Search Results (53)

Introduction/Objectives: Patient-centered communication is essential in oncology care, where healthcare professionals often manage emotionally demanding conversations, uncertainty, complex decisions, and patient involvement in care. However, the relationship between communication knowledge, empathic listening, and practical communication skills remains insufficiently examined. This study aimed to examine the associations between communication knowledge, empathic listening, and interpersonal communication skills among healthcare professionals involved in oncology care. Methods: A cross-sectional study was conducted in Croatia from May to November 2025 on a convenience sample of 138 healthcare professionals involved in oncology care. Communication knowledge was assessed using a study-specific questionnaire, empathic listening using an adapted Active Empathic Listening Scale, and interpersonal communication skills using an adapted Interpersonal Communication Skills Inventory. Because the instruments were adapted to the oncology care context, their dimensions were examined using exploratory factor analysis and interpreted as sample-specific exploratory constructs. Descriptive statistics, correlation analyses, and multiple linear regression analyses were performed. Results: Clear message delivery and assertiveness had the highest self-reported score, whereas emotional interaction management had the lowest. Communication knowledge was not an independent predictor of communication skills dimensions. Processing and responding positively predicted clear message delivery and assertiveness (β = 0.361; p = 0.001; R² = 13.4%), while noticing emotional and nonverbal cues negatively predicted emotional interaction management (β = −0.234; p = 0.032; R² = 7.6%). The explained variance of the models was low. Conclusions: The findings suggest limited but potentially relevant associations between selected dimensions of empathic listening and self-reported communication skills in oncology care. Communication knowledge, measured using a study-specific exploratory instrument, was not independently associated with communication skills. Because of the exploratory design, self-report measures, adapted instruments, and convenience sampling, the results should be interpreted with caution. Full article

Background/Objectives: Despite ongoing innovation, few interventions—including Clinical Decision Support Systems (CDSS)—are successfully integrated into routine care. Understanding the process through which innovations are implemented is therefore essential for advancing practice and research. In perinatal settings, evidence on how CDSS implementation unfolds and which strategies support adoption, scale-up, and sustainment remains limited. This study aimed to understand the implementation process, key determinants and implementation strategies of a shared antenatal psychosocial CDSS (i.e., the Born in Belgium Professionals [BIB-Pro]) implemented in a real-world, cross-sectoral perinatal care setting. Methods: A qualitative exploratory case study was conducted between January and March 2025. Data included semi-structured interviews with all seven implementation agents, document analysis of the implementation plan. Directed content analysis was applied using the Exploration, Preparation, Implementation, Sustainment (EPIS) framework to categorise contextual determinants and the ERIC taxonomy to classify implementation strategies. Data were synthesised across the four EPIS phases. Results: The implementation process unfolded across all EPIS phases, showing a shift in responsibility from the policy level to the implementation team and healthcare organisations. Implementation was shaped by key determinants across multiple levels: (1) the bridging functions by the BIB-Pro implementation agents connecting policy, innovation, and organisational practice; (2) the system-level leadership and funding by the National Institute for Health and Disability Insurance that enabled initiation and sustainability; and (3) the multilevel stakeholder involvement and inter-organisational collaboration across care settings. In addition, the personal attributes of implementation agents—accessibility, active listening, adaptability, and persistent follow-up—were also identified as relevant factors in the implementation process. Across the implementation process, a broad range of implementation strategies was identified. The most prominent ERIC strategies were developing stakeholder interrelationships, evaluative and iterative strategies, engaging stakeholders, training and educating stakeholders, and providing interactive assistance. Barriers encountered during the implementation process included fragmented care networks, inconsistent regional referral structures, legal uncertainties, and variable digital readiness. In response to these challenges, implementation strategies were applied to support collaboration, clarify procedures and provide targeted support. Conclusions: This study provides insight into how a CDSS was introduced, scaled, and sustained across complex multiple Belgian perinatal care settings. Strong bridging functions, stakeholder interrelationships, iterative evaluation, and system-level support were key factors throughout the implementation process. Across all phases, stakeholder interrelationship strategies and evaluative and iterative strategies were the most prominent and consistently applied, supporting stakeholder engagement and sustained use of the platform. These findings offer actionable guidance for implementing digital tools in multi-organisational and multi-level contexts within perinatal care and other healthcare settings. Full article

