Search Results (1,135)

In an era where digitalization shapes economic and social landscapes, the intersection of digital skills, ethics, and integrity plays a crucial role in understanding the vulnerability of youth classified as NEET (Not in Education, Employment, or Training). This study explores how risky internet use and digital skill gaps contribute to socio-economic exclusion, integrating a multivariate and spatial approach to assess regional disparities in Europe. This study adopts a systems thinking perspective to explore digital exclusion as an emergent outcome of multiple interrelated subsystems. The research employs logistic regression, Principal Component Analysis (PCA) with Promax rotation, and Geographic Information Systems (GIS) to examine the impact of digital behaviors on NEET status. Using Eurostat data aggregated at the country level for the period (2000–2023) across 28 European countries, this study evaluates 24 digital indicators covering social media usage, instant messaging, daily internet access, data protection awareness, and digital literacy levels. The findings reveal that low digital skills significantly increase the likelihood of being NEET, while excessive social media and internet use show mixed effects depending on socio-economic context. A strong negative correlation between digital security practices and NEET status suggests that youths with a higher awareness of online risks are less prone to socio-economic exclusion. The GIS analysis highlights regional disparities, where countries with limited digital access and lower literacy levels exhibit higher NEET rates. Digital exclusion is not merely a technological issue but a multidimensional socio-economic challenge. To reduce the NEET rate, policies must focus on enhancing digital skills, fostering online security awareness, and addressing regional disparities. Integrating GIS methods allows for the identification of territorial clusters with heightened digital vulnerabilities, guiding targeted interventions for improving youth employability in the digital economy. Full article

This study aims to provide a comprehensive overview of psychological distress among medical students in Spain, a growing concern given the high prevalence rates of anxiety, depression, and burnout reported across multiple medical schools and universities. To assess the scope and key characteristics of this phenomenon, a thorough literature search was conducted in the PubMed, ProQuest, and Web of Science (WoS) databases. Studies published between 2010 and 2024 in peer-reviewed scientific journals, written in English or Spanish, and specifically focused on medical students enrolled in Spanish universities were considered for inclusion. A total of 14 studies were analysed. The findings indicate that psychological distress often emerges early in medical training and tends to intensify as students progress academically. Female medical students are consistently more affected, as most of the studies reviewed indicate that they exhibit higher levels of depressive symptoms, trait anxiety, and perceived stress. Some research also suggests greater levels of burnout among female students compared to their male peers. Key contributing factors include academic overload and dissatisfaction, sleep deprivation, and the use of maladaptive coping strategies. Although awareness of the issue is increasing, available evidence suggests that institutional responses remain limited, and that only a small number of universities have implemented structured mental health programmes. Overall, the results underscore the urgent need for institutional reforms in Spanish medical education to safeguard students’ mental wellbeing. Key priorities include revising curricula, implementing structured emotional support programmes, and ensuring accessible services—requiring coordinated, long-term commitment across academic, healthcare, and policy sectors. Future research should explore longitudinal trends and the effectiveness of targeted interventions. Full article

Sustainable education requires addressing the challenges posed by digital transformation, including technostress among university students. This study evaluates technostress levels in higher education through the validation of the TS4US scale and its implications for sustainable learning environments. A cross-sectional study was conducted with 328 university students from four districts in Lima, Peru, using an online survey to measure technostress. Confirmatory factor analysis (CFA) was performed to assess the psychometric properties of the TS4US scale, resulting in a refined model with two latent factors and thirteen validated items. Findings indicate that 28% of students experience high technostress levels, while 5% report very high levels, though no significant associations were found between technostress and sociodemographic variables such as campus location, employment status, gender, and academic level. The TS4US instrument had been previously validated in Chile; this study confirms its structure in a new sociocultural context, reinforcing its cross-cultural applicability. These results highlight the need for sustainable strategies to mitigate technostress in higher education, including institutional support, digital literacy programs, and policies fostering a balanced technological environment. Addressing technostress is essential for promoting sustainable education (SDG4) and enhancing student well-being (SDG3). This study directly contributes to the achievement of Sustainable Development Goals 3 (Good Health and Well-being) and 4 (Quality Education) by providing validated tools and evidence-based recommendations to promote mental health and equitable access to digital education in Latin America. Future research should explore cross-country comparisons and targeted interventions, including digital well-being initiatives and adaptive learning strategies, to ensure a resilient and sustainable academic ecosystem. Full article

