Search Results (2,361)

Regular physical activity (PA) is essential for healthy aging. For older adults residing in urban areas, access to urban green space (UGS) can help increase PA levels. This systematic review examined the association between availability, accessibility, and attractiveness of the UGS on PA among older adults. PubMed, CINAHL, and Web of Science were searched for articles published 2016–2024 that used quantitative methods to explore associations between the qualities of UGS and measures of PA in this demographic. Findings from nine studies from Europe, China, Hong Kong, and Australia were synthesized by availability, accessibility, and attractiveness domains. For availability, the presence and size of UGS were positively associated with older adults’ PA in several studies, whereas UGS proximity was inconsistently associated with PA. For accessibility, infrastructure-related features such as trail length were positively associated with PA, but findings for park features and safety were mixed. Results were also inconsistent for attractiveness; some land-cover and amenity features showed positive associations, while others showed no clear relationship with PA. In addition to variability in associations, there was great heterogeneity across studies in age inclusion criteria (e.g., 45+ vs. 65+), participant inclusion criteria, setting, operationalization of UGS quality, PA measures, and study rigor, reducing the ability to draw conclusions about the association between UGS qualities and PA. Although findings can begin to inform urban planners, public health professionals, and policymakers in designing UGS to promote PA in older adults, the field would benefit from more consistent definitions and measures of UGS qualities and PA. Full article

Background/Objectives: Electronic prescribing (E-prescribing) systems provide several advantages and are a key component of digital health. In Taiwan, the implementation of e-prescribing systems began in 2025. This study aimed to examine health care professionals’ perceptions, satisfaction, trust, and intention to use e-prescribing during its early implementation phase. Methods: The research subjects included health care professionals in hospitals and pharmacies in Hualien County, Eastern Taiwan. A total of 107 valid responses were collected and analyzed using structural equation modeling (SEM). Results: The access to medicines, digital health service quality, and digital trust significantly positively affected user satisfaction. Both access to medicines and digital trust significantly influenced intention to use. Institutional trust significantly affected digital trust. Additionally, user satisfaction significantly influenced intention to use. Institutional trust indirectly influenced both user satisfaction and intention to use through the mediation of digital trust. Access to medicines, digital health service quality, and digital trust each indirectly influenced intention to use through user satisfaction. Conclusions: This study advances the literature on adoption by presenting a novel, technical and social–psychological integration framework that contextualizes e-prescribing within regional health care networks. By validating the key mediating roles of user satisfaction and digital trust, these findings empower health care authorities to mitigate frontline resistance and optimize the implementation of digital health policies. Full article

This study utilized an experimental single-case design to evaluate a professional development package to support educators’ implementation of an augmentative and alternative communication (AAC)-supported, play-based naturalistic developmental behavioral intervention (NDBI), which we called naturalistic AAC intervention (N-AAC). Participants were three minimally speaking students with autism (4–8 years of age), each paired with one of their educators (i.e., speech-language pathologist, pre-service special education teacher, early childhood assistant teacher). The primary aim was to examine the effects of professional development on educator implementation of N-AAC. We also descriptively examined changes in students’ communication and language use during educator–child play and generalization to peer interactions. The findings showed that professional development was effective at teaching educators to implement N-AAC with fidelity. Student communication outcomes showed descriptive improvements following educator training and coaching and N-AAC implementation. However, as expected, gains did not generalize to peer interactions. The findings suggest that professional development improves educator implementation of AAC-supported NDBI strategies during play and that their increased implementation fidelity is accompanied by promising descriptive changes in student communication. Future research is needed to further examine the impact on student communication, promote generalization to peer interactions, and evaluate the potential for larger-scale implementation. Full article

In a policy context characterized by both supportive initiatives (e.g., school-based mental health services) and enforcement-oriented approaches that may contribute to student stress, schools are increasingly tasked with addressing trauma-related needs. A rapid umbrella review was conducted on existing systematic reviews of trauma-informed school practices. The umbrella review synthesized findings from multiple systematic reviews to provide a comprehensive assessment of the evidence, identify areas of consensus or inconsistency, and explain discrepancies across studies. Fifteen reviews met the inclusion criteria of a systematic or scoping review of mental health and academic outcomes associated with trauma-informed school practices. Nine of these included studies with newcomer students. Overall, most reviews reported positive associations between trauma-informed practices and student outcomes, including reductions in trauma symptoms and behavioral problems, as well as improvements in resilience, engagement, and academic performance. Evidence was strongest for targeted clinical interventions delivered by trained mental health professionals, while classroom and schoolwide approaches showed promising but less conclusive results due to methodological limitations. Findings suggest that while trauma-informed approaches are beneficial, their implementation remains fragmented and often incremental. Greater attention to cultural, linguistic, and relational dimensions of displacement, along with improved cross-system coordination and rigorous evaluation, is needed. Trauma-informed school practices represent a promising but underdeveloped strategy for supporting newcomer students within complex and evolving policy environments. Full article

