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Search Results (12,359)

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25 pages, 830 KiB  
Article
Writing Is Coding for Sustainable Futures: Reimagining Poetic Expression Through Human–AI Dialogues in Environmental Storytelling and Digital Cultural Heritage
by Hao-Chiang Koong Lin, Ruei-Shan Lu and Tao-Hua Wang
Sustainability 2025, 17(15), 7020; https://doi.org/10.3390/su17157020 (registering DOI) - 1 Aug 2025
Abstract
In the era of generative artificial intelligence, writing has evolved into a programmable practice capable of generating sustainable narratives and preserving cultural heritage through poetic prompts. This study proposes “Writing Is Coding ” as a paradigm for sustainability education, exploring how students engage [...] Read more.
In the era of generative artificial intelligence, writing has evolved into a programmable practice capable of generating sustainable narratives and preserving cultural heritage through poetic prompts. This study proposes “Writing Is Coding ” as a paradigm for sustainability education, exploring how students engage with AI-mediated multimodal creation to address environmental challenges. Using grounded theory methodology with 57 twelfth-grade students from technology-integrated high schools, we analyzed their experiences creating environmental stories and digital cultural artifacts using MidJourney, Kling, and Sora. Data collection involved classroom observations, semi-structured interviews, and reflective journals, analyzed through systematic coding procedures (κ = 0.82). Five central themes emerged: writing as algorithmic design for sustainability (89.5%), emotional scaffolding for environmental awareness (78.9%), aesthetics of imperfection in cultural preservation (71.9%), collaborative dynamics in sustainable creativity (84.2%), and pedagogical value of prompt literacy (91.2%). Findings indicate that AI deepens environmental consciousness and reframes writing as a computational process for addressing global issues. This research contributes a theoretical framework integrating expressive writing with algorithmic thinking in AI-assisted sustainability education, aligned with SDGs 4, 11, and 13. Full article
12 pages, 639 KiB  
Article
Clinical Relevance of PCR Versus Culture in Urinary Tract Infections Diagnosis: Quantification Cycle as a Predictor of Bacterial Load
by Pallavi Upadhyay, Arjuna Vallabhaneni, Edward Ager, Barbara Alexander, Adriana Rosato and Vijay Singh
Diagnostics 2025, 15(15), 1939; https://doi.org/10.3390/diagnostics15151939 (registering DOI) - 1 Aug 2025
Abstract
Background: Unambiguous clinical interpretation of PCR results for urinary tract infections (UTIs) remains a challenge. Here we compare and correlate multiplex qPCR results (quantification cycle values) with traditional microbial culture results (colony forming units) for clinical samples. Methods: Serial dilutions [10 [...] Read more.
Background: Unambiguous clinical interpretation of PCR results for urinary tract infections (UTIs) remains a challenge. Here we compare and correlate multiplex qPCR results (quantification cycle values) with traditional microbial culture results (colony forming units) for clinical samples. Methods: Serial dilutions [108 to 100 colony forming units (CFU)/mL] were performed on five Gram-negative and two Gram-positive UTI-causing bacterial pathogens. For each dilution, quantitative cultures on solid media to confirm CFU/mL values and a real-time PCR UTI panel employing a nanofluidic Open ArrayTM platform producing quantification cycle (Cq) values were performed. Cq values were correlated with CFU/mL values, generating a semi-quantitative interpretive scale for clinical samples. The clinical utility of the scale was then assessed using PCR and culture data from 168 clinical urine samples. Results: For Gram-negative bacteria, Cq values of <23, 23 to 28, and >28 corresponded with ≥105 CFU/mL, <105 CFU/mL and negative cultures, respectively. For Gram-positive bacteria, Cq values of <26, 26 to 30, and >30 corresponded with ≥105 CFU/mL, <105 CFU/mL and negative cultures, respectively. Among 168 urine specimens (including 138 Gram-negative and 30 Gram-positive bacteria), there was 83.3% agreement (n = 140/168) and 16.6% non-agreement (n = 28/168) between culture CFU/mL and qPCR Cq. Gram-negative bacteria had higher agreement (87.6%, 121/138) than Gram-positive bacteria (63.3%, 19/30). Conclusions: This study demonstrates that qPCR Cq results can be directly correlated with traditional urine quantitative culture results and reliably identify the clinically relevant cutoff of 105 CFU/mL for detected uropathogens. Full article
(This article belongs to the Special Issue Urinary Tract Infections: Advances in Diagnosis and Management)
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13 pages, 235 KiB  
Article
Motivations of Sports Volunteers at Mass Endurance Events: A Case Study of Poznan
by Milena Michalska, Mateusz Grajek and Mateusz Rozmiarek
Sports 2025, 13(8), 255; https://doi.org/10.3390/sports13080255 (registering DOI) - 1 Aug 2025
Abstract
Sport volunteering plays an important role in achieving the goals of sustainable development by supporting the social dimension of sustainability, fostering social integration, and promoting a healthy lifestyle. However, there is a lack of systematic research in Poland on the motivations of sport [...] Read more.
