Search Results (15,725)

Background/Objectives: The transformation of nursing and midwifery education through digital technologies has gained momentum worldwide, with algorithm-based video instruction and virtual reality (VR) emerging as promising tools for improving clinical learning. This quasi-experimental study explores the impact of an enhanced flipped classroom model on Bulgarian nursing and midwifery students’ self-perceived competence. Methods: A total of 228 participants were divided into a control group receiving traditional instruction (lectures and simulations with manikins) and an experimental group engaged in a digitally enhanced preparatory phase. The latter included pre-class video algorithms, VR, and clinical problem-solving tasks for learning and improving nursing skills. A 25-item self-report questionnaire was administered before and after the intervention to measure perceived competence in injection techniques, hygiene care, midwifery skills, and digital readiness. Results: Statistical analysis using Welch’s t-test revealed significant improvements in the experimental group in all domains (p < 0.001). Qualitative data from focus group interviews further confirmed increased student engagement, motivation, and receptiveness to digital learning tools. Conclusions: The findings highlight the pedagogical value of integrating structured video learning, VR components, and case-based learning within flipped classrooms. The study advocates for the wider adoption of blended learning models to foster clinical confidence and digital competence in healthcare education. The results of the study may be useful for curriculum developers aiming to improve clinical readiness through technology-enhanced learning. Full article

Addressing global challenges such as climate change and inequality requires convergence competencies that enable learners to devise sustainable solutions. Such competencies have been emphasized in Science, Technology, Engineering, Mathematics (STEM) fields, but empirical research and assessment tools tailored to Humanities, Arts, and Social Sciences (HASS) remain scarce. This study aimed to develop and validate a self-assessment tool to measure convergence competencies among HASS learners. A three-round Delphi survey with domain experts was conducted to evaluate and refine an initial pool of items. Items with insufficient content validity were revised or deleted, and all retained items achieved a Content Validity Ratio (CVR) of ≥0.800, with most scoring 1.000. The validated instrument was administered to 455 undergraduates participating in a convergence education program. Exploratory factor analysis identified five key dimensions: Convergent Commitment, Future Problem Awareness, Future Efficacy, Convergent Learning, and Multidisciplinary Inclusiveness, explaining 69.72% of the variance. Confirmatory factor analysis supported the model’s goodness-of-fit (χ² (160) = 378.786, RMSEA = 0.054, CFI = 0.952), and the instrument demonstrated high internal consistency (Cronbach’s α = 0.919). The results confirm that the tool is both reliable and valid for diagnosing convergence competencies in HASS contexts, providing a practical framework for interdisciplinary learning and reflective engagement toward sustainable futures. Full article

Force-field Monte Carlo and Molecular Dynamics simulations are used to compare wetting behaviors of model carbon sheets mimicking neat graphene, its saturated derivative, graphane, and related planar allotropes penta-graphene, γ-graphyne, and ψ-graphene in contact with aqueous droplets or an aqueous film confined between parallel carbon sheets. Atomistic and area-integrated surface/water potentials are found to be essentially equivalent in capturing moderate differences between the wetting free energies of tested substrates. Despite notable differences in mechanical and electric properties of distinct allotropes, the predicted allotrope/water contact angles span a narrow window of weakly hydrophilic values. Contact angles in the range of 80 ± 10° indicate modest hydration repulsion incapable of competing with van der Waals attraction between carbon particles. Poor dispersibility in neat water is hence a common feature of studied materials. Full article

Pediatric palliative care (PPC) aims to enhance the quality of life of children with life-limiting conditions and their families through individualized, interdisciplinary support. Among this population, children with neurological diseases represent a substantial and growing group, often facing prolonged disease courses, cognitive impairment, and high prognostic uncertainty. Effective communication is central to PPC; however, it remains deeply influenced by cultural, religious, and spiritual frameworks that shape family perceptions of illness, suffering, and decision-making. This narrative review explores communication strategies in PPC, with a specific focus on children with neurological conditions, highlighting conceptual foundations, cross-cultural variations, and emerging best practices. Key findings highlight the importance of culturally humble approaches, family-centered communication models, and structured tools, such as co-designed advance care planning and dignity therapy, to enhance communication. Additionally, the review highlights the presence of ethical and interdisciplinary challenges, particularly in neonatal and neurology settings, where misaligned team messaging and institutional hesitancy may compromise trust and timely referral to palliative care. Future research, policy, and clinical education priorities should advocate for models that are inclusive, ethically grounded, and tailored to the unique trajectories of neurologically ill children. Integrating cultural competence, team alignment, and family voices is essential for delivering equitable and compassionate PPC across diverse care settings. Full article