Autobiographical memory plays a central role in identity continuity, narrative functioning, and psychological well-being in later life. In nursing home residents, however, reduced environmental stimulation, cognitive vulnerability, and limited opportunities for self-expression may compromise autobiographical engagement. Music, as an emotionally salient and personally meaningful cue, may facilitate memory retrieval through affective and self-referential mechanisms. This exploratory pilot study examined whether personalized music listening influences the productivity and linguistic features of autobiographical narration in nursing home residents. Eleven older adults completed one baseline autobiographical recall session without music and three weekly music-assisted sessions focused on different life periods. Narratives were transcribed and analyzed using LIWC-22. Within-subject differences were tested with Wilcoxon signed-rank analyses. In addition, an exploratory qualitative paper-and-pencil analysis was conducted to identify recurrent narrative and experiential patterns in the music-assisted accounts. Music-assisted recall was associated with higher total word count compared with baseline, although this difference should be interpreted cautiously given the asymmetry between the single-session baseline and the three-session post-intervention format. No significant changes emerged in positive or negative emotion words. Qualitative observations of the music-assisted narratives highlighted recurrent features including vivid autobiographical scenes, references to meaningful social identities and former life roles, and emotionally salient communication. These preliminary findings suggest that personalized music may support autobiographical recall by increasing verbal output during narration and by facilitating meaningful self-expression and relational communication in later life. Larger controlled studies are needed to clarify its role in supporting autobiographical narrative processes in nursing home older adults. Full article

This study investigated the psychological, temperamental, and experiential factors associated with background music use among Chinese adults and examined predictive models incorporating psychological variables, demographic characteristics, and music-related experiences. In total, 332 Chinese adults aged 18–65 years (M = 35.89, SD = 13.34) participated in the study. Background music use was analyzed using correlational analyses, stepwise regression, and decision tree modeling. Results indicated that extraversion, neuroticism, and self-efficacy were significantly associated with background music use. Among temperamental traits, fun seeking showed a small but significant negative relationship. Stepwise regression analysis revealed that extraversion accounted for the largest proportion of variance, followed by neuroticism and self-efficacy, with the overall model explaining a significant portion of the variance in background music use. The decision tree model further identified experiential and contextual variables, including formal music education, enjoyment of music classes in childhood, living arrangements, and music-related family experiences, as important factors differentiating usage patterns. These findings suggest that background music use among Chinese adults is shaped by arousal-related personality traits, self-regulatory resources, and early musical experience. The results provide useful implications for further research and offer foundational knowledge for understanding background music use in everyday contexts. Full article

Individual differences in second-language (L2) proficiency are expected to influence how listeners parse and represent continuous speech, yet their neural signatures under naturalistic conditions remain unclear. We investigated this question using task-based fMRI during continuous speech listening. A total of 43 healthy participants completed four listening runs synchronized with MRI acquisition via PsychoPy(Peirce 2007), with eyes open throughout scanning. To promote sustained attention and comprehension, participants provided a native-language oral recall after each run. Based on behavioral proficiency scores, participants were grouped into low- (LP, n = 14), moderate- (MP, n = 14), and high-proficiency (HP, n = 15) groups. We evaluated three temporal information-encoding frameworks derived from BOLD dynamics: direct temporal series, functional connectivity (FC), and self-information weighted inter-subject correlation (ISC-W). Using a 10 × 5-fold nested cross-validation scheme, we tested both categorical classification (Support Vector Machines) for discrete proficiency groups (LP, MP, HP) and continuous multivariate regression (Ridge/Lasso) for continuous proficiency scores. Furthermore, we applied ROI-based ANOVA and univariate Neural Correlation Analysis (NCA) to identify key brain regions, evaluating significance via nonparametric permutation testing (1000 permutations) and False Discovery Rate (FDR) correction. Results indicated that while categorical classification yielded numerical trends—with ISC-W performing best—it did not reach statistical significance under stringent permutation testing. However, multivariate continuous regression using ISC-W features successfully predicted continuous proficiency scores with statistical significance (p < 0.05). Exploratory ROI analysis highlighted the bilateral orbital inferior frontal gyrus (IFG_orb_bilat) as a highly sensitive region. These findings suggest that L2 proficiency is best represented as a distributed, continuous neural variable, and that self-information weighting effectively filters background noise to capture cognitive variance. Methodologically, this study provides a reproducible pipeline integrating information-theoretic feature construction with rigorous whole-brain nonparametric inference. Full article

