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17 pages, 451 KiB  
Article
Which Standards to Follow? The Plurality of Conventions of French Principals Within the School Organization
by Romuald Normand
Educ. Sci. 2025, 15(8), 998; https://doi.org/10.3390/educsci15080998 (registering DOI) - 5 Aug 2025
Abstract
This study examines the moral agency of French secondary school headteachers through the lens of the theory of conventions. Using qualitative data from interviews with fifteen headteachers involved in professional development, this study explores how these leaders justify their practices within a centralized, [...] Read more.
This study examines the moral agency of French secondary school headteachers through the lens of the theory of conventions. Using qualitative data from interviews with fifteen headteachers involved in professional development, this study explores how these leaders justify their practices within a centralized, bureaucratic, and hierarchical education system. It identifies a variety of conventions—civic, domestic, industrial, project, market, inspired, and fame—that headteachers draw on to navigate institutional constraints, manage professional relationships, and foster pedagogical and organizational change. Particular attention is given to how civic and domestic conventions shape leadership discourse and practices, especially regarding trust building, decision making, and reform implementation. We also compare the French context with international examples from the International Successful School Principalship Project (ISSPP), focusing on Nordic countries, where leadership emphasizes democratic participation, professional trust, and shared responsibility. This study underscores the uniqueness of the French leadership model, which resists managerial and market logics while remaining rooted in republican and egalitarian ideals. It concludes by advocating for a more context-aware, ethically grounded, and dialogical approach to school leadership. Full article
24 pages, 472 KiB  
Article
The Effect of Workplace Mobbing on Positive and Negative Emotions: The Mediating Role of Psychological Resilience Among Nurses
by Aristotelis Koinis, Ioanna V. Papathanasiou, Ioannis Kouroutzis, Iokasti Papathanasiou, Dimitra Anagnostopoulou, Ioannis Androutsakos, Maria Papandreou, Ioulia Katsaiti, Nikolaos Tsioumas, Melpomeni Mourtziapi, Pavlos Sarafis and Maria Malliarou
Healthcare 2025, 13(15), 1915; https://doi.org/10.3390/healthcare13151915 - 5 Aug 2025
Abstract
Background: Workplace mobbing is a widespread phenomenon with serious psychological and emotional consequences on employees’ emotional well-being. Psychological resilience has been identified as a potential protective factor against such adverse outcomes. Aim: This study investigates the relationship between workplace mobbing and emotional well-being, [...] Read more.
Background: Workplace mobbing is a widespread phenomenon with serious psychological and emotional consequences on employees’ emotional well-being. Psychological resilience has been identified as a potential protective factor against such adverse outcomes. Aim: This study investigates the relationship between workplace mobbing and emotional well-being, as expressed through positive and negative affect, and examines the mediating role of psychological resilience in this association. Methods: Ninety nurses participated in this cross-sectional study. Data were collected using the Connor–Davidson Resilience Scale (CD-RISC), the Workplace Psychologically Violent Behaviors (WPVB) scale, and the Positive and Negative Affect Schedule (PANAS). Statistical analyses included correlation, multiple regression, and mediation using bootstrapped confidence intervals. Results: Resilience was strongly associated with positive affect (r = 0.74, p < 0.001) and inversely with negative affect (r = −0.46, p < 0.001). Mobbing was significantly related to increased negative affect (β = 0.12, p < 0.001) but not to positive affect. Resilience emerged as the strongest predictor of emotional outcomes and partially mediated the relationship between “Attack on professional role” and negative affect. Conclusions: Psychological resilience plays a key protective role in moderating the emotional impact of workplace mobbing. Enhancing resilience in healthcare professionals may mitigate the negative emotional effects of mobbing, although it does not fully buffer against all its consequences. Full article
(This article belongs to the Special Issue Well-Being of Healthcare Professionals: New Insights After COVID-19)
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15 pages, 1223 KiB  
Article
Point-of-Care Ultrasound (POCUS) in Pediatric Practice in Poland: Perceptions, Competency, and Barriers to Implementation—A National Cross-Sectional Survey
by Justyna Kiepuszewska and Małgorzata Gałązka-Sobotka
Healthcare 2025, 13(15), 1910; https://doi.org/10.3390/healthcare13151910 - 5 Aug 2025
Abstract
Background: Point-of-care ultrasound (POCUS) is gaining recognition as a valuable diagnostic tool in various fields of medicine, including pediatrics. Its application at the point of care enables real-time clinical decision-making, which is particularly advantageous in pediatric settings. Although global interest in POCUS is [...] Read more.
