Search Results (1,177)

In conditions of liquid modernity, marked by accelerated technological change, the virtualization of essential services, and the erosion of stable institutional support, digital participation in later life is less a matter of initial access than of continuously renegotiating engagement within unstable socio-technical environments. While established technology adoption models such as TAM, UTAUT, and STAM have provided robust explanations of cognitive and age-related determinants of adoption, they remain limited in accounting for the relational processes through which technological engagement is learned, stabilized, and sustained over time. This article advances a relational perspective on technology appropriation by foregrounding the role of warm experts—trusted informal supporters who mediate learning, interpretation, and adaptation in everyday contexts. Moving beyond dyadic understandings of assistance, the paper conceptualizes mediation as a distributed ecology of roles embedded within relational networks that both enable and constrain digital inclusion. Building on this perspective, the study proposes the Relational Technology Appropriation Model (RELTAM) as a general multi-level architecture integrating individual determinants, relational mediation processes, and network-level support configurations within a dynamic framework of appropriation. The Relational (Older Adult) Technology Appropriation Model (REL(OA)TAM) is introduced as a context-specific instantiation of this broader framework, calibrated to the distinctive conditions of later life. By incorporating temporal instability and mediation ecologies as structural components, REL(OA)TAM offers a socially grounded account of digital inclusion as an ongoing process of adaptive negotiation within the fluid and uncertain conditions of liquid modernity. Full article

The hospitality industry is characterised by high levels of complexity, uncertainty, and interpersonal intensity. While emotional intelligence (EI) has dominated both academic and practitioner debates on effective hospitality leadership, considerably less attention has been paid to cognitive intelligence (CI) as a foundational managerial competency. Drawing on interdisciplinary research from management, psychology, and hospitality studies, this paper argues that cognitive intelligence constitutes a critical yet under-theorised capability for innovation management and organisational performance in hospitality contexts. Building on established distinctions between cognitive and emotional intelligence, and synthesising evidence from hospitality and general management research, this paper develops a conceptual framework positioning CI as a core meta-competency that enables sensemaking, judgement, problem-solving, and adaptive decision-making in complex service environments. This conceptual paper contributes to the literature on innovation and hospitality management by reframing managerial intelligence as a performance-enabling capability that underpins learning, adaptability, and long-term organisational effectiveness in hospitality organisations. Full article

Visual arts education (VAE) offers a promising pedagogical space for addressing sustainability challenges by engaging the cognitive, emotional, and ethical dimensions of learning. This study examines how engagement with contemporary visual arts and art-based pedagogical practices can foster ecological thinking, ecological literacy, and sustainability awareness among pre-service teachers. The research was conducted over one academic year (2022/2023) within two visual arts courses attended by a total of 69 second- and third-year students enrolled in a teacher education programme. Using a qualitative, interpretative research design, the study investigated how selected contemporary artworks addressing ecological themes were pedagogically contextualised and discussed, and how students engaged with these artworks through dialogue, reflection, and their own art-making processes. Data were collected from students’ written reflections, group discussions, and visual works, and analysed using an interpretative framework informed by visual hermeneutics and sustainability education discourse. The findings indicate that engagement with contemporary visual art can foster the development of ecological literacy by enabling students to integrate experiential, affective, reflective, and relational dimensions of sustainability into their understanding of environmental issues. In line with the objectives of SDG 4 (Quality Education), SDG 12 (Responsible Consumption and Production), and SDG 13 (Climate Action), the study contributes to existing literature by demonstrating the pedagogical potential of visual arts education within teacher education and Education for Sustainable Development. Full article

