Search Results (841)

The emergence of generative artificial intelligence (GenAI) in higher education offers new opportunities for academic support while also raising complex ethical concerns. This study explores how university students ethically evaluate the use of GenAI in three academic contexts: improving essay writing, preparing for exams, and generating complete essays without personal input. Drawing on the Multidimensional Ethics Scale (MES), the research assesses five philosophical frameworks—moral equity, relativism, egoism, utilitarianism, and deontology—based on a survey conducted among undergraduate social sciences students in Spain. The findings reveal that students generally view GenAI use as ethically acceptable when used to improve or prepare content, but express stronger ethical concerns when authorship is replaced by automation. Gender and full-time employment status also influence ethical evaluations: women respond differently than men in utilitarian dimensions, while working students tend to adopt a more relativist stance and are more tolerant of full automation. These results highlight the importance of context, individual characteristics, and philosophical orientation in shaping ethical judgments about GenAI use in academia. Full article

This convergent mixed-methods study explores the lived experiences of Black women DEI leaders at predominantly white institutions within the context of an increasingly contentious national discourse surrounding diversity, equity, and inclusion (DEI) in higher education. Conducted prior to the 2024 election, a period marked by escalating resistance to DEI efforts, this research explores how America’s racial reckoning influenced institutional DEI initiatives and shaped the realities of those leading this work. Data were collected through a climate survey of 20 DEI administrators and semi-structured interviews with three senior-level Black women DEI leaders. The survey findings suggest that institutional commitments to DEI were largely reactive, emerging as crisis responses to national calls for racial justice. These efforts resulted in the short-term elevation of Black women into leadership roles, often without sustained structural support. The interview data revealed that Black women senior DEI leaders routinely encounter discrimination, marginalization, and the paradox of hypervisibility and invisibility within their roles. This study concludes with implications and suggestions for institutional policy and structural reform aimed at fostering more equitable and sustainable DEI leadership environments. Full article

Heart failure (HF) is a major global health challenge, characterized by high morbidity, mortality, and frequent hospital readmissions. Despite the advent of guideline-directed medical therapies (GDMTs), the burden of HF continues to grow, necessitating a shift toward comprehensive, multidisciplinary care models. Heart Failure Disease Management Programs (HF-DMPs) have emerged as structured frameworks that integrate evidence-based medical therapy, patient education, telemonitoring, and support for social determinants of health to optimize outcomes and reduce healthcare costs. This review outlines the key components of HF-DMPs, including patient identification and risk stratification, pharmacologic optimization, team-based care, transitional follow-up, remote monitoring, performance metrics, and social support systems. Incorporating tools such as artificial intelligence, pharmacist-led titration, and community health worker support, HF-DMPs represent a scalable approach to improving care delivery. The success of these programs depends on tailored interventions, interdisciplinary collaboration, and health equity-driven strategies. Full article

Digital competence refers to the integration of digital technology in teaching and learning, as outlined in the national curriculum of Estonia for upper secondary schools. This study presents original research findings on Estonian science teachers’ use of digital tools and materials, their digital competence, and the main benefits and challenges they face. The findings emphasize the need for continued professional development, accessible digital resources, and equitable digital infrastructure to maintain Estonia’s leadership in digital science education. A survey of 58 secondary school science teachers revealed that computers (desktops, laptops, and tablets) are the primary digital tools used. The article explores digital literacy advancements in secondary science education, research methodologies used to assess digital tool usage, and key findings from recent studies. However, challenges such as digital equity, technological barriers, and digital fatigue persist. Additionally, discrepancies were found in teachers’ responses regarding digital tool effectiveness, implementation strategies, and perceived barriers. While some teachers reported a successful integration and improved student outcomes, others highlighted difficulties in aligning digital resources with curriculum requirements and pedagogical approaches. Full article

