Search Results (1,124)

Background/Objectives: The World Health Organisation (WHO) recommends exclusive breastfeeding for the first six months of life, but exclusive breastfeeding (EBF) rates remain low in many countries, including Poland. Factors related to pregnancy, childbirth and the organisation of care can significantly affect the maintenance of lactation. There is a lack of representative data on these relationships in Poland, which makes it difficult to plan effective support measures. The aim of this study is to analyse the relationship between pregnancy and perinatal factors and exclusive breastfeeding in infants aged 6 to 12 months. Methods: This cross-sectional online survey was conducted between April and October 2025. A total of 557 women aged ≥18 years with infants aged 6–12 months participated in the research. Data were collected using a structured questionnaire covering sociodemographic characteristics, the course of pregnancy and childbirth, postpartum complications, early breastfeeding experiences and maternal birth satisfaction assessed using the Polish version of the Birth Satisfaction Scale—Revised (BSS-R). Multivariable logistic regression analysis was used to identify factors associated with exclusive breastfeeding up to six months. Results: Exclusive breastfeeding was significantly associated with vaginal delivery, the absence of postpartum complications and a lack of early breastfeeding problems in the first days postpartum, with initial lactation difficulties emerging as its strongest predictor. Most specific pregnancy-related conditions, maternal birth satisfaction and selected recommended hospital practices, including early skin-to-skin contact, were not independently associated with exclusive breastfeeding in the model. Conclusions: Exclusive breastfeeding up to six months is primarily determined by factors operating in the immediate perinatal and early postpartum period, particularly postpartum clinical stability and successful early lactation. Targeted support during this critical window may be key to improving exclusive breastfeeding outcomes. Full article

The Netherlands is widely recognised as the global leader in water management, with its flood risk management (FRM) infrastructure lauded as being of the best in the world. This status notwithstanding, Dutch FRM primarily maintains established infrastructural practices and experimental applications of NBSs remain less frequent than established structural projects. This paper details and examines the challenges associated with the prevailing ‘business-as-usual’ approach to FRM in The Netherlands, in which traditional ‘grey’ infrastructural techniques are prioritised over innovative ‘green’ nature-based solutions (NBSs). In line with emerging international trends, such as the EU Water Resilience Strategy, NBSs are increasingly advocated as a strategic, complementary layer to enhance the resilience of existing safety frameworks rather than a self-evident replacement for them. Contrary to grey infrastructure, NBSs provide a number of environmental and social co-benefits extending beyond their flood and drought protection utility. The literature on NBSs details the design, effectiveness, and positive socio-economic impact of the operationalisation of such projects for FRM. This notwithstanding, the uptake and practical implementation of NBSs have been slow in The Netherlands. From a legal and policy perspective, this has been attributed to a lack of political will and the corresponding failure to include NBSs in long term FRM planning. Given the long planning horizons associated with FRM (50–100 years), the failure to incorporate NBSs can lead to policy lock-in that blocks future adaptations. Against this backdrop, this paper employs a semi-systematic literature review to clarify the obstacles to implementing NBSs in Dutch FRM and sets a research agenda that charts a course to mainstreaming NBSs in Dutch FRM. Seven core focus areas for future research are identified. The paper concludes by drawing on these identified focus areas to construct a research agenda aimed at systematically addressing each barrier to the practical operationalisation of NBSs in Dutch FRM, emphasising a hybrid green–grey approach which may serve to inspire similar research in other jurisdictions. Full article

Teachers’ language assessment literacy (LAL) encompasses the knowledge and competencies required to design and implement assessment practices that support learning. Although prior research has documented general trends in LAL development, less is known about how individual teachers, particularly student teachers, interpret, appropriate, and negotiate formative assessment (FA) task design within the context of initial teacher education (ITE). Adopting an in-depth qualitative case study approach, this study examines how a single student teacher in a Chinese initial teacher education developed her cognition and classroom practice related to FA tasks across a teaching methodology course and a practicum. Drawing on thematic analysis of semi-structure interviews, lesson plans, classroom observations, stimulated recall interviews, and reflective journals, the study traces developmental changes and the contextual factors shaping the student teacher’s LAL in relation to FA tasks. Findings show that the sustained engagement with FA task design supported more sophisticated understandings of FA, including (1) an increased recognition of the pedagogical necessity of incorporating authentic FA tasks into lesson planning, (2) a growing aspiration to implement FA-oriented instruction that promotes higher-order thinking, (3) an enhanced awareness of the empowering role of FA tasks in fostering students’ self-regulated learning, and (4) a more nuanced understanding of the challenges inherent in implementing FA practices. Meanwhile, the case illustrates how pre-existing assessment conceptions, school culture norms, and limited targeted mentoring can constrain LAL development in relation to FA. By providing a fine-grained account of developmental processes, this study offers insights into how ITE can mediate student teachers’ engagement with FA task design. The findings have implications for teacher education programs in other similar educational contexts, particularly regarding the integration of FA task design into assessment courses and the provision of sustained, context-sensitive support during teaching practicum. Full article

