Search Results (789)

In higher education, there is growing recognition that mental health support should be responsive to students’ lived experiences, educational contexts, and disciplinary norms. For instance, engineering students report high levels of distress and underutilize professional mental health services when compared to students in other disciplines, reflecting a culture that normalizes excessive workload, self-reliance, and academic rigor. Therefore, this case study examined the impact of a 15-min contextualized, classroom-based mental health presentation tailored to undergraduate engineering students at a large Southeastern U.S. university. Grounded in the Integrated Behavioral Model of Mental Health Help-Seeking, the presentation integrated findings from the literature on engineering culture and its influence on student well-being. Across two years, the presentation was delivered to nearly 4500 engineering students, reaching an average of 82% of enrolled engineering students. The study evaluated this impact by comparing presentation and non-presentation groups among students who completed surveys in Spring 2023 (n = 431) and Spring 2024 (n = 132). The presentation group showed significant improvements in perceived and objective knowledge of mental health and help-seeking resources, whereas help-seeking beliefs, mechanisms, and intention did not significantly change, likely due to the deeply culturally ingrained nature of these constructs. These findings underscore the value of contextualized approaches to mental health promotion and provide support for scalable, classroom-embedded presentations and other interventions within engineering education and higher education more broadly. Full article

Management accounting systems (MASs) are essential to organisations because they provide high-quality information that supports planning and decision-making when it is relevant, timely and reliable. The effectiveness of MAS depends on the delivery of relevant, timely, and understandable information, yet organisations often fail to evaluate the quality of these services systematically, thereby limiting their strategic impact. Our study addresses the underexplored area of MAS service quality, focusing on internal dynamics within accounting departments and gaps in service provision. We conduct a gap analysis within a single consistent cultural environment (Slovenia) to assess the functioning of accounting services. In our study, the statistically significant preparer–user mismatch is concentrated in the reliability dimension. The findings suggest that reliability should be prioritised in efforts to improve MAS service quality. We discuss practical implications for strengthening MAS service quality, particularly through data integrity, reporting reliability, process standardisation and user expectation management. Full article

Background/Objectives: Internet Gaming Disorder (IGD) is included in ICD-11 and poses a substantial risk to Saudi university students, yet no structured nursing intervention framework exists within Saudi higher education health services. This paper presents the Resilience-Based Nursing Intervention Framework (RBNIF), a three-tiered, theory-driven nursing architecture translating evidence on impulsivity, resilience, and IGD into practice specifications for this setting. Methods: Using secondary analysis of a dataset of 207 gaming students from four King Saud University colleges, framework development followed a four-phase Medical Research Council (MRC) process: theoretical identification (I-PACE, Dual Process Theory, COM-B), evidence synthesis, Behavior Change Wheel/Intervention Mapping, and cultural adaptation via Bernal et al.’s Ecological Validity Framework. Results: The sample (58.9% male; 20–25 years, 61.4%; bachelor’s level, 73.9%) yielded three tiers differentiated by a dual-domain screening rule (elevated impulsivity and/or low resilience, rather than a single combined score): Tier 1 (universal psychoeducation); Tier 2 (six-session group program, S-UPPS-P ≥ 52 and/or CD-RISC-10 ≤ 20; 63 of 207 participants [30.4%]); and Tier 3 (10-session RIRDH clinical program, IGDS9-SF ≥ 36, met by 38 of 207 participants [18.4%]). Fifty-two participants (25.1%) met the elevated-impulsivity criterion, and 51 (24.6%) met the low-resilience criterion. Each tier specifies nursing competencies and behavior change techniques, with cultural adaptation integrating Islamic values concepts (sabr, mizan, tawakkul), family protocols, and single-sex delivery. Conclusions: To our knowledge, the RBNIF is the first theory-driven, culturally adapted nursing intervention architecture for IGD in Saudi university health services; a focused, non-systematic search of PubMed, Scopus, and CINAHL identified no directly comparable published framework. It is pre-implementation and requires feasibility testing, pilot evaluation, and a cluster-randomized controlled trial (c-RCT). Full article