Background/Objectives: Adequate cardiopulmonary resuscitation (CPR), defibrillation, and treatment of reversible causes are essential for improving the survival of patients suffering from out-of-hospital cardiac arrests (OHCAs). The Advanced Life Support (ALS) algorithm includes reversible causes for cardiac arrest. This study aimed to develop an interactive mobile checklist to identify reversible causes of OHCA (REBECCA) and evaluate their usability and usefulness among emergency physicians. Methods: This mixed-methods study was conducted at the Emergency Medical Service Vienna, Austria. All participants were emergency physicians from the Medical University of Vienna. An interactive mobile checklist was developed using a participatory design approach involving a focus group of 10 emergency physicians. Usability and applicability were assessed using structured questionnaires. Descriptive statistics were used to summarize participant characteristics and evaluation outcomes. Results: Among the included participants, 70% were specialists with a median prehospital experience of 2.0 (1.0–4.3) years. Although most participants were confident about their level of professional experience with OHCA, 85% still found the checklist to be helpful. The majority of the participants preferred the digital checklist over the paper-based checklist and appreciated its integration with the point-of-care ultrasound (POCUS) application. Although the participants did not communicate a significant need for further details on most causes, a small majority favored more information on intoxication and electrolyte disorders. Conclusions: The majority of the included emergency physicians found the REBECCA checklist helpful regardless of training level, whereas almost no physician needed further detailed information on the reversible causes. Our findings underscore the potential importance of future investigations aiming to reduce the cognitive load of emergency physicians during OHCA scenarios. Full article

Background/Objective: Breast cancer is one of the leading diseases affecting the Brazilian population and is often diagnosed at advanced stages. Due to its heterogeneity, treatment involves multiple therapeutic modalities, such as chemotherapy, hormone therapy, immunotherapy, and radiotherapy. The aim of this study was to characterize the profile of patients undergoing treatment for breast cancer in a private hospital in southern Brazil, and to assess the physical and psychological effects associated with different therapeutic modalities. Methods: An ambidirectional longitudinal cohort study was conducted from September 2018 to December 2024, incorporating retrospective data since 2013. Clinical and therapeutic data were collected, and Patient-Reported Outcome Measures (PROMs) using the QLQ-C30 Summary Score (QLQ-BR23, FACT-ES, BREAST-Q, LMC21) and Symptom Global Score questionnaires were analyzed using mixed-effects models to evaluate physical, emotional, cognitive, social, and overall quality-of-life domains, as well as body image. The temporal trend of time-to-treatment was assessed via linear regression. Results: Among 871 individuals evaluated, 98.4% were female, and invasive ductal carcinoma was the predominant histological type (75.1%). Radiotherapy was one of the most frequently used treatment modalities (39.2%), while immunotherapy had the lowest usage rate (2.7%). A significant reduction in the time between diagnosis and initiation of treatment was observed from 2013 to 2024 (from 21.0 to 10.9 days; p < 0.01), reflecting improvements in healthcare services. Mixed-effects models for PROMs indicated significant improvements across all assessed domains (p < 0.01) over the 48-month follow-up, despite a median follow-up of 22 months. Conclusions: High-quality and timely oncological care provided to breast cancer patients in a private hospital in southern Brazil demonstrates the implementation of a dynamic, agile, and human-centered care model, contributing to improved clinical and patient-reported outcomes validated by robust longitudinal analysis. Full article

The physical and mental health of adolescents is a cornerstone of national future. However, traditional “one-size-fits-all” school health interventions often fail to address the diverse needs of students. To overcome this limitation, this research introduces an evidence-based, tiered intervention model designed to provide personalized health support. This study constructs and validates a dynamic ‘Dynamic Weighting-based Asset-Condition-Resource Allocation-Evaluation-Feedback’ (DWA-CRISPR) tiered intervention model, moving from a “triage-driven” to a “needs-driven” service delivery framework. The model is built upon a Response to Intervention (RTI)/Multi-Tiered System of Support (MTSS) three-tier structure and integrates ecological systems theory, social cognitive theory, and the health belief model. Using a quasi-experimental design with propensity score matching (PSM), the intervention’s effectiveness was evaluated on a final matched cohort of 470 students. Difference-in-differences (DID) analysis was then employed to assess the outcomes. The results demonstrate that the tiered intervention significantly reduced the BMI Z-scores of at-risk students compared to the control group. Furthermore, by employing XGBoost and SHAP, the study identified key risk factors, such as cardiorespiratory fitness and baseline BMI, enabling precise and early risk identification. Hierarchical linear models (HLMs) further clarified the multi-level factors influencing intervention outcomes. In conclusion, the DWA-CRISPR tiered model proves to be more effective than traditional approaches, providing a scientific, efficient, and personalized pathway for improving the physical health of primary and secondary school students. Full article