This study explores the integration of Georgi Lozanov’s Suggestopedia with Alain Berthoz’s theory of simplexity as a pedagogical paradigm for inclusive and creative educational design. The research, conducted within the specialization courses for educational support at the University of Salerno, involved 230 trainee teachers engaged in a participatory action-research process aimed at translating suggestopedic principles, positive suggestion, music, and relational harmony into didactic planning. Through a combination of theoretical training, laboratory design activities, and reflective evaluation, participants produced 21 interdisciplinary educational projects assessed according to the properties and rules of simplexity. The results show a high degree of methodological coherence, aesthetic quality, and curricular inclusiveness, with music emerging as a key factor in fostering attention, cooperation, and emotional engagement. Data analysis indicates that the fusion of suggestopedic and simplex approaches promotes adaptive, modular, and meaning-oriented design processes that enhance teachers’ creativity and metacognitive awareness. Overall, the findings highlight the educational value of a pedagogy of resonance, in which body, mind, and environment interact harmoniously. The study concludes that the suggestopedic—simplex model represents a regenerative framework for contemporary didactics, capable of transforming complexity into harmony and restoring to education its aesthetic, relational, and human dimension. Full article

Global climate change has emerged as a critical challenge for human society in the 21st century. As hubs of population and economic activity, urban and rural areas are increasingly exposed to complex and compounded disaster risks. To systematically evaluate the role of educational intervention in climate adaptability capacity building, this study employs a case study approach, focusing on the “Climate Change Adaptation Education and Teaching Alliance Program” launched in Taiwan in 2014. Through a comprehensive analysis of its institutional structure, curriculum, alliance network, and practical activities, the study explores the effectiveness of educational innovation in cultivating climate resilience talent. The study found that the program, through interdisciplinary collaboration and a practice-oriented teaching model, successfully integrated climate adaptability content into 57 courses, training a total of 2487 students. Project-based learning (PBL) and workshops significantly improved students’ systems thinking and practical abilities, and many of its findings were adopted by local governments. Based on these empirical results, the study proposes that urban and rural planning education should be promoted in the following ways: first, updating teaching materials to reflect regional climate characteristics and local needs; second, enhancing curriculum design by introducing core courses such as climate-resilient planning and promoting interdisciplinary collaboration; third, enriching hands-on learning through real project cases and participatory workshops; and fourth, deepening integration between education and practice by establishing multi-stakeholder partnerships supported by dedicated funding and digital platforms. Through such an innovative educational framework, we can prepare a new generation of professionals capable of supporting global sustainable development in the face of climate change. This study provides a replicable model of practice for education policymakers worldwide, particularly in promoting the integration of climate resilience education in developing countries, which can help accelerate the achievement of UN Sustainable Development Goals (SDG11) and foster interdisciplinary collaboration to address the global climate crisis. Full article

