Search Results (6,407)

Climate changes have increased interest in the circular economy, an alternative model that seeks to minimize environmental impact and maximize resource reuse. A key element of this model is individuals’ behaviors and attitudes, which determine the overall efficiency of recycling processes. The study fills the gap by investigating how selected socio-demographic factors affect attitudes and intentions toward recycling and material reuse in the Slovak Republic, by using the Perceived Characteristics of Innovating (PCI) framework. Through a two-way ANOVA, we tested the hypotheses that higher education correlates with stronger recycling attitudes and that women are more willing than men to engage in circular practices. The results show that gender differences in consumer attitudes towards the circular economy do occur, but their magnitude is often conditioned by education level. Education proved to be the strongest predictor of ecological behavior: respondents with higher education reported stronger beliefs in the importance of recycling and a greater willingness to act sustainably. The interaction between gender and education revealed that university-educated women hold the most pronounced pro-environmental attitudes, underscoring the importance of gender-sensitive educational strategies. It is recommended that environmental education and outreach focus on less-educated groups, particularly women, who have high potential to influence their communities. Full article

DIALOGUE (DIagnostic AI Learning through Objective Guided User Experience) is a generative artificial intelligence (GenAI)-based training program designed to enhance diagnostic communication skills in medical students. In this single-arm pre–post study, we evaluated whether DIALOGUE could improve students’ ability to disclose a type 2 diabetes mellitus (T2DM) diagnosis with clarity, structure, and empathy. Thirty clinical-phase students completed two pre-test virtual encounters with an AI-simulated patient (ChatGPT, GPT-4o), scored by blinded raters using an eight-domain rubric. Participants then engaged in ten asynchronous GenAI scenarios with automated natural-language feedback. Seven days later, they completed two post-test consultations with human standardized patients, again evaluated with the same rubric. Mean total performance increased by 36.7 points (95% CI: 31.4–42.1; p < 0.001), and the proportion of high-performing students rose from 0% to 70%. Gains were significant across all domains, most notably in opening the encounter, closure, and diabetes specific explanation. Multiple regression showed that lower baseline empathy (β = −0.41, p = 0.005) and higher digital self-efficacy (β = 0.35, p = 0.016) independently predicted greater improvement; gender had only a marginal effect. Cluster analysis revealed three learner profiles, with the highest-gain group characterized by low empathy and high digital self-efficacy. Inter-rater reliability was excellent (ICC ≈ 0.90). These findings provide empirical evidence that GenAI-mediated training can meaningfully enhance diagnostic communication and may serve as a scalable, individualized adjunct to conventional medical education. Full article

Background/Objectives: Older adults (65+) are the fastest growing age group in Canada, comprising 18.8% of the country’s population. During the COVID-19 pandemic, use of virtual care, including telehealth and tele-medicine, increased dramatically among older adults in Canada who often face higher health risks, mobility limitations, and many barriers to accessing healthcare. Despite the rapid expansion in virtual care, no systematic review has focused specifically on virtual care among older adults in Canada. This review aims to explore the factors influencing virtual care adoption and the experiences of older Canadians during the pandemic through a systematic review. Methods: Conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, the review involved a comprehensive search of PubMed, Scopus, ESCBOHost, and Web of Science on 2 May 2025, yielding 281 unique citations. After screening and applying eligibility criteria, 15 studies employing quantitative, qualitative, or mixed-methods designs, with sample sizes ranging from 15 to 2,282,798, were included and appraised using the Mixed Methods Appraisal Tool (MMAT). Results: The review identified three domains of factors and the ways in which each factor shapes older adults’ virtual care experiences: (1) personal factors influencing virtual care use and demand (e.g., age, education, language, income, immigration status, community sizes), (2) resource factors impacting virtual care adoption (e.g., technology access, support), and (3) varying virtual care experiences among older adults (e.g., in assessment and communication efficacy, privacy, care quality, convenience, safety, and costs). Conclusions: This review highlights the complexities of virtual care engagement among older adults and underscores the need for inclusive, tailored strategies to improve the accessibility and effectiveness of virtual care delivery in both pandemic and post-pandemic contexts. Full article