Background: Point-of-care ultrasound (POCUS) is gaining recognition as a valuable diagnostic tool in various fields of medicine, including pediatrics. Its application at the point of care enables real-time clinical decision-making, which is particularly advantageous in pediatric settings. Although global interest in POCUS is growing, many European countries—including Poland—still lack formal training programs for POCUS at both the undergraduate and postgraduate levels. Nevertheless, the number of pediatricians incorporating POCUS into their daily clinical practice in Poland is increasing. However, the extent of its use and perceived value among pediatricians remains largely unknown. This study aimed to evaluate the current level of POCUS utilization in pediatric care in Poland, focusing on pediatricians’ self-assessed competencies, perceptions of its clinical utility, and key barriers to its implementation in daily practice. Methods: This cross-sectional study was conducted between July and August 2024 using an anonymous online survey distributed to pediatricians throughout Poland via national professional networks, with a response rate of 7.3%. Categorical variables were analyzed using the chi-square test of independence to assess the associations between key variables. Quantitative data were analyzed using descriptive statistics, and qualitative data from open-ended responses were subjected to a thematic analysis. Results: A total of 210 pediatricians responded. Among them, 149 (71%) reported access to ultrasound equipment at their workplace, and 89 (42.4%) reported having participated in some form of POCUS training. Only 46 respondents (21.9%) reported frequently using POCUS in their clinical routine. The self-assessed POCUS competence was rated as low or very low by 136 respondents (64.8%). While POCUS was generally perceived as a helpful tool in facilitating and accelerating clinical decisions, the main barriers to implementation were a lack of formal training and limited institutional support. Conclusions: Although POCUS is perceived as clinically valuable by the surveyed pediatricians in Poland, its routine use remains limited due to training and systemic barriers. Future efforts should prioritize the development of a validated, competency-based training framework and the implementation of a larger, representative national study to guide the structured integration of POCUS into pediatric care. Full article
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25 pages, 956 KiB  
Review
Sexual Health Education in Nursing: A Scoping Review Based on the Dialectical Structural Approach to Care in Spain
by Mónica Raquel Pereira-Afonso, Raquel Fernandez-Cézar, Victoria Lopezosa-Villajos, Miriam Hermida-Mota, Maria Angélica de Almeida Peres and Sagrario Gómez-Cantarino
Healthcare 2025, 13(15), 1911; https://doi.org/10.3390/healthcare13151911 - 5 Aug 2025
Abstract
Sexual health constitutes a fundamental aspect of overall well-being, with direct implications for individual development and the broader social and economic progress of communities. Promoting environments that ensure sexual experiences free from coercion, discrimination, and violence is a key public health priority. Sexuality, [...] Read more.
Sexual health constitutes a fundamental aspect of overall well-being, with direct implications for individual development and the broader social and economic progress of communities. Promoting environments that ensure sexual experiences free from coercion, discrimination, and violence is a key public health priority. Sexuality, in this regard, should be understood as an inherent dimension of human experience, shaped by biological, cultural, cognitive, and ideological factors. Accordingly, sexual health education requires a holistic and multidimensional approach that integrates sociocultural, biographical, and professional perspectives. This study aims to examine the level of knowledge and training in sexual health among nursing students and healthcare professionals, as well as to assess the extent to which sexual health content is incorporated into nursing curricula at Spanish universities. A scoping review was conducted using the Dialectical Structural Model of Care (DSMC) as the theoretical framework. The findings indicate a significant lack of knowledge regarding sexual health among both nursing students and healthcare professionals, largely due to educational and structural limitations. Furthermore, sexual health education remains underrepresented in nursing curricula and is frequently addressed from a narrow, fragmented biomedical perspective. These results highlight the urgent need for the comprehensive integration of sexual health content into nursing education. Strengthening curricular inclusion is essential to ensure the preparation of competent professionals capable of delivering holistic, inclusive, and empowering care in this critical area of health. Full article
(This article belongs to the Special Issue Advances in Sexual and Reproductive Health)
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20 pages, 10605 KiB  
Article
Network Analysis of Outcome-Based Education Curriculum System: A Case Study of Environmental Design Programs in Medium-Sized Cities
by Yang Wang, Zixiao Zhan and Honglin Wang
Sustainability 2025, 17(15), 7091; https://doi.org/10.3390/su17157091 - 5 Aug 2025
Abstract
With deepening global higher education reforms, outcome-based education has emerged as the core paradigm for teaching model innovation. This study investigates the structural dependencies and teaching effectiveness of the Environmental Design curriculum at Hubei Engineering University in medium-sized cities, China, addressing challenges of [...] Read more.
