Search Results (269)

Background: Dementia is one of the most common diseases of the elderly worldwide. Sharing experiences of caring for patients with dementia with other carers is essential to improve the quality of care, promote better outcomes, and learn from others. Aim: to explore nurses’ experiences of working with patients with dementia in Lithuanian supportive treatment and nursing hospitals. Methods: A qualitative descriptive design was employed in this study, with data collected through semi-structured interviews. Nurses with direct experience caring for patients with dementia in supportive treatment and nursing hospitals were recruited through purposive sampling. This sampling strategy was chosen to ensure that participants could provide rich, contextual, and experience-based insights into the phenomenon under investigation. Open-ended questions were divided into three themes: 1. Identifying nursing needs. 2. Care for people with dementia. 3. Patient behavior management and situation management. To ensure methodological rigor and transparency, the Consolidated Criteria for Reporting Qualitative Research (COREQ) were applied throughout the study’s planning, data collection, and analysis processes. Results: Nine nurses working in three different Lithuanian hospitals participated in the study. Theme 1: respondents reported that the needs of patients with dementia depend on their previous lifestyle and hobbies, as well as on essential physiological needs such as eating and drinking, bathing and personal hygiene, and the absence of pain. Theme 2: All participants emphasized that ensuring a safe environment is crucial for people with dementia. Theme 3: When faced with inappropriate patient behaviour, nurses attempt to calm the patient, speak gently, provide distraction, or, when necessary, temporarily separate the patient from others. Additional actions include administering medication and stabilizing the patient. Overall, these findings illustrate that dementia care requires continuous emotional presence, situational judgment, and adaptation to each patient’s individual needs. Conclusions: Patients with dementia require highly individualized care focused on nutrition, hygiene, pain control, and communication. Nurses’ daily activities centered on essential bodily care, medication management, and mobility support to maintain safety and prevent complications. Full article

Distracted driving is one of the primary causes of road traffic accidents. Behavior recognition technology based on machine vision has emerged as a research hotspot due to its non-contact and high-efficiency nature. To address the challenges of complex lighting conditions in the driver’s cabin, low detection accuracy for small-scale keypoints, and the difficulty in effectively characterizing behavioral features, this paper proposes a distracted driving behavior recognition method based on an improved YOLOv8n-Pose model and multi-feature fusion. First, the original YOLOv8n-Pose model is optimized. A P2 detection layer is added to enhance the feature extraction capabilities for small-scale human keypoints, and the SE attention module is incorporated to improve the model’s robustness under complex lighting conditions. In addition, the loss function is replaced with focal loss to tackle the class imbalance problem, thus forming the YOLOv8n-PSF-Pose keypoint detection network. Subsequently, based on the coordinates of 12 human keypoints extracted by this network, a multi-dimensional feature vector is constructed, which takes joint angles as the core and integrates the relative distances between keypoints and the number of valid keypoints. Finally, a BP neural network is adopted to classify the constructed feature vectors, enabling the accurate recognition of six typical distracted driving behaviors (normal driving, drinking or eating, making phone calls, using mobile phones, operating vehicle infotainment systems, and turning around to fetch items). The experimental results show that the improved YOLOv8n-PSF-Pose model achieves an mAP50 of 93.8% in keypoint detection, which is 6.7 percentage points higher than the original model; the BP classification model based on multi-feature fusion achieves an F1-score of 97.7% in the behavior recognition task, which is significantly better than traditional classifiers such as SVM and random forest, and the image processing speed on the NVIDIA RTX 3090TI reaches a high throughput of 45 FPS. This proves that the proposed method achieves an excellent balance between accuracy and speed. This study provides an effective solution for the real-time and accurate recognition of distracted driving behaviors. Full article

Cognitive or visual distraction caused by drivers using mobile phones, operating the central console, or conversing with passengers while driving is a significant contributing factor to road traffic accidents. Aiming to solve the problem that existing driving behavior monitoring systems exhibit insufficient recognition accuracy and low real-time detection performance in complex driving environments, this study proposes a dual-flow driver distraction detection model based on Sobel edge detection (DFSED-Model). The model is designed with a collaborative learning framework: the first flow adopts a lightweight pre-trained backbone network to achieve efficient semantic feature extraction. The second flow utilizes Sobel edge detection to extract the driver’s driving contours and enhances the model’s spatial sensitivity to driving movements and hand movements. Through the feature learning process of the first-flow-guided auxiliary branch, collaborative optimization of knowledge transfer and attention focusing is realized, thereby improving the model’s convergence speed and discriminative performance. The proposed model is evaluated on three widely used public datasets: the State Farm Distracted Driver Detection (SFD) dataset, the 100-Driver dataset, and the American University in Cairo Distracted Driver Dataset (AUCDD-V1). Under the premise of maintaining low computational overhead, the accuracy of the DFSED-Model reaches 99.87%, 99.86%, and 95.71%, respectively, which is significantly superior to that of many mainstream models. The results demonstrate that the proposed method achieves a favorable balance between accuracy, parameter count, and efficiency, and possesses strong practical value and deployment potential. Full article

