Search Results (2,818)

Background and Objectives: Exclusive breastfeeding offers optimal nutrition and health benefits for infants, yet many mothers face challenges that impact their ability to breastfeed. This study aimed to explore breastfeeding practices among Romanian mothers and identify factors associated with successful exclusive breastfeeding. Materials and Methods: A cross-sectional online survey was conducted from February to March 2025, targeting Romanian mothers via social media platforms. The questionnaire, developed specifically for this study, collected data on sociodemographics, birth and neonatal variables, hospital practices, feeding intentions, community influences, and breastfeeding outcomes. A total of 874 valid responses were analyzed using Fisher’s exact tests and multivariable logistic regression. Results: While 87.2% of mothers intended to breastfeed, only 56.1% reported exclusive breastfeeding. Factors significantly associated with reduced likelihood of exclusive breastfeeding included maternal age ≥ 30 years (OR = 1.40, p = 0.042), Cesarean delivery (OR = 1.78, p < 0.001), absence of rooming-in (OR = 2.32, p < 0.001), and pacifier use (OR > 4.7, p < 0.001). Protective factors included non-smoking status (OR = 0.52, p < 0.001) and encouragement to breastfeed by medical staff (OR = 1.60, p = 0.004). Despite external advice to use formula, many mothers continued breastfeeding. Conclusions: Although breastfeeding intention was high, exclusive breastfeeding remains suboptimal in Romania. Targeted support—particularly in maternity hospitals and for mothers recovering from Cesarean sections—alongside prenatal education and consistent postnatal guidance are essential to bridge the gap between intention and practice. Full article

Background: The interaction between prosthetic restorations and periodontal health is a critical factor for the long-term success of dental treatments. A biologically compatible prosthetic design supports periodontal stability, whereas neglecting periodontal principles can compromise treatment outcomes. This study aimed to validate a questionnaire designed to assess dentists’ perceptions regarding the influence of prosthetic restorations on the periodontium. Material and Methods: An observational cross-sectional study was conducted using a self-administered questionnaire distributed to licensed dentists across Romania. The questionnaire underwent expert review, pilot testing (n = 50), and statistical validation, including the Content Validity Index (CVI), Cronbach’s alpha for internal consistency, and Exploratory Factor Analysis (EFA) using Principal Component Analysis (PCA) with Varimax rotation. The final sample included 39 respondents. Data was analyzed using SPSS v26.0. Results: The questionnaire demonstrated excellent internal consistency (Cronbach’s alpha = 0.900; standardized alpha = 0.917). Most items had corrected item-total correlations > 0.40. EFA revealed eight coherent factors explaining 81.68% of total variance, with high communalities (0.549–0.966), strong Kaiser–Meyer–Olkin test (KMO) values, and significant Bartlett’s test values, confirming construct validity. Descriptive statistics showed predominantly positive attitudes among dentists regarding the periodontal considerations in prosthetic treatment. The highest-rated items emphasized oral hygiene, periodontal stability, and biological adaptation of restorations. Lower scores were associated with routine use of periodontal indices and recognition of failures due to insufficient evaluation. Conclusions: The validated instrument proved reliable and demonstrated strong psychometric properties in this exploratory validation, supporting its use in research and education. Romanian dentists demonstrated a favorable perception of the role of periodontal health in prosthetic success. This tool can inform curriculum development and interdisciplinary clinical protocols in prosthodontics and periodontology. Full article

In the digital age, online teacher professional development (TPD) has become a key strategy for enhancing instructional quality and ensuring equitable access to continuous learning. This research compares and analyzes Chinese online teacher professional development (TPD) with the United States over a period of ten years, from 2014 to 2024. This study uses a mixed-methods approach based on policy documents, structured surveys, and interviews to investigate how governance regimes influence TPD outcomes for fair education. Both countries experienced a massive expansion of web-based TPD access and engagement, with participation rates over 75% and effectiveness scores over 4.3 by 2024. China focused on fast scaling by way of centralized mandates and investments in infrastructure, while the United States emphasized gradual expansion through decentralized, locally appropriate models. Most indicators had converged by the end of the period, even with these different approaches. Yet, qualitative evidence reveals persisting gaps in functional access and contextual appropriateness, especially in rural settings. Equality frameworks with attention to teacher agency, policy implementation, and digital usability must supplant weak access metrics. A hybrid paradigm presents itself as an attractive means toward building equitable and productive digital TPD environments through the symbiotic integration of China’s successful scalability and the United States’ professional autonomy. Full article