The Estimated Time of Arrival (ETA) of vessels is a vital operational indicator for voyage planning, fleet deployment, and resource allocation. However, most existing studies focus on short-distance liner services with fixed routes, while ETA prediction for long-distance tramp bulk carriers remains insufficiently accurate, often resulting in operational inefficiencies and charter party disputes. To fill this gap, this study proposes a data-driven stacking ensemble learning framework that integrates Light Gradient-Boosting Machine (LightGBM), Extreme Gradient Boosting (XGBoost), and Random Forest (RF) as base learners, combined with a Linear Regression meta-learner. This framework is specifically tailored to the unique complexities of tramp shipping, advancing beyond traditional single-model approaches by incorporating systematic feature engineering and model fusion. The study also introduces the construction of a comprehensive multi-dimensional AIS feature system, incorporating baseline, temporal, speed-related, course-related, static, and historical behavioral features, thereby enabling more nuanced and accurate ETA prediction. Using AIS trajectory data from bulk carrier voyages between Weipa (Australia) and Qingdao (China) in 2023, the framework leverages multi-feature fusion to enhance predictive performance. The results demonstrate that the stacking model achieves the highest accuracy, reducing the Mean Absolute Error (MAE) to 3.30 h—a 74.7% improvement over the historical averaging benchmark and an 11.3% reduction compared with the best individual model, XGBoost. Extensive performance evaluation and interpretability analysis confirm that the stacking ensemble provides stability and robustness. Feature importance analysis reveals that vessel speed, course stability, and remaining distance are the primary drivers of ETA prediction. Additionally, meta-learner weighting analysis shows that LightGBM offers a stable baseline, while systematic deviations in XGBoost predictions act as effective error-correction signals, highlighting the complementary strengths captured by the ensemble. The findings provide operational insights for maritime logistics and port management, offering significant benefits for port scheduling and maritime logistics management. Full article

Objective: To test whether inpatient electrical muscle stimulation (EMS) using Russian current (5 kHz carrier, 50 Hz modulation; 4 s ON/6 s OFF) improves mobility and balance in elderly people with chronic cerebral ischaemia. Design: Prospective single-centre controlled observational pilot, embedded in routine inpatient rehabilitation; no concealed randomisation (EMS + standard care; sham EMS + standard care; standard care only (control)). Methods: A single-centre controlled observational study with three groups was conducted (EMS n = 27, control n = 10, sham n = 7) with 3–9 sessions over 2 weeks (20 min; quadriceps and calves). Pre/Post Outcomes: Tinetti (balance/gait), Rivermead Mobility Index, Timed Up and Go (TUG), ankle extensor maximal voluntary force (MVF), stabilography (statokinesiogram path length (L), mean velocity of COP (V), sway area (S), and myotonometry; ANOVA, α = 0.05). Ethics approval and informed consent were obtained. Between-group differences in change scores were evaluated descriptively, and no formal hypothesis-testing was planned. Results: EMS showed significant gains versus control/sham—higher Tinetti total and Rivermead scores, faster TUG, higher MVF, and improved stabilography in the eyes-closed condition (reduced L, V, and S), with good tolerability and no serious adverse events (SAEs). Conclusions: Short-course Russian-current EMS is feasible and associated with clinically meaningful improvements in balance, gait, and strength in elderly patients with chronic cerebral ischaemia; however, larger randomised trials are warranted. Full article

This article provides an in-depth overview of mine gas emission monitoring practices in the Ostrava-Karviná Coalfield (OKR), one of the most significant regions in Central Europe affected by post-mining methane leakage. The study presents field measurement techniques, including atmogeochemical surveys, systematic methane screening in soil air, and surface emission rate monitoring using accumulation chambers. Over the course of several long-term projects, more than 43 km² of land were surveyed, and risk classification maps were developed based on measured methane concentrations and surface release rates. These data support land-use planning, the design of degasification measures, and the verification of their effectiveness. Results confirm that methane emissions persist even decades after mine closures and vary depending on atmospheric pressure and local geological conditions. The OKR methodology was also compared to international practices in Poland, Canada, and China. The article concludes with future research directions focused on automation, integration of sensor networks, and predictive modeling of gas migration in post-mining environments. Full article

Growing interest in food sustainability education aims to increase awareness of food distribution systems, environmental degradation, and the connectivity of sustainable and ethical food practices. However, recent scholarship has questioned whether such pedagogical efforts are meaningfully internalized by students or lead to sustained behavioral change. Prior studies document persistent gaps in students’ understanding of sustainability impacts and the limited effectiveness of existing instructional approaches in promoting transformative engagement. To address these concerns, the Food Ethics, Sustainability and Alternatives (FESA) course was implemented with 21 undergraduate and graduate students at Montclair State University (Montclair, NJ, USA). Course outcomes were evaluated using a mixed-methods design integrating qualitative analysis with quantitative measures informed by the Theory of Planned Behavior, to identify influences on students’ attitudes, and a Transtheoretical Model (TTM) panel survey to address progression from awareness to action, administered pre- and post-semester. Qualitative findings revealed five central themes: increased self-awareness of food system contexts, heightened attention to animal ethics, the importance of structured classroom dialogue, greater recognition of food waste, and increased openness to alternative food sources. TTM results indicated significant reductions in contemplation and preparation stages, suggesting greater readiness for change, though no significant gains were observed in action or maintenance scores. Overall, the findings suggest that while food sustainability education can positively shape student attitudes, the conversion of attitudinal shifts into sustained behavioral change remains limited by external constraints, including time pressures, economic factors, culturally embedded dietary practices, structural tensions within contemporary food systems, and perceptions of limited individual efficacy. Full article