This study employs a constructivist grounded theory approach based on 69 in-depth interviews conducted between March 2022 and December 2023 to examine socio-cognitive dynamics in Korea’s bottled water and household water purifier markets. The study addresses a gap in prior research by explaining how product meanings and stakeholder strategies co-evolve across adjacent “safe-water” markets under regulatory and sustainability pressures. Drawing on qualitative data from 69 stakeholders, including producers (n = 30), consumers (n = 19), and institutional experts (n = 20), we analyze how distrust, risk perception, and health consciousness reshape conceptual systems and market strategies. These shifts drive innovation across markets, including new technologies, service models, and branding strategies. The findings show that socio-cognitive stabilization arises through iterative interactions among institutional shocks, producer reinterpretation, and consumer adaptation. In the bottled water market, the meanings of “natural purity” became materially embedded in packaging, mineral labeling, and brand narratives. In the purifier sector, “technological reliability” was institutionalized through service-based maintenance systems and visible quality control technologies. These processes developed within asymmetric communicative environments shaped by corporate branding capacity and media amplification. This study refines socio-cognitive market theory by specifying boundary conditions under institutional distrust in developed economies. Although Republic of Korea possesses advanced drinking water infrastructure comparable to that of other developed economies, public confidence in tap water has periodically weakened following highly salient contamination incidents and regulatory transitions. This paradox provides a theoretically informative context for examining how product meanings and stakeholder behaviors mutually adapt over time. Although environmental impact metrics were not directly measured, the findings suggest that sustainability policies must address socio-cognitive trust dynamics alongside regulatory instruments such as plastic levies, certification schemes, and transparent risk communication. Full article

Traditional approaches to university-level history education often fail to provide immersive and interactive environments that foster deep cognitive engagement. To address these limitations, we developed an AI-enabled virtual museum system that integrates AI-generated content with knowledge graphs through a multi-layered architecture. The system architecture follows a three-tier framework: a front-end interaction layer (Unity/Unreal Engine) for real-time user engagement, a core service layer for intelligent event scheduling and response control (Chat General Language Model/Stable Diffusion), and a data and model layer (My Structured Query Language/MongoDB) to provide structured knowledge. To evaluate the system’s effectiveness, a four-week controlled experiment was conducted with 83 university students. The experimental group using the AI virtual museum showed a significantly higher mean post-test score (84.5 ± 6.8) than that of the control group (71.6 ± 7.9), with statistical significance at p < 0.001, starting from nearly identical baseline scores (61.2 and 60.4 for the experimental and control groups). Correlation analysis was conducted to identify scenario simulations (r = 0.59) and deep inquiry tasks (r = 0.54) as key drivers of learning mastery. By aligning advanced system engineering with educational theory, the results of this study offer a solution for high-fidelity, intelligent digital educational platforms, proposing a validated model for integrated system innovation in education. Full article

This study examines prospective teachers’ perceptions of sustainable development (SD) and explores the relationship between the SD scenarios they developed and the actions they performed. Based on 58 scenarios and 128 actions reported by pre-service teachers, the study found that scenarios primarily focused on education, resource conservation, and waste management. While the environmental dimension emphasized protection, economic and social dimensions were largely associated with financial savings and public welfare. In contrast, participants’ actual behaviors were predominantly limited to simple resource conservation, such as turning off lights and saving water. A significant discrepancy emerged: despite the strong emphasis on education-related themes in scenarios, educational actions were notably limited in practice. These results suggest that prospective teachers’ high cognitive awareness of SD is only partially reflected in their practical engagement. The findings highlight a “cognitive–practice gap,” underscoring the need for teacher education programs to prioritize action-oriented competencies. Full article