Background: Family caregivers are a vital yet often under-recognized part of the healthcare system. They provide essential emotional, physical, and logistical support to individuals with illness, disability, or frailty, and their contributions improve continuity of care and reduce system strain. However, many healthcare and social service providers are not equipped to meaningfully engage caregivers as partners. In Alberta, stakeholders validated the Caregiver-Centered Care Competency Framework and identified the need for a three-tiered education model—Foundational, Advanced, and Champion—to help providers recognize, include, and support family caregivers across care settings. This paper focuses on the development and early evaluation of the Advanced Caregiver-Centered Care Education modules, designed to enhance the knowledge and skills of providers with more experience working with family caregivers. The modules emphasize how partnering with caregivers benefits not only the person receiving care but also improves provider effectiveness and supports better system outcomes. Methods: The modules were co-designed with a 154-member interdisciplinary team and grounded in the competency framework. Evaluation used the first three levels of the Kirkpatrick–Barr health workforce education model. We analyzed pre- and post-surveys from the first 50 learners in each module using paired t-tests and examined qualitative feedback and SMART goals through inductive content analysis. Results: Learners reported a high level of satisfaction with the education delivery and the knowledge and skill acquisition. Statistically significant improvements were observed in 53 of 54 pre-post items. SMART goals reflected intended practice changes across all six competency domains, indicating learners saw value in engaging caregivers as partners. Conclusions: The Advanced Caregiver-Centered Care education improved providers’ confidence, knowledge, and skills to work in partnership with family caregivers. Future research will explore whether these improvements translate into real-world practice changes and better caregiver experiences in care planning, communication, and navigation. Full article

Value-at-Risk (VaR) is a key metric widely applied in market risk assessment and regulatory compliance under the Basel III framework. This study compares two Monte Carlo-based VaR models using publicly available equity data: a return-based model calibrated to historical portfolio volatility, and a CAPM-style factor-based model that simulates risk via systematic factor exposures. The two models are applied to a technology-sector portfolio and evaluated under historical and rolling backtesting frameworks. Under the Basel III backtesting framework, both initially fall into the red zone, with 13 VaR violations. With rolling-window estimation, the return-based model shows modest improvement but remains in the red zone (11 exceptions), while the factor-based model reduces exceptions to eight, placing it into the yellow zone. These results demonstrate the advantages of incorporating factor structures for more stable exception behavior and improved regulatory performance. The proposed framework, fully transparent and reproducible, offers practical relevance for internal validation, educational use, and model benchmarking. Full article

Background: Artificial intelligence (AI) and machine learning (ML) have been reshaping maternal, fetal, neonatal, and reproductive healthcare by enhancing risk prediction, diagnostic accuracy, and operational efficiency across the perinatal continuum. However, no comprehensive synthesis has yet been published. Objective: To conduct a scoping review of reviews of AI/ML applications spanning reproductive, prenatal, postpartum, neonatal, and early child-development care. Methods: We searched PubMed, Embase, the Cochrane Library, Web of Science, and Scopus through April 2025. Two reviewers independently screened records, extracted data, and assessed methodological quality using AMSTAR 2 for systematic reviews, ROBIS for bias assessment, SANRA for narrative reviews, and JBI guidance for scoping reviews. Results: Thirty-nine reviews met our inclusion criteria. In preconception and fertility treatment, convolutional neural network-based platforms can identify viable embryos and key sperm parameters with over 90 percent accuracy, and machine-learning models can personalize follicle-stimulating hormone regimens to boost mature oocyte yield while reducing overall medication use. Digital sexual-health chatbots have enhanced patient education, pre-exposure prophylaxis adherence, and safer sexual behaviors, although data-privacy safeguards and bias mitigation remain priorities. During pregnancy, advanced deep-learning models can segment fetal anatomy on ultrasound images with more than 90 percent overlap compared to expert annotations and can detect anomalies with sensitivity exceeding 93 percent. Predictive biometric tools can estimate gestational age within one week with accuracy and fetal weight within approximately 190 g. In the postpartum period, AI-driven decision-support systems and conversational agents can facilitate early screening for depression and can guide follow-up care. Wearable sensors enable remote monitoring of maternal blood pressure and heart rate to support timely clinical intervention. Within neonatal care, the Heart Rate Observation (HeRO) system has reduced mortality among very low-birth-weight infants by roughly 20 percent, and additional AI models can predict neonatal sepsis, retinopathy of prematurity, and necrotizing enterocolitis with area-under-the-curve values above 0.80. From an operational standpoint, automated ultrasound workflows deliver biometric measurements at about 14 milliseconds per frame, and dynamic scheduling in IVF laboratories lowers staff workload and per-cycle costs. Home-monitoring platforms for pregnant women are associated with 7–11 percent reductions in maternal mortality and preeclampsia incidence. Despite these advances, most evidence derives from retrospective, single-center studies with limited external validation. Low-resource settings, especially in Sub-Saharan Africa, remain under-represented, and few AI solutions are fully embedded in electronic health records. Conclusions: AI holds transformative promise for perinatal care but will require prospective multicenter validation, equity-centered design, robust governance, transparent fairness audits, and seamless electronic health record integration to translate these innovations into routine practice and improve maternal and neonatal outcomes. Full article