University canteens occupy a structurally significant position within European higher education, functioning simultaneously as food security infrastructures, socioeconomic equalizers, and community-building spaces. Yet, access to these services remains deeply uneven, shaped by financial constraints, logistical barriers, and a frequently underexplored cultural and symbolic dimension that precedes and overrides direct experiential evaluation. Drawing on 56 semi-structured qualitative interviews conducted with university students in Milan between April and May 2025, this paper investigates how students organize and experience their midday lunch break and what motivates them to access or exclude themselves from the university canteen service. The findings reveal that the student sample departs substantially from the dominant framing in the contemporary literature of the canteen as an existential food-security resource, instead deploying a range of domestic and commercial food tactics that bypass institutional catering entirely. More significantly, the data demonstrates that canteen avoidance is driven less by objective assessments of food quality or pricing than by a stratification of memories in which childhood memories of institutional dining spaces trigger pre-emptive rejection of the university facility before any direct engagement takes place. Against this backdrop, peer socialization emerges as a particularly salient counterforce for overriding both affective aversion and economic and logistical inconvenience, symbolically transforming the canteen from a regimented site of institutional constraint into a shared territory of collective belonging. Taken together, these findings suggest that improving canteen access requires intervention not only at the level of food quality and pricing, but at the level of spatial culture, service typology, and the culinary imagery that students carry with them to campus. Full article

Adaptive reuse research commonly evaluates completed projects, overlooking cases in which the design, program, and/or construction are not yet finished. This article examines the ongoing reuse of the Çırpıcı Meadow Textile Factory in Istanbul to investigate architectural continuity within a fragmented post-industrial complex. This qualitative single-case study combines three semi-structured interviews with the lead architect, two site visits, photographs, drawings, project visualizations, aerial images, and historical sources. Material, spatial, symbolic, and programmatic transformations are the connected analytical lenses. The findings reveal uneven and conflicting forms of continuity. Original reinforced-concrete structures remain in Blocks L, S, B, and C, whereas H and F have been reconstructed and R is under construction as of July 2026. The courtyard and selected footprints sustain spatial relationships despite material loss, while the surviving denim-washing pools and new steel tower provide references to the industrial past. The shift from a culture-oriented campus to municipal offices has altered the subdivision, circulation, servicing, and access control. Because the complex was unoccupied and its public landscape unbuilt, accessibility, adaptability, and symbolic reception could not be evaluated. The study shows that existing conditions, completed interventions, ongoing works, approved proposals, and abandoned concepts must be distinguished when interpreting continuity in unfinished adaptive reuse projects. Full article

Background: Previous Australian child developmental assessment service (CDAS) cohorts have identified a small proportion of children experiencing extreme waiting times (≥730 days) for standardised developmental assessments. However, factors associated with these extreme waits remain poorly understood. Aim: To examine factors associated with a priori defined extreme waiting times (≥730 days) by comparing affected children with the remaining CDAS cohort, while validating administrative data and exploring caregiver experiences. Methods: An embedded mixed-methods service evaluation was undertaken. Quantitative data were extracted from the CDAS database and electronic medical records for children assessed between October 2022 and September 2024. Children with validated extreme waiting times were compared with the remaining CDAS cohort. Records initially identified as waiting ≥730 days underwent manual validation of referral and assessment dates. Caregivers of children with validated extreme waits were purposively recruited for semi-structured interviews. Fifteen caregivers participated; twelve families did not respond. Interview transcripts underwent thematic analysis. Results: Of 67 children initially identified as waiting ≥730 days, 20 (29.9%) were excluded following manual validation because of administrative recording inaccuracies, leaving 47 children with confirmed extreme waiting times. Of these, 46 completed CDAS assessment and had available validated waiting-time data, with a median wait of 859 days (IQR 775–932), compared with 254 days (IQR 111–355) in the comparison cohort of 2039 other children. Children in the extreme-wait cohort were more often from culturally and linguistically diverse backgrounds (76.6% vs. 53.5%; p = 0.002), required interpreters more frequently (23.4% vs. 9.0%; p = 0.003), and were more likely to be referred by paediatricians (89.4% vs. 74.1%; p = 0.017). Over one-third (n = 17) were prioritised for assessment within six months at triage. Review assessments accounted for 25/47 (53.2%) of the extreme-wait cohort. Caregivers described acceptance of lengthy public-sector waits, communication gaps, uncertainty regarding service pathways, reliance on interim supports, financial barriers to private assessment, and positive experiences once assessments were completed. Conclusions: Children experiencing extreme waits had distinct characteristics. Extreme waiting reflected genuine service delays, planned clinical review pathways, and administrative recording inaccuracies. Administrative data should be validated before waiting-time metrics are used for service evaluation. Improved communication, service navigation, equitable access to interim supports, and targeted service redesign may improve caregiver experiences and reduce extreme waits in publicly funded developmental assessment services. Full article