Physically Active Learning (PAL) integrates physical activity into classroom teaching and has been shown to benefit students’ cognitive, social, and academic outcomes. Despite these advantages, PAL is not yet sustainably implemented in everyday school practice, highlighting the need for effective professional development (PD) formats for teachers. This randomized controlled experimental study examined how different PD formats, varying in their mode of engagement with ready-to-use PAL materials, affect teachers’ motivation, professional competence, and implementation of PAL. A total of 153 in-service primary teachers participated in a 2.5 h PD training and were randomly assigned to one of three formats: example-based learning, experience-based learning, or problem-solving. Data were collected at pre-test, post-test, and a six-week follow-up using standardized questionnaires. Results showed that teachers in the experience-based format reported significantly higher motivation during the PD training than those in the other formats. Across all formats, attitude and self-efficacy regarding PAL increased over time, whereas no significant gains in knowledge were observed. No significant differences between PD formats regarding overall implementation of PAL were observed. Exploratory analyses indicated a potential advantage of the experience-based format. Overall, the findings suggest that immersive, experience-based PD formats may be particularly effective in fostering teachers’ motivation. Full article

Psychosocial and cognitive interventions are increasingly implemented in pediatric hospital settings. However, evidence regarding their structure, delivery, and outcomes remains dispersed. This scoping review aimed to synthesize current evidence on these interventions, focusing on their design, professional delivery, reported outcomes, and existing research gaps. It was conducted using established scoping review methodology and is reported in accordance with PRISMA-ScR guidelines. Systematic searches were conducted in PubMed, Scopus, Web of Science, PsycINFO, and ProQuest Dissertations to identify peer-reviewed and grey literature published between 2009 and 2024. Following study selection based on predefined inclusion criteria, data were charted using a standardized data extraction form and analyzed to synthesize and map key characteristics of interventions and outcomes in relation to the review questions. Sixty-one studies met the inclusion criteria. Interventions primarily targeted school-aged children and adolescents and were delivered by psychologists, educators, and nurses, frequently within interdisciplinary teams. A wide range of materials and resources were used, including digital technologies, playful and artistic materials, audiovisual and informational supports, and sensory or therapeutic objects. Techniques primarily involved guided conversation, cognitive and body-based exercises, and play-based approaches. Outcomes mainly focused on emotional well-being and recovery, while fewer interventions explicitly addressed cognitive processes such as attention and executive functioning. Overall, reported effects were generally positive. These findings suggest that psychosocial and cognitive interventions in pediatric hospital settings reflect a wide range of approaches, while also revealing methodological heterogeneity, variability in reporting, and the underrepresentation of low- and middle-income countries, pointing to the need for more robust and inclusive future research. Full article

As countries confront rapid population ageing alongside escalating climate hazards, long-term care (LTC) systems are increasingly exposed to climate-related risks yet remain under-recognised within climate adaptation policy. This study aims to bridge the gap between climate and health adaptation frameworks and LTC system planning by developing a climate-tailored integrated LTC framework. A horizon scanning and theory-informed synthesis approach was employed, drawing on peer-reviewed and grey literature published between 2010 and 2025 to identify climate hazards affecting LTC users and systems. Evidence was organised by hazard type and analysed in relation to system-level disruption mechanisms and adaptation functions. Findings demonstrate that major climate hazards, including heatwaves, flooding, storms, droughts, wildfires, and air pollution, disproportionately affect LTC users, leading to increased morbidity, cognitive decline, and functional deterioration. At the same time, LTC systems are vulnerable to cascading infrastructure failures, workforce strain, supply chain disruptions, and service discontinuities. Despite these risks, the WHO Operational Framework for Climate-Resilient and Low-Carbon Health Systems does not explicitly address LTC, while the WHO Integrated LTC Framework does not incorporate climate-related risks. In response, this paper proposes a climate-tailored LTC framework that systematically embeds climate risk, adaptation, and mitigation within the four core LTC domains of needs, governance, service delivery, and system enablers. Equity, user participation, and decarbonisation are integrated as cross-cutting principles. The framework provides a policy-oriented architecture to strengthen climate-resilient LTC systems and align long-term care reform with broader climate and sustainable development strategies. Full article

