Search Results (1,173)

Sociotechnical systems (STSs) are generally assumed to be systems that incorporate humans and technology, strongly depending on a sustainable equilibrium between the following nondeterministic social context ingredients: social structures, roles, and rights, as well as the designers’ Holy Grail, the deterministic nature of the underlying technical system. The fact that the relevant social concepts are more mature than the supporting technologies qualifies the digital transformation of sociotechnical systems as a reengineering rather than an engineering endeavor. Preserving the social mission throughout the digital transformation process in varying social contexts is mandatory, making the digital twins (DT) methodology application a contemporary research hotspot. In this research, we combined continuous transformation STS theory principles, an observer-based system-of-sociotechnical-systems (SoSTS) architecture model, and digital twinning methods to address common STS context representation challenges. Additionally, based on model-driven systems engineering methodology and meta-object-facility principles, the research specifies the universal meta-concepts and meta-modeling templates, supporting the creation of arbitrary sociotechnical systems’ external context digital twins. Due to the inherent diversity, significantly influenced by geopolitical, economic, and cultural influencers, a higher education external context specialization illustrates the reusability potentials of the proposed universal meta-concepts. Substituting higher-education-related meta-concepts and meta-models with arbitrary domain-dependent specializations further fosters the proposed universal meta-concepts’ reusability. Full article

Background/Objectives: Strengthening antimicrobial stewardship (AMS) programs is an invaluable intervention in the ongoing efforts to contain the threat of antimicrobial resistance (AMR), particularly in low-resource settings. This study evaluates the impact of the Telementoring, Education, and Advocacy Collaboration initiative for Health through Antimicrobial Stewardship (TEACH AMS), which uses the virtual Extension for Community Healthcare Outcomes (ECHO) learning model to enhance AMS capacity in Kenya, Ghana, and Malawi. Methods: A mixed-methods approach was used, which included attendance data collection, facility-level assessments, post-session and follow-up surveys, as well as focus group discussions. Results: Between September 2023 and February 2025, 77 virtual learning sessions were conducted, engaging 2445 unique participants from hospital-based AMS committees and health professionals across the three countries. Participants reported significant knowledge gain, and data showed facility improvements in two core AMS areas, including the implementation of multidisciplinary ward-based interventions/communications and enhanced monitoring of antibiotic resistance patterns. Along those lines, participants reported that the program assisted them in improving prescribing and culture-based treatments, and also evidence-informed antibiotic selection. The evidence of implementing ward-based interventions was further stressed in focus group discussions, as well as other strengthened practices like point-prevalence surveys, and development or revision of stewardship policies. Substantial improvements in microbiology services were also shared by participants, particularly in Malawi. Other practices mentioned were strengthened multidisciplinary communication, infection prevention efforts, and education of patients and the community. Conclusions: Our findings suggest that a virtual case-based learning educational intervention, providing structured and tailored AMS capacity building, can drive behavior change and strengthen healthcare systems in low resource settings. Future efforts should aim to scale up the engagements and sustain improvements to further strengthen AMS capacity. Full article

This study assessed the effectiveness of stress-based cognitive-behavioral training compared to standard training in firefighters, emphasizing their ability to distribute extinguishing water and cool environments evenly during enclosure fires. Experiments took place at the Zbiroh training facility with two firefighter teams (Team A with stress-based training and Team B with standard training) under realistic conditions. Using 58 thermocouples and 4 radiometers, temperature distribution and radiant heat flux were measured to evaluate water distribution efficiency and cooling performance during interventions. Team A consistently achieved temperature reductions of approximately 320 °C in the upper layers and 250–400 °C in the middle layers, maintaining stable conditions, whereas Team B only achieved partial cooling, with upper-layer temperatures remaining at 750–800 °C. Additionally, Team A recorded lower radiant heat flux densities (e.g., 20.74 kW/m² at 0°) compared to Team B (21.81 kW/m²), indicating more effective water application and adaptability. The findings confirm that stress-based training enhances firefighters’ operational readiness and their ability to distribute water effectively during interventions. This skill is essential for safer and effective management of indoor fires under extreme conditions. This study supports the inclusion of stress-based and scenario-based training in firefighter education to enhance safety and operational performance. Full article