Sport volunteering plays an important role in achieving the goals of sustainable development by supporting the social dimension of sustainability, fostering social integration, and promoting a healthy lifestyle. However, there is a lack of systematic research in Poland on the motivations of sport volunteers, particularly in the context of mass endurance events. This study employed a quantitative, cross-sectional design involving 148 sport volunteers engaged in mass endurance events in Poznan, Poland. To measure motivation, the Polish adaptation of the VMS-ISE scale was used. Data analysis was conducted using one-way analysis of variance (ANOVA). The results showed that volunteer motivations were relatively homogeneous regardless of gender and education level, with the exception of passion for sport, which was significantly stronger among men (p = 0.037). Significant differences were found based on place of residence: residents of medium-sized cities demonstrated the highest motivation for personal development (p < 0.001), whereas individuals from rural areas exhibited stronger patriotism, a greater need for interpersonal interaction, and a higher valuation of external rewards (p < 0.05). The motivations of sport volunteers in Poland are complex and sensitive to environmental factors. Understanding these differences allows for better alignment of recruitment and volunteer management strategies, which can enhance both the effectiveness and sustainability of volunteer engagement. It is recommended to develop volunteer programs that take into account the demographic and socio-cultural characteristics of participants. Full article
27 pages, 830 KiB  
Systematic Review
What Pushes University Professors to Burnout? A Systematic Review of Sociodemographic and Psychosocial Determinants
by Henry Cadena-Povea, Marco Hernández-Martínez, Gabriela Bastidas-Amador and Hugo Torres-Andrade
Int. J. Environ. Res. Public Health 2025, 22(8), 1214; https://doi.org/10.3390/ijerph22081214 (registering DOI) - 1 Aug 2025
Abstract
Burnout syndrome is a growing concern in higher education, affecting the psychological well-being and performance of university professors. This systematic review presents a narrative synthesis of findings from quantitative studies on sociodemographic and psychosocial determinants of academic burnout. Following PRISMA 2020 guidelines, sixty [...] Read more.
Burnout syndrome is a growing concern in higher education, affecting the psychological well-being and performance of university professors. This systematic review presents a narrative synthesis of findings from quantitative studies on sociodemographic and psychosocial determinants of academic burnout. Following PRISMA 2020 guidelines, sixty peer-reviewed articles published between Jan 2019 and May 2024 were selected from Scopus and Web of Science. Inclusion criteria required validated psychometric instruments and exclusive focus on university faculty. Methodological quality was assessed using the Newcastle-Ottawa Scale and CASP checklist. Data from approximately 43,639 academic staff were analyzed. Key risk factors identified include excessive workload, lack of institutional support, and workplace conflict. In contrast, collegial support, participative leadership, and job satisfaction functioned as protective elements. Variables such as age, gender, academic rank, and employment stability significantly influenced burnout vulnerability. While general patterns were observed across studies, differences in design and sampling require caution in generalization. The evidence supports the implementation of integrated strategies encompassing mental health programs, workload regulation, participatory governance, and culturally responsive approaches. These findings inform the development of institutional policies aimed at preventing burnout and fostering academic well-being. Future research should adopt longitudinal and cross-cultural designs to further explore burnout trajectories and support educational reform. Full article
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23 pages, 1706 KiB  
Article
Community-Based Halal Tourism and Information Digitalization: Sustainable Tourism Analysis
by Immas Nurhayati, Syarifah Gustiawati, Rofiáh Rofiáh, Sri Pujiastuti, Isbandriyati Mutmainah, Bambang Hengky Rainanto, Sri Harini and Endri Endri
Tour. Hosp. 2025, 6(3), 148; https://doi.org/10.3390/tourhosp6030148 (registering DOI) - 1 Aug 2025
Abstract
This study employs a mixed method. In-depth interviews and observational studies are among the data collection approaches used in qualitative research. The quantitative method measures the weight of respondents’ answers to the distributed questionnaire. The questionnaire, containing 82 items, was distributed to 202 [...] Read more.