This scoping review examines the integration of the Sustainable Development Goals (SDGs)—specifically SDG 4, which concerns quality education—into national curricula at various levels of education between 2020 and 2025. This qualitative study uses the scoping review method to synthesise international research, identifying thematic trends, methodological approaches, and implications for curriculum development. The analysis reveals a strong focus on higher education, with articles from Asia and Europe dominating the discourse, while perspectives from early childhood education and the Global South are under-represented. Most articles favour qualitative designs, engaging with the SDGs as curricular content, institutional transformation frameworks, or community-based education tools. Despite these promising approaches, significant gaps remain in addressing behavioural change and equity across educational systems. Therefore, the study calls for more inclusive, context-sensitive, and interdisciplinary strategies to support the transformative ambitions of the 2030 Agenda. Full article

African, Caribbean, and Black (ACB) communities face increased COVID-19 morbidity and mortality, coupled with significant barriers to vaccine acceptance and uptake. Addressing these challenges requires innovative, multifaceted strategies. Peer-led interventions, grounded in critical health literacy (CHL) and critical racial literacy (CRL), and integrating collaborative equity learning processes, can enhance community capacity, empowerment, and health outcomes, contributing to long-term health equity. This paper describes and presents the evaluative outcomes of a peer-led intervention aimed at enhancing COVID-19 vaccine confidence and acceptance. The Peer-Equity Navigator (PEN) intervention consisted of a specialized training curriculum grounded in CHL and CRL. Following training, PENs undertook a 5-month practicum in community or health settings, engaging in diverse outreach and educational activities to promote vaccine literacy in ACB communities. The evaluation utilized a modified Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) Framework, using quantitative and qualitative methods to collect data. Sources of data included tracking records with community feedback, and a PEN focus group, to assess program feasibility, outreach, and effectiveness. From 16 September 2022, to 28 January 2023, eight trained PENs conducted 56+ community events, reaching over 1500 community members. Both PENs and community members reported high engagement, endorsing peer-led, community-based approaches and increased vaccine literacy. The PEN approach proves feasible, acceptable, and effective in promoting positive health behaviors among ACB communities. This intervention has clear implications for health promotion practice, policy, and research in equity-deserving communities, including immigrants and refugees, who also face multiple and intersecting barriers to health information and care. Full article