This article studies practical argumentation in the context of designing application problems and transforming them into modelling problems. To this end, the practical arguments developed by prospective primary education teachers were analysed, using a scheme for structuring and representing these arguments and a modelling cycle for representing the solution plans proposed to these problems. This is a case study with three groups of prospective teachers who were taking a course on mathematical reasoning and activity in primary education, where problem solving and mathematical modelling were the two most relevant topics. For data collection, a questionnaire was applied to and an interview was conducted with the study subjects, thus identifying nine episodes of practical argumentation based on the justification of their pedagogical decisions made on the design and transformation of problems. Also, the written reports prepared by the study subjects were reviewed to analyse their solution plans proposed to the problems. The results showed that the study subjects developed practical arguments to justify the design of motivating learning situations and problems for students in realistic contexts close to their environment and the transformation of application problems into modelling problems by eliminating data from their statements and formulating an open-ended question. Full article

Engineering programmes have been giving more weight to experiential learning, largely because many students still find it difficult to see how classroom theory connects to the work that engineers handle on the ground. With this in mind, a robotics-centred Project-based Learning (PBL) module was introduced to first-year general engineering students as part of the faculty’s engineering spine. The module asks students to design, build, and program small autonomous robots capable of navigating and competing in a set arena. Even a simple task of this kind draws together multiple strands of engineering. Students shift between sketching mechanical layouts, wiring basic circuits, writing code, testing prototypes, and negotiating the usual challenges that arise when several people share responsibility for the same piece of hardware. To explore how students learned through the module, a mixed-methods evaluation was carried out using survey responses alongside reflective pieces written by the students themselves. Certain patterns appeared repeatedly. Many students felt that their technical skills had grown, particularly in breaking down a messy problem into smaller, more workable components. Teamwork also surfaced as a prominent theme. Groups often had to sort out issues such as a robot veering off course due to a misaligned sensor or a block of code producing unpredictable behaviour. These issues were undoubtedly challenging for the students, but they also had a certain pedagogical flavour, with many students describing them as a source of frustration as well as a learning opportunity. Later iterations of the module may benefit from more targeted support at key stages. Despite the many challenges, robotics has been shown to be an attractive way for students to step into engineering practice. The project helped them build technical capability, but it also encouraged habits that matter just as much in real work, such as planning, communicating clearly, and returning to a problem until it behaves as expected. Taken together, the experience offers useful guidance for curriculum designers seeking to create early learning environments that feel authentic and manageable and for motivating students who are just beginning their engineering journey. Full article

Total hip arthroplasty (THA) is a widely performed procedure that significantly enhances patients’ quality of life. However, nerve injury remains a concerning complication, with an incidence ranging from 0.6% to 3.7%, depending on patient and surgical variables. This narrative review provides a comprehensive overview of nerve injuries associated with THA, focusing on etiology, risk factors, clinical manifestations, prevention, and treatment strategies. The most affected nerves include the sciatic, femoral, lateral femoral cutaneous (LFCN), superior gluteal, and obturator nerves. Anatomical factors such as developmental hip dysplasia (DDH), limb length discrepancy, and aberrant nerve courses, along with patient-specific conditions like female sex, obesity, and pre-existing spinal disorders, increase the risk of nerve damage. Surgical complexity, revision procedures, and surgeon experience also influence injury likelihood. Clinical manifestations range from sensory disturbances to motor deficits including foot drop, Trendelenburg gait, or impaired knee extension, depending on the nerve involved. Diagnosis is primarily clinical, supported by electrophysiological studies and imaging when needed. Prevention hinges on careful preoperative planning, appropriate surgical approach selection, meticulous intraoperative technique, and attention to limb positioning. Treatment is typically conservative, involving pain control, physical therapy, and neurostimulation. In refractory or severe cases, interventions such as nerve decompression, repair, or tendon transfer may be considered. Pharmacological agents including vitamin B12, tacrolimus, and melatonin show potential in promoting nerve regeneration. Although most nerve injuries resolve spontaneously or with conservative measures, some cases may result in long-term deficits. Understanding the mechanisms, risk factors, and management strategies is essential to mitigating complications and optimizing functional outcomes in patients undergoing THA. Full article