This study employs a mixed method. In-depth interviews and observational studies are among the data collection approaches used in qualitative research. The quantitative method measures the weight of respondents’ answers to the distributed questionnaire. The questionnaire, containing 82 items, was distributed to 202 tourists to collect their perceptions based on the 4A tourist components. The results indicate that tourists’ perceptions of attractions, accessibility, and ancillary services are generally positive. In contrast, perceptions of amenity services are less favorable. Using the scores from IFAS, EFAS, and the I-E matrix, the total weighted scores for IFAS and EFAS are 2.68 and 2.83, respectively. The appropriate strategy for BTV is one of aggressive growth in a position of strengths and opportunities. The study highlights key techniques, including the application of information technology in service and promotion, the strengthening of community and government roles, the development of infrastructure and facilities, the utilization of external resources, sustainable innovation, and the encouragement of local governments to issue regulations for halal tourism villages. By identifying drivers and barriers from an economic, environmental, social, and cultural perspective, the SWOT analysis results help design strategies that can make positive contributions to the development of sustainable, community-based halal tourism and digital information in the future. Full article
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37 pages, 642 KiB  
Article
The Goddess of the Flaming Mouth Between India and Tibet
by Arik Moran and Alexander Zorin
Religions 2025, 16(8), 1002; https://doi.org/10.3390/rel16081002 - 1 Aug 2025
Abstract
This article examines the evolution and potential cross-cultural adaptations of the “Goddess of the Flaming Mouth”, Jvālāmukhī (Skt.) or Kha ‘bar ma (Tib.), in Indic and Tibetan traditions. A minor figure in medieval Hindu Tantras, Jvālāmukhī is today best known through her tangible [...] Read more.
This article examines the evolution and potential cross-cultural adaptations of the “Goddess of the Flaming Mouth”, Jvālāmukhī (Skt.) or Kha ‘bar ma (Tib.), in Indic and Tibetan traditions. A minor figure in medieval Hindu Tantras, Jvālāmukhī is today best known through her tangible manifestation as natural flames in a West Himalayan temple complex in the valley of Kangra, Himachal Pradesh, India. The gap between her sparse portrayal in Tantric texts and her enduring presence at this local “seat of power” (śakti pīṭha) raises questions regarding her historical development and sectarian affiliations. To address these questions, we examine mentions of Jvālāmukhī’s Tibetan counterpart, Kha ‘bar ma, across a wide range of textual sources: canonical Buddhist texts, original Tibetan works of the Bön and Buddhist traditions, and texts on sacred geography. Regarded as a queen of ghost spirits (pretas) and field protector (kṣetrapāla) in Buddhist sources, her portrayal in Bön texts contain archaic motifs that hint at autochthonous and/or non-Buddhist origins. The assessment of Indic material in conjunction with Tibetan texts point to possible transformations of the goddess across these culturally proximate Himalayan settings. In presenting and contextualizing these transitions, this article contributes critical data to ongoing efforts to map the development, adaptation, and localization of Tantric deities along the Indo-Tibetan interface. Full article
16 pages, 1651 KiB  
Article
Modular Pipeline for Text Recognition in Early Printed Books Using Kraken and ByT5
by Yahya Momtaz, Lorenza Laccetti and Guido Russo
Electronics 2025, 14(15), 3083; https://doi.org/10.3390/electronics14153083 (registering DOI) - 1 Aug 2025
Abstract
Early printed books, particularly incunabula, are invaluable archives of the beginnings of modern educational systems. However, their complex layouts, antique typefaces, and page degradation caused by bleed-through and ink fading pose significant challenges for automatic transcription. In this work, we present a modular [...] Read more.