Virtual agents powered by large language models are increasingly deployed in digital mental health services, yet the influence of avatar appearance on users’ emotional, cognitive, and physiological responses remains insufficiently understood. This study was conducted between March and April 2024 and examined how three avatar designs—animal-like, human-like, and object-like—shape affective experience, user evaluation, autonomic activity, and attentional allocation during virtual doctor interactions. Forty-two participants completed a within-subjects experiment involving self-reported affect ratings, multidimensional user-experience assessments, heart rate variability (HRV) measures, and eye-tracking indicators. The avatar type did not yield statistically significant differences in changes in positive or negative affect across conditions. However, physiological data revealed clear divergences. The animal-like avatar elicited the strongest parasympathetic activation, reflected by significant increases in the root mean square of successive differences (RMSSD) and high-frequency (HF) power, whereas the object-like avatar produced a sympathetic-dominant response. Across six user-experience dimensions, the animal-like avatar consistently received the highest evaluations. Eye-tracking results showed faster first fixation and a longer face-directed fixation duration for the animal-like avatar, indicating stronger social attention. The human-like avatar demonstrated slightly delayed initial fixation, consistent with subtle yet nonsignificant uncanny-valley tendencies. These findings underscore the critical role of avatar visual design in shaping emotional safety, engagement, and social processing in virtual mental-health interactions. Full article

This study examines intelligent judgment formation in blockchain-based public digital wallet systems within smart city environments. Drawing on an integrated framework that combines cognitive evaluation, social influence, and trust–risk appraisal, this research conceptualizes intelligent decision-making as a socially embedded and contextually enacted evaluative process rather than a fixed cognitive attribute. A structural equation modeling approach is employed to analyze the interrelationships among perceived usefulness, perceived ease of use, subjective norms, social electronic word of mouth, trust–risk appraisal, attitude, and behavioral intention. The findings indicate that socially distributed information signals play a dominant role in shaping evaluative integration and decision readiness, while cognitive and institutional appraisals operate primarily through mediated pathways. The results suggest that intelligent action in public digital service ecosystems emerges from the coordinated interaction of usability perception, institutional confidence, and socially calibrated information flows. These findings contribute to theoretical extensions of technology acceptance models in public governance contexts and offer implications for the design of socially responsive digital service infrastructures. Full article

With the rapid advancement of agricultural modernization, ensuring production safety has become a pressing concern, yet the mechanisms through which government regulation fosters safe production remain underexplored. This study addresses this gap using a two-stage survey design: first, panel-tracked survey data collected from 2021 to 2024 are used to document the evolution of regulatory perceptions among agricultural enterprises; second, a cross-sectional analytical design based on three survey waves conducted in 2024 is employed to examine the effect mechanisms using structural equation modeling method. Drawing on survey data from 485 Chinese agricultural enterprises in 2024, the findings show that four regulatory types—normative, punitive, incentive, and service—promote safe production both directly and indirectly through dual pathways: knowledge acquisition (cognitive–technical capacity building) and risk awareness (preventive attitudinal orientation). Mediation comparison analysis reveals that these two mechanisms exert equivalent effects across all regulatory pathways, indicating complementary rather than competing roles. Theoretically, the study advances regulatory pluralism and dual-mediation frameworks in organizational safety research; practically, it offers guidance for policymakers to design integrated regulatory portfolios and for managers to strengthen both knowledge systems and risk-aware cultures. Full article