As tourism shifts from sightseeing to experience-oriented consumption, understanding how tourist perception differs across heterogeneous destination types and spatial scales remains challenging. Using 23,439 Volunteered Geographic Information (VGI) reviews archived for six destinations in Shangrao, China, this study compares mountain-type and rural comprehensive destination products. These are operational dominant-function categories rather than mutually exclusive geomorphological classes. The archive supports fine-grained sentiment, topic, and semantic-network analyses; annual temporal comparisons use the full 23,439-review corpus covering 2019–2025, whereas a separate subset of reviews posted from 1 August 2022 with official IP labels, aggregated into 2022–2024 province–year observations, supports Pooled Ordinary Least Squares (Pooled OLS) estimation. A hybrid lexicon–XLM-RoBERTa workflow, BERTopic, semantic co-occurrence analysis, and Pooled OLS are integrated in a cross-scale framework. Static results reveal shared strengths and weaknesses—high scenery and overall-experience evaluations but low price evaluations—alongside type-specific structures: mountain reviews concentrate on natural scenery, climbing effort, and accessibility, whereas rural reviews span village landscapes, cultural activities, accommodation, and nighttime experiences. Temporally, mountain demand retains a stable scenic core while accessibility concerns become more salient; rural demand shifts from traditional agricultural landscapes toward nighttime performances and other experience-oriented products. Cross-scale regressions identify destination- and dimension-specific correlates rather than causal drivers: urbanization is positively associated with several rural evaluations, while ecological contrast, climatic difference, and competing scenic resources are associated with more critical assessments in selected dimensions. The findings show that perception differences arise from the interaction of destination product structures and origin-region contexts, supporting differentiated accessibility management for mountain destinations and balanced product innovation, service improvement, and commercialization control for rural destinations. Full article

Background/Objectives: Double-J (DJ) ureteral stents are prone to luminal occlusion, which causes renal dysfunction and complicates exchange. Risk stratification in chronically stent-dependent patients is poorly defined, and the management of confirmed occlusion is not standardised. We aimed to identify independent risk factors for DJ stent occlusion in a chronically stent-dependent population and to evaluate stent-type substitution at first confirmed occlusion. Methods: We conducted a single-centre retrospective cohort study at a tertiary urology service in Melbourne, Australia (January 2023 to December 2025). Patients requiring three or more sequential DJ replacements were eligible. Mechanical occlusion was defined as inability to pass a guidewire through the stent lumen at fluoroscopic exchange, an objective intraoperative surrogate; clinical failure events (nephrostomy conversion, septic admission, or acute kidney injury requiring intervention) were recorded separately. Midstream urine culture and pre-exchange renal ultrasound were obtained at each visit. Cox proportional hazards modelling with robust patient-level clustering was performed. Results: We analysed 125 ureters (97 patients) over a mean follow-up of 20.6 months. Occlusion occurred in 55 ureters (44.0%). Four predictors were robust to Bonferroni correction: indwelling urethral catheter (hazard ratio [HR] 4.62), urinary stone disease versus malignant disease (HR 4.02), retroperitoneal fibrosis versus malignant disease (HR 3.24), and bacteriuria at exchange (HR 2.76). Two further associations, Eastern Cooperative Oncology Group (ECOG) performance status 2 to 4 (HR 2.31) and prior pyelonephritis (HR 1.89), did not survive correction and are exploratory. After stent-type substitution at first occlusion, 43 of 55 ureters (78.2%) had no further occlusion without interval shortening. Summer accounted for 45.1% of events (p < 0.001). Conclusions: In chronically stent-dependent patients, several factors were independently associated with DJ stent occlusion, four of them robust to multiple-comparison correction. Stent-type substitution was associated with occlusion-free outcomes in most cases without interval shortening; because the analysis was uncontrolled and regression to the mean cannot be excluded, this observation is hypothesis-generating. All hazard estimates are exploratory in view of an events-per-variable ratio below ten and a survivor-selected cohort, and apply only to patients with established chronic stent dependency. Prospective randomised evaluation is warranted. Full article