With deepening global higher education reforms, outcome-based education has emerged as the core paradigm for teaching model innovation. This study investigates the structural dependencies and teaching effectiveness of the Environmental Design curriculum at Hubei Engineering University in medium-sized cities, China, addressing challenges of enrollment decline and market contraction critical for urban sustainability. Using network analysis, we construct curriculum support and contribution networks and course temporal networks to assess structural dependencies and teaching effectiveness, revealing structural patterns and optimizing the OBE-based Environmental Design curriculum to enhance educational quality and student competencies. Analysis reveals computer basic courses as knowledge transmission hubs, creating a course network with a distinct core–periphery structure. Technical course reforms significantly outperform theoretical course reforms in improving student performance metrics, such as higher average scores, better grade distributions, and reduced performance gaps, while innovative practice courses show peripheral isolation patterns, indicating limited connectivity with core curriculum modules, which reduces their educational impact. These findings provide empirical insights for curriculum optimization, supporting urban sustainable development through enhanced professional talent cultivation equipped to address environmental challenges like sustainable design practices and resource-efficient urban planning. Network analysis applications introduce innovative frameworks for curriculum reform strategies. Future research expansion through larger sample validation will support urban sustainable development goals and enhance professional talent cultivation outcomes. Full article
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13 pages, 532 KiB  
Systematic Review
A Systematic Review of Early-Career Teacher Wellbeing, Stress, Burnout and Support Mechanisms During and Post COVID-19 Pandemic
by Trent Davis and Eunjae Park
Educ. Sci. 2025, 15(8), 996; https://doi.org/10.3390/educsci15080996 (registering DOI) - 5 Aug 2025
Abstract
Early-career teachers (ECTs) entered the profession during the COVID-19 pandemic, a period that introduced unique stressors to an already-demanding career phase. This systematic review examines empirical studies published between 2020 and February 2025 to explore how the pandemic influenced ECT wellbeing, with particular [...] Read more.
Early-career teachers (ECTs) entered the profession during the COVID-19 pandemic, a period that introduced unique stressors to an already-demanding career phase. This systematic review examines empirical studies published between 2020 and February 2025 to explore how the pandemic influenced ECT wellbeing, with particular attention to stressors and protective factors impacting long-term retention and professional sustainability. Guided by PRISMA protocols, databases including Web of Science, ERIC, Google Scholar, and Scopus were searched, screening 470 records and identifying 30 studies that met inclusion criteria: peer-reviewed, empirical, focused on early-career teachers (within the first five years), and situated in or explicitly addressing the pandemic and its ongoing impacts. The results of Braun and Clarke’s thematic analysis (2006) revealed that pandemic-related challenges such as increased workload, professional isolation, disrupted induction processes, and emotional strain have persisted into the post-pandemic era, contributing to sustained risks of burnout and attrition. Regardless, protective factors identified during the pandemic—including high-quality mentoring, structured induction programmes, collegial support, professional autonomy, and effective individual coping strategies—continue to offer essential support, enhancing resilience and professional wellbeing. These findings underscore the necessity of institutionalising targeted supports to address the enduring effects of pandemic-related stressors on ECT wellbeing. By prioritising sustained mental health initiatives and structural supports, education systems can effectively mitigate long-term impacts and improve retention outcomes for early-career teachers in a post-pandemic educational landscape. Full article
(This article belongs to the Special Issue Education for Early Career Teachers)
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19 pages, 913 KiB  
Article
Understanding Diversity: The Cultural Knowledge Profile of Nurses Prior to Transcultural Education in Light of a Triangulated Study Based on the Giger and Davidhizar Model
by Małgorzata Lesińska-Sawicka and Alina Roszak
Healthcare 2025, 13(15), 1907; https://doi.org/10.3390/healthcare13151907 - 5 Aug 2025
Abstract
Introduction: The increasing cultural diversity of patients poses new challenges for nurses. Cultural competence, especially knowledge of the cultural determinants of health and illness, is an important element of professionalism in nursing care. The aim of this study was to analyse nurses’ self-assessment [...] Read more.