Background: Peripheral venous cannulation is one of the most common clinical procedures, yet it often causes significant pain, anxiety, and discomfort for patients. While pharmacological methods exist, non-pharmacological interventions offer a low-cost, low-risk alternative that eliminates waiting times for anesthetic onset. The aim of this review is to synthesize the various nonpharmacological interventions for procedural pain reduction during PIVC in adults, covering interventions ranging from psychological distraction to advanced procedural support technologies. Methods: A systematic review was conducted following PRISMA 2020 guidelines and the Joanna Briggs Institute (JBI) framework. Databases including PubMed, CINAHL, Web of Science, and Scopus were searched for studies published between 2015 and 2025. Inclusion criteria focused on randomized controlled trials (RCTs) and quasi-experimental studies involving adult patients undergoing PIVC. Results: Thirty studies (29 randomized controlled trials and one experimental study) were included in the final analysis. The interventions were categorized into three primary groups: distraction techniques, physical methods, and behavioral techniques. The application of virtual reality (VR), optical illusion cards, and music therapy significantly reduced pain scores and enhanced patient satisfaction. Similarly, physical methods, such as thermomechanical stimulation (e.g., the Buzzy^® device), local heat application, and vibration, were found to be effective in lowering pain intensity compared to standard care. Behavioral techniques, including the “cough trick,” diaphragmatic breathing, and the Valsalva maneuver, consistently demonstrated efficacy in reducing both procedural pain and anxiety. Notably, while most interventions successfully reduced pain, certain methods—such as near-infrared (NIR) vein visualization—improved procedural success rates without significantly altering the subjective perception of pain. Conclusions: Findings from this review suggest that non-pharmacological interventions may serve as effective, safe, and feasible adjuncts for pain management during peripheral venous cannulation. Techniques such as the cough trick and vibration-based devices are particularly recommended due to their ease of integration into routine nursing practice, potentially improving patient comfort and clinical outcomes. Full article

This study identifies and explains road safety behavior patterns in Colombia using explainable artificial intelligence (XAI). Based on 9232 records and 38 variables from the Territorial Survey of Road Safety Behavior, the CRISP-DM methodology was applied, including data cleaning, normalization, encoding, and feature selection. XGBoost, Random Forest, Bagging, and AdaBoost models were evaluated, incorporating three domain-specific indices: Distraction Index (DI), Risky Road Interaction Index (RRI), and Normative Compliance Index (NCI). AdaBoost achieved the best overall balance (Precision = 0.78; Recall = 0.75; F1-score = 0.77), simultaneously reducing false positives and false negatives. SHAP analysis revealed that environmental and infrastructure factors (lighting, traffic signals, intersections, congestion, perceived crime) explain more variance than self-reported behaviors (mobile phone use, alcohol consumption, speeding). The complementary indices indicated above-average distraction levels, high exposure to risky interactions, and low compliance in specific segments. These findings enable the prioritization of targeted interventions (improvements in lighting and crossings, focused enforcement, and educational campaigns) and support operation with thresholds adjusted to error costs, providing traceable decision support for public road safety policies. Overall, the proposed approach integrates prediction and explainability to enable actionable decisions and continuous monitoring aimed at reducing traffic accidents. Full article