Gender-neutral terms such as “sex work” and “sex worker” have gained prominence in academic, activist, and policy discourses. Unlike terms such as ‘prostitutes’ and ‘prostitution,’ these terms serve to reduce stigma and emphasize the labor involved in sex work. However, numerous studies suggest that these terms carry different meanings across cultural contexts, and their impact is experienced differently by various sub-groups of sex workers. Although originally coined by American activist Carol Leigh to unify sex workers across genders and sectors, these terms are, in some settings—including Kolkata, India—met with silence, coded language, or secrecy, particularly among transient sex workers, including cisgender and transgender women. As researchers with two decades of ethnographic research with 46 cisgender and 37 transgender women engaged in sex work in Kolkata and Eastern India, the authors argue that such silence and non-verbal forms of communication should not be interpreted merely as ignorance or disengagement but rather as strategic/willful acts of agency or resistance. These practices enable sex workers situated in different contexts to navigate unequal power dynamics within NGOs, manage respectability, mitigate structural violence, and foster communal identity. By examining how diverse groups of sex workers employ silence and secrecy, this study contributes to a more nuanced and empathetic understanding of the complexities surrounding the former’s lives and their agency. The study results indicate that it is essential for scholars, advocates and activists to employ strengths-based, context-specific language and research practices to be able to hear the stories of subaltern groups like commercial sex workers. It is also suggested that training of service providers and helping professionals focus on accepting and honoring the language people use to identify themselves in varied spaces and contexts. Full article

Background: Empowerment during pregnancy is linked to improved maternal and infant health outcomes and greater maternal well-being. Group Antenatal Care (GANC), a participant-centered model of care, promotes empowerment, active engagement, and the deconstruction of hierarchy between participants and care providers. It combines health assessment, interactive learning, and community building. While empowerment is a core concept of GANC, the ways it manifests and the elements that facilitate it remain unclear. Method: We conducted a generic qualitative study across four organizations in Brussels, using multiple data collection methods. This included interviews with 13 participants and 21 observations of GANC sessions, combining both the insider and outsider perspective. An adapted version of the Pregnancy-Related Empowerment Scale (PRES) guided the interviews guide and thematic analysis. Results: We identified seven themes that capture how empowerment occurs in GANC: peer connectedness, provider connectedness, skillful decision-making, responsibility, sense of control, taking action, and gaining voice. Several aspects of GANC contribute to empowerment, particularly the role of facilitators. Conclusions: This study highlights how GANC enhances empowerment during pregnancy through interpersonal, internal, and external processes. Important components within GANC that support this process include the group-based format and the interactive nature of the discussions. The presence of skillful GANC facilitators is an essential prerequisite. In a diverse and often vulnerable context like Brussels, strengthening empowerment through GANC presents challenges but is especially crucial. Full article

Social media has become a vital communication tool for higher education institutions (HEIs) to reach larger targets, attract followers, and engage with diverse audiences. This study conducted a quantitative and qualitative analysis of 4148 Facebook posts from 16 public and private HEIs in the United Arab Emirates (UAE). The aim of the study is to evaluate users’ engagement through their reactions to various post characteristics, including format, language, and content type. The posts generated 177,022 emotes, 17,269 shares, and 8374 comments. The results showed that images are an efficient format for boosting interaction, whereas plain text posts did not generate high engagement. The English language was more conducive for generating shares, while Arabic-language posts generated more emotes and likes. The comparative analysis results showed that private HEIs are more active on their Facebook pages than public HEIs. The content analysis suggested that student-related posts generate the highest level of engagement, while announcements and faculty- and research-related posts drive the lowest levels of engagement. These results offer valuable insights into how HEIs can optimize their social media strategies to enhance user engagement. Full article

Despite the increasing adoption of a syndemic approach in HIV research, few health communication campaigns have used a syndemic approach in messaging to improve health outcomes for persons living with HIV (PWH). This paper introduces a framework for practitioners and researchers developing health communication messages in support of a syndemic approach to HIV care for PWH in the United States. Grounded in insights from a review of counseling and psychosocial interventions that demonstrated significant positive effects on HIV clinical outcomes, the C4H Framework emphasizes four components: compassion, comprehensive messaging, capacity-building, and coordination. Compassion ensures that messages resonate with individuals experiencing the intertwined challenges of HIV, substance abuse, and mental health issues. Comprehensive messaging integrates a holistic view of the barriers faced by PWH. Capacity-building empowers individuals to effectively engage with and act upon health information. Coordination promotes alignment between stakeholders and resources to ensure consistent and supportive messaging. The C4H Framework bridges the gap between research and practice, offering a foundation for crafting effective communication messages that resonate with individuals facing the complex challenges inherent in HIV syndemics. Future research should explicitly test the effectiveness and acceptability of messages developed using the C4H Framework with people living with HIV. Full article