Introduction: The increasing cultural diversity of patients poses new challenges for nurses. Cultural competence, especially knowledge of the cultural determinants of health and illness, is an important element of professionalism in nursing care. The aim of this study was to analyse nurses’ self-assessment of cultural knowledge, with a focus on the six dimensions of the Giger and Davidhizar model, prior to formal training in this area. Methods: A triangulation method combining qualitative and quantitative analysis was used. The analysis included 353 statements from 36 master’s student nurses. Data were coded according to six cultural phenomena: biological factors, communication, space, time, social structure, and environmental control. Content analysis, ANOVA, Spearman’s rank correlation, and cluster analysis (k-means) were conducted. Results: The most frequently identified that categories were environmental control (34%), communication (20%), and social structure (16%). Significant knowledge gaps were identified in the areas of non-verbal communication, biological differences, and understanding space in a cultural context. Three cultural knowledge profiles of the female participants were distinguished: pragmatic, socio-reflective, and critical–experiential. Conclusions: The cultural knowledge of the participants was fragmented and simplified. The results indicate the need to personalise cultural learning and to take into account nurses’ level of readiness and experience profile. The study highlights the importance of the systematic development of reflective and contextual cultural knowledge as a foundation for competent care. Full article
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14 pages, 614 KiB  
Article
Development of Cut Scores for Feigning Spectrum Behavior on the Orebro Musculoskeletal Pain Screening Questionnaire and the Perceived Stress Scale: A Simulation Study
by John Edward McMahon, Ashley Craig and Ian Douglas Cameron
J. Clin. Med. 2025, 14(15), 5504; https://doi.org/10.3390/jcm14155504 - 5 Aug 2025
Abstract
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 [...] Read more.
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
(This article belongs to the Section Clinical Rehabilitation)
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18 pages, 5327 KiB  
Article
Few-Shot Supervised Learning for Multivariate Knowledge Extraction from Dietary Reviews: Addressing Low-Resource Challenges with Optimized Datasets and Schema Layers
by Yuanhao Zhang, Wanxia Yang, Beiei Zhou, Xiang Zhao and Xin Li
Electronics 2025, 14(15), 3116; https://doi.org/10.3390/electronics14153116 - 5 Aug 2025
Abstract
Dietary reviews contain rich emotional and objective information; however, existing knowledge extraction methods struggle with low-resource scenarios due to sparse and imbalanced label distributions. To address these challenges, this paper proposes a few-shot supervised learning approach. First, we develop a professional dietary–emotional schema [...] Read more.
Dietary reviews contain rich emotional and objective information; however, existing knowledge extraction methods struggle with low-resource scenarios due to sparse and imbalanced label distributions. To address these challenges, this paper proposes a few-shot supervised learning approach. First, we develop a professional dietary–emotional schema by integrating domain knowledge with real-time data to ensure the coverage of diverse emotional expressions. Next, we introduce a dataset optimization method based on dual constraints—label frequency and quantity—to mitigate label imbalance and improve model performance. Utilizing the optimized dataset and a tailored prompt template, we fine-tune the DRE-UIE model for multivariate knowledge extraction. The experimental results demonstrate that the DRE-UIE model achieves a 20% higher F1 score than BERT-BiLSTM-CRF and outperforms TENER by 1.1%. Notably, on a 20-shot subset, the model on the Chinese dataset scores 0.841 and attains a 15.16% F1 score improvement over unoptimized data, validating the effectiveness of our few-shot learning framework. Furthermore, the approach also exhibits robust performance across Chinese and English corpora, underscoring its generalization capability. This work offers a practical solution for low-resource dietary–emotional knowledge extraction by leveraging schema design, dataset optimization, and model fine-tuning to achieve high accuracy with minimal annotated data. Full article
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13 pages, 322 KiB  
Article
Clinical Perspectives on Cochlear Implantation in Pediatric Patients with Cochlear Nerve Aplasia or Hypoplasia
by Ava Raynor, Sara Perez, Megan Worthington and Valeriy Shafiro
Audiol. Res. 2025, 15(4), 96; https://doi.org/10.3390/audiolres15040096 (registering DOI) - 5 Aug 2025
Abstract
Background: Cochlear implantation (CI) in pediatric patients with cochlear nerve deficiencies (CND) remains controversial due to a highly variable clinical population, lack of evidence-based guidelines, and mixed research findings. This study assessed current clinical perspectives and practices regarding CI candidacy in children [...] Read more.