Housing insecurity is a growing public health concern linked to adverse health outcomes and lifelong vulnerability. Although housing is a well-established social determinant of health, this review employs a life-course framework to explain how housing insecurity contributes to the accumulation of health inequities and chronic disparities across the different stages of human development. A rapid review was conducted across PubMed, Google Scholar, SCOPUS, and Web of Science, focusing on peer-reviewed studies published between 1991 and 2025. Studies were screened using predefined eligibility criteria, and the selection process was documented through a PRISMA flow diagram. Fifty-five studies met the inclusion criteria. Housing insecurity was consistently associated with adverse health outcomes across pregnancy, infancy, childhood, adolescence, adulthood, and older age. Each life stage presents distinct vulnerabilities shaped by environmental and social conditions, which are manifested through physiological and psychosocial pathways. While physical health effects were most frequently reported, developmental and mental health impacts accumulated over time, amplifying overall burden. The findings demonstrate a clear life-course pathway linking housing insecurity to immediate and long-term health risks. Early-life disadvantages create lasting, preventable consequences, underscoring the urgent need for policies that embed housing stability within broader public health planning. Full article

Oesophageal cancer remains a significant global health burden with poor survival outcomes despite multimodal treatment. Recent advances in magnetic resonance imaging (MRI) have opened opportunities to improve radiotherapy delivery. This review examines the role of MRI and MR-guided radiotherapy (MRgRT) in oesophageal cancer, focusing on applications in staging, treatment planning, and response assessment, with particular emphasis on magnetic resonance linear accelerator (MR-Linac)-based delivery. Compared to computed tomography (CT), MRI offers superior soft-tissue contrast, enabling more accurate tumour delineation and the potential for reduced treatment margins. Real-time MR imaging during treatment can facilitate motion management, while daily adaptive planning can accommodate anatomical changes throughout the treatment course. Functional MRI sequences, including diffusion-weighted and dynamic contrast-enhanced imaging, offer quantitative data for treatment response monitoring. Early clinical and dosimetric studies demonstrate that MRgRT can significantly reduce radiation dose to critical organs while maintaining target coverage. However, clinical evidence for MRgRT in oesophageal cancer is limited to small early-phase studies, with no phase II/III trials demonstrating improvements in survival, toxicity, or patient-reported outcomes. Long-term clinical benefits and cost-effectiveness remain unproven, highlighting the need for prospective outcome-focused studies to define the role for MRgRT within multimodality treatment pathways. Full article

Background: Sinonasal neuroendocrine carcinoma (SNEC) is an extremely rare malignancy, and, to date, no clinical reports have detailed the use of proton beam therapy (PBT) for this disease. The present study describes the clinical courses of patients with SNEC treated with PBT and highlights the advantages of PBT. Methods: In this retrospective study, we included patients with pathologically confirmed SNEC without distant metastasis who underwent PBT at our institution between 2006 and 2021. To evaluate the dosimetric advantages of PBT, comparative treatment plans using VMAT were created. Result: Six patients with pathologically diagnosed SNEC without distant metastasis were treated with PBT. Multimodal treatment was applied in five patients, including chemotherapy in four cases and surgery in two cases. The median follow-up period was 37.4 months (range: 6.9 to 108.9 months). At the end of the follow-up, three patients were alive without recurrence, while three had died due to the disease. Recurrence occurred in three cases: one local recurrence, one in cervical lymph nodes, and two distant metastases. A late adverse event of Grade 4 vision decrease was observed in one patient on the ipsilateral side. Compared with VMAT, PBT lowered the average brain dose (median 3.3 Gy (RBE) vs. 12.6 Gy), brainstem D2 cc (10.7 Gy (RBE) vs. 34.9 Gy) and contralateral optic nerve D0.1 cc (47.6 Gy (RBE) vs. 63.3 Gy), while doses to the ipsilateral optic pathway were comparable. Conclusions: PBT in multimodal treatment achieved feasible local control for SNEC. The dose-sparing effect of PBT was more evident in organs distant from the target, although careful consideration is required for adjacent structures. Full article