. The focus is on transportation choices, food consumption, and the use of resources. The results of an adapted questionnaire, which was distributed to 855 students and 124 teachers, reveal meaningful differences: students tend to adopt more sustainable transport habits. In contrast, teachers demonstrate a greater commitment to reducing food waste and conserving resources. Cross-country comparisons also highlight differences. When focusing on the major samples (Portugal and Mexico), Portuguese participants scored higher in terms of food and resource sustainability, whereas Mexican participants relied more on public transport. These insights shed light on how sustainability is shaped not only by individual awareness but also by context and educational culture. Furthermore, the findings emphasize the ongoing role of higher education institutions in inspiring meaningful change and fostering a mindset of sustainability in future generations. Full article

COVID-19 led to substantial changes in early literacy instruction. Although emerging evidence documents its effects on children’s reading achievement, much less is known about how these changes relate to young children’s reading motivation and school-related well-being. This study compared two cohorts of second graders (N = 287) from the same four low-SES schools, all assessed at the beginning of second grade. A pre-COVID-19 cohort, whose first-grade instruction was delivered entirely face-to-face, was compared with a during-COVID-19 cohort whose first-grade reading instruction took place amid extended distance learning with intermittent, restricted in-person schooling. Cohorts were compared on reading motivation, school-related well-being (covitality), and reading achievement (word reading, vocabulary, and reading comprehension). Multivariate analyses of variance (MANOVAs) were conducted to compare cohorts (pre- vs. during COVID-19) and reader groups (typical vs. poor readers), with gender, class, and school entered as control variables. In motivation, self-concept was higher during COVID-19, and typical readers reported higher motivation than their peers. In well-being, covitality was higher during COVID-19 at the total score and across gratitude, optimism, zest, and persistence; a cohort by group interaction for persistence indicated higher scores for typical readers during COVID-19. In achievement, phonological decoding and orthographic word identification were lower during COVID-19; typical readers scored higher than poor readers on all achievement outcomes. Together, these findings suggest that the educational setting shapes motivation and well-being alongside achievement, and that distance learning is not uniformly detrimental, as it coincided with higher covitality and reading self-concept at school reentry. Full article

The teacher–student relationship is often more strongly associated with learning outcomes than the family relationship during emerging adulthood, primarily through self-efficacy. However, most of these findings are based on offline contexts, where teachers interact with students face-to-face and families remain relatively distant. Online learning may involve different dynamics, especially during the COVID-19 pandemic, when families became more engaged and teacher–student interactions were digitally mediated. These shifts may also reshape the traditionally blurred boundaries between parental and teacher roles in China, where teachers are often regarded as quasi-parental figures. Therefore, it is necessary to re-examine and compare the relative contributions of family and teacher–student relationships to online learning outcomes. Data were collected from 1793 university students (Mage = 21.28, SD = 2.26; 50.08% male) across 32 provinces in China. Structural equation modeling with bootstrapping was used to test mediation and compare direct and indirect effects. The results showed that (a) both family and teacher–student relationships were positively associated with online learning outcomes via self-efficacy, and (b) although total effects were similar, the teacher–student relationship exhibited a stronger indirect effect. These findings suggest that family relationships primarily offer emotional and environmental support, maintaining background stability, whereas teacher–student relationships foster the cognitive–motivational processes underlying autonomous learning. They may play complementary roles in online learning within the Chinese higher education, where schools retain instructional authority even in digital environments and families continue to act as educational mediators. Full article