(1) Podcasts are increasingly used in undergraduate medical education. They differ from traditional learning activities and may influence exam performance. Podcasts also offer insights into learning behaviour and perceptions of family medicine (FM). Despite their frequent use in medical education, it remains unclear how they can best be integrated into competency-based curricula and motivate students to study for FM. This study examines the impact of a medical podcast on learning behaviour and academic performance at Saarland University (UdS). (2) This exploratory mixed-methods study analyzed podcast-related learning behaviour and exam relevance among year-five medical students at UdS in the winter semester 2024/25. Demographic, quantitative, and qualitative data were collected via an online questionnaire (Google Forms^®) in January 2025. Data were descriptively and analytically evaluated and linked to exam results. Qualitative data were analyzed using Kuckartz’s content analysis. (3) Of 123 eligible students, 92 participated. Most listened to episodes in full. Podcasts were seen as low-threshold means to access study content, but they were often not perceived as a separate learning activity. Listening to podcasts did not directly influence exam performance but helped connecting theory with clinical relevance and increased motivation for FM. (4) Podcasts are popular for exploring clinical practice and complex topics. Their didactic value lies in contextual learning and career orientation, rather than improving exam performance. Full article

Background/Objectives: Shift work in healthcare professionals affects performance in high cognitive processing, especially in complex environments. However, the beneficial effects that working in complex environments may have on auditory–cognitive processing remain unknown. These professionals face increased challenges in decision-making due to factors such as noise exposure and sleep disturbances, which may lead to the development of enhanced auditory–cognitive resources. This study aims to investigate the associations between shift work and auditory–cognitive processing in middle-aged healthcare workers. Methods: Thirty middle-aged healthcare workers were equally allocated to a shift worker (SW) or a fixed-schedule worker (FSW) group. Performance on a cognitive test, and in pure-tone audiometry, speech in quiet and noise, and listening effort were used to explore whether correlations were specific to shift work. Results: Exploratory analyses indicated that shift workers tended to perform better in visuospatial/executive function, memory recall, memory index, orientation, and total MoCA score domains compared to fixed-schedule workers. In the SW group, hearing thresholds correlated with memory recall and memory index. In the FSW group, hearing thresholds correlated with orientation, memory index, and total MoCA score, while listening effort correlated with naming, and speech intelligibility in quiet correlated with total MoCA scores. Conclusions: These exploratory findings suggest that shift work may be linked to distinct auditory–cognitive patterns, with potential compensatory mechanisms in visuospatial/executive functions and memory among middle-aged healthcare workers. Larger, longitudinal studies are warranted to confirm whether these patterns reflect true adaptive mechanisms. Full article

Music plays an increasingly vital role in modern society, becoming a fundamental part of everyday life. Beyond entertainment, it contributes to emotional well-being by helping individuals express their feelings, process emotions, and find comfort during different life moments. This study explores the emotional impact of Ed Sheeran’s lyrics and Sia’s lyrics on listeners. Using an exploratory approach, it applies a text mining tool to extract data, identify key dimensions, and compare thematic elements across both artists’ work. The analysis reveals distinct emotional patterns and thematic contrasts, offering insight into how their lyrics resonate with audiences on a deeper level. These findings enhance our understanding of the emotional power of contemporary music and highlight how lyrical content can shape listeners’ emotional experiences. Moreover, the study demonstrates the value of text mining as a method for examining popular music, providing a new lens through which to explore the connection between music and emotion. Full article