Hospitals are complex institutions where clinical, social, and cultural practices intersect. In Ghanaian hospitals, interactions are shaped by multilingual communication, professional hierarchies, cultural norms, and community expectations. Drawing on five months of ethnographic fieldwork, this study examines coordination of care in a Ghanaian hospital to understand how boundaries (i.e., professional hierarchies, communication barriers, community accountabilities), ruling relations, and power dynamics influence care. Institutional ethnography (IE) was implemented. Participants were purposively sampled, and data were collected through participant observation, documentary materials, and interviews with nurses (n = 11), patients (n = 21), and caregivers (n = 11). Thematic and IE analyses trace how boundaries and professional hierarchies, informal economies, and multilayered surveillance (“medical,” “social,” and “community” gazes) organize care work through institutional texts and how nurses, patients, and caregivers access or deliver care. The findings showed that boundaries at the Yendi Hospital were simultaneously rigid and negotiable, with informal economic activities compensating for institutional resource constraints. Communication work was central to navigating linguistic and cultural diversity, while surveillance from within and beyond the hospital-shaped behaviour and accountability. These everyday practices revealed how institutional texts and societal forces co-produce the conditions of care, with implications for teamwork, patient–provider relationships, and hospital governance. Full article

Background/Objectives: Bedside manners are an important part of patient-centered physical therapy care, yet little is known about how Saudi physical therapists understand and apply them in practice. This study examined therapists’ perceptions of bedside manners and ethics, and explored differences related to gender and work setting. Methods: A cross-sectional mixed-methods study was conducted among 147 licensed Saudi physical therapists. Quantitative data were collected using a 28-item questionnaire, and qualitative data were gathered through semi-structured interviews with 22 participants. Survey responses were summarized using frequencies and percentages, and differences by gender and work setting were reported. Interview data were analyzed using Braun and Clarke’s thematic analysis. Results: Most participants were female (66.7%) and aged 20–30 years (70.7%). Overall, therapists reported very high agreement with bedside-manner principles across most items. Descriptive patterns by gender and work setting in some perceptions (e.g., patient privacy, therapist presence, and attention to minor cases) were noted. Qualitative analysis identified seven themes: building trust, perceived positive contribution to care, body language, differing views on empathy, therapist presence, patient equity, and seeking help from colleagues. Conclusions: Saudi physical therapists strongly supported core bedside manner behaviors, especially communication, privacy, reassurance, and fair treatment of patients. These findings may inform efforts to incorporate bedside manners into physical therapy education and professional development in support of ethical, patient-centered practice. Full article

Machine-readable financial reporting changes how corporate disclosures become visible, verified, and answerable. Inline eXtensible Business Reporting Language (Inline XBRL) combines a human-readable report with embedded structured data, while artificial intelligence expands automated extraction and screening. The study develops Machine-Readable Accountability as a bounded socio-technical construct organised around dynamic visibility, distributed judgement, and responsibility displacement. A qualitative documentary analysis examines four primary archives: regulatory rules, official filing-evidence records, verification materials, and algorithmic-governance documents. Peer-reviewed studies serve as contextual framing and external corroboration. They do not form primary documentary observations. The corpus covers the mature United States Securities and Exchange Commission regime and the European Single Electronic Format from 2020 to July 2026, with earlier sources retained for historical grounding. A seven-family codebook guides analysis of classification, visibility, validation, judgement, audit, artificial intelligence, and accountability. Results arise from coded rules, official filing observations, assurance requirements, and cross-archive role mapping. Structured reporting reduces extraction costs, supports comparison, and permits automated quality checks. It also places institutional weight on taxonomy fit, extension design, validation logic, and software-mediated review. Documentary evidence supports the relocation of judgement across preparers, taxonomy designers, software vendors, auditors, and regulators. Evidence for deliberate narrative optimisation aimed at artificial intelligence remains indirect, so algorithmic answerability remains a bounded theoretical proposition. The framework links market-efficiency research with studies of quantification, professional judgement, and digital governance, and specifies controls for data lineage, extension approval, model documentation, human review, and responsibility assignment. Full article