The integration of Inquiry-Based Learning (IBL) and mobile technologies can transform science education, offering experimentation opportunities to students from budget-constrained schools. This study investigates the efficacy of smartphone-assisted experimentation (SAE) within IBL to enhance pre-service science teachers’ understanding of human physiology and presents a newly developed and validated rubric for assessing their scientific skills. Students (N = 286) from a Science and Mathematics Teacher Education Program participated in a summative IBL activity (“Investigating the Human Physiology”—iHPhys) where they designed experimental projects using smartphone applications to collect body sign data. The scoring rubric, assessing seven criteria including hypothesis formulation, methodological design, data presentation, and conclusion writing, was validated as substantial to almost perfect inter-rater reliability. Results reveal that students exhibited strong skills in hypothesis clarity, theoretical grounding, and experimental design, with a high degree of methodological innovation observed. However, challenges persisted in predictive reasoning and evidence-based conclusion writing. The students were strongly interested in inquiring about the cardiovascular and nervous systems. Correlational analyses suggest a positive relationship between project originality and overall academic performance. Thus, integrating SAE and IBL fosters critical scientific competencies, creativity, and epistemic cognition while democratizing access to scientific experimentation and engaging students in tech-savvy pedagogical practices. Full article

In an increasingly complex global context, higher education faces the challenge of preparing professionals who are innovative, committed, and socially responsible. Entrepreneurial competence is particularly prominent among the key skills required to meet this goal, given its significant personal and social impact. This study examines how final-year undergraduate students at the University of Deusto (Spain) perceive the importance of entrepreneurial competence—defined as a set of transversal skills, knowledge, and attitudes enabling initiative and opportunity recognition across various contexts—rather than entrepreneurial competence strictly understood as business creation. The sample included 267 students from different faculties. Descriptive, comparative, and ordinal logistic regression analyses (SPSS) were used. The results show that, while entrepreneurial competence was given significant importance, it was ranked comparatively low relative to other competencies. Significant differences by gender were observed, with women rating entrepreneurial competence more highly than men. The faculty variable showed slight disparities, and there were no relevant differences between campuses. These findings highlight the need to reinforce the integration of entrepreneurial competence into educational curricula on a transversal basis, adapting the teaching of this competence to the sociocultural context of students, as well as the need to increase students’ awareness of the importance of entrepreneurial competence. It is proposed that further research should focus on the relationships between intrapreneurship, gender, and academic disciplines, in order to enrich entrepreneurial competence education and its impact on the employability and social commitment of students. Full article

This study explores the perceptions of future educators, specifically Early Childhood Education students at the Universities of Cádiz and Gdansk, regarding the interconnections between critical thinking and sustainability. The work aims to provide valuable insights into general teacher training, examining how these students’ experiences are contextualized within their respective educational systems and cultural contexts. To achieve this, eleven group interviews (three in Cádiz, eight in Gdansk) were conducted using a structured and expert-validated script. The transcribed data were qualitatively analyzed using QDA MINER v.6 software. Key findings reveal divergent perceptions of critical thinking among pre-service teachers: while Spanish students leaned towards a subjective understanding, Polish students emphasized an objective, data-driven approach. This distinction has significant implications for the conceptualization and teaching of critical thinking in educator training. Despite these differences, both groups of participants highlighted the necessity of implementing active methodologies in higher education (such as cooperative learning, problem-solving, and debates) to foster critical thinking, both for their own development and for preparing for their future practice with young children. This study also identified an excessive emphasis on theoretical aspects of sustainability in these future teachers’ training and a limited understanding of their practical application in the classroom. Furthermore, explicit connections between critical thinking and sustainability were scarce in student responses, highlighting a gap in current educator training in these areas. Collectively, the results suggest significant weaknesses in current teacher training efforts regarding the development of critical thinking and its effective integration with sustainability competencies. Full article