Objectives: The objective of this study was to explore the views expressed online by COPD patients regarding adherence to inhaled therapy. Methods: This study applied a qualitative, exploratory-interpretive design and an inductive methodology. Sources analyzed included COPD websites, patient forums, and social networks. Units of analysis were videos, stories, questions and answers, and conversation threads. Saturation criteria were applied. Applying a constant comparative methodology, analyses were conducted at textual (quotes, initial and focused coding, families) and conceptual (categories, networks, meta-network, provisional and final model) levels using ATLAS.ti 7.5. Reports were returned to patients. Results: There were 248 patients (51 men, 148 women, 49 unidentified) corresponding to 29 testimonies (6 narratives, 11 videos, 10 conversation threads, 2 questions collections). Adherence to inhalers is based on their perception of effectiveness to enable a normal life, and benefits should outweigh adverse effects. Adherence facilitators included mutual support between patients encouraging adherence and effective doctor-patient communication. Adherence barriers included (1) side effects; (2) mistaken beliefs about inhalers (habituation, attribution of non-existent side effects, fear of corticosteroids); (3) poor doctor-patient relationship (lack of listening, failure to consider patient’s preferences, communication iatrogenesis); (4) considering natural remedies as substitutes for treatment. Conclusions: Adherence to inhalers as reported in online testimony from COPD patients depends on the balance between efficacy and side effects. Adherence is influenced by peer support and doctor-patient communication. Doubts, erroneous beliefs, and iatrogenic effects of poor communication can hinder adherence. Full article

Background/Objectives: The voice is often perceived as a natural and spontaneous means of communication, but it involves complex interactions among physiological, psychological, and environmental factors. For teachers, whose profession relies heavily on vocal use, understanding and managing vocal strain is crucial. This study investigates the correlation between ambient noise levels in classrooms and teachers’ self-assessed voice-related quality of life, as measured by the Voice Handicap Index (VHI). The focus is on how classroom acoustics affect vocal health, considering the high incidence of vocal fatigue among educators. Methods: A pilot exploratory study was conducted from September 2022 to November 2022 involving four primary school teachers (two language and two science) from an Italian primary school. Classroom noise levels were recorded using the “Listen Responsibly” app at intervals during lessons. Following each lesson, teachers completed the VHI questionnaire to evaluate their voice-related quality of life. Statistical analyses included simple and multiple linear regressions, logistic regression, and Spearman’s correlation to assess the relationships between noise levels and VHI scores. Results: The study yielded 60 observations categorized into VHI Grade 1 (0–30) and Grade 2 (31–60). Significant differences were observed in average noise levels between these groups, with Grade 2 exhibiting higher noise levels (p < 0.0001). Simple and multiple linear regression analyses confirmed a positive correlation between average recorded noise and VHI scores, with each unit increase in noise associated with a 0.72 unit increase in VHI score (p < 0.0001). Logistic regression identified average recorded noise > 59.5 dB as a significant predictor of higher VHI grades (p < 0.0001). Spearman’s correlation confirmed a strong positive correlation (ρ = 0.77, p < 0.01). Conclusions: The study demonstrates a significant relationship between increased classroom noise levels and worse voice-related quality of life among teachers. These findings highlight the need for improved acoustic management in schools to reduce vocal strain. Implementing noise reduction strategies and enhancing classroom acoustics can help mitigate vocal health issues among educators, ultimately improving their professional and personal well-being. Full article