Background/Objectives: In many parts of the world, pharmacists hold the primary responsibility for providing safe and effective pharmacotherapy. A key aspect is the availability of appropriate medicines for each individual patient. When industrially manufactured medicines are unsuitable or unavailable, pharmacists can prepare tailor-made medicines. While this principle applies globally, practices vary between countries. In the Netherlands, the preparation of medicines in pharmacies is well-established and integrated into routine healthcare. This narrative review explores the role and significance of extemporaneous compounding, pharmacy preparations and related product care in the Netherlands. Methods: Pharmacists involved in pharmacy preparations across various professional sectors, including community and hospital pharmacies, central compounding facilities, academia, and the professional pharmacists’ organisation, provided detailed and expert insights based on the literature and policy documents while also sharing their critical perspectives. Results: We present arguments supporting the need for pharmacy preparations and examine their position and role in community and hospital pharmacies in the Netherlands. Additional topics are discussed, including the regulatory and legal framework, outsourcing, quality assurance, standardisation, education, and international context. Specific pharmacy preparation topics, often with a research component and a strong focus on product care, are highlighted, including paediatric dosage forms, swallowing difficulties and feeding tubes, hospital-at-home care, reconstitution of oncolytic drugs and biologicals, total parenteral nutrition (TPN), advanced therapy medicinal products (ATMPs), radiopharmaceuticals and optical tracers, clinical trial medication, robotisation in reconstitution, and patient-centric solid oral dosage forms. Conclusions: The widespread acceptance of pharmacy preparations in the Netherlands is the result of a unique combination of strict adherence to tailored regulations that ensure quality and safety, and patient-oriented flexibility in design, formulation, and production. This approach is further reinforced by the standardisation of a broad range of formulations and procedures across primary, secondary and tertiary care, as well as by continuous research-driven innovation to develop new medicines, formulations, and production methods. Full article

Early childhood forest and nature education plays a vital role in shaping values and promoting sustainability throughout life. Conceptualized in Denmark, forest and nature childcare groups have been established in Austria for over 20 years, contributing to mental well-being and supporting both Education for Sustainable Development (ESD) and Early Childhood Education and Care (ECEC). With increasing demand for childcare and a growing disconnect from nature—factors linked to physical and mental health challenges—there is a pressing need to expand these groups and integrate them into formal legal frameworks. This study examines the organization, staffing, infrastructure, risk prevention, and hygiene of 79 Austrian forest and nature kindergarten groups, identifying key areas of improvement to ensure safe access for all children, including those in public childcare. A semi-standardized online survey of 72 groups was analyzed using descriptive and statistical methods, including a Spearman correlation, Kruskal–Wallis test, Chi-square test, and ANOVA. Results revealed three main infrastructure types—house, container/trailer, and tipi—with houses offering the most comprehensive facilities. The ANOVA indicated significant effects of sponsorship type (p < 0.01), caregiver numbers (p < 0.001), and their interaction (p < 0.05) on half-day care costs. Currently, legal frameworks exist only in Tyrol and Salzburg. Broader access requires standardized infrastructure and risk assessment guidelines, collaboratively developed with stakeholders, to ensure safety and inclusivity in Austrian forest and nature childcare groups. Full article

Racket sports are very popular not only in professional sports but also among recreational players. As a result, their impact on the field of education has grown significantly in recent years. Table tennis (TT) offers significant advantages in terms of skill acquisition and health improvement. Nevertheless, its application within physical education (PE) curricula remains undetermined. The aim of this systematic review was to analyze the use of TT as educational content in the subject of PE in primary school. The PRISMA 2020 methodology was used to conduct the systematic review. Six databases (ERIC, Pubmed, ScienceDirect, Scopus, Sport Discus, and Web of Science) were used during the search process. The search cutoff date was December 31, 2024. After applying the eligibility criteria, 3595 articles were found. Only seven studies were selected for the final analysis and the data included 1526 students from primary school. The results indicate that TT is rarely used in primary education during PE classes. Research indicates interest among teachers and students in playing it during PE. Furthermore, due to the benefits, motivation, and interest this sport generates, educational experiences have been developed, such as roundtable discussions, table top tennis, balloon TT, and TT triathlon. A lack of materials, facilities, and teacher training for teaching this sport is notable. The teaching experiences analyzed in this review confirm that TT is a highly versatile and interesting sport as a subject matter in school PE. The use of TT allows for innovative, comprehensive, and inclusive PE, thanks to the sport’s multiple possibilities. Given its adaptability and low entry barrier, TT could serve as an effective tool for increasing children’s physical activity levels, improving motor skills, and fostering social–emotional development. However further research is needed to quantify its impact on health outcomes such as cardiovascular fitness or obesity prevention. Full article