Background: Cochlear implantation (CI) in pediatric patients with cochlear nerve deficiencies (CND) remains controversial due to a highly variable clinical population, lack of evidence-based guidelines, and mixed research findings. This study assessed current clinical perspectives and practices regarding CI candidacy in children with CND among hearing healthcare professionals in the USA. Methods: An anonymous 19-question online survey was distributed to CI clinicians nationwide. The survey assessed professional background, experience with aplasia and hypoplasia, and perspectives on CI versus auditory brainstem implant (ABI) candidacy, including imaging practices and outcome expectations. Both multiple-choice and open-ended responses were analyzed to identify trends and reasoning. Results: Seventy-two responses were analyzed. Most clinicians supported CI for hypoplasia (60.2%) and, to a lesser extent, for aplasia (41.7%), with audiologists more likely than neurotologists to favor CI. Respondents cited lower risk, accessibility, and the potential for benefit as reasons to attempt CI before ABI. However, many emphasized a case-by-case approach, incorporating imaging, electrophysiological testing, and family counseling. Only 22.2% considered structural factors the best predictors of CI success. Conclusions: Overall, hearing health professionals in the USA tend to favor CI as a first-line option, while acknowledging the limitations of current diagnostic tools and the importance of individualized, multidisciplinary decision-making in CI candidacy for children with CND. Findings reveal a high variability in clinical perspectives on CI implantation for pediatric aplasia and hypoplasia and a lack of clinical consensus, highlighting the need for more standardized assessment and imaging protocols to provide greater consistency across centers and enable the development of evidence-based guidelines. Full article
(This article belongs to the Section Hearing)
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17 pages, 1707 KiB  
Article
Influence of Work Environment Factors on Burnout Syndrome Among Freelancers
by Youri Ianakiev and Teodora Medneva
Psychiatry Int. 2025, 6(3), 95; https://doi.org/10.3390/psychiatryint6030095 (registering DOI) - 5 Aug 2025
Abstract
The problem associated with the manifestation of burnout syndrome is the subject of ongoing interest. In recent years, occupational burnout has been actively studied among professionals in the helping professions (teachers, physicians, social workers, psychologists, prison officers, etc.). However, the phenomenon has been [...] Read more.
The problem associated with the manifestation of burnout syndrome is the subject of ongoing interest. In recent years, occupational burnout has been actively studied among professionals in the helping professions (teachers, physicians, social workers, psychologists, prison officers, etc.). However, the phenomenon has been poorly studied among freelancers. Therefore, the aim of this study is to fill this gap by determining the level of burnout syndrome among Bulgarian freelancers and investigate the influence of some work environment factors on professional burnout in the sample. A survey of 1138 freelancers was carried out using the Burnout Self-Assessment Questionnaire developed by Maslach and a questionnaire developed in-house to explore the factors of the occupational environment and ask questions related to socio-demographic factors. Hypotheses are tested using correlation analysis and structural equation modelling. The study reveals high levels of emotional exhaustion (40.91%, n = 484). High values on the scale of depersonalization were reported for 26,3% of the respondents (n = 311). Only 3.1% of the respondents (n = 37) had high values on the reduced personal accomplishment scale. The high levels of burnout among freelancers could be influenced by the specific characteristics of their work environment and the nature of their tasks. Full article
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27 pages, 4239 KiB  
Article
Implementing Zero Trust: Expert Insights on Key Security Pillars and Prioritization in Digital Transformation
by Francesca Santucci, Gabriele Oliva, Maria Teresa Gonnella, Maria Elena Briga, Mirko Leanza, Marco Massenzi, Luca Faramondi and Roberto Setola
Information 2025, 16(8), 667; https://doi.org/10.3390/info16080667 - 5 Aug 2025
Abstract
As organizations continue to embrace digital transformation, the need for robust cybersecurity strategies has never been more critical. This paper explores the Zero Trust Architecture (ZTA) as a contemporary cybersecurity framework that addresses the challenges posed by increasingly interconnected systems. Zero Trust (ZT) [...] Read more.