1-in-5 people are prescribed an antidepressant for a common mental disorder (CMD), such as depression or anxiety. Most people do not require lifelong treatment, however more than half continue antidepressants for ≥2 years despite no ongoing symptoms. Antidepressant deprescribing is not routine practice in primary care and healthcare professionals report barriers including concerns about withdrawal effects, perceived patient attachment to antidepressants and limited availability of withdrawal-informed support. Drawing on realist principles and behavioural science, this review will identify behavioural mechanisms and contexts from academic and grey literature to formulate programme theories describing how to facilitate primary care healthcare professionals to deprescribe antidepressants. The review is guided by the Behavioural science Approach to Realist Reviews/Evaluations (BARR/E) and will follow five steps: (1) define the review scope, (2) develop initial programme theories, (3) evidence search, (4) selection and appraisal and (5) data extraction and synthesis. Peer-reviewed literature will be identified through MEDLINE, Embase, PsycINFO and CINAHL, supplemented by grey literature identified through expert consultation, database and citation searches. The evidence will be assessed for relevance, rigour and richness, and data extracted and synthesised to develop context–mechanism–outcome configurations. Findings will be reported in accordance with RAMESES quality and publication standards. Full article

The rapid integration of artificial intelligence (AI) into learning environments has driven the development of personalized learning models, yet systematic cross-sector comparisons remain limited. This systematic literature review addresses this gap by comparing AI-based personalized learning models in knowledge-intensive organizations and educational organizations, using the Nine-Cell Model as an integrative analytical framework. Following PRISMA 2020 guidelines, 43 peer-reviewed studies (2017–2026) were analyzed. The findings indicate that while both sectors rely on shared AI infrastructures (e.g., adaptive algorithms), they diverge substantially: organizational models prioritize competency development and training transfer aligned with strategic goals, whereas educational models emphasize mastery of disciplinary knowledge through structured assessments. Furthermore, managerial involvement is a key differentiator, with managers in organizations acting as active learning architects, while educational leaders primarily enable self-directed learning conditions. Across both sectors, alignment with the Nine-Cell Model is strong in knowledge acquisition but critically weak in cultivating professional values and ethics. This review advances the field by foregrounding the underexamined managerial role and demonstrating the need to shift from defensive to generative ethics in AI-based professional development. Full article

Conversion Rate Optimisation (CRO) has emerged as a central strategic priority in e-commerce management, yet its positioning within the broader interactive marketing paradigm remains theoretically underdeveloped. Interactive marketing, defined as a multi-directional value creation process through active customer connection, engagement, participation, and interaction, provides a critical lens through which the effectiveness and efficiency of digital marketing tactics can be understood, as each tactic mediates a distinct form of consumer brand interactivity. The academic literature, however, remains fragmented; no unified comparative framework exists that simultaneously assesses both effectiveness and efficiency of digital marketing tactics within an interactive marketing context. Drawing on the classical effectiveness and efficiency framework and interactive marketing theory, this study addresses this gap through a cross-sectional quantitative survey of 302 digital marketing professionals, evaluating a broad range of tactics across both dimensions using a validated psychometric instrument. The findings reveal that Email Marketing consistently dominates across effectiveness and efficiency assessments, reflecting its permission-based structure and its capacity to sustain ongoing consumer–brand dialogue. Search Engine Marketing exhibits the most pronounced divergence between effectiveness and efficiency, consistent with auction-driven cost dynamics that constrain interactive value creation. Attribution modelling difficulty emerges as the primary structural barrier to CRO implementation, revealing a systemic challenge to evidence-based resource allocation in multi-channel interactive environments. An exploratory factor analysis identifies a three-factor taxonomy of tactic effectiveness, distinguishing Paid Conversion tactics, data-driven optimisation tools, and organic or relationship-based channels, each representing a qualitatively distinct mode of consumer–brand interaction. This study advances interactive marketing theory by providing the first empirically validated effectiveness–efficiency framework for e-commerce CRO, and offers actionable guidance for cross-channel budget allocation decisions in interactive digital environments. Full article

Digital technologies are an integral part of young children’s everyday lives, yet their pedagogical integration in early childhood education and care (ECEC) remains limited and highly variable across ECEC centers. Drawing on the extended Structure–Process (SP-E) framework, this study examines how structural characteristics of ECEC centers, particularly the range of available ICT equipment, and educators’ ICT-related professional competencies, especially beliefs and motivational orientations, predict ICT implementation in pedagogical practice. Data from the DIGIPaed project comprised 266 educators across 97 German ECEC centers. Hierarchical regression models with cluster-adjusted standard errors were estimated for two outcomes: ICT use with children and pedagogical ICT activities. Results revealed distinct predictor patterns for the two outcomes. The range of available ICT equipment was positively associated with pedagogical ICT activities but not with ICT use with children. ICT-related self-efficacy was the only professional competence variable to predict both outcomes, explaining additional variance beyond structural conditions and beliefs. Centers with higher proportions of children with a migration background showed lower levels of ICT use with children. These findings suggest that ICT implementation in ECEC is not a unitary construct and that different dimensions of implementation may depend on different conditions. Self-efficacy emerged as a particularly promising target for professional development aimed at supporting meaningful ICT integration in ECEC centers. Full article