The social acceptance of Renewable Energy Sources (RESs) is a decisive factor in the successful implementation of clean energy projects. This study explores the attitudes, demographic profiles, and common misconceptions of citizens in the Region of Epirus, Greece, toward photovoltaic and wind energy installations. Special attention is given to the role of education, age, and access to information—as well as spatial factors such as visual exposure—in shaping public perceptions and influencing acceptance of RES deployment. A structured questionnaire was administered to 320 participants across urban and rural areas, with subdivision between regions with and without visual exposure to RES infrastructure. Findings indicate that urban residents exhibit greater acceptance of RES, while rural inhabitants—especially those in proximity to installations—express skepticism, often grounded in esthetic concerns or perceived procedural injustice. Misinformation and lack of knowledge dominate in areas without visual contact. Statistical analysis confirms that younger and more educated participants are more supportive and environmentally aware. The study highlights the importance of targeted educational interventions, transparent consultation, and spatially sensitive communication strategies in fostering constructive engagement with renewable energy projects. The case of Epirus underscores the need for inclusive, place-based policies to bridge the social acceptance gap and support the national energy transition. Full article

The successful deployment of sustainable building construction (SBC) is connected to sound knowledge sharing. Concerning SBC, knowledge sharing has been identified to directly and indirectly increase innovation, environmental performance, cost saving, regulatory compliance awareness and so on. The necessity of enhancing SBC practice globally has been emphasised by earlier research. Consequently, this study aims to investigate knowledge-sharing elements to enhance SBC in South Africa (SA). Utilising a questionnaire survey, this study elicited data from 281 professionals in the built environment. Data analysis was performed with “descriptive statistics”, the “Kruskal–Wallis H-test”, and “principal component analysis” to determine the principal knowledge-sharing features (KSFs). This study found that “creating public awareness of sustainable practices”, the “content of SBC training, raising awareness of green building products”, “SBC integration in professional certifications”, an “information hub or repository for sustainable construction”, and “mentoring younger professionals in sustainable practices” are the most critical KSFs for SBC deployment. These formed a central cluster, the Green Education Initiative and Eco-Awareness Alliance. The results achieved a reliability test value of 0.956. It was concluded that to embrace the full adoption of SBC, corporate involvement is critical, and all stakeholders must embrace the sustainability paradigm. It is recommended that the principal knowledge-sharing features revealed in this study should be carefully considered to help construction stakeholders in fostering knowledge sharing for a sustainable built environment. 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

This study examines the moral agency of French secondary school headteachers through the lens of the theory of conventions. Using qualitative data from interviews with fifteen headteachers involved in professional development, this study explores how these leaders justify their practices within a centralized, bureaucratic, and hierarchical education system. It identifies a variety of conventions—civic, domestic, industrial, project, market, inspired, and fame—that headteachers draw on to navigate institutional constraints, manage professional relationships, and foster pedagogical and organizational change. Particular attention is given to how civic and domestic conventions shape leadership discourse and practices, especially regarding trust building, decision making, and reform implementation. We also compare the French context with international examples from the International Successful School Principalship Project (ISSPP), focusing on Nordic countries, where leadership emphasizes democratic participation, professional trust, and shared responsibility. This study underscores the uniqueness of the French leadership model, which resists managerial and market logics while remaining rooted in republican and egalitarian ideals. It concludes by advocating for a more context-aware, ethically grounded, and dialogical approach to school leadership. Full article