Self-regulated learning (SRL) has been widely recognized as a critical skill for academic success in online and blended learning contexts. However, many students experience difficulty in effectively applying SRL strategies in the absence of structured instructional guidance. To address this challenge, this study developed and implemented a learning management system integrated with SRL support (SRL-LMS), specifically designed for the online component of a blended learning course. The SRL-LMS consisted of two sections: a conventional course content section and a SRL training section designed to support students in applying SRL strategies. A quasi-experimental design was adopted with 69 college students assigned to either an experimental group, with access to both course and SRL sections, or a control group, which accessed only the course section. Results indicated that students in the experimental group reported higher levels of self-regulation and showed more frequent and diverse application of SRL strategies compared to the control group. In terms of academic performance, the experimental group performed significantly better than the control group on the first exam, though no significant difference was observed on the second exam. These results highlight the effectiveness of structured SRL interventions within digital learning platforms for improving students’ self-regulatory behaviors. Future implementations should address cognitive load and incorporate strategic approaches to sustain student motivation. This study advances current SRL intervention designs and offers valuable insights for educators and instructional designers aiming to integrate targeted SRL supports in online and blended learning environments. Full article

In today’s fast-changing world, the higher education system must evolve to enhance the quality of learning and teaching. Fulfilling the role of a university is a major challenge. Universities must implement strategies that place the student at the center of their concerns; so, these strategies must be designed for and by the student. However, the high university dropout rate is one of the current problems faced by many universities. This suggests that there are some issues that hinder the learning process. Several studies have highlighted the advantage of artificial intelligence (AI) technologies in providing explorative and predictive analyses that explain why students are dropping out, with the aim of improving the quality of teaching and providing an integrated learning environment. This paper proposes a framework that predicts student dropout rates using machine learning techniques, based on data collected from various sources. Data collection was carried out between 2022 and 2024. We used a quantitative analysis method employed through a questionnaire distributed to 120 students (aged 18–26) from open access faculties of a Moroccan public university to identify the factors leading to an increase in university dropout rates. We discuss the impact of selected variables, and the findings show that several factors are related to university dropout rates, such as social background, psychological and health problems, insufficient motivation of professors, limited perspective on educational programs, changes in language and teaching methodologies, absenteeism, student attitude, and a lack of interaction between professors and students. Full article

High-quality, openly accessible clinical datasets remain a significant bottleneck in advancing both research and clinical applications within medical artificial intelligence. Case reports, often rich in multimodal clinical data, represent an underutilized resource for developing medical AI applications. We present an enhanced version of MultiCaRe, a dataset derived from open-access case reports on PubMed Central. This new version addresses the limitations identified in the previous release and incorporates newly added clinical cases and images (totaling 93,816 and 130,791, respectively), along with a refined hierarchical taxonomy featuring over 140 categories. Image labels have been meticulously curated using a combination of manual and machine learning-based label generation and validation, ensuring a higher quality for image classification tasks and the fine-tuning of multimodal models. To facilitate its use, we also provide a Python package for dataset manipulation, pretrained models for medical image classification, and two dedicated websites. The updated MultiCaRe dataset expands the resources available for multimodal AI research in medicine. Its scale, quality, and accessibility make it a valuable tool for developing medical AI systems, as well as for educational purposes in clinical and computational fields. Full article