Background: Pancreatic adenocarcinoma (PDAC) with liver oligometastases (LOM) presents a therapeutic challenge, with optimal management strategies remaining uncertain. This study evaluates the long-term outcomes, patterns of disease progression, and potential factors influencing prognosis in this patient subset. Methods: Patients diagnosed with PDAC and LOM were retrospectively analyzed. Disease progression patterns, causes of death, and predictors of long-term outcomes were assessed. Results: Among 1442 patients diagnosed with metastatic PDAC between November 2009 and July 2024, 129 (9%) presented with LOM, defined as ≤3 liver lesions each measuring <2 cm. Patients with LOM had significantly improved overall survival (OS) compared to those with high-burden disease (p = 0.026). The cause of death (local regional disease vs. systemic disease) could be determined in 74 patients (57%), among whom age at diagnosis, history of smoking, and white blood cell (WBC) count differed significantly between groups. However, no significant difference in OS was observed between the two groups (p = 0.64). Sixteen patients (22%) died from local complications of the primary tumor, including 6 patients (7%) who showed no evidence of new or progressive metastases. In competing risk and multivariable analysis, a history of smoking remained the only factor significantly associated with death due to local complications. Conclusions: Approximately one in five patients with PDAC-LOM died from local tumor-related complications—some without metastatic progression—highlighting a potential role for surgical intervention. Further multicenter studies are warranted to refine diagnostic criteria and better identify patients who may benefit from surgery. Full article

Current learning and development approaches often struggle to capture dynamic individual capabilities, particularly the skills they acquire informally every day on the job. This dynamic creates a significant gap between what traditional models think people know and their actual performance, leading to an incomplete and often outdated understanding of how ready the workforce truly is, which can hinder organizational adaptability in rapidly evolving environments. This paper proposes a novel dynamic learner-state ecosystem—an AI-driven solution designed to bridge this gap. Our approach leverages specialized AI agents, orchestrated via the Model Context Protocol (MCP), to continuously track and evolve an individual’s multi-dimensional state (e.g., mastery, confidence, context, and decay). The seamless integration of in-workflow performance data will transform daily work activities into granular and actionable data points through AI-powered dynamic xAPI generation into Learning Record Stores (LRSs). This system enables continuous, authentic performance-based assessment, precise skill gap identification, and highly personalized interventions. The significance of this ecosystem lies in its ability to provide a real-time understanding of everyone’s capabilities, enabling more accurate workforce planning for the future and cultivating a workforce that is continuously learning and adapting. It ultimately helps to transform learning from a disconnected, occasional event into an integrated and responsive part of everyday work. Full article

Weed management remains a critical challenge in the U.S. container ornamental production industry, where weeds not only compete with crops for limited resources but also harbor pests and pathogens, thereby diminishing plant quality and marketability. The paper explores the economic impact of weed infestations, herbicide resistance development, and the limited availability of selective herbicides for ornamental crops in the United States. This review synthesizes current chemical weed control tactics, focusing not only on both preemergence and postemergence herbicides commonly used in ornamental nurseries, but also organic alternatives and integrated weed management (IWM) approaches as complementary strategies by evaluating their effectiveness, crop safety, and usage. There is a critical need for research in the areas of alternative chemical options such as insecticides, miticides (e.g., Zerotol and Tetra Curb Max), and organic products for liverwort control in greenhouses. Although essential oils and plant-based extracts show some potential, their effectiveness and practical use remain largely unexplored. Full article

This study aims to understand the meaning nursing professionals attribute to their lived experiences of providing humanized care within a public hospital setting. Grounded in Jean Watson’s theory of human caring, the research adopts a qualitative, descriptive phenomenological design to capture the perceptions and emotions of nurses regarding humanized care. Data were collected through semi-structured interviews with nine experienced nurses, selected through purposive sampling. The interviews, conducted virtually between July and December 2024, were analyzed using Colaizzi’s method and supported by Atlas.ti software. Four main thematic categories emerged: institutional health policies, professional image and identity, strengths and challenges in care, and essential competencies for humanized care. The findings highlight the critical role of empathy, cultural sensitivity, ethical commitment, and emotional presence in delivering compassionate care. Participants emphasized that, beyond clinical procedures, humanized care requires relational and contextual sensitivity, often hindered by institutional limitations and excessive administrative burdens. The study concludes that nursing professionals are key agents in promoting ethical, empathetic, and culturally respectful practices that humanize health services. These insights offer valuable contributions for designing policies and training strategies aimed at strengthening humanized care as a cornerstone of quality healthcare systems. Full article