Establishing an entrepreneurship education ecosystem is crucial for the continual nurturing of young entrepreneurs and, consequently, the enhancement of economic development. Beyond the expansion of entrepreneurship programs, the active involvement and support from relevant resources and external stakeholders are pivotal to constructing such ecosystems. However, obstacles arise from the lower intention of external stakeholders to participate, and constraints imposed by information technology, hindering the ecosystem’s development. The Metaverse, an innovative technology amalgamating three-dimensional virtual technologies with blockchain and artificial intelligence, emerges as a potential solution to overcome these barriers and construct an entrepreneurship education ecosystem. Despite this potential, there is a lack of analysis explaining how the Metaverse achieves this. To address this gap, a framework for entrepreneurship education ecosystems is established in this study, highlighting two barriers and elucidating how these barriers impede ecosystem construction. Furthermore, four efficiencies of the Metaverse are identified as key factors with positive effects in terms of surmounting barriers to ensure the successful establishment of an entrepreneurship education ecosystem: communication convenience, enhanced simulation environment, information filtering, and the creation of valuable information. Full article

This article presents a spatial analysis of projects selected by city residents and implemented in five successive editions (2015–2019) of the participatory budgeting in Częstochowa, Poland. The study examines the relationship between the type of hard projects (small investments in public infrastructure and landscaping) and the pre-existing characteristics of the land use of each district. Kernel density estimation and Spearman correlation analysis were used. The highest spatial density occurred in projects related to the modernization of roads and sidewalks, recreation, and greenery, indicating a relatively high number of proposals within or near residential areas. Key correlations included the following: (1) greenery projects were more common in districts lacking green areas; (2) recreational infrastructure was more frequently chosen in areas with significant water features; (3) street furniture projects were mostly selected in districts with sparse development, scattered buildings, and postindustrial sites; (4) educational infrastructure was often chosen in low-density, but developing districts. The selected projects often reflect local deficits in specific land use or public infrastructure, but also stress the predestination of the recreational use of waterside areas. Full article

This study examined data from participants who completed the SLeep Education for Everyone Program (SLEEP) to explore how various demographic variables affected sleep outcomes and to determine which participant characteristics predicted success. A total of 104 individuals participated. The Sleep Hygiene Index (SHI) measured undesirable sleep behaviors; the Pittsburgh Sleep Quality Index (PSQI) assessed sleep quality and self-reported sleep duration. Participant demographic information was collected at baseline. A mixed ANOVA evaluated group differences, and a multiple linear regression model identified predictors of sleep improvements. Change in SHI scores from pre- to post-intervention demonstrated a significant time × group interaction between Black and white participants (p = 0.024); further analysis indicated Black participants improved more. Better baseline scores predicted more favorable post-intervention outcomes for SHI, PSQI, and sleep duration. Fewer chronic conditions predicted better post-intervention SHI and PSQI scores. Older age also predicted better SHI scores. More favorable initial scores, fewer chronic conditions, and older age were the strongest predictors of positive outcomes following SLEEP. Improved sleep hygiene, sleep quality, and sleep duration were observed over time within subjects across all groups. In summary, SLEEP appears to be effective. Further work exploring challenges experienced by younger participants or those with multiple co-morbidities is warranted. Full article

The right to development, an inherent human right for all, emphasizes that all individuals and communities have the right to participate in, contribute to, and benefit from development that ensures the full realization of human rights. In Kenya, where a significant portion of the population faces poverty and vulnerability to climate change, access to rights-based needs such as clean water, healthcare, and education still remains a critical challenge. This study explored the implementation of a Human Rights-Based approach to community development through a Public–Private Development Partnership model (PPDP), with a focus on alleviating poverty and improving access to rights-based services at the community level in Narok and Nakuru counties. The research aimed to identify critical success factors for scaling the PPDP model and explore its effects on socio-economic empowerment. The study employed a mixed-methods approach for data collection, using questionnaires to obtain quantitative data, focus group discussions, and key informant interviews with community members, local leaders, and stakeholders to gather qualitative data. We cleaned and analyzed all our data in R (version 4.4.3) and used the chi-square to establish the significance of differences between areas where the PPDP model was implemented and control areas where it was not. Results reveal that communities with the PPDP model experienced statistically significant improvements in employment, income levels, and access to rights-based services compared to control areas. The outcomes underscore the potential of the PPDP model to address inclusive and sustainable development. This study therefore proposes a scalable pathway beginning with access to rights-based needs, followed by improved service delivery, and culminating in economic empowerment. These findings offer valuable insights for governments, development practitioners, investment agencies, and researchers seeking community-driven developments in similar socio-economic contexts across Africa. For the first time, it can be adopted in the design and implementation of development projects in rural and local communities across Africa bringing into focus the need to integrate rights-based needs at the core of the project. Full article