Background/Objectives: International students pursuing higher education in the United States face unique challenges that increase their risk of food insecurity, including limited financial resources, employment restrictions, and cultural barriers. While food insecurity among domestic students has been widely studied, limited research focuses on the lived experiences of international graduate students. This study explores the challenges, perceptions, and coping strategies related to food insecurity among international graduate students at a large public university in North Texas. Methods: This qualitative, ethnographic study involved 20 semi-structured interviews with international graduate students who were clients of the university’s food pantry. Participants were recruited using purposive convenience sampling. Interviews focused on students’ experiences with food access, financial constraints, campus resources, and cultural food preferences. Data were analyzed using thematic coding in MAXQDA. Two standardized food insecurity measures—the USDA and FAO scales—were also administered and analyzed using SPSS. Results: Findings revealed that 85% of participants experienced limited access to nutritious and culturally appropriate foods, with 70% reporting hunger due to financial constraints. Themes included lack of cooking skills, limited campus food options, difficulty accessing familiar groceries, and limited job opportunities. Students expressed that food insecurity significantly impacted their physical health, mental well-being, and social lives, though many continued to prioritize academics over personal nourishment. Conclusions: Food insecurity among international graduate students is multifaceted, shaped by financial, cultural, and institutional barriers. Addressing this issue requires culturally sensitive interventions, improved access to diverse food options, tailored student support services, and institutional efforts to better understand and meet the needs of international students. Full article

Blended and virtual learning have become an integral part in international higher education, especially in the wake of the COVID-19 pandemic and the European Union’s Digital Education Action Plan. These modalities have enabled more inclusive, flexible, and sustainable forms of international collaboration, such as Collaborative Online International Learning (COIL) and Blended Intensive Programs (BIPs), reshaping the landscape of global academic mobility. This paper introduces the INVITE Learning Design Framework (LDF), developed to support higher education instructors in designing high-quality, internationalized blended and virtual learning experiences. The framework addresses the growing need for structured, theory-informed approaches to course design that foster student engagement, intercultural competence, and motivation in non-face-to-face settings. The INVITE LDF was developed through a rigorous scoping review of existing models and frameworks, complemented by needs-identification analysis and desk research. It integrates Self-Determination Theory, Active Learning principles, and the ADDIE instructional design model to provide a comprehensive, adaptable structure for course development. The framework was successfully implemented in a large-scale online training module for over 1000 educators across Europe. Results indicate that the INVITE LDF enhances educators’ ability to create engaging, inclusive, and pedagogically sound international learning environments. Its application supports institutional goals of internationalization by making global learning experiences more accessible and scalable. The findings suggest that the INVITE LDF can serve as a valuable tool for higher education institutions worldwide, offering a replicable model for fostering intercultural collaboration and innovation in digital education. This contributes to the broader transformation of international higher education, promoting equity, sustainability, and global citizenship through digital pedagogies. Full article

Background: Environmental exposures, such as per- and polyfluoroalkyl substances (PFAS), in conjunction with social and behavioral factors, can significantly impact liver health. This research investigates the combined effects of PFAS (perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS), alcohol consumption, smoking, income, and education on liver function among the U.S. population, utilizing data from the 2017–2018 National Health and Nutrition Examination Survey (NHANES). Methods: PFAS concentrations in blood samples were analyzed using online solid-phase extraction combined with liquid chromatography–tandem mass spectrometry (LC-MS/MS), a highly sensitive and specific method for detecting levels of PFAS. Liver function was evaluated using biomarkers such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyltransferase (GGT), total bilirubin, and the fatty liver index (FLI). Descriptive statistics and multivariable linear regression analyses were employed to assess the associations between exposures and liver outcomes. Bayesian Kernel Machine Regression (BKMR) was utilized to explore the nonlinear and interactive effects of these exposures. To determine the relative influence of each factor on liver health, Posterior Inclusion Probabilities (PIPs) were calculated. Results: Linear regression analyses indicated that income and education were inversely associated with several liver injury biomarkers, while alcohol use and smoking demonstrated stronger and more consistent associations. Bayesian Kernel Machine Regression (BKMR) further highlighted alcohol and smoking as the most influential predictors, particularly for GGT and total bilirubin, with posterior inclusion probabilities (PIPs) close to 1.0. In contrast, PFAS showed weaker associations. Regression coefficients were small and largely non-significant, and PIPs were comparatively lower across most liver outcomes. Notably, education had a higher PIP for ALT and GGT than PFAS, suggesting a more protective role in liver health. People with higher education levels tend to live healthier lifestyles, have better access to healthcare, and are generally more aware of health risks. These factors can all help reduce the risk of liver problems. Overall mixture effects demonstrated nonlinear trends, including U-shaped relationships for ALT and GGT, and inverse associations for AST, FLI, and ALP. Conclusion: These findings underscore the importance of considering both environmental and social–behavioral determinants in liver health. While PFAS exposures remain a long-term concern, modifiable lifestyle and structural factors, particularly alcohol, smoking, income, and education, exert more immediate and pronounced effects on hepatic biomarkers in the general population. Full article