Island destinations combine natural settings, local culture, and participatory activities that may support recovery, social connection, and personal meaning. Evidence remains limited on the relative contribution of different island experience dimensions to tourist satisfaction and well-being, especially in inhabited island destinations. This study examined four experience dimensions in West Island, Sanya, China, and used the findings to develop a destination improvement model. Tourist satisfaction was conceptualised as a visit-specific evaluation, while tourist well-being referred to the broader psychological benefits associated with travel. An explanatory sequential mixed-methods design was adopted. The quantitative phase used 411 valid questionnaires from Chinese domestic tourists. A full six-construct confirmatory factor analysis assessed the measurement model, after which multiple and simple linear regressions tested the prespecified direct relationships. The six-factor model showed good fit (χ²(390) = 389.98, p = 0.491, CFI = 1.000, TLI = 1.000, RMSEA = 0.000, SRMR = 0.035). The four experience dimensions explained 58.0% of the variance in tourist satisfaction. Co-creation experience made the largest unique contribution (β = 0.345), followed by emotional experience (β = 0.329) and environmental experience (β = 0.312; all p < 0.001). Educational experience was not significant (β = 0.029, p = 0.422). Tourist satisfaction had a significant positive influence on tourist well-being (β = 0.764, p < 0.001; R² = 0.583). Semi-structured interviews with 12 experienced tourists explained the coefficient pattern through ten themes, and seven academic and industry experts refined five strategic components through two Delphi rounds. The resulting model prioritises cultural co-creation, emotional resonance, environmental quality, and service support, while treating transformative learning as an area for targeted development and evaluation. The integration of survey results, tourist accounts, and expert assessment provides an evidence base for selecting and monitoring destination improvements in inhabited island settings. Full article

Great Wall villages are living cultural landscapes within a linear heritage corridor, yet they face growing pressures from population decline, rural hollowing, uneven development, and tourism-related transformation. This study evaluates the cultural landscape resilience of 20 Great Wall villages in Chicheng County, China. A Cultural Landscape Resilience Index (CLRI) was constructed from three dimensions: resistance, recovery, and learning capacity. The AHP-CRITIC method was used to determine indicator weights, while spatial autocorrelation analysis, principal component analysis (PCA), and multiscale geographically weighted regression (MGWR) were applied to identify the spatial pattern of CLRI and the multiscale effects of its influencing factors. The results show that CLRI was generally low and spatially uneven. Villages with relatively high resilience were mainly concentrated near the county seat and major transportation corridors, whereas many villages along the Great Wall corridor showed lower resilience levels. MGWR results revealed clear spatial heterogeneity in the influencing factors. Heritage revitalization and social development features, heritage preservation and protection, tourism development and utilization, and village patterns and collaborative heritage protection were positively associated with CLRI. In contrast, the diversity of rural village landscapes and the strength of the human-land relationship showed negative associations with CLRI. Heritage revitalization and social development features and rural village landscape diversity operated at relatively broad spatial scales, whereas heritage preservation and protection and tourism development and utilization exhibited stronger local variation. The findings demonstrate that improving the resilience of Great Wall village cultural landscapes requires spatially differentiated conservation and development strategies, including strengthened heritage protection, coordinated conservation of village patterns and heritage elements, context-sensitive tourism development, and improved public services and development opportunities in less resilient villages. Full article