Background/Objectives: Dental anxiety represents a significant barrier to oral care in children with neurodevelopmental disorders (NDDs), whose sensory sensitivities and behavioral challenges often complicate clinical management and limit access to treatment. Virtual reality (VR) has emerged as a supportive tool to improve the feasibility of dental procedures in this vulnerable population. This study aims to evaluate whether a VR-based distraction approach could facilitate the completion of dental treatment in children with mild intellectual disability (ID). Methods: A prospective comparative observational study was conducted between February and September 2025 involving 56 children aged 11–15 years with mild ID and moderate dental anxiety (Corah Dental Anxiety Scale, DAS: 9–12). Participants were allocated to two groups of distraction approaches—VR distraction (n = 28) using the Oculus Quest 3^® headset or a monitor-based cartoon (n = 28)—according to device availability and to maintain balanced group sizes. The primary outcome was treatment success, defined as completion of the restorative dental procedure under local anesthesia within 50 min. Results: Treatment success was achieved in 78.6% of the VR group versus 46.4% of the monitor group (p = 0.026). The odds of successful treatment were more than four times higher with VR compared to monitor distraction (OR 4.12; 95% CI: 1.16–16.47), with a risk ratio of 2.50 (95% CI: 1.14–5.50). Stratified analysis suggested a stronger effect in females (OR 12.25; 95% CI: 1.27–118.36) than in males (OR 2.56; 95% CI: 0.53–12.43). Conclusions: VR-based distraction significantly improved dental treatment success in children with mild ID compared with conventional distraction. Although gender differences were observed, they should be interpreted with caution due to the small sample size. This work lays the foundation for developing both short- and long-term protocols to facilitate dental treatment management and cooperation in patients with NDDs. Full article

This study evaluates how different alert conditions influence driver attention transitions under conditions of visual distraction using sequence analysis. Employing a within-subject experimental design, 13 participants underwent trials in a driving simulator, experiencing three distinct alert conditions: face-tracking auditory alerts, steering wheel auditory torque alerts, and a control scenario without alerts. An eye-tracking system was used to capture drivers’ gaze durations and sequences across three key areas of interest: road, dashboard, and tablet-based infotainment system. Analysis involved computation of transition probabilities, Markov chain modeling for long-term attentional distributions, and entropy analyses to quantify the randomness of gaze transitions. Results showed that face-tracking alerts significantly increased the likelihood of gaze redirection to the road compared to the other conditions, enhancing both immediate and sustained attention. Steering wheel torque alerts demonstrated minimal effectiveness, sometimes performing worse than the no-alert condition due to their passive nature, allowing drivers to bypass attention redirection. Steady-state analyses confirmed that face alerts notably improved sustained driver focus on the road by approximately 3.6%, reinforcing their utility for prolonged attentional control. Entropy analyses further revealed that face alerts provided an optimal balance between structured attention shifts and behavioral flexibility, enhancing attentional predictability. Findings are consistent with previous literature, emphasizing the superior effectiveness of active, gaze-based interventions over passive mechanisms. This research underscores the importance of designing proactive alert systems in vehicle safety technology to effectively mitigate visual distraction-related risks. Full article

Temporal preparation has been consistently shown to be driven by regular rhythms, which are commonly considered to automatically attract attentional resources to on-beat moments, facilitating behavioral performance relative to off-beat moments in both younger and older adults. However, when targets occur more often at off-beat moments such that the rhythm becomes task-disadvantageous, it remains unclear whether older adults can adjust preparatory resources away from on-beat moments and toward the high-probability time point. To address this issue, younger and older adults completed a temporal preparation task at fast (800 ms) and slow (2000 ms) tempos under three conditions: attend-on-beat (rhythmic sequence; 80% on-beat targets), attend-off-beat (rhythmic sequence; 80% off-beat targets), and random (nonrhythmic sequence; 50% each). The results showed that, relative to the random condition, both age groups responded faster at the instructed high-probability time point in both rhythmic conditions, even when it fell off-beat, indicating that temporal probabilities can guide temporal preparation away from a task-disadvantageous on-beat moment toward the task-relevant time point. Moreover, this pattern was observed under both the fast and slow tempos. Together, these findings suggest that older adults preserve the ability to use temporal probabilities to reduce rhythmic distraction across sub-second and supra-second time scales. Full article

Student gaze behavior has been scarcely studied in real Latin American primary school classrooms. The objective of this study is to analyze the relationship between primary students’ eye behavior and cognitive development in urban and rural contexts. A quantitative method was employed, including 126 primary school students aged 6 to 8 years old, from urban and rural schools in Chile. Raven’s Colored Progressive Matrices (CPM) measured cognitive development, and students’ eye behavior was recorded during a real class using eye-tracking glasses. Eye behavior was analyzed in six areas of interest: (1) Own material (2) teacher, (3) teacher’s material, (4) peer, (5) peer’s material, and (6) non-interactional gaze. The results indicate that the CPM scale demonstrates adequate reliability (α = 0.89). In addition, no significant differences, nor relationship between eye behavior and cognitive development, were found by sex; however, significant differences were found by environment (urban versus rural). The regression analysis is significant (F(7, 102) = 6.173, p < 0.001) and suggests that gazing at the teacher’s material and one’s own material are negative predictors of non-interactional gaze or students’ disconnection from the class. In conclusion, distraction in the classroom is influenced by learning-related contextual variables rather than sex or cognitive development. Full article