In the context of increasing Artificial Intelligence integration in higher education, understanding the factors influencing university teachers’ adoption of AI tools is critical for effective implementation. This study adopts a perception–intention–behavior framework to explores the roles of perceived usefulness, perceived ease of use, perceived trust, perceived substitution crisis, and perceived risk in shaping teachers’ behavioral intention and actual usage of AI tools. It also investigates the moderating effects of peer influence and organizational support on these relationships. Using a comprehensive survey instrument, data was collected from 487 university teachers across four major regions in China. The results reveal that perceived usefulness and perceived ease of use are strong predictors of behavioral intention, with perceived ease of use also significantly influencing perceived usefulness. Perceived trust serves as a key mediator, enhancing the relationship between perceived usefulness, perceived ease of use, and behavioral intention. While perceived substitution crisis negatively influenced perceived trust, it showed no significant direct effect on behavioral intention, suggesting a complex relationship between job displacement concerns and AI adoption. In contrast, perceived risk was found to negatively impact behavioral intention, though it was mitigated by perceived ease of use. Peer influence significantly moderated the relationship between perceived trust and behavioral intention, highlighting the importance of peer influence in AI adoption, while organizational support amplified the effect of perceived ease of use on behavioral intention. These findings inform practical strategies such as co-developing user-centered AI tools, enhancing institutional trust through transparent governance, leveraging peer support, providing structured training and technical assistance, and advancing policy-level initiatives to guide digital transformation in universities. Full article

The presence of ciprofloxacin antibiotic in water is a threat to humans and aquatic life since antibiotics are currently regarded as emerging contaminants of major concern. This work reported the use of Nexar^TM film, a sulfonated pentablock copolymer, to effectively remove ciprofloxacin antibiotic from water in a sustainable approach. The removal efficiency of Nexar film was evaluated in aqueous or salty (NaCl 0.5 M) ciprofloxacin solutions as a function of contact time and the initial ciprofloxacin concentration. In the investigated conditions, the polymeric film totally removed ciprofloxacin in MilliQ solution while its removal efficiency in salty solution was approximately 73%. This lower value is due to the presence of Na⁺ ions that compete with antibiotic molecules for adsorption on active surface sites of the polymeric film. No further release of adsorbed antibiotic molecules occurred. The kinetic studies, conducted for ciprofloxacin adsorption on Nexar film in both MilliQ and salty solutions, revealed that the overall sorption process is controlled by the rate of surface reaction between ciprofloxacin molecules and active sites on Nexar surface. Furthermore, at equilibrium conditions, the isotherm model that best fits experimental parameters was not linear. This indicates that the competition between the solute and the solvent for binding sites on the adsorbent should be considered to describe adsorption processes in both MilliQ and salty solutions. Full article

Digital competence refers to the integration of digital technology in teaching and learning, as outlined in the national curriculum of Estonia for upper secondary schools. This study presents original research findings on Estonian science teachers’ use of digital tools and materials, their digital competence, and the main benefits and challenges they face. The findings emphasize the need for continued professional development, accessible digital resources, and equitable digital infrastructure to maintain Estonia’s leadership in digital science education. A survey of 58 secondary school science teachers revealed that computers (desktops, laptops, and tablets) are the primary digital tools used. The article explores digital literacy advancements in secondary science education, research methodologies used to assess digital tool usage, and key findings from recent studies. However, challenges such as digital equity, technological barriers, and digital fatigue persist. Additionally, discrepancies were found in teachers’ responses regarding digital tool effectiveness, implementation strategies, and perceived barriers. While some teachers reported a successful integration and improved student outcomes, others highlighted difficulties in aligning digital resources with curriculum requirements and pedagogical approaches. Full article

Improving construction site safety remains a critical challenge in Saudi Arabia’s rapidly growing construction sector, where high accident rates and diverse labor forces demand evidence-based managerial interventions. This study investigated the influence of Managers’ Safety Perceptions and Practices (MSP) on Workers’ Safety Behaviors (WSB) in the Saudi construction industry, emphasizing the mediating roles of Workers’ Safety Awareness (WSA), Safety Competency (WSC), and Safety Actions (SA). The conceptual framework integrates these three mediators to explain how managerial attitudes and practices translate into frontline safety outcomes. A quantitative, cross-sectional design was adopted using a structured questionnaire distributed among construction workers, supervisors, and project managers. A total of 352 from 384 valid responses were collected, and the data were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM) via SmartPLS 4. The findings revealed that MSP does not directly influence WSB but has significant indirect effects through WSA, WSC, and SA. Among these, WSC emerged as the most powerful mediator, followed by WSA and SA, indicating that competency is the most critical driver of safe worker behavior. These results provide robust empirical support for a multidimensional mediation model, highlighting the need for managers to enhance safety behaviors not merely through supervision but through fostering awareness and competency, providing technical training, and implementing proactive safety measures. Theoretically, this study contributes a novel and integrative framework to the occupational safety literature, particularly within underexplored Middle Eastern construction contexts. Practically, it offers actionable insights for safety managers, industry practitioners, and policymakers seeking to improve construction safety performance in alignment with Saudi Vision 2030. Full article