As organizations continue to embrace digital transformation, the need for robust cybersecurity strategies has never been more critical. This paper explores the Zero Trust Architecture (ZTA) as a contemporary cybersecurity framework that addresses the challenges posed by increasingly interconnected systems. Zero Trust (ZT) operates under the principle of “never trust, always verify,” ensuring that every access request is thoroughly authenticated, regardless of the requester’s location within or outside the network. However, implementing ZT is a challenging task, requiring an adequate roadmap to prioritize the different initiatives in agreement with company culture, exposure and cyber posture. We apply multi-criteria decision analysis (MCDA) to evaluate the relative importance of various components within a ZT framework, using the Incomplete Analytic Hierarchy Process (IAHP). Expert opinions from professionals in cybersecurity and IT governance were gathered through structured questionnaires, leading to a prioritized ranking of the eight key ZT pillars, as defined by the Cybersecurity and Infrastructure Security Agency (CISA), Washington, DC, USA, along with a prioritization of the sub-elements within each pillar. The study provides actionable insights into the implementation of ZTA, helping organizations prioritize security efforts to mitigate risks effectively and build a resilient digital infrastructure. The evaluation results were used to create a prioritized framework, integrated into the ZEUS platform, developed with Teleconsys S.p.A., to enable detailed assessments of a firm’s cyber partner regarding ZT and identify improvement areas. The paper concludes by offering recommendations for future research and practical guidance for organizations transitioning to a ZT model. Full article
(This article belongs to the Section Information Security and Privacy)
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14 pages, 5448 KiB  
Article
A Study of Climate-Sensitive Diseases in Climate-Stressed Areas of Bangladesh
by Ahammadul Kabir, Shahidul Alam, Nusrat Jahan Tarin, Shila Sarkar, Anthony Eshofonie, Mohammad Ferdous Rahman Sarker, Abul Kashem Shafiqur Rahman and Tahmina Shirin
Climate 2025, 13(8), 166; https://doi.org/10.3390/cli13080166 - 5 Aug 2025
Abstract
The National Adaptation Plan of Bangladesh identifies eleven climate-stressed zones, placing nearly 100 million people at high risk of climate-related hazards. Vulnerable groups such as the poor, floating populations, daily laborers, and slum dwellers are particularly affected. However, there is a lack of [...] Read more.
The National Adaptation Plan of Bangladesh identifies eleven climate-stressed zones, placing nearly 100 million people at high risk of climate-related hazards. Vulnerable groups such as the poor, floating populations, daily laborers, and slum dwellers are particularly affected. However, there is a lack of data on climate-sensitive diseases and related hospital visits in these areas. This study explored the prevalence of such diseases using the Delphi method through focus group discussions with 493 healthcare professionals from 153 hospitals in 156 upazilas across 21 districts and ten zones. Participants were selected by district Civil Surgeons. Key climate-sensitive diseases identified included malnutrition, diarrhea, pneumonia, respiratory infections, typhoid, skin diseases, hypertension, cholera, mental health disorders, hepatitis, heat stroke, and dengue. Seasonal surges in hospital visits were noted, influenced by factors like extreme heat, air pollution, floods, water contamination, poor sanitation, salinity, and disease vectors. Some diseases were zone-specific, while others were widespread. Regions with fewer hospital visits often had higher disease burdens, indicating under-reporting or lack of access. The findings highlight the need for area-specific adaptation strategies and updates to the Health National Adaptation Plan. Strengthening resilience through targeted investment and preventive measures is crucial to reducing health risks from climate change. Full article
(This article belongs to the Section Climate and Environment)
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13 pages, 364 KiB  
Case Report
Racial Imposter Syndrome and Music Performance Anxiety: A Case Study
by Trisnasari Fraser
Behav. Sci. 2025, 15(8), 1057; https://doi.org/10.3390/bs15081057 - 4 Aug 2025
Abstract
The impact of cultural identity on music performance anxiety (MPA) is under-researched. This retrospective case study explores the treatment of a professional musician in her 30s who presented with MPA associated with performing music related to her estranged father’s cultural background. The case [...] Read more.