The development of Industry 4-oriented facilities in academia for training and research purposes is playing a significant role in pushing forward the Fourth Industrial Revolution. This study can serve academic staff who are intending to build their Industry 4 facilities, to better understand the key features, constraints, and opportunities. This paper presents a systematic literature review of 145 peer-reviewed studies published between 2011 and 2023, which are identified across Scopus, SpringerLink, and Web of Science. As a result, we emphasise the significance of developing Industry 4 learning facilities in academia and outline the main design principles of the Industry 4 ecosystems. We also investigate and discuss the key Industry 4-related technologies that have been extensively used and represented in the reviewed literature, and summarise the challenges and roadblocks that current participants are facing. From these insights, we identify research gaps, outline technology mapping and maturity level, and propose a strategic roadmap for future implementation of Industry 4 facilities. The results of the research are expected to support current and future participants in increasing their awareness of the significance of the development, clarifying the research scope and objectives, and preparing them to deal with inherent complexity and skills issues. Full article

Educational institutions are facing a crisis characterized by the need to address diverse learning styles and vocational aspirations, exacerbated by ongoing financial pressures. To navigate these challenges effectively, there is an urgent need to innovate educational practices and learning environments, ensuring they are adaptable and responsive to the evolving needs of students and the workforce. The adoption of the Industry 5.0 framework offers a promising solution, providing a holistic approach that emphasizes the integration of human creativity and advanced technologies to transform educational institutions into resilient, human-centric, and sustainable learning environments. In this context, this article presents a transdisciplinary methodology that integrates Asset Management (AM) with Social Innovation (SI) through Design Thinking (DT) to co-design Educational Facilities 5.0 with stakeholders. The application of the proposed approach in an AgroLab case study—a food and agricultural laboratory—demonstrates how the methodology enables the definition of an Educational Facility 5.0 and generates AM Design Knowledge to support informed decision-making in the subsequent design, implementation, and operation phases. Following DT principles—where knowledge emerges through iterative experimentation and insights from practical applications—this article also discusses the role of SI and DT in AM, the role of Large Language Models in convergent processes, and a vision for Educational Facilities 5.0. Full article

Background/Objective: Maternal immunization is highly recommended, particularly in developed countries. However, its awareness among pregnant women in Japan remains low. This study aimed to assess the awareness and attitudes toward maternal immunization among pregnant women in Japan and to identify the factors that may promote its acceptance. Methods: We conducted a cross-sectional questionnaire survey among pregnant women attending antenatal checkups at nine facilities in Kanagawa Prefecture, Japan, from August 2024 to January 2025. The survey assessed knowledge and intention regarding maternal immunization for influenza, pertussis, respiratory syncytial virus (RSV), and group B streptococcus (GBS) as well as attitudes toward vaccination costs and information sources. Results: Overall, 523 respondents were included in this study. The overall awareness of maternal immunization was 16%. Willingness to receive vaccinations during pregnancy was reported for influenza (68%), pertussis (58%), RSV (59%), and GBS (71%). A common reason for vaccine hesitancy included uncertainty about its effects on the fetus. The key factors associated with vaccine acceptance were higher educational attainment and prior knowledge of maternal immunization. Regarding costs, most respondents were willing to pay up to JPY 5000 (approximately USD 35). The most frequently prioritized sources were explanations from physicians, followed by explanations from midwives. Conclusions: Despite low awareness, vaccination intention was comparable to that reported in other countries. Points that may contribute to improved vaccine uptake were also identified. These findings may lead to the prevention of infectious diseases in newborns and infants in Japan and possibly improve public health. Full article