Self-regulated learning (SRL) has been widely recognized as a critical skill for academic success in online and blended learning contexts. However, many students experience difficulty in effectively applying SRL strategies in the absence of structured instructional guidance. To address this challenge, this study developed and implemented a learning management system integrated with SRL support (SRL-LMS), specifically designed for the online component of a blended learning course. The SRL-LMS consisted of two sections: a conventional course content section and a SRL training section designed to support students in applying SRL strategies. A quasi-experimental design was adopted with 69 college students assigned to either an experimental group, with access to both course and SRL sections, or a control group, which accessed only the course section. Results indicated that students in the experimental group reported higher levels of self-regulation and showed more frequent and diverse application of SRL strategies compared to the control group. In terms of academic performance, the experimental group performed significantly better than the control group on the first exam, though no significant difference was observed on the second exam. These results highlight the effectiveness of structured SRL interventions within digital learning platforms for improving students’ self-regulatory behaviors. Future implementations should address cognitive load and incorporate strategic approaches to sustain student motivation. This study advances current SRL intervention designs and offers valuable insights for educators and instructional designers aiming to integrate targeted SRL supports in online and blended learning environments. Full article

Information and communication technologies (ICTs) are becoming increasingly important for sustainable rural development through the smart village concept. This study aims to model ICT’s potential for public services management in European rural areas. It identifies ICT applications across rural service domains, analyzes how these technologies address specific rural challenges, and evaluates their benefits, implementation barriers, and future prospects for sustainable rural development. A qualitative content analysis method was applied using purposive sampling to analyze 79 peer-reviewed articles from EBSCO and Elsevier databases (2000–2024). A deductive approach employed predefined categories to systematically classify ICT applications across rural public service domains, with data coded according to technology scope, problems addressed, and implementation challenges. The analysis identified 15 ICT application domains (agriculture, healthcare, education, governance, energy, transport, etc.) and 42 key technology categories (Internet of Things, artificial intelligence, blockchain, cloud computing, digital platforms, mobile applications, etc.). These technologies address four fundamental rural challenges: limited service accessibility, inefficient resource management, demographic pressures, and social exclusion. This study provides the first comprehensive systematic categorization of ICT applications in smart villages, establishing a theoretical framework connecting technology deployment with sustainable development dimensions. Findings demonstrate that successful ICT implementation requires integrated urban–rural cooperation, community-centered approaches, and balanced attention to economic, social, and environmental sustainability. The research identifies persistent challenges, including inadequate infrastructure, limited digital competencies, and high implementation costs, providing actionable insights for policymakers and practitioners developing ICT-enabled rural development strategies. Full article

More recently, artificial intelligence (AI)-generated content (AIGC) is fundamentally transforming multiple sectors, including materials discovery, healthcare, education, scientific research, and industrial manufacturing. As for the complexities and challenges of intelligent robot design, AIGC has the potential to offer a new paradigm, assisting in conceptual and technical design, functional module design, and the training of the perception ability to accelerate prototyping. Taking the design of an apple-harvesting robot, for example, we demonstrate a basic framework of the AIGC-assisted robot design methodology, leveraging the generation capabilities of available multimodal large language models, as well as the human intervention to alleviate AI hallucination and hidden risks. Second, we study the enhancement effect on the robot perception system using the generated apple images based on the large vision-language models to expand the actual apple images dataset. Further, an apple-harvesting robot prototype based on an AIGC-aided design is demonstrated and a pick-up experiment in a simulated scene indicates that it achieves a harvesting success rate of 92.2% and good terrain traversability with a maximum climbing angle of 32°. According to the tentative research, although not an autonomous design agent, the AIGC-driven design workflow can alleviate the significant complexities and challenges of intelligent robot design, especially for beginners or young engineers. Full article