Early printed books, particularly incunabula, are invaluable archives of the beginnings of modern educational systems. However, their complex layouts, antique typefaces, and page degradation caused by bleed-through and ink fading pose significant challenges for automatic transcription. In this work, we present a modular pipeline that addresses these problems by combining modern layout analysis and language modeling techniques. The pipeline begins with historical layout-aware text segmentation using Kraken, a neural network-based tool tailored for early typographic structures. Initial optical character recognition (OCR) is then performed with Kraken’s recognition engine, followed by post-correction using a fine-tuned ByT5 transformer model trained on manually aligned line-level data. By learning to map noisy OCR outputs to verified transcriptions, the model substantially improves recognition quality. The pipeline also integrates a preprocessing stage based on our previous work on bleed-through removal using robust statistical filters, including non-local means, Gaussian mixtures, biweight estimation, and Gaussian blur. This step enhances the legibility of degraded pages prior to OCR. The entire solution is open, modular, and scalable, supporting long-term preservation and improved accessibility of cultural heritage materials. Experimental results on 15th-century incunabula show a reduction in the Character Error Rate (CER) from around 38% to around 15% and an increase in the Bilingual Evaluation Understudy (BLEU) score from 22 to 44, confirming the effectiveness of our approach. This work demonstrates the potential of integrating transformer-based correction with layout-aware segmentation to enhance OCR accuracy in digital humanities applications. Full article
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21 pages, 6231 KiB  
Article
Integrating In Vitro Propagation and Machine Learning Modeling for Efficient Shoot and Root Development in Aronia melanocarpa
by Mehmet Yaman, Esra Bulunuz Palaz, Musab A. Isak, Serap Demirel, Tolga İzgü, Sümeyye Adalı, Fatih Demirel, Özhan Şimşek, Gheorghe Cristian Popescu and Monica Popescu
Horticulturae 2025, 11(8), 886; https://doi.org/10.3390/horticulturae11080886 (registering DOI) - 1 Aug 2025
Abstract
Aronia melanocarpa (black chokeberry) is a medicinally valuable small fruit species, yet its commercial propagation remains limited by low rooting and genotype-specific responses. This study developed an efficient, callus-free micropropagation and rooting protocol using a Shrub Plant Medium (SPM) supplemented with 5 mg/L [...] Read more.
Aronia melanocarpa (black chokeberry) is a medicinally valuable small fruit species, yet its commercial propagation remains limited by low rooting and genotype-specific responses. This study developed an efficient, callus-free micropropagation and rooting protocol using a Shrub Plant Medium (SPM) supplemented with 5 mg/L BAP in large 660 mL jars, which yielded up to 27 shoots per explant. Optimal rooting (100%) was achieved with 0.5 mg/L NAA + 0.25 mg/L IBA in half-strength SPM. In the second phase, supervised machine learning models, including Random Forest (RF), XGBoost, Gaussian Process (GP), and Multilayer Perceptron (MLP), were employed to predict morphogenic traits based on culture conditions. XGBoost and RF outperformed other models, achieving R2 values exceeding 0.95 for key variables such as shoot number and root length. These results demonstrate that data-driven modeling can enhance protocol precision and reduce experimental workload in plant tissue culture. The study also highlights the potential for combining physiological understanding with artificial intelligence to streamline future in vitro applications in woody species. Full article
(This article belongs to the Special Issue Tissue Culture and Micropropagation Techniques of Horticultural Crops)
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16 pages, 333 KiB  
Article
Changes, Desire, Fear and Beliefs: Women’s Feelings and Perceptions About Dental Care During Pregnancy
by Natália Correia Fonseca Castro, Vânia Maria Godoy Pimenta Barroso, Henrique Cerva Melo, Camilla Aparecida Silva de Oliveira Lima, Rafaela Silveira Pinto and Lívia Guimarães Zina
Int. J. Environ. Res. Public Health 2025, 22(8), 1211; https://doi.org/10.3390/ijerph22081211 - 31 Jul 2025
Abstract
Oral health during pregnancy is essential for maternal and child well-being, as hormonal and physiological changes increase women’s susceptibility to oral diseases. Despite the recognized importance of prenatal dental care, adherence to dental services remains a challenge in the public health context. This [...] Read more.