Background: Clinician empathy is associated with family satisfaction and reduced anxiety, but quantitative data from the parents’ perspective in pediatric psychiatry are limited. Objective: To assess parent-perceived physician empathy in pediatric psychiatry consultations and explore its associations with clinical and demographic factors. Methods: Cross-sectional, consecutive sample of parents attending an outpatient pediatric psychiatry clinic (n = 163 parents). A 10-item behavioral empathy scale (range 10–40) was used. Analyses included reliability testing, group comparisons, correlations, OLS regression, and exploratory PCA. Results: The mean total empathy score was 34.5 (SD 4.2); most parents rated physicians as highly empathic (65%). Parents of children with ASD reported lower empathy compared to those with anxiety/depression. Empathy increased modestly with child age and was associated with a calmer state at the end of the visit. PCA suggested exploratory evidence of potential subdimensions, including child-centered communication and listening/facilitation. Conclusions: Parent-perceived empathy in this sample was generally high; however, behaviors that directly involve and facilitate the child (listening, encouraging questions) may need strengthening, particularly for children with ASD. Results should be interpreted in light of the single-center design, the absence of a recorded participation rate, parent-proxy reporting, and the exploratory nature of the PCA. Full article

Background: Hearing and cognition decline with age. Hearing is now considered an independent risk factor for later cognitive impairment. Computerized cognitive auditory training is being discussed as a possible adjunctive therapy approach. Objectives: The aim of this exploratory study is to investigate how the success of a computer-based cognitive auditory training (CCAT) can be measured. For this purpose, the influence of a CCAT on different dimensions of hearing and cognition was determined. Materials and Methods: 23 subjects between 52 and 77 years old were recruited with normacusis to moderate hearing loss. They underwent 40 digital training lessons at home. Before, during, and after completion, concentration ability with the d2-R, memory (VLMT), subjective hearing impairment (HHI), hearing quality (SSQ12), listening effort in noise (ACALES), and speech understanding in noise (GÖSA) were measured. Results and Discussion: In this uncontrolled, non-randomized study, one of the main findings was that cognitive dimensions, namely processing speed, improved by 12.11 ± 16.40 points (p = 0.006), and concentration performance improved by 12.56 ± 13.50 points (p = 0.001), which were not directly trained in CCAT. Learning performance also improved slightly by 4.00 ± 7.00 (p = 0.019). Subjective hearing handicap significantly reduced by 10.70 ± 12.38 (p = 0.001). There were no significant changes in the SSQ-12 (p = 0.979). Hearing effort improved by 1.79 ± 2.13 dB SPL (p = 0.001), 1.75 ± 2.09 (p = 0.001), and 3.32 ± 3.27 dB (p < 0.001), respectively. Speech understanding in noise did not improve significantly. CCAT is likely to improve several dimensions of hearing and cognition. Controlled future studies are needed to investigate its efficacy. Full article

Background/Objectives: With a 17.9 million annual mortality rate, cardiovascular disease is the leading global cause of death. As such, early detection and disease diagnosis are critical for effective treatment and symptom management. Cardiac auscultation, the process of listening to the heartbeat, often provides the first indication of underlying cardiac conditions. This practice allows for the identification of heart murmurs caused by turbulent blood flow. In this exploratory research paper, we propose an AI model to streamline this process to improve diagnostic accuracy and efficiency. Methods: We utilized data from the 2022 George Moody PhysioNet Heart Sound Classification Challenge, comprising phonocardiogram recordings of individuals under 21 years of age in Northeast Brazil. Only patients who had recordings from all four heart valves were included in our dataset. Audio files were synchronized across all recordings and converted to Mel spectrograms before being passed into a pre-trained Vision Transformer, and finally a MiniROCKET model. Additionally, data augmentation was conducted on audio files and spectrograms to generate new data, extending our total sample size from 928 spectrograms to 14,848. Results: Compared to the existing methods in the literature, our model yielded significantly enhanced quality assessment metrics, including Weighted Accuracy, Sensitivity, and F-Score, and resulted in a fast evaluation speed of 0.02 s per patient. Conclusions: The implementation of our method for the detection of heart murmurs can supplement physician diagnosis and contribute to earlier detection of underlying cardiovascular conditions, fast diagnosis times, increased scalability, and enhanced adaptability. Full article