Background/Objectives: Behavior management is a major challenge in pediatric dentistry, particularly during the first dental visit, when anxiety, fear, and negative expectations can compromise cooperation and clinical outcomes. While evidence-based behavior guidance techniques are well established, their effectiveness depends on early identification of behavioral risk and individualized planning. This study aimed to develop and clinically evaluate a parent-completed digital pre-visit tool to support individualized behavior management and targeted use of digital distraction in pediatric dentistry. Methods: A web-based application was developed using HTML, CSS, and JavaScript. It was applied to a prospective observational cohort of 90 pediatric patients aged 4–8 years (mean 6.1 ± 1.2), including 48 girls and 42 boys. Parents completed a pre-visit questionnaire covering four domains: child’s age, previous dental experiences, reactions to unfamiliar situations, and individual interests, including stimuli to avoid. Based on predefined decision rules, the tool generated recommended clinical approaches, including behavior guidance techniques, digital distraction, and inhalation sedation. Results: Over 90% of children were successfully managed during their first visit. Children in low- and moderate-risk groups had significantly higher odds of treatment success compared to high-risk children. Low-risk children almost universally completed treatment at the first visit, while a substantial portion of moderate-risk children were successfully managed without an adaptation visit. Digital distraction, particularly when tailored to individual interests, enhanced cooperation and tolerance of procedures. Conclusions: The digital pre-visit tool enables early identification of behavioral risk and supports targeted application of digital distraction and sedation. This approach can improve child cooperation, reduce anxiety, optimize clinical efficiency, and contribute to positive early dental experiences. Full article

Background: Dental anxiety remains a prevalent and persistent challenge in pediatric dentistry, significantly affecting children’s cooperation, treatment outcomes, and long-term oral health behaviors. Despite advances in minimally invasive care, anxiety continues to act as a barrier to effective clinical management. This narrative review aims to synthesize current evidence on validated assessment tools for pediatric dental anxiety and to examine contemporary non-pharmacological management strategies applicable in routine clinical practice. Methods: A structured literature search was conducted in major electronic databases to identify relevant studies, systematic reviews, and clinical guidelines addressing dental anxiety assessment and behavioral management in children. Particular emphasis was placed on validated anxiety scales, communication strategies, environmental adaptations, and emerging digital interventions such as immersive distraction technologies. Results: Multiple validated instruments are available to assess pediatric dental anxiety; however, their applicability varies by age, cognitive development, and clinical context. Non-pharmacological approaches including tell–show–do, modeling, parental guidance, audiovisual distraction, and virtual reality-based techniques demonstrate consistent effectiveness in reducing anxiety and improving behavioral cooperation. Recent trends emphasize multimodal, patient-centered strategies integrating communication, environmental modification, and digital tools. Conclusions: Structured anxiety assessment combined with contemporary multimodal management strategies can enhance clinical efficiency, improve child cooperation, and promote positive dental experiences. The integration of emerging digital technologies represents a promising advancement in pediatric anxiety management and supports a more individualized approach to care. Furthermore, a structured multimodal clinical framework is proposed to facilitate chairside decision-making and practical implementation. Full article

This study examined the effects of environmental conditions, behavioral history, management practices, and personality traits on the operational performance of search and rescue (SAR) dogs and dogs admitted to SAR certification testing. Thirty-two handlers completed a questionnaire collecting demographic data, as well as information on their dogs’ behavioral history, management practices, and personality descriptors. Each dog–handler unit also undertook a search trial consisting of locating a hidden person in a wooded area, which was evaluated both by professional instructors and the handlers through ratings of critical behavioral indicators. Objective measurements were obtained through a weather station and GPS devices. Handlers described their dogs mainly in terms of work-relevant traits, such as socio-cognitive engagement, assertiveness, and arousal. The performance evaluation form was practical and efficient, though the Distraction parameter may require refinement, and handler ratings suggested a self-reporting bias. Temperature and wind speed were negatively associated with performance, whereas higher humidity was positively associated with it. Performance was also associated with litter size, age at adoption, dog experience, and management-related factors. Finally, speed, ground coverage, and a canine profile characterized by high arousal and reactivity were strong determinants of good search performance (|ρ| ≥ 0.3; p < 0.05). Although these findings require confirmation in larger samples, search performance appears to be a multifactorial construct shaped by the interplay of extrinsic and intrinsic factors. Defining the contribution of each factor could help optimize performance and dogs’ welfare. Full article