The impact of cultural identity on music performance anxiety (MPA) is under-researched. This retrospective case study explores the treatment of a professional musician in her 30s who presented with MPA associated with performing music related to her estranged father’s cultural background. The case formulation identified attachment ruptures and negative cognitions associated with her mixed cultural heritage that contributed to an experience of imposterism—referred to in lay literature as ‘racial imposter syndrome’ (RIS). It was hypothesized that RIS served to perpetuate her MPA. An attachment-based approach and Acceptance and Commitment Therapy framework was adopted, drawing on evidence-based treatment for MPA and mixed heritage individuals. The Depression Anxiety Stress Scale-21 (DASS-21), Outcome Rating Scale (ORS) and Session Rating Scale (SRS) were used as outcome measures. These measures fluctuated throughout the therapy. While improvements were observed in depression scores midway through treatment, elevated stress and depression scores at the conclusion of treatment were understood to reflect situational factors related to financial and housing precarity. Nonetheless, at the conclusion of treatment, the client showed improvement in managing MPA, evidenced by her progress in recording an album and reengagement with public performances. This case study adds to the limited research on treating MPA in racially minoritized and mixed-race individuals, Further research is required across larger and more diverse samples to better understand the relationship between MPA and RIS and to develop effective interventions. Full article
(This article belongs to the Special Issue Interventions for Music Performance Anxiety)
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20 pages, 519 KiB  
Article
Bridging the Capacity Building Gap for Antimicrobial Stewardship Implementation: Evidence from Virtual Communities of Practice in Kenya, Ghana, and Malawi
by Ana C. Barbosa de Lima, Kwame Ohene Buabeng, Mavis Sakyi, Hope Michael Chadwala, Nicole Devereaux, Collins Mitambo, Christine Mugo-Sitati, Jennifer Njuhigu, Gunturu Revathi, Emmanuel Tanui, Jutta Lehmer, Jorge Mera and Amy V. Groom
Antibiotics 2025, 14(8), 794; https://doi.org/10.3390/antibiotics14080794 (registering DOI) - 4 Aug 2025
Abstract
Background/Objectives: Strengthening antimicrobial stewardship (AMS) programs is an invaluable intervention in the ongoing efforts to contain the threat of antimicrobial resistance (AMR), particularly in low-resource settings. This study evaluates the impact of the Telementoring, Education, and Advocacy Collaboration initiative for Health through [...] Read more.
Background/Objectives: Strengthening antimicrobial stewardship (AMS) programs is an invaluable intervention in the ongoing efforts to contain the threat of antimicrobial resistance (AMR), particularly in low-resource settings. This study evaluates the impact of the Telementoring, Education, and Advocacy Collaboration initiative for Health through Antimicrobial Stewardship (TEACH AMS), which uses the virtual Extension for Community Healthcare Outcomes (ECHO) learning model to enhance AMS capacity in Kenya, Ghana, and Malawi. Methods: A mixed-methods approach was used, which included attendance data collection, facility-level assessments, post-session and follow-up surveys, as well as focus group discussions. Results: Between September 2023 and February 2025, 77 virtual learning sessions were conducted, engaging 2445 unique participants from hospital-based AMS committees and health professionals across the three countries. Participants reported significant knowledge gain, and data showed facility improvements in two core AMS areas, including the implementation of multidisciplinary ward-based interventions/communications and enhanced monitoring of antibiotic resistance patterns. Along those lines, participants reported that the program assisted them in improving prescribing and culture-based treatments, and also evidence-informed antibiotic selection. The evidence of implementing ward-based interventions was further stressed in focus group discussions, as well as other strengthened practices like point-prevalence surveys, and development or revision of stewardship policies. Substantial improvements in microbiology services were also shared by participants, particularly in Malawi. Other practices mentioned were strengthened multidisciplinary communication, infection prevention efforts, and education of patients and the community. Conclusion: Our findings suggest that a virtual case-based learning educational intervention, providing structured and tailored AMS capacity building, can drive behavior change and strengthen healthcare systems in low resource settings. Future efforts should aim to scale up the engagements and sustain improvements to further strengthen AMS capacity. Full article
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