Background/Objectives: Paediatricians’ recommendations influence parental decisions to vaccinate their children. On 19 January 2022, the World Health Organization authorized the Pfizer-BioNTech COVID-19 vaccine (BNT162b2) under Emergency Use Listing for children under 12 years as a measure to mitigate disease spread and direct protection for children with underlying conditions. We assessed knowledge, attitudes, and practices (KAP) of Palestinian paediatricians regarding COVID-19 vaccination for children under 12 years and identified factors affecting support for vaccination. Methods: From 1 October to 8 November 2023, we surveyed paediatricians across the West Bank using structured telephone interviews. We collected data on sociodemographic characteristics and KAP regarding COVID-19 vaccination and calculated KAP scores from eight, nine, and nine items, respectively, with total scores categorized as poor/moderate/good. We performed bivariable and multivariable analyses to identify factors associated with paediatricians supporting COVID-19 vaccination for children under 12 years. Results: Of the 367 eligible paediatricians, 323 (88%) responded; the median age was 51 years (range: 28–70); 27% supported COVID-19 vaccination for children. Mean scores for knowledge (range 0–8), attitude (0–9), and practice (0–9) were 3.0 ± 2.1, 3.9 ± 2.4, and 4.0 ± 1.7, respectively. The mean overall KAP score (0–26) was 11 ± 4.8. Safety and efficacy concerns and lack of long-term data were the main reasons for hesitancy. Higher knowledge scores (PR = 1.8, 95% CI: 1.3–2.5, p = 0.001) and positive attitudes (PR = 1.6, 95% CI: 1.1–2.3, p = 0.01) were significantly associated with paediatricians’ support for vaccination. After adjustment for other factors, participants with regular continuing medical education attendance (aPR = 1.4, 95% CI: 1.0–2.6, p = 0.045), trusting WHO recommendations (aPR = 3.1, 95% CI: 1.4–7.8, p = 0.047), having a positive attitude score (aPR = 1.3, 95% CI: 0.4–4.4, p = 0.041), and a good total KAP score (aPR = 1.1, 95% CI: 1.0–1.2, p = 0.044) supported COVID-19 vaccination for children. Conclusions: Support for COVID-19 vaccination among Palestinian paediatricians was low, associated with their knowledge, attitudes, and trust in health authorities. The revised WHO recommendations from 10 November 2023, decreasing the priority of vaccinating healthy children, could influence the opinion of paediatricians. However, the low support for COVID-19 vaccinations could affect the performance of other vaccination programmes and should be carefully addressed through targeted education. Full article

Background/Objectives: Depression has increased substantially in Korea following the COVID-19 pandemic, with prevalence reaching 7.3% in 2023, the highest level in a decade, raising urgent concerns about widening mental health disparities. Although physical activity (PA) is associated with reduced depressive symptoms, nationally representative post-pandemic evidence from Korean adults remains limited. This study descriptively examined patterns of PA participation and depressive symptoms across key sociodemographic groups using 2023 Korea Community Health Survey (KCHS) data. Methods: We analyzed cross-sectional data from 228,249 adults aged ≥19 years in the 2023 KCHS. Depressive symptoms were measured using nine PHQ-9 items (1–4 on Likert scale). PA was assessed as the number of days per week (0–7) of moderate (MPA) and vigorous (VPA) physical activity according to KCHS operational definitions. All analyses incorporated complex survey features (strata, clusters, weights). Group differences were examined using design-corrected t-tests and ANOVA. Results: Women, adults aged 60 years or older, bereaved individuals, and those with lower educational attainment reported higher depressive symptom levels (p < 0.001). PA participation was higher among men, younger adults, married individuals, and those with higher education. Depressive symptom scores decreased with increasing PA frequency, with the lowest levels observed among adults active 5–7 days per week. Although mean differences were modest (0.02–0.12 points on the four-point scale; η² < 0.06), these steady population-level gradients provide meaningful baseline information for understanding post-pandemic mental health patterns in Korea. Conclusions: Although individual-level differences were small (η² < 0.06), the population-level gradients are important for monitoring mental health disparities in post-pandemic Korea. Women, older adults, bereaved individuals, and lower-education groups represent key high-burden populations. Future studies should employ longitudinal designs, objective PA measures, and confounder-adjusted models to clarify mechanisms and directionality, and evaluate the effectiveness of community-based PA interventions. Full article