Oral health during pregnancy is essential for maternal and child well-being, as hormonal and physiological changes increase women’s susceptibility to oral diseases. Despite the recognized importance of prenatal dental care, adherence to dental services remains a challenge in the public health context. This study aimed to analyze oral health and the use of dental services during pregnancy through the perception of pregnant women. It represents the qualitative phase of a mixed-method study conducted with 25 pregnant women (with and without dental care) receiving prenatal care in the Brazilian Unified Health System (SUS). Participants were selected through saturation sampling, and data were collected via semi-structured interviews, followed by content analysis. The findings revealed four major themes: barriers and facilitators to dental care, changes during pregnancy and oral health. Discomfort from oral changes was a common concern. Barriers included misinformation, fear, cultural beliefs, and service organization. In contrast, facilitating factors were identified, such as care prioritization, support from healthcare teams, health education, and access through SUS. This study concludes that emotional, cultural, and contextual aspects shape the use of dental services during pregnancy. Access through SUS is perceived as an important facilitator, which simultaneously presents organizational weaknesses that need to be addressed. Full article
(This article belongs to the Special Issue Perceptions of Women, Child and Adolescents' Oral Health)
13 pages, 585 KiB  
Article
Coping Processes of Congolese Refugee Women Newly Resettled in the United States: A Qualitative Exploration
by Na’Tasha Evans, Kamesha Spates, Cedric Mubikayi Kabasele and Chelsey Kirkland
Int. J. Environ. Res. Public Health 2025, 22(8), 1208; https://doi.org/10.3390/ijerph22081208 - 31 Jul 2025
Abstract
The present study aimed to provide Congolese refugee women with an opportunity to narrate firsthand experiences coping with resettlement challenges in the United States. Translator-assisted, face-to-face semi-structured individual interviews were conducted with newly resettled Congolese refugee women (n = 20) aged 18 and [...] Read more.
The present study aimed to provide Congolese refugee women with an opportunity to narrate firsthand experiences coping with resettlement challenges in the United States. Translator-assisted, face-to-face semi-structured individual interviews were conducted with newly resettled Congolese refugee women (n = 20) aged 18 and older who arrived in the United States between 2011 and 2018. All participants were receiving assistance from a resettlement agency, located in the Midwestern US, at the time of the study. Data were analyzed using descriptive coding and thematic analysis. Three overarching themes were developed, indicating that Congolese refugee women adopt three main coping mechanisms to deal with challenges they face after resettling in the United States: (1) use of social support, (2) acceptance of the situation, and (3) spirituality. Resettlement support services, such as those provided by resettlement agencies, mental health providers, and community-based organizations, should integrate both economic and cultural dimensions into their services to address the complex physiological, mental, and emotional impacts of resettlement. These services should prioritize culturally and spiritually sensitive techniques that are linguistically accessible. Full article
(This article belongs to the Special Issue Reducing Disparities in Health Care Access of Refugees and Migrants)
13 pages, 403 KiB  
Article
“It All Starts by Listening:” Medical Racism in Black Birthing Narratives and Community-Identified Suggestions for Building Trust in Healthcare
by Jasmine Y. Zapata, Laura E. T. Swan, Morgan S. White, Baillie Frizell-Thomas and Obiageli Oniah
Int. J. Environ. Res. Public Health 2025, 22(8), 1203; https://doi.org/10.3390/ijerph22081203 - 31 Jul 2025
Abstract
This study documents Black Wisconsinites’ birthing experiences and their proposed solutions to improve Black birthing people’s trust in healthcare. Between 2019 and 2022, we conducted semi-structured, longitudinal interviews (both individual and focus group interviews) with those enrolled in a local perinatal support group [...] Read more.
This study documents Black Wisconsinites’ birthing experiences and their proposed solutions to improve Black birthing people’s trust in healthcare. Between 2019 and 2022, we conducted semi-structured, longitudinal interviews (both individual and focus group interviews) with those enrolled in a local perinatal support group program for Black birthing people (N = 25), asking about their pregnancy, birthing, and postpartum experiences and their ideas for building trust in healthcare. Using the Daughtering Method and Braun and Clarke’s method of reflexive thematic analysis, we coded the interview data and then iteratively collated the codes into themes and subthemes. Participants described experiencing medical racism, including healthcare trauma and provider bias, during pregnancy and delivery. They drew connections between those experiences and the distrust they felt toward healthcare providers and the healthcare system. They provided actionable strategies that individual providers and the healthcare system can take to build the trust of Black birthing people: employ more Black providers, listen to Black birthing people, exhibit cultural humility, engage in shared decision-making, build personal connections with patients, and spend more time with patients. This study connects Black birthing people’s experiences of medical racism to feelings of medical distrust and provides community-identified actionable suggestions to build trust and shape how we combat racial disparities in healthcare provision and health outcomes. Full article
(This article belongs to the Special Issue Understanding and Addressing Factors Related to Health Inequalities)
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20 pages, 538 KiB  
Article
Segmenting Preventive Health Behavior: Gender Disparities and Psychosocial Predictors in a Culturally Diverse Italian Region
by Dietmar Ausserhofer, Verena Barbieri, Stefano Lombardo, Timon Gärtner, Klaus Eisendle, Giuliano Piccoliori, Adolf Engl and Christian J. Wiedermann
Eur. J. Investig. Health Psychol. Educ. 2025, 15(8), 148; https://doi.org/10.3390/ejihpe15080148 - 31 Jul 2025
Abstract
Grounded in health behavior theory, this study examined patterns of preventive health behavior in a culturally diverse, multilingual region of northern Italy using data from a representative population survey (n = 2090). Preventive behaviors were assessed using the 16-item Good Health Practices [...] Read more.
