Search Results (439)

This study investigated academic and environmental predictors of national licensing examination success among physical therapy graduates in Thailand, examining overall academic achievement, domain-specific competencies (Code 01: Law/Ethics/Administration; Code 02: Techniques; Code 03: Clinical), admission pathway, and COVID-19-related online-learning disruption. This retrospective cohort study analyzed 342 graduates (2020–2023) using multivariable logistic regression and Pearson correlation, with GPA-based predictors rescaled per 0.1-point increase. Undergraduate GPAX and Code 02/03 grades were the strongest positive predictors of both first-attempt and annual licensing success (adjusted OR range 1.35–1.74, all p < 0.001). Online-learning duration reduced first-attempt odds by 24% (OR = 0.757, p = 0.036) but did not affect annual success, while TCAS admission round was a significant negative predictor of first-attempt success only in the model excluding domain-specific scores (OR = 0.671, p = 0.011); Code 01 score was not significant in any model. These findings indicate that domain-specific academic performance, rather than general achievement or admission pathway, was the strongest predictor of licensing success, underscoring the value of early monitoring of coursework performance for identifying at-risk students. Full article

Background: Educational workplace dietary interventions have emerged as a promising approach to supporting occupational well-being among healthcare professionals. This scoping review mapped and synthesized the available evidence on such interventions across healthcare settings. Methods: A scoping review was conducted in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. PubMed, Scopus, and the Cochrane Library were searched for studies published between December 2020 and March 2026. Thirteen studies met the predefined eligibility criteria. Results: Across the included studies, healthcare professionals exhibited irregular eating patterns, meal skipping, and suboptimal dietary behaviours associated with occupational stress. Educational workplace interventions combining nutrition education with behavioural, organizational, and lifestyle components were associated with improved nutrition knowledge, dietary behaviours, selected health indicators, and occupational well-being. Thematic synthesis identified workplace organization, behavioural determinants, and organizational support as key influences on dietary practices and professional well-being. Conclusions: Workplace nutrition should be considered an integral