Understanding the net outcomes of ecological interactions by examining the costs and benefits of organism associations is central to ecology. The mutualistic relationship between ants and plants mediated by extrafloral nectaries (EFNs) has long been viewed as protective, with ants defending plants from herbivores in exchange for nectar. However, alternative hypotheses, like the ant-distraction and flower-distraction, highlight the multifunctionality of EFNs. The flower-distraction hypothesis proposes that EFNs evolved to divert ants from flowers, reducing ant impact on pollination. Recent studies reveal that EFN interactions with ants are highly context-dependent, shaped by factors such as EFN location and ant behavior. Although EFNs often occur on vegetative tissues, they are sometimes located near flowers, raising the possibility that they serve both protective and distracting roles. This duality challenges the notion that EFNs can be categorized exclusively by location or function. Instead, their ecological roles likely shift in space and time, depending on plant growth form, pollination system, and interacting species. We propose moving beyond a dichotomous framework toward a nuanced perspective that embraces a potential continuum of functionalities. Considering multiple ecological and evolutionary factors will enhance understanding of EFN evolution, plant–animal interactions, and ecosystem dynamics. Full article

Background/Objectives: Adolescence is a critical developmental period during which peer attitudes and school experiences play an important role in social inclusion and academic adjustment. Although attention-deficit/hyperactivity disorder (ADHD) is common in secondary school populations, adolescents’ own knowledge and attitudes toward ADHD remain underexplored, particularly in non-Anglophone contexts. This study aimed to assess knowledge and attitudes toward ADHD among Greek secondary school students, focusing on awareness of the disorder, perceptions of ADHD-related classroom behaviors, and views on educational support and intervention. Methods: A cross-sectional survey was conducted among 154 adolescents aged 12–18 years attending Gymnasium (Grades 7–9) and Lyceum (Grades 10–12) in Greece. Data were collected using an anonymous online questionnaire assessing prior awareness of ADHD, perceptions of classroom behaviors associated with ADHD, attitudes toward inclusion and teacher support, and views on educational and therapeutic interventions. Adolescents with and without a self-reported ADHD diagnosis completed different questionnaire sections according to study design. Descriptive statistics and chi-square tests were used for data analysis. Results: Approximately two thirds of participants (66.9%) reported prior awareness of ADHD. Among typically developing adolescents (n = 134), 83.0% recognized distractibility due to external noise, 70.4% noted off-topic interruptions, and 60.0% reported peers getting up without permission. While 75.5% believed students with ADHD can participate in the classroom, 65.9% also reported academic challenges such as incomplete homework or lower performance. Overall, 79.2% of participants stated that school success depends on teacher and specialist support; however, among adolescents with ADHD (n = 20), only 60.0% endorsed this, with 40.0% emphasizing personal effort. Speech-language therapy was viewed as helpful by 55.6% of typically developing adolescents, though 76.9% of adolescents with ADHD reported not receiving such services. Conclusions: Greek adolescents demonstrate moderate awareness of ADHD and generally supportive attitudes toward peers with ADHD, alongside some uncertainty regarding available educational supports. Schools may represent an important context for improving adolescents’ mental health literacy and understanding of ADHD-related support options. Full article

Car accidents remain a leading cause of death worldwide, with drowsiness and distraction accounting for roughly 25% of fatal crashes in Ecuador. This study presents a real-time driver monitoring system that uses computer vision and deep learning to detect fatigue, distraction, and emotions from facial expressions. It combines a MobileNetV2-based CNN trained on RAF-DB for emotion recognition and MediaPipe’s 468 facial landmarks to compute the EAR (Eye Aspect Ratio), the MAR (Mouth Aspect Ratio), the gaze, and the head pose. Tests with 27 participants in both real and simulated driving environments showed strong results. There was a 100% accuracy in detecting distraction, 85.19% for yawning, and 88.89% for eye closure. The system also effectively recognized happiness (100%) and anger/disgust (96.3%). However, it struggled with sadness and failed to detect fear, likely due to the subtlety of real-world expressions and limitations in the training dataset. Despite these challenges, the results highlight the importance of integrating emotional awareness into driver monitoring systems, which helps reduce false alarms and improve response accuracy. This work supports the development of lightweight, non-invasive technologies that enhance driving safety through intelligent behavior analysis. Full article