Refugees experience disproportionately high rates of sleep disturbances due to trauma, displacement, and resettlement stressors. Sleep health is critically linked to both physical and mental well-being, yet remains an underexplored area of intervention for refugee populations. This systematic review aimed to (1) identify interventions implemented to improve sleep health among refugees, (2) assess their effectiveness, and (3) evaluate the extent of cultural adaptation in their design and implementation. A comprehensive search of peer-reviewed literature from 2004 to 2024 identified nine studies focused on adult refugees in high-income countries. Interventions included psychoeducation, music-assisted relaxation, guided imagery, and nightmare-focused therapies. Several demonstrated improvements in sleep quality, insomnia severity, and nightmare frequency. Music-based interventions and sleep health education stood out as accessible, non-stigmatizing strategies that may be particularly well suited to refugee contexts. However, cultural adaptation emerged as the most significant gap. Using the 4-Domain Cultural Adaptation Model (CAM4)—which assesses adaptation across context, content, delivery, and engagement—most studies showed only surface-level modifications. Few incorporated community voices, and none validated sleep assessment tools for cultural relevance. Future research should prioritize co-creation with refugee communities to ensure interventions are not only evidence-based, but also culturally grounded, trusted, and sustainable across diverse refugee populations. Full article

A principal factor of the fourth Industrial Revolution is the Internet of Things (IoT), a network of “smart” objects that communicate by exchanging helpful information about themselves and their environment. Our research aims to address the gaps in the existing literature regarding the educational and technological affordances of IoT applications in learning environments in secondary education. Our systematic review using the PRISMA method allowed us to extract 25 empirical studies from the last 10 years. We present the categorization of educational and technological affordances, as well as the devices used in these environments. Moreover, our findings indicate widespread adoption of organized educational activities and design-based learning, often incorporating tangible interfaces, smart objects, and IoT applications, which enhance student engagement and interaction. Additionally, we identify the impact of IoT-based learning on knowledge building, autonomous learning, student attitude, and motivation. The results suggest that the IoT can facilitate personalized and experiential learning, fostering a more immersive and adaptive educational experience. Based on these findings, we discuss key recommendations for educators, policymakers, and researchers, while also addressing this study’s limitations and potential directions for future research. Full article

The social acceptance of Renewable Energy Sources (RESs) is a decisive factor in the successful implementation of clean energy projects. This study explores the attitudes, demographic profiles, and common misconceptions of citizens in the Region of Epirus, Greece, toward photovoltaic and wind energy installations. Special attention is given to the role of education, age, and access to information—as well as spatial factors such as visual exposure—in shaping public perceptions and influencing acceptance of RES deployment. A structured questionnaire was administered to 320 participants across urban and rural areas, with subdivision between regions with and without visual exposure to RES infrastructure. Findings indicate that urban residents exhibit greater acceptance of RES, while rural inhabitants—especially those in proximity to installations—express skepticism, often grounded in esthetic concerns or perceived procedural injustice. Misinformation and lack of knowledge dominate in areas without visual contact. Statistical analysis confirms that younger and more educated participants are more supportive and environmentally aware. The study highlights the importance of targeted educational interventions, transparent consultation, and spatially sensitive communication strategies in fostering constructive engagement with renewable energy projects. The case of Epirus underscores the need for inclusive, place-based policies to bridge the social acceptance gap and support the national energy transition. Full article

Background/Objectives: Frailty is a prevalent geriatric syndrome associated with impaired postural control and elevated fall risk. Although conventional exercise is a core strategy for frailty management, adherence remains limited. Virtual reality (VR)-based interventions have emerged as potentially engaging alternatives, but their effects on objective postural control and task-specific confidence in frail populations remain understudied. This study aimed to evaluate the effectiveness of a supervised VR training program using the Nintendo Ring Fit Plus™ on postural control, functional mobility, and balance confidence among frail community-dwelling older adults. Methods: Fifty-one adults aged ≥65 years classified as frail or prefrail were enrolled in a four-week trial. Participants were assigned to either a VR intervention group (n = 28) or control group (n = 23). Participants were non-randomly assigned based on availability and preference. Outcome measures were collected at baseline and post-intervention. Primary outcomes included center of pressure (CoP) metrics—sway area, mean velocity, and sway path. Secondary outcomes were the Timed Up and Go (TUG), Berg Balance Scale (BBS), Activities-specific Balance Confidence (ABC), and Falls Efficacy Scale–International (FES-I). Results: After adjusting for baseline values, age, and BMI, the intervention group showed significantly greater improvements than the control group across all postural control outcomes. Notably, reductions in sway area, mean velocity, and sway path were observed under both eyes-open and eyes-closed conditions, with effect sizes ranging from moderate to very large (Cohen’s d = 0.57 to 1.61). For secondary outcomes, significant between-group differences were found in functional mobility (TUG), balance performance (BBS), and balance confidence (ABC), with moderate-to-large effect sizes (Cohen’s d = 0.53 to 0.73). However, no significant improvement was observed in fear of falling (FES-I), despite a small-to-moderate effect size. Conclusions: A supervised VR program significantly enhanced postural control, mobility, and task-specific balance confidence in frail older adults. These findings support the feasibility and efficacy of VR-based training as a scalable strategy for mitigating frailty-related mobility impairments. Full article