Land-use and land-cover (LULC) change is a major driver of ecosystem degradation and ecosystem service loss in tropical landscapes. This study assessed the impacts of LULC changes between 1985 and 2023 on the potential of different LULC classes to supply ecosystem services in the Upper Rio Pardo Basin (Rio Pardo and Rio São João do Paraíso watersheds), northern Minas Gerais, Brazil. LULC data from the MapBiomas Project were used to quantify transitions among LULC classes within the study area. The potential supply of ecosystem services was assessed using the Burkhard matrix, adapted to local environmental conditions and informed by expert knowledge, while the relative importance of ecosystem services was evaluated through a participatory assessment involving local communities. The expansion of pasturelands and commercial forest plantations was identified as the primary driver of ecosystem service loss in the study region. Native ecosystems showed the highest potential to provide regulating, supporting, provisioning, and cultural ecosystem services, particularly water regulation, soil protection, carbon sequestration, and biodiversity conservation. In contrast, anthropogenic land uses were primarily associated with provisioning services and showed limited capacity to sustain regulating and supporting services, indicating clear trade-offs between production and ecosystem functioning. Local communities identified water-related services as the highest priority, followed by climate regulation, soil fertility, and food provision. These findings demonstrate the value of integrating expert-based and participatory approaches to ecosystem service assessment and provide a basis for territorial planning strategies that prioritize the conservation and restoration of native vegetation, particularly in hydrologically sensitive areas. Full article

Comprehensive orientation is essential for ensuring client and patient safety, strengthening safety culture, and supporting workforce competence in social and health care. Although orientation is recognized as an important patient safety intervention, little is known about how comprehensively client and patient safety topics are incorporated into orientation programs. This study evaluated the extent to which client and patient safety topics were incorporated into orientation programs across Finnish wellbeing services counties. Data: A cross-sectional electronic survey was conducted in 2024. The questionnaire was based on the Finnish national client and patient safety orientation framework and included thirty-nine orientation topics covering safety management, occupational safety, safety culture, risk management, medication safety, infection prevention, information security, and emergency preparedness. Responses were requested from ten predefined social and health care service areas in each of Finland’s 23 wellbeing services counties. Fourteen counties participated, yielding 107 responses. Results: Traditional client and patient safety topics were widely incorporated into orientation programs. The highest affirmative responses concerned individual job responsibilities, confidentiality, processing of client and patient information, occupational safety, medication competence, and incident reporting (all 96–99%). In contrast, psychological safety (58%), second victim practices (14%), self-monitoring programs and plans (42% and 54%), safety culture assessment (41%), and client and patient safety in digital and remote services (62%) were incorporated less frequently. Conclusions: This study provides a national overview of client and patient safety orientation practices based on responses from participating Finnish wellbeing services counties. Traditional client and patient safety topics were widely incorporated into orientation programs, whereas psychological safety, second victim support, self-monitoring, and digital safety were less consistently represented. The findings suggest that implementation of patient safety priorities is uneven across safety domains, with newer organizational and systems-oriented topics appearing less embedded in orientation than traditional clinical safety topics. Orientation may therefore be viewed not merely as an onboarding activity but also as a strategic mechanism for implementing patient safety priorities within healthcare organizations. Full article