Introduction: Dental caries and molar–incisor hypomineralisation (MIH) are prevalent conditions affecting children’s oral health, with functional, aesthetic, and psychosocial implications. In Spain, previous studies have highlighted geographic and sociodemographic disparities in their distribution, particularly among rural and migrant populations. Objective: To characterise oral health status, in terms of caries and MIH, among 6–7-year-old children from the towns of Palos de la Frontera, Mazagón, and San Bartolomé. Methods: A cross-sectional study was conducted involving 229 children recruited from public primary schools. Sociodemographic, anthropometric, and behavioural data were collected through clinical examination and interview. Statistical analysis included univariate and multivariate logistic regression. The study protocol was approved by the Ethics Committee of Huelva. Results: The prevalence of caries (DMFT ≥ 1) was 53.3%, with mean DMFT and dft indices of 1.78 and 0.31, respectively. MIH affected 32.8% of the cohort, with a predominance in the first permanent molars (teeth 36 and 26). Multivariate analysis identified independent predictors of caries: African (OR = 7.47; 95% CI: 2.84–23.8) and European (OR = 4.56; 95% CI: 1.26–22.3) parental origin, poor oral hygiene (OR = 3.07; 95% CI: 1.60–6.03), and the presence of MIH (OR = 3.20; 95% CI: 1.64–6.42). The municipality of San Bartolomé was associated with a higher risk of MIH (OR = 2.90; 95% CI: 1.21–7.45). Conclusions: The high prevalence of caries and MIH in the Condado-Campiña district, exceeding national averages, reflects oral health inequities linked to social determinants (migrant origin, locality) and clinical factors (MIH, oral hygiene). Targeted preventive interventions are urgently needed in high-risk populations, including culturally tailored education and policies ensuring equitable access to dental care services. Full article

Background/Objectives: A food allergy (FA) is an immune-mediated hypersensitivity reaction to specific food. FA reactions vary from mild to life-threatening anaphylaxis. Despite the effectiveness of epinephrine auto-injectors (EAIs), barriers such as lack of knowledge, limited access, and fear of needles hinder their use. This study explores EAI possession among children with parent-reported food allergies in Saudi Arabia. Methods: A cross-sectional study conducted from October 2023 to February 2024 included 296 parents of children with reported food allergies under the age of 18. Data were collected through a validated self-administered questionnaire. Results: Among 2102 respondents, 296 (14.1%) reported having a child with a food allergy. Most respondents were female (70%), with asthma being the most common comorbidity (26%). Common allergens included eggs, tree nuts, peanuts, milk, and sesame. Only 23.3% of children had an EAI. Higher EAI possession was associated with parental education, maternal allergy history, and access to specialist care. Conclusions: EAI possession among Saudi children with food allergies is suboptimal. Targeted educational interventions, increased access to allergists, and comprehensive management plans are essential to improve preparedness for anaphylaxis. Full article

This research investigates higher education admission outcomes at Hungarian universities for ethnic Hungarian minority students residing in countries within the Carpathian Basin. The region is distinguished by a variety of national policies that impact minority education. By analyzing extensive data on the availability of mother tongue education, the status of minority rights, advanced level examination performance, and types of settlement using a wide range of statistical methods, our study reveals significant cross-national differences in the distribution of admission scores and central tendencies. Compared to lower and more varied scores for students from Ukraine and Romania, ethnic Hungarian students from Serbia and Slovakia achieved high average admission scores. Performance was notably more consistent among students from EU member states compared to non-EU regions, strongly linking outcomes to the more robust implementation of minority rights and better access to mother-tongue education within the EU framework. A critical finding is the strong positive correlation (Pearson r = 0.837) between admission scores and advanced level examination results, highlighting the pivotal role of these exams for the academic progression of these minority students. The Jonckheere-Terpstra test (p < 0.05) further confirmed significant performance differences between ranked country groups, with Serbian and Slovak students generally outperforming their Ukrainian and Romanian counterparts. Counterintuitively, settlement type (urban vs. rural) exhibited a negligible relationship with admission scores (r = 0.150), explaining only 2% of score variability. This challenges common assumptions and suggests other factors specific to the Hungarian minority context are more influential. This study provides crucial insights into the complex dynamics influencing Hungarian minority students’ access to higher education, underscoring cross-country educational inequalities, and informing the development of equitable minority rights and mother-tongue education policies in Central Europe for these often-marginalized communities. Full article