Educational facilities are the physical environment that supports the academic process for a better education. The quality of offices as workspaces is crucial in creating a supportive environment to enhance the staff and students’ experience. This paper aims to study the concept of space personalization and its impact on faculty members’ productivity, performance, and satisfaction in universities’ educational facilities. To achieve this aim, the research applied the qualitative research method of semi-structured interviews to gather comprehensive data about user experience. Approaching 39 faculty members within Al Yamamah University across three departments within the College of Engineering (Architecture, Industrial, and Computer). Data were analyzed using thematic analysis for qualitative insights, focusing on environmental aspects (such as: natural lighting, ventilation, noise control, etc.), psychological factors (such as: privacy, aesthetic appeal, etc.), and architectural settings (such as: area, space layout, materials, etc.). The research proposes a methodological framework for design considerations for office spaces in universities, fostering more flexible and personalized designs for enhancing sense of ownership and well-being. Findings indicate that personalized office spaces significantly enhance faculty satisfaction and productivity. Qualitative data highlighted that a lack of privacy in standardized offices adds stress and an overwhelming environment. These findings suggest that universities should consider flexible office designs to optimize academic work environments. Full article

Background/Objectives: On 6 June 2023, two varicella cases were reported at a highly vaccinated elementary school in Gyeonggi Province, Republic of Korea. We investigated the outbreak to describe its transmission dynamics; quantify attack rates in school, household, and private-academy settings; and assess the impact of coordinated control measures. Methods: A case-series study included 89 teachers and students who had contact with suspected patients. Using case definitions, laboratory tests, questionnaires, and environmental assessments, we evaluated exposures and factors facilitating spread. Results: Varicella developed in 23 of 89 contacts (25.8%); laboratory confirmation was obtained in 2 (8.7% of cases). The mean incubation period was 13 days. Epidemic-curve and network analyses indicated that the outbreak began with a single index case and extended through household contacts and private educational facilities, ultimately involving multiple schools. Conclusions: Breakthrough transmission can occur even when single-dose coverage exceeds 95%, particularly as vaccine-induced immunity may wane over time. Poorly regulated extracurricular facilities, such as private academies, act as bridging hubs that amplify spread across grades and even between schools. For timely detection and control, these venues should be incorporated into routine varicella surveillance, and rapid, coordinated infection-control measures are required across all educational settings. Full article

Background/Objectives: Childhood stunting remains a critical public health issue in low- and middle-income countries. Despite Malaysia’s economic growth, there is limited large-scale evidence on the determinants of stunting among children from infancy to primary school age. This cross-sectional study, part of South East Asian Nutrition Surveys II (SEANUTS II), aimed to determine sociodemographic and environmental risk factors for stunting among 2989 children aged 0.5–12 years. Methods: Children were recruited from four regions in Peninsular Malaysia (Central, East Coast, 2022–2030Northern, Southern). Standing height or recumbent length was measured, and stunting was classified based on WHO criteria (height-for-age Z-score below −2 standard deviations). Parents reported information on socioeconomic status, sanitation facilities, and hygiene practices. Multivariate binary logistic regression was used to determine the determinants of stunting. Results: Stunting prevalence was 8.9%, with infants (aOR = 2.92, 95%CI:1.14–7.52) and young children (aOR = 2.92, 95%CI:1.80–4.76) having higher odds than school-aged children. Key biological predictors included low birth weight (aOR = 2.41; 95%CI:1.40–4.13) and maternal height <150 cm (aOR = 2.24; 95%CI:1.36–3.70). Chinese (aOR = 0.56; 95%CI:0.35–0.88) and Indian children (aOR = 0.16; 95%CI:0.05–0.52) had a lower risk of stunting compared to Malays. Conclusions: This study highlights the ongoing challenge of childhood stunting in Malaysia, with age, birth weight, ethnicity, and maternal height identified as key determinants. These findings call for early identification of at-risk households and targeted support, especially through education and financial aid to foster healthy child growth. Full article