The growing concern over environmental sustainability has intensified the focus on consumers’ perceptions of eco-friendly food packaging, especially among younger generations. This study aims to investigate the attitudes, preferences, and barriers faced by Greek university students regarding sustainable food packaging, a demographic considered pivotal for driving future consumption trends. An online questionnaire assessing perceptions, preferences, and behaviours related to sustainable packaging was administered to students, with responses measured on a five-point Likert scale. Three hundred and sixty-four students took part in this survey, with the majority (60%) of them being female. Principal component analysis was employed to identify underlying factors influencing perceptions, and k-means cluster analysis revealed two consumer segments: “Innovatives”, including one hundred and ninety-eight participants (54%), who demonstrate strong environmental awareness and willingness to adopt sustainable behaviours, and “Sceptics”, including one hundred sixty-six participants (46%), who show moderate engagement and remain cautious in their choices. Convenience, affordability, and clear product communication emerged as significant factors shaping student preferences. The findings suggest that targeted educational campaigns and transparent information are essential to converting positive attitudes into consistent purchasing behaviours. This research provides valuable insights for policymakers and marketers looking to design effective sustainability strategies tailored to the student population. Full article

Joint attention, the capacity of two or more individuals to focus on a common event simultaneously, is fundamental to human–human interaction, enabling effective communication. When considering the field of social robotics, emulating this capability might be necessary for promoting natural interactions and thus improving user engagement. Responding to joint attention (RJA), defined as the ability to react to external attentional cues by aligning focus with another individual, plays a critical role in promoting mutual understanding. This study examines how RJA impacts user engagement during human–robot interaction. The participants play a turn-taking game against a social robot under two conditions: with our RJA system active and with the system inactive. Auditory and visual stimuli are introduced to simulate real-world dynamics, testing the robot’s ability to detect and follow the user’s focus of attention. We use a twofold approach to evaluate the system’s impact on the user’s experience during the interaction. On the one hand, we use head pose telemetry to quantify attentional aspects of engagement, including measures of distraction and focus during the interaction. On the other hand, we use a post-experimental questionnaire incorporating the User Engagement Scale Short Form to assess engagement. The results regarding telemetry data reveal reduced distraction and improved attentional consistency, highlighting the system’s ability to maintain attention on the current task effectively. Furthermore, the questionnaire responses show that RJA significantly enhances self-reported engagement when the system is active. We believe these findings confirm the value of attentional mechanisms in promoting engaging human–robot interactions. Full article

The sustainable development of teaching expertise in research-intensive universities remains a critical global challenge. This study investigates the distinctive characteristics of expert teachers—exemplary faculty in research universities—addressing their developmental trajectories and motivational mechanisms within prevailing incentive systems that prioritize research productivity over pedagogical excellence. Employing grounded theory methodology, we conducted iterative coding of 20,000-word interview transcripts from 13 teaching-awarded professors at Chinese “Double First-Class” universities. Key findings reveal the following: (1) Compared to the original K-12 expert teacher model, university-level teaching experts exhibit distinctive disciplinary mastery—characterized by systematic knowledge structuring and cross-disciplinary integration capabilities. (2) Their developmental trajectory transcends linear expertise acquisition, instead manifesting as a problem-solving continuum across four nonlinear phases: career initiation, dilemma adaptation, theoretical consciousness, and leadership expansion. (3) Sustainable teaching excellence relies fundamentally on teachers’ professional passion, sustained through a virtuous cycle of high-quality instructional engagement and external validation (including positive student feedback, institutional recognition, and peer collaboration). Universities must establish comprehensive support systems—including (a) fostering a supportive and flexible learning atmosphere, (b) reforming evaluation mechanisms, and (c) facilitating interdisciplinary collaboration through teaching development communities—to institutionalize this developmental ecosystem. Full article

Teacher education faces persistent challenges, including limited access to authentic field experiences and a disconnect between theoretical instruction and classroom practice. While virtual reality (VR) simulations offer an alternative, most are constrained by inflexible design and lack scalability, failing to mirror the complexity of real teaching environments. This study introduces TeacherGen@i, a generative AI (GenAI)-enhanced VR simulation designed to provide pre-service teachers with immersive, adaptive teaching practice through realistic GenAI agents. Using an explanatory case study with a mixed-methods approach, the study examines the simulation’s usability, design challenges, and instructional utility within a university-based teacher preparation course. Data sources included usability surveys and reflective journals, analyzed through thematic coding and computational linguistic analysis using LIWC. Findings suggest that TeacherGen@i facilitates meaningful development of teaching competencies such as instructional decision-making, classroom communication, and student engagement, while also identifying notable design limitations related to cognitive load, user interface design, and instructional scaffolding. This exploratory research offers preliminary insights into the integration of generative AI in teacher simulations and its potential to support responsive and scalable simulation-based learning environments. Full article