This research analyzed university students’ perceptions of the use of generative artificial intelligence (hereafter Gen-AI) in a higher education context. Specifically, it addressed the potential benefits and challenges related to the application of these web-based resources. A mixed method was adopted and the sample consisted of 407 teacher training students enrolled in the Early Childhood and Primary Education Degrees in the Region of Murcia in Spain. The results indicated a clear recognition of the relevance of these technological tools for teaching and learning. Respondents highlighted the potential to engage them in academic tasks, increase their motivation, and personalize their learning pathways. However, participants identified some challenges related to technology dependency, ethical issues, and privacy concerns. By understanding learners’ beliefs and assumptions, educators and educational administrations can adapt Gen-AI according to learners’ needs and preferences to improve their academic performance. In learning practice, these adaptations could involve evidence-based interventions, such as AI literacy modules or hybrid assessment frameworks, to translate findings into practice. In addition, it is necessary to adjust materials, methodologies, and the assessment of the academic curriculum to facilitate student learning and ensure that all students have access to quality education and the adequate development of digital skills. Full article

Background/Objectives: Health literacy plays a fundamental role in adolescents’ health-related decisions and behaviors. The aim of our study was to assess the level of health literacy among 16–17-year-old students in Southern Hungary and to examine the associations between sociodemographic characteristics and health behaviors. Methods: This cross-sectional quantitative study was conducted in the autumn of 2024 in Baranya and Somogy counties. A total of 133 students completed a self-administered questionnaire including sociodemographic variables and health behaviors. Health literacy was measured using the validated HELMA-H instrument. Statistical analysis included chi-square tests, t-tests, and ANOVA (p < 0.05). Results: Overall, 62.7% of the students demonstrated adequate, while 37.3% demonstrated inadequate levels of health literacy. No significant association was found between overall health literacy and sociodemographic variables; however, partial associations were observed on specific subscales. Boys reported better access to health information (p = 0.037), while children of mothers with higher educational attainment scored better in comprehension (p = 0.042) and appraisal (p = 0.036). In the case of the numeracy subscale, children of mothers with the lowest educational level showed significantly better results (p = 0.006). Students with higher health literacy levels were less likely to smoke or consume caffeine; however, a reverse trend was observed regarding alcohol consumption. Physical activity showed a positive association with healthier behaviors (p < 0.05). Discussion: The use of digital technologies, interactive learning strategies, and the involvement of family members—especially mothers—may support the development of health-conscious decision-making in adolescents. Consequently, health education programs should focus not only on knowledge transfer but also on fostering critical thinking and decision-making skills. Full article

Food security is defined as a state in which all people at all times have both physical and economic access to sufficient food to meet their dietary needs for a productive and healthy life. The general objective of this work was to assess the situation of food insecurity and its impact on the quantity and quality of food consumption during lockdown in the first wave of the COVID-19 pandemic and to identify the determinants associated with the different food insecurity (FI) categories on a sample of 2227 people (1168 people from Spain and 1059 people from Morocco). Food insecurity (FI) assessed by the Household Food Insecurity Access Scale (HFIAS) were compared in both countries, controlling for the effect of sociodemographic variables, age, gender, marital status, and education level. The mean HFIAS was 0.53 in the Spanish and 3.55 in the Moroccan samples (p < 0.001). Only 2.1% of the Spanish sample were in a situation of severe insecurity against 15.5% in Morocco (p < 0.001). Moroccans with moderate and severe food insecurity decreased their consumption of meat, fish, eggs, nuts, legumes, and fruits. The risk of food insecurity was higher in men than in women, in separated or divorced people, in people with secondary and middle education, and in younger people. Full article