Background: Micronutrient deficiencies, particularly among pregnant women and children under five years old, remain a significant public health challenge in Nigeria. Despite existing policies and programmes, national data on prevalence and risk factors are fragmented. Objective: To synthesise the current evidence on the prevalence of key micronutrient deficiencies and associated risk factors among pregnant women and children under five years old in Nigeria. Methods: A systematic review and meta-analysis were conducted using peer-reviewed studies that were published between 2008 and 2024. The databases searched included PubMed, Scopus, and African Journals Online. After screening 1207 studies, 37 studies were included: 27 were conducted among pregnant women and 10 were among children. A meta-analysis was conducted to estimate the anaemia prevalence using a random-effects model. A narrative synthesis was conducted to synthesise evidence on other micronutrients (i.e., magnesium, copper, and vitamins C and E) due to the limited data and risk factors. Results: The pooled prevalence of anaemia was 56% among children and 54% among pregnant women. The prevalence of other micronutrient deficiencies varied widely, with a high prevalence of zinc (86.4%), magnesium (94%), and vitamin D (73.3%) deficiencies in certain regions. The identified risk factors included poor dietary diversity, lower socioeconomic status, low maternal education, infection burden, and early or high parity. Most studies were facility-based and sub-national, limiting the generalisability. Conclusions: This review highlights a high prevalence of anaemia and micronutrient deficiencies among pregnant women and children in Nigeria. Key risk factors included a poor diet, low maternal education, infections, and reproductive health challenges. Targeted, multisectoral policies are urgently needed to address these gaps and improve health outcomes. Full article

Safe and adequate water supply, sanitation, and hygiene (WASH) in schools are prerequisites within the right to basic education. WASH facilities across schools in developing nations, particularly in Africa, are unsatisfactory and expose children to risks of disease and infection. This study aims to gather insights into the WASH status of secondary schools in Ibadan, Nigeria, to develop a sustainable water management framework for schools. A concurrent mixed-method design (questionnaires and interviews) was adopted to benchmark water management in schools and inform the design of a framework. Results reveal a wealth of issues and concerns that include infrastructure challenges accessing reliable and safe water supplies, rundown and unhygienic toilet/urinal facilities, and dilapidated sinks/taps, plus resource challenges, such as an absence of tissue paper and soap. These issues are exposing schoolchildren to unnecessary health risks, further supported by reported illnesses and reduced school attendance. Based on these findings, and guided by the UN SDG#6 targets, a water improvement framework has been created and validated by school officials. The framework identifies both short-term and long-term guidance/actions to improve water management in schools across Sub-Saharan Africa. These form crucial steps toward better WASH, building healthier communities and enhancing educational environments and outcomes for schoolchildren. Full article

In recent decades, the River Ganges in India has been heavily contaminated with domestic waste and industrial toxins because of cultural activities, a lack of community awareness, an absence of sewage disposal facilities, and rapid population growth. Previous studies have focused separately on either the physical or social factors associated with River Ganges pollution but have not combined these elements in a single study. To fill this research gap, our study assesses the bio-physical and social vulnerability of the River Ganges by using a holistic approach. The following four sampling stations were selected: Rishikesh, Haridwar, Kanpur, and Varanasi. These locations were chosen to test the water quality in bio-physical aspects and to assess the social perceptions of river vulnerability among the residents and visitors. Perceptions of river water quality and likely sources of pollution were gathered via the distribution of over 1000 questionnaires. Data collection took place in the winter and summer of 2022 and 2023. The results showed that river water quality is not suitable for drinking purposes at any of the four cities without conventional treatment, and that the river is unsuitable for bathing at all locations, except upstream of Rishikesh. Nearly 50% of those questioned agreed that the river is polluted, whilst 74% agreed that pollution has increased in recent decades, particularly in the last 10 years. These compelling results are critical for policymakers and decision makers. They highlight the urgent need for novel strategies that address Ganges pollution while fostering community health education and environmental management. By dispelling myths surrounding river quality, this study strengthens the ongoing efforts to restore the Ganges, ensuring that it remains a vital lifeline for present and future generations. Full article