Background/Objectives: The integration of AI chatbots in nursing education, particularly in simulation-based learning, is advancing rapidly. However, there is a lack of structured evaluation models, especially to assess AI-generated simulations. This article introduces the AI-Integrated Method for Simulation (AIMS) evaluation framework, a dual-phase evaluation framework adapted from the FAITA model, designed to evaluate both prompt design and chatbot performance in the context of nursing education. Methods: This simulation-based study explored the application of an AI chatbot in an emergency planning course. The AIMS framework was developed and applied, consisting of six prompt-level domains (Phase 1) and eight performance criteria (Phase 2). These domains were selected based on current best practices in instructional design, simulation fidelity, and emerging AI evaluation literature. To assess the chatbots educational utility, the study employed a scoring rubric for each phase and incorporated a structured feedback loop to refine both prompt design and chatbox interaction. To demonstrate the framework’s practical application, the researchers configured an AI tool referred to in this study as “Eval-Bot v1”, built using OpenAI’s GPT-4.0, to apply Phase 1 scoring criteria to a real simulation prompt. Insights from this analysis were then used to anticipate Phase 2 performance and identify areas for improvement. Participants (three individuals)—all experienced healthcare educators and advanced practice nurses with expertise in clinical decision-making and simulation-based teaching—reviewed the prompt and Eval-Bot’s score to triangulate findings. Results: Simulated evaluations revealed clear strengths in the prompt alignment with course objectives and its capacity to foster interactive learning. Participants noted that the AI chatbot supported engagement and maintained appropriate pacing, particularly in scenarios involving emergency planning decision-making. However, challenges emerged in areas related to personalization and inclusivity. While the chatbot responded consistently to general queries, it struggled to adapt tone, complexity and content to reflect diverse learner needs or cultural nuances. To support replication and refinement, a sample scoring rubric and simulation prompt template are provided. When evaluated using the Eval-Bot tool, moderate concerns were flagged regarding safety prompts and inclusive language, particularly in how the chatbot navigated sensitive decision points. These gaps were linked to predicted performance issues in Phase 2 domains such as dialog control, equity, and user reassurance. Based on these findings, revised prompt strategies were developed to improve contextual sensitivity, promote inclusivity, and strengthen ethical guidance within chatbot-led simulations. Conclusions: The AIMS evaluation framework provides a practical and replicable approach for evaluating the use of AI chatbots in simulation-based education. By offering structured criteria for both prompt design and chatbot performance, the model supports instructional designers, simulation specialists, and developers in identifying areas of strength and improvement. The findings underscore the importance of intentional design, safety monitoring, and inclusive language when integrating AI into nursing and health education. As AI tools become more embedded in learning environments, this framework offers a thoughtful starting point for ensuring they are applied ethically, effectively, and with learner diversity in mind. Full article

Securing thermal comfort while minimizing energy consumption in educational buildings is vital for achieving sustainable development goals. Drawing on the Environmental, Social, and Governance (ESG) framework, this systematic review synthesizes findings from 84 peer-reviewed studies published over the past decade, with a focus on how thermal comfort and energy use are assessed in educational contexts. The review identifies three primary research themes: climate resilience, multidimensional human-centric design, and energy decarbonization. However, it also reveals that existing studies have placed disproportionate emphasis on the environmental dimension, with insufficient exploration of issues related to social equity and governance structures. To address this gap, this study introduces an ESG-driven theoretical framework encompassing seven dimensions: thermal environment stability, multimodal thermal comfort assessment integration, sustainable energy use, heterogeneous thermal demand equality, passive–active design synergy, participatory thermal data governance, and educational thermal well-being inclusivity. By fostering interdisciplinary convergence and emphasizing inclusive stakeholder engagement, the proposed framework provides a resilient and adaptive foundation for enhancing indoor environmental quality in educational buildings while advancing equitable climate and energy strategies. Full article

Blended and virtual learning have become an integral part in international higher education, especially in the wake of the COVID-19 pandemic and the European Union’s Digital Education Action Plan. These modalities have enabled more inclusive, flexible, and sustainable forms of international collaboration, such as Collaborative Online International Learning (COIL) and Blended Intensive Programs (BIPs), reshaping the landscape of global academic mobility. This paper introduces the INVITE Learning Design Framework (LDF), developed to support higher education instructors in designing high-quality, internationalized blended and virtual learning experiences. The framework addresses the growing need for structured, theory-informed approaches to course design that foster student engagement, intercultural competence, and motivation in non-face-to-face settings. The INVITE LDF was developed through a rigorous scoping review of existing models and frameworks, complemented by needs-identification analysis and desk research. It integrates Self-Determination Theory, Active Learning principles, and the ADDIE instructional design model to provide a comprehensive, adaptable structure for course development. The framework was successfully implemented in a large-scale online training module for over 1000 educators across Europe. Results indicate that the INVITE LDF enhances educators’ ability to create engaging, inclusive, and pedagogically sound international learning environments. Its application supports institutional goals of internationalization by making global learning experiences more accessible and scalable. The findings suggest that the INVITE LDF can serve as a valuable tool for higher education institutions worldwide, offering a replicable model for fostering intercultural collaboration and innovation in digital education. This contributes to the broader transformation of international higher education, promoting equity, sustainability, and global citizenship through digital pedagogies. Full article