Background/Objectives: Health literacy and vaccine literacy influence vaccine uptake behavior. Ensuring that people in rural communities are knowledgeable about vaccines can be an important tool in increasing influenza vaccination rates. The goal of this research was to evaluate rural community member knowledge of influenza and influenza vaccine. Methods: A cross-sectional survey was conducted with residents of a rural a medically underserved community in Washington State. Three thousand rural residents were contacted up to five times by a survey research center with a request to participate, with the goal of receiving 500 returned surveys based on the current population size, a z-score of 95, and an error rate of 5%. The survey evaluated rural resident knowledge and opinions about influenza and influenza vaccine. Results: Participants who were vaccinated against influenza in the last five years were more likely to know that influenza vaccine does not cause influenza (χ² = 13.44, p < 0.01) and that antibiotics cannot be used to treat influenza (χ² = 19.36, p < 0.01) than people who were not vaccinated. There was no statistical difference between people who are vaccinated and unvaccinated regarding knowing that influenza is viral rather than bacterial with the majority in both groups responding correctly (χ² = 0.05, p < 0.82), or that people who have influenza are at higher risk for contracting pneumonia (χ² = 0.78, p = 0.08) or COVID-19 (χ² = 1.54, p = 0.21). Unvaccinated people were more likely to have had their opinion about vaccines changed in recent years (p < 0.01) and feel that COVID-19 impacted their ability to trust public health officials (p < 0.01). Conclusions: Understanding gaps that exist in rural resident knowledge about influenza could be valuable in developing future educational outreach efforts in these communities. Full article

Background: Teledentistry constitutes a key component of digital health, enabling remote oral healthcare delivery through information and communication technologies (ICT). The COVID-19 pandemic accelerated its global adoption; however, data regarding its implementation within Romanian dental practice remain limited. Understanding usage patterns, perceived benefits, and implementation barriers is essential for effective integration. Objectives: This study examined the adoption of teledentistry among dental practitioners in Sibiu County, Romania, identified its main applications, assessed professional perceptions, and explored barriers and their interrelations using association rule mining (ARM). Methods: A cross-sectional online survey was distributed in 2025 to all 630 registered dentists in Sibiu County. The questionnaire collected demographic data, usage patterns, perceived benefits, and barriers. A total of 197 valid responses were obtained (response rate: 31.2%). Descriptive statistics, Chi-square tests, and ARM were used to identify associations between usage contexts and recorded obstacles. Results: Overall, 44.6% of respondents reported using teledentistry tools, primarily for interdisciplinary consultations (29.4%), postoperative counseling (26.4%), and treatment monitoring (25.3%). The most frequently cited barriers were the inability to perform direct clinical examinations (71.5%), practitioner reluctance (37.1%), insufficient infrastructure (29.9%), and the lack of a clear legislative framework (27.4%). ARM revealed frequent co-occurrence patterns among these barriers. Practitioners with prior experience in teledentistry reported significantly higher perceived utility (58% vs. 22.1%) and greater interest in training (58% vs. 38.5%, p < 0.05). Conclusions: Teledentistry shows moderate but increasing adoption among Romanian dentists. Addressing current barriers, through legislative clarification, infrastructure development, targeted professional training, and public education, is essential for achieving sustainable integration into modern dental practice. Full article

Though higher education has returned to in-person instruction in the wake of the COVID-19 pandemic, demand for online learning continues to increase. This rapid growth in virtual instruction necessitates examining its impact, particularly in skill-based courses that have traditionally been taught in person. Public speaking, a course requiring experiential learning and active engagement, presents unique challenges and opportunities when converted to an online format. This study explores student experiences in an online public-speaking course designed to parallel the structure of traditional in-person instruction, examining whether the essential learning outcomes of a skill-based class can be effectively achieved remotely. Using archival student data (n = 1151) from 2021 to 2024, we conducted a qualitative analysis of student reflections on how in-person pedagogical strategies effectively implemented in the online format influenced their self-concept, mindset, and overall learning experience. Our findings indicate significant improvements in students’ self-concept, growth mindset, self-confidence, and their ability to overcome fears related to public speaking. Additionally, students highlighted unexpected benefits of the online format, including enhanced support for multilingual learners and increased connections between course content and greater future career readiness in utilizing remote communication. These results highlight the potential of well-designed online public speaking instruction to foster skill development, professional preparedness, and inclusive learning. The study has implications for future skill-based online pedagogy and curriculum development. Full article