The COVID-19 pandemic has brought significant changes to the way people live and work, prompting organizations to reconsider how they accommodate their employees. These adjustments may vary depending on the organization’s conditions. This study aimed to identify variables that predict work performance in a sample of professionally active adults. A cross-sectional, quantitative, and correlational study was conducted, with the participation of 1000 Portuguese adults (M_age = 40.8; SD = 10.6; 68.4% female) who were professionally active. The study used a Sociodemographic and Professional Questionnaire to characterize the sample. Data from the Work–Life Balance (WLB) scale, Organizational Culture (O.C.) scale, Organizational Life Cycle scale, and Health and Work Questionnaire were analyzed. The model demonstrated an acceptable fit (χ²/df = 4.14; SRMR = 0.07; CFI = 0.82; TLI = 0.81; GFI = 0.80; RMSEA = 0.05). An O.C. characterized by trust and participation (β = 0.17; p < 0.001) was negatively associated with higher productivity. Increased non-work satisfaction was positively associated with a better perception of WLB (β = 0.44; p < 0.001). These findings suggest that fostering trust and participation in O.C. and supporting employees’ non-work satisfaction are concrete strategies for improving work performance (e.g., productivity, job satisfaction), ultimately improving the overall organizational well-being. Full article

Policy makers and educators have increasingly recognized the importance of K-12 teacher professional development (PD) in computer science (CS) to foster student growth and academic achievement. In this exploratory mixed-methods study (focus groups $n=23$, survey $n=661$), we addressed two research questions: (1) What features and data do teachers think will enhance the usefulness of an application designed to keep track of their PD-related data?and (2) Which demographic factors are most predictive of teacher ratings? Based on a survey, teachers identified several features and data-related elements that would make the platform useful and usable and add value to their experiences. Notably, the most highly requested data-related items focused on the content and professional credits associated with past CS PD that they have taken (i.e., subjects/grade levels targeted by PD, training hours/continuing education units earned). The most highly rated feature was a catalog of searchable upcoming PD offerings. Further, we noted statistically significant differences in teachers’ ratings across various demographic subgroups (i.e., race/ethnicity, teaching experience, disability, gender, and locale) for all potential platform features and data items. This indicates the importance of considering the perspectives of various subgroups when developing a platform that meets the needs of all teachers. Full article

The growing deployment of European Data Spaces requires more than advanced technical infrastructures; it also demands specialised human competencies to ensure interoperability, governance, and trust. This paper redefines organisational readiness as a key indicator of the transition from experimental deployments to large-scale, governed data exchange. Although technical solutions provide the necessary foundation, training is essential to ensure that the digital transition is supported by professionals capable of operating these ecosystems effectively. To address the research question, “Which competencies are required to enable data reuse within Data Spaces?”, with a specific focus on spatial data and Urban Digital Twins, this study proposes a hybrid methodology. This approach combines a top-down analysis of reference architectures (e.g., EIF and DSSC Blueprint) with a bottom-up diagnosis based on an expert-based qualitative survey. Preliminary results suggest that, although 58% of organisations identify technical integration between BIM and GIS as the main obstacle, 47% identify the shortage of specialised skills as the primary bottleneck preventing operational maturity. The analysis reveals a Maturity Plateau that hinders the transition from technical connectivity (Data Space Maturity Model Level 2) to full operational maturity (Level 3). To overcome this barrier, the study presents a convergence matrix based on the DIS4SME initiative, mapping knowledge gaps to a competency roadmap. This framework identifies urgent training needs in the semantic and legal domains, and provides an operational guide for supporting organisational maturity across Data Spaces and strengthening professional expertise. Full article

This study aims to assess the impact of an 8-week multidisciplinary intervention on the physical and psychosocial health in active women over 55 years old, paying attention to the need of supervision. Eighty-one women were assessed for pelvic floor strength (using PERFECT’s guidelines), body composition and satisfaction with life, and later blindly assigned to a supervised or reduced-supervision pelvic floor exercise program (i.e., therapeutic exercises guided by a professional, twice a week, or identical exercises performed at home). All of them received six additional educational sessions together, interspersed along the program, for nutritional and psychological counseling. Twenty-eight women of 36 [66.50 (4.68) years] in the supervised group, and another 20 of 34 [64.65 (5.12) years] (reduced-supervision) ended the intervention. Although both groups improved in all four dimensions of pelvic floor muscle strength, with endurance showing differences between-groups. Completion rate was lower in the reduced-supervision group (58.8% vs. 77.7%). Lack of motivation was their main reason to leave. No significant changes were found in body composition or life satisfaction. However, the results suggest that comparable pelvic floor strength benefits can be achieved with fewer resources when health awareness is emphasized. Ongoing supervision appears important to minimize dropout in these sensitive interventions. Multidisciplinary, movement-based programs show strong potential for public health promotion in older women. Pelvic floor training should be incorporated into preventive care for this population and supervised or follow-up formats seem essential to support adherence and long-term effectiveness. Full article