Academic performance has become a consolidated indicator of a nation’s educational and social equity. Consequently, increasing attention has been paid to determining the factors associated with school performance, particularly in the case of students with extreme academic outcomes. The aim of this study is to identify and compare the factors related to the level of mathematical competence of Spanish students with low and high levels of achievement, based on data from the Spanish sample of PISA 2022 (n = 30,800). The results of the multilevel quantile regression analysis reveal that the social, economic, and cultural status of the students have a significant and positive effect on both groups. Other variables, such as gender, grade repetition, and length of pre-primary education, show differentiated effects depending on the level of competence. Moreover, school-related factors, such as school location and competition among centres, exhibit opposite effects. Finally, aspects such as school ownership, average class size, and the degree of curricular autonomy only have a significant impact on the mathematical competence of low-achieving students. These findings highlight the need for differentiated educational policies that address the specific needs of each group of students. Full article

Background and Objectives: Gender disparities in pain management persist, with women frequently receiving inadequate analgesia despite reporting similar or higher pain levels compared with men. This issue is particularly evident across various medical and gynecological procedures. Materials and Methods: This integrative literature review synthesizes recent empirical studies examining gender biases in pain perception and management, focusing specifically on procedural pain in women. It includes an analysis of clinical research, patient-reported outcomes, and healthcare provider behaviors. Results: The findings indicate that unconscious biases, a lack of gender-specific clinical protocols, and prevailing cultural stereotypes contribute to the undertreatment of pain in women during procedures such as intrauterine device insertion and diagnostic hysteroscopy. Additionally, communication gaps between patients and healthcare providers exacerbate these disparities. Conclusions: Addressing gender disparities in pain management necessitates systemic reforms, including the implementation of gender-sensitive clinical guidelines, enhanced provider education, and targeted policy changes. Personalized, gender-informed approaches are essential to improving equity and quality of care in pain treatment. Full article

In alignment with global educational trends, Australia has adopted a pluralistic approach to initial teacher education (ITE), encompassing traditional university-based programs, employment-integrated models and vocational training routes. This diversification of pathways has emerged as a strategic response to persistent workforce challenges, including chronic shortages, uneven distribution of qualified educators, and limited demographic diversity within the profession. Rather than supplanting conventional ITE models, these alternative pathways serve as complementary options, broadening access and enhancing system responsiveness to evolving societal and educational needs. The rise in non-traditional routes represents a deliberate response to the well-documented global teacher shortage, frequently examined in comparative educational research. Central to their design is a restructuring of traditional program elements, particularly duration and delivery methods, to facilitate more flexible and context-sensitive forms of teacher preparation. Such approaches often create opportunities for individuals who may be excluded from conventional pathways due to socioeconomic constraints, geographic isolation, or non-linear career trajectories. Significantly, the diversity introduced by alternative entry candidates has the potential to enrich school learning environments. These educators often bring a wide range of prior experiences, disciplinary knowledge, and cultural perspectives, contributing to more inclusive and representative teaching practices. The implications for student learning are substantial, particularly in disadvantaged communities where culturally and professionally diverse teachers may enhance engagement and academic outcomes. From a policy perspective, the development of flexible, multifaceted teacher education pathways constitutes a critical component of a sustainable workforce strategy. As demand for qualified teachers intensifies, especially in STEM disciplines and in rural, regional and remote areas, the role of alternative pathways is likely to become increasingly pivotal in achieving broader goals of equity, quality and innovation in teacher preparation. Full article