Background/Objectives: Children with Autism Spectrum Disorder (ASD) often display heightened sensitivity to simple auditory stimuli, but have difficulty discriminating and integrating multiple phonological features (segmental: consonants and vowels; suprasegmental: lexical tones) at the syllable level, which negatively impacts their communication. This study aims to investigate the neural basis of segmental, suprasegmental and combinatorial speech processing challenges in Mandarin-speaking children with ASD compared with typically developing (TD) peers. Methods: Thirty children with ASD and thirty TD peers will complete a multi-feature oddball paradigm to elicit auditory ERP during passive listening. Stimuli include syllables with single (e.g., vowel only), dual (e.g., vowel + tone), and triple (consonant + vowel + tone) phonological deviations. Neural responses will be analyzed using temporal principal component analysis (t-PCA) to isolate overlapping ERP components (early/late MMN), and representational similarity analysis (RSA) to assess group differences in neural representational structure across feature conditions. Expected Outcomes: We adopt a dual-framework approach to hypothesis generation. First, from a theory-driven perspective, we integrate three complementary models, Enhanced Perceptual Functioning (EPF), Weak Central Coherence (WCC), and the Neural Complexity Hypothesis (NCH), to account for auditory processing in ASD. Specifically, we hypothesize that ASD children will show enhanced or intact neural discriminatory responses to isolated segmental deviations (e.g., vowel), but attenuated or delayed responses to suprasegmental (e.g., tone) and multi-feature deviants, with the most severe disruptions occurring in complex, multi-feature conditions. Second, from an empirically grounded, data-driven perspective, we derive our central hypothesis directly from the mismatch negativity (MMN) literature, which suggests reduced MMN amplitudes (with the exception of vowel deviants) and prolonged latencies accompanied by a diminished left-hemisphere advantage across all speech feature types in ASD, with the most pronounced effects in complex, multi-feature conditions. Significance: By testing alternative hypotheses and predictions, this exploratory study will clarify the extent to which speech processing differences in ASD reflect cognitive biases (local vs. global, per EPF/WCC/NCH) versus speech-specific neurophysiological disruptions. Findings will advance our understanding of the sensory and integrative mechanisms underlying communication difficulties in ASD, particularly in tonal language contexts, and may inform the development of linguistically tailored interventions. Full article

Background/Objectives: with the aim of describing how students and their teachers perceive and define their hearing and auditory experience in the classroom, we present the results of a questionnaire that examined the listening challenges faced by students and teachers at the University of Perugia and in four secondary schools in Friuli-Venezia Giulia, Italy. Methods: A survey was developed as part of the A.Ba.Co. project (Overcoming Communication Barriers). Closed or open-ended questions were used to analyze the responses of students and teachers regarding diagnosed or only perceived hearing difficulties in daily life and the quality of listening in school classes. Results: Hearing difficulties, either clinically diagnosed or only perceived, were reported by 8–9% of students. Between teachers, the reported hearing difficulties were 27.1% in high school and 12% at university (p < 0.001). The most frequent reason for less-than-optimal ease of listening in class differed between the two educational levels; 45.8% of high school students blamed it on the noise in the room compared to 18.2% of university students (p < 0.001). Inversely, 40.9% of university students connected listening difficulty with their place in class compared to 9.5% (101/1065) of high school students (p < 0.001). Conclusions: Although the minimum acoustic requirements for educational facilities have been established by the UNI 11532-2 standard, it is speculated that the majority of high school and university classrooms in Italy do not meet optimal listening conditions. Furthermore, the reasons for students’ poor listening quality appear to not be fully understood, neither by students nor by teachers. In addition to the need for greater attention to physical learning spaces (advocating the universal design principles), effective change will also need to involve a greater awareness of what the barriers to listening are and how much they influence both teaching and learning quality and effectiveness. Full article