Grounded in health behavior theory, this study examined patterns of preventive health behavior in a culturally diverse, multilingual region of northern Italy using data from a representative population survey (n = 2090). Preventive behaviors were assessed using the 16-item Good Health Practices (GHP-16) scale. Latent profile analysis (LPA) identified five behavioral profiles, ranging from ‘Globally Low Engagers’ to ‘Comprehensive High Engagers’. Binary logistic regression compared ‘Globally Low Engagers’ to ‘Broadly Moderate Preventers’, examining predictors including gender, age, education, language, chronic disease status, health literacy (HLS-EU-Q16), patient activation (PAM-10), mistrust of health information, living situation, and healthcare employment. The results showed that men, younger adults, individuals with low patient activation, those living alone, and respondents with high mistrust of health information had higher odds of belonging to the low engagement group. Health literacy and language group membership were not significantly associated with the profile membership. Item-level comparisons revealed gender differences in information-seeking, oral hygiene, and dietary behaviors, with men reporting lower engagement. These findings support a segmentation-based understanding of preventive health behavior and highlight the need to address personal capacities and contextual barriers in interventions while challenging assumptions of uniformly higher female health vigilance. Full article
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18 pages, 255 KiB  
Article
Making the Invisible Visible: Addressing the Sexuality Education Needs of Persons with Disabilities Who Identify as Queer in Kenya
by Amani Karisa, Mchungwani Rashid, Zakayo Wanjihia, Fridah Kiambati, Lydia Namatende-Sakwa, Emmy Kageha Igonya, Anthony Idowu Ajayi, Benta Abuya, Caroline W. Kabiru and Moses Ngware
Disabilities 2025, 5(3), 69; https://doi.org/10.3390/disabilities5030069 (registering DOI) - 31 Jul 2025
Abstract
Persons with disabilities face barriers to accessing sexuality education. For those who identify as queer, these challenges are compounded by stigma, ableism, and heteronormativity, resulting in distinct and overlooked experiences. This study explored the sexuality education needs of persons with disabilities who identify [...] Read more.
Persons with disabilities face barriers to accessing sexuality education. For those who identify as queer, these challenges are compounded by stigma, ableism, and heteronormativity, resulting in distinct and overlooked experiences. This study explored the sexuality education needs of persons with disabilities who identify as queer in Kenya—a neglected demographic—using a phenomenological approach. Data were collected through a focus group discussion with six participants and analyzed thematically. Three themes emerged: invisibility and erasure; unprepared institutions and constrained support networks; and agency and everyday resistance. Educational institutions often overlook the intersectional needs of persons with disabilities who identify as queer, leaving them without adequate tools to navigate relationships, sexuality, and rights. Support systems are often unprepared or unwilling to address these needs. Societal attitudes that desexualize disability and marginalize queerness intersect to produce compounded exclusion. Despite these challenges, participants demonstrated agency by using digital spaces and informal networks to resist exclusion. This calls for policy reforms that move beyond tokenism to address the lived realities of multiply marginalized groups. Policy reform means not only a legal or governmental shift but also a broader cultural and institutional process that creates space for recognition, protection, and participation. Full article
22 pages, 970 KiB  
Article
The Emotional Foundations of Value Co-Creation in Sustainable Cultural Heritage Tourism: Insights into the Motivation–Experience–Behavior Framework
by Lin Zhou, Xue Liu and Wei Wei
Sustainability 2025, 17(15), 6961; https://doi.org/10.3390/su17156961 (registering DOI) - 31 Jul 2025
Abstract
As sustainable cultural heritage tourism increasingly demonstrates its unique value and appeal, effectively stimulating tourists’ emotional experiences and value co-creation behaviors has become a focal issue. This study investigates how multiple tourist motivations (self-enhancement, escapism, and social interaction) shape value co-creation through emotional [...] Read more.