Despite its economic profitability, fur farming in Europe, responsible for half of global production, faces a growing ethical backlash. Animal welfare concerns, particularly regarding mink, foxes, and raccoon dogs kept in restrictive cages, have intensified due to advocacy, scientific reviews, and COVID-19 outbreaks. In response, several EU nations have implemented bans or stricter regulations. However, limited research exists on EU public opinion. This study analyses data from Eurobarometer 533 (March 2023), surveying 26,368 citizens across 27 EU countries, to assess attitudes toward fur farming. Respondents selected from three policy preferences: a full ban, EU-wide regulation, or acceptance of current practices. Multinomial logistic regression and chi-square tests revealed significant socio-demographic and ideological influences. Older individuals were more supportive of current practices (p = 0.001), while higher education levels correlated with support for a ban or stricter regulation (p = 0.003). Income positively influenced support for regulation (p = 0.002), and women (p = 0.008), urban residents (p = 0.001), and those with regular animal contact (p = 0.007) were more likely to support reform. Right-leaning respondents (p = 0.012) and residents of countries without fur farming bans (p < 0.001) were less supportive. These findings suggest that values, demographics, and national legislation significantly shape public opinion. Aligning policy with evolving societal values requires integrated legislative reform, public engagement, and equitable transition strategies to ensure meaningful and sustainable improvements in animal welfare across the EU. Full article

Introduction: John Dewey, a prominent educational philosopher, emphasized the importance of connecting education and democracy, and advocated for the cultivation of civic values through experiential learning. Dewey’s pedagogical model most often unfolds with educators designing students’ experiences, which Dewey believed instills and advances the moral foundation of a democracy. Dewey faced many detractors over his lifetime who maintained that his emphasis on experience and moral development lacked the substance of traditional educational philosophy and was marginally connected to civic education. In recent years and in an increasingly contentious social/political environment, Dewey’s perspective has been rediscovered and rehabilitated by research that has identified both political and moral identities to be central constructs in the construction of a civic identity. This paper explores how civic education is affected when socio-political crises disrupt the established educational order, leaving students to navigate these turbulent circumstances on their own. Methods: This study employs a mixed-methods approach to examine the impact of the socio-political crises of 2020—COVID-19 and racial unrest—on civic learning in higher education. A total of 1217 college students were surveyed during the spring of 2020 to assess how their academic experiences influenced their engagement with these twin crises. Both quantitative and qualitative data were gathered to provide insight into students’ experiences. Results: The findings suggest that students’ learning experiences during these crises had a significant impact on how they engaged with the socio-political challenges of 2020. Students who engaged in more self-reflective experiential learning during the pandemics reported a renewed understanding of their roles as citizens and increased commitment to a more equitable and just communal existence. Students reported that being forced to actively engage with the crises—rather than passively receiving information—helped them to develop a sense of civic responsibility. Discussion: The results of this study highlight the potential for civic education to be enriched during times of crisis, particularly when students are encouraged to actively engage with their experiences. Dewey’s model of experiential learning proves relevant when socio-political upheaval forces students into a direct, personal, unmediated experience with the issues at hand. The result seems to be deeper, previously unappreciated understanding of their roles in a democratic society. The study suggests that higher education can serve as a vital space for fostering civic engagement, even in the face of unexpected challenges. Furthermore, the disruption of traditional educational processes during crises can create opportunities for students to develop critical thinking skills and a more profound commitment to civic participation. Full article

Background: Medical education is highly demanding and often entails stress, pressure, and competition. Understanding what drives students’ satisfaction is essential to support learning and well-being. This study aims to identify factors associated with satisfaction with medical education among Polish medical students, focusing on motivation, personal circumstances, resilience, and the long-term impact of COVID-19. Methods: In a cross-sectional online survey, 334 students from years one, four, and six completed measures of satisfaction with medical studies (nineteen items), motivation (ten items), resilience (using the Brief Resilience Scale), self-rated health, financial situation, global life satisfaction, and study-related stress, plus eight items on COVID-19 impact. Associations were assessed using Spearman correlations and Mann–Whitney U tests. Results: Higher satisfaction was associated with intrinsic motivation (e.g., personal decision to study medicine or interest in medicine), more favorable personal circumstances (better health, financial situation, higher global life satisfaction, and lower stress), and greater individual resilience. Students reporting pandemic-related setbacks (knowledge gaps, reduced confidence, curtailed clinical exposure, and interpersonal skills) showed lower satisfaction with overall experience, relationships, theoretical and practical classes, and perceived future competence. Conclusions: Intrinsic motivation, resilience, and supportive personal circumstances were linked to higher satisfaction, whereas enduring pandemic disruptions coincided with lower satisfaction across domains. Targeted strategies that cultivate intrinsic motivation and resilience and address financial/health stressors and COVID-19 learning gaps may enhance student satisfaction. Full article