Digitalization and intelligent interaction technologies are transforming museum services, making interactive interfaces important for cultural information access and user experience. Existing studies often examine aesthetics, usability, visual cognition, or emotional experience separately. To address this gap, this study proposes a multi-criteria evaluation method for interactive interface layouts in smart digital museums. The evaluation system includes nine indicators across layout aesthetics, visual cognition, and emotional experience: symmetry, density score, orderliness, total fixation duration, average pupil diameter, saccade count, pleasure, arousal, and dominance. Six layouts were evaluated using layout aesthetics calculations, an eye-tracking experiment with 32 participants, and the Pleasure–Arousal–Dominance (PAD) scale. Descriptive statistics were used to summarize the eye-tracking and PAD data. RANCOM and LOPCOW were used to calculate the subjective and objective weights, respectively, and TOPSIS was used to rank the layouts. Ranking robustness was examined through 54 weight-perturbation scenarios, while ranking agreement was assessed using Spearman’s and Kendall’s coefficients and four alternative multi-criteria decision-making (MCDM) procedures. L1 ranked first with a relative closeness of 0.876, followed by L5 and L6, while L4 ranked last with 0.120. The baseline ranking was retained in 51 of the 54 scenarios, with a consistency rate of 94.44%. Spearman’s coefficients ranged from 0.943 to 1.000, and Kendall’s coefficients ranged from 0.867 to 1.000. These results indicate relative ranking robustness under the tested scenarios and high agreement within the current dataset. Layouts with balanced spatial relationships, continuous functional modules, and clear visual paths showed more favorable descriptive patterns in visual cognition and emotional experience. The method provides a quantifiable and interpretable approach for comparing smart digital museum interface layouts, while its broader applicability remains to be examined. Full article

Historic landscape forests within cultural heritage sites represent a distinct category of urban green space that provides critical ecosystem services under strict conservation constraints. This study applied i-Tree Eco v6.0 to quantify the ecosystem services of the historic landscape forest of Jinju Fortress (Jinjuseong; Historic Site No. 118), South Korea, with focus on species-level contributions. A total of 822 trees representing 30 species were inventoried across 1.272 ha of tree cover. Zelkova serrata was the dominant species (importance value = 57.8) and contributed disproportionately to all ecosystem service categories, accounting for 40.7% of air pollutant removal, 61.3% of carbon storage, 58.2% of carbon sequestration and oxygen production, and 55.4% of avoided runoff. The forest removed 123.1 kg yr⁻¹ of air pollutant Korean Won (KRW 8.834 million yr⁻¹), stored 200.7 t (KRW 138 million), sequestered 8.834 t/yr (KRW 6.09 million/yr), produced 23.56 t/yr⁻¹ of oxygen, avoided 10,413.7 L yr⁻¹ of runoff and had a structural replacement value of KRW 1.63 billion. Beyond providing a species-level baseline for evidence-based management, this study introduces the concept of Heritage Ecosystem Service Efficiency (HESE) and the Species Ecosystem Service Dominance Index (SESDI), offering transferable frameworks for evaluating and managing ecosystem service performance in conservation-constrained heritage forests. Full article

As urban renewal progresses, transforming old industrial plants into sports service complexes has become a prevalent strategy to revitalize urban stock space. To evaluate the actual performance of this spatial reproduction from the users’ perspective, this study analyzes 3702 consumer reviews from five typical Chinese sports service complexes using an interdisciplinary text-mining framework. We employ the LDA topic model to extract core dimensions of consumer concern and utilize the DistilBERT model for fine-grained, sentence-level sentiment computation. The results reveal that consumer attention spans five key topics: venue services, cultural business districts, sports training, industrial integration, and heritage utilization. Critically, the sentiment analysis uncovers a structural paradox: while topics associated with cultural and heritage utilization trigger highly positive emotions and strong place identity, core functional modules like sports training and venue services generate substantial negative feedback. This disparity highlights a profound friction between rigid historical industrial architectural structures and the flexible demands of modern servicescapes, reflecting a clear path dependency in spatial transformation. Based on these theoretical and empirical findings, we propose targeted optimization strategies, including the structural reconstruction of training services and the flexible upgrading of basic venue facilities, to transition these complexes from initial physical construction toward long-term, service-oriented operation. Full article