As sustainable cultural heritage tourism increasingly demonstrates its unique value and appeal, effectively stimulating tourists’ emotional experiences and value co-creation behaviors has become a focal issue. This study investigates how multiple tourist motivations (self-enhancement, escapism, and social interaction) shape value co-creation through emotional mediators—namely aesthetic, nostalgic, and flow experiences. Data were collected from 470 valid responses from visitors to the UNESCO-listed Suzhou Classical Gardens in China and analyzed using partial least squares structural equation modeling (PLS-SEM). The results show that these emotional experiences significantly drive value co-creation behavior: self-enhancement motivation enhances all three experiences, escapism mainly promotes nostalgic and flow experiences, and social interaction primarily affects aesthetic experience. These findings clarify the psychological mechanisms through which tourists’ motivations and emotional experiences influence value co-creation behavior in cultural heritage tourism. This research advances our understanding of the motivation–experience–behavior framework and emphasizes that enhancing emotional engagement is key to fostering sustainable cultural heritage tourism practices. The study provides practical implications for designing experiences and strategies that balance visitor satisfaction with the long-term vitality of cultural heritage sites and local communities, thereby contributing to broader sustainable development goals. Full article
(This article belongs to the Special Issue Sustainable Heritage Tourism)
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11 pages, 415 KiB  
Article
A Nosocomial Outbreak of Burkholderia cepacia complex Linked to Contaminated Intravenous Medications in a Tertiary Care Hospital
by Hanife Nur Karakoc Parlayan, Firdevs Aksoy, Masite Nur Ozdemir, Esra Ozkaya and Gurdal Yilmaz
Antibiotics 2025, 14(8), 774; https://doi.org/10.3390/antibiotics14080774 (registering DOI) - 31 Jul 2025
Abstract
Objectives: Burkholderia cepacia complex (Bcc), a Gram-negative organism, is a well-recognized cause of hospital outbreaks, often linked to a contaminated shared source, such as multidose medications. In this study, we report an outbreak of Bcc infections in a tertiary care hospital, associated with [...] Read more.
Objectives: Burkholderia cepacia complex (Bcc), a Gram-negative organism, is a well-recognized cause of hospital outbreaks, often linked to a contaminated shared source, such as multidose medications. In this study, we report an outbreak of Bcc infections in a tertiary care hospital, associated with the intrinsic contamination of a prepared solution used in interventional radiology (IR) procedures. Additionally, we provide a detailed explanation of the interventions implemented to control and interrupt the outbreak. Methods: Records from the infection control committee from 1 January 2023 to 31 October 2024 were screened to identify cases with Bcc growth in cultured blood, urine, or respiratory samples. Clinical and laboratory data were collected in March 2025. Bacterial identification was performed using conventional methods and MALDI-TOF (Bruker Daltonics, Bremen, Germany). Controls were matched to cases by ward, date of initial growth, and duration of hospitalization. Demographic and clinical data of these patients were systematically collected and analyzed. Microbiological cultures were obtained from environmental objects of concern and certain medications. Results: A total of 82 Burkholderia species were identified. We enrolled 77 cases and 77 matched controls. The source of contamination was identified in ready-to-use intravenous medications (remifentanil and magnesium preparations) in the IR department. These preparations were compounded in advance by the team and were used repeatedly. Although the outbreak originated from contaminated IV medications used in IR, secondary transmission likely affected 28 non-IR patients via fomites, shared environments, and possible lapses in isolation precautions. The mortality rate among the cases was 16.9%. Infection with Bcc was associated with prolonged intensive care unit stays (p = 0.018) and an extended overall hospitalization duration (p < 0.001); however, it was not associated with increased mortality. The enforcement of contact precautions and comprehensive environmental decontamination successfully reduced the incidence of the Bcc outbreak. No pathogens were detected in cultures obtained after the disinfection. Conclusions: The hospital transmission of Bcc is likely driven by cross-contamination, invasive medical procedures, and the administration of contaminated medications. Implementing stringent infection control measures such as staff retraining, updated policies on medication use, enhanced environmental decontamination, and strict adherence to isolation precautions has proven effective in curbing the spread of virulent and transmissible Bcc. Full article
(This article belongs to the Section Antibiotics Use and Antimicrobial Stewardship)
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