Background: Vaccination remains one of the most effective public health interventions, yet hesitancy persists even among healthcare students who aid in promoting immunization. Understanding students’ perspective plays a crucial role in designing targeted educational interventions. The purpose of this study was to evaluate knowledge, attitude, and practices of healthcare students (HSCs) in Kuwait about vaccines. Methods: A quantitative, cross-sectional study was conducted between August and October 2024. A validated 21-item questionnaire was used to assess vaccine-related knowledge, attitude, and practices, along with demographic data. Descriptive statistics and binary logistic regression were used to identify predictors of higher knowledge and positive attitude. Results: A total of 351 students participated (mean age 23.0 ± 2.4 years; 90.6% female). The mean knowledge score was 3.9/7 (55.7%), indicating moderate knowledge, with misconceptions noted regarding benefits of post-infection vaccination and extra vaccine doses. The mean attitude score was 3.6/6 (60%), indicating moderately positive attitude, yet safety concerns, particularly about long-term effect, were common (59.3%). Nearly half (45.9%) delayed vaccination until mandatory. Vaccine uptake was highest for COVID-19 (92.3%), followed by hepatitis B (73.8%). Older age, male gender, and being a medical student predicted higher knowledge (p = 0.011), while older age and being in later study years predicted more positive attitude (p = 0.032). Conclusions: HSCs demonstrated moderate knowledge and attitude toward vaccines, with significant hesitancy driven by safety concerns despite high eventual uptake. Early targeted curricular interventions addressing vaccine safety evidence, benefits of timely immunization, and professional responsibility are warranted to improve confidence and proactive vaccine acceptance among future healthcare professionals (HCPs). Full article

This study examines the current Digital Transformation (DT) knowledge in higher education, focusing on mobile app usage among Generation I. It examines publication trends, influential works, intellectual structures, keyword trends, and network visualizations to provide a foundation for future research and practice. This study used bibliometric analysis to examine articles from the Scopus database published from 2014 to 2024. Using the PRISMA method, the authors identified the articles and bibliographic information in the database and utilized VOS viewer to produce mapping and graphical presentations. This study presents how DT in higher education through mobile apps has evolved between 2014 and 2024. Studies on DT in higher education saw an 86% increase in 2020, primarily due to the COVID-19 pandemic. The top journals, influential authors, and affiliated countries are identified. The United States leads in contributions to this field with 35 publications, accounting for 19% of the total, followed by China and the UK, which account for 9% and 7%, respectively. Several key research gaps are identified based on existing literature, and suggestions are made for future studies. By examining current and influential trends, this study contributes to the knowledge of digital transformation in higher education and offers insights for institutions seeking to enhance mobile-based support services. Full article

Background/Objectives: Following the COVID-19 pandemic, the influenza season returned to its typical pre-pandemic circulation patterns. The category of people most vulnerable to severe influenza was older adults, and frail individuals, confirming their central role as a priority group for vaccination. The objective of this study was to evaluate the impact of an active influenza vaccination program in an area with low influenza vaccination rates and propensity to vaccine co-administration. Methods: People recruited were hospitalized frail individuals, patients over the age of 60, and those with chronic illnesses or comorbidities. It was administered a questionnaire to investigate adherence to influenza vaccination and the Health Action Process Approach was used to evaluate the propensity to co-administration. Results: A total of 418 hospitalized patients were enrolled in the study, of whom 58.4% (n = 244) received the influenza vaccine and 17.9% (n = 75) had a higher propensity to have co-administration of influenza and other recommended vaccines. The factors associated with influenza vaccination acceptance were received advice from hospital healthcare workers (aOR = 10.6 p < 0.001) and previous influenza vaccination (aOR = 18.1; p < 0.001). Propensity to vaccine co-administration was associated with a higher educational level (aOR = 4.21; p = 0.002), receiving vaccination advice from hospital healthcare workers (aOR = 2.80; p = 0.03), perceived positive outcome (aOR = 1.29; p = 0.02) and perceived self-efficacy (aOR = 1.48; p < 0.001). Conslusions: This study explored the impact on influenza vaccination coverage in implementing in hospital vaccination offer. The reliability of this strategy, together with the standard vaccination offer, could allow reaching the recommended vaccination coverage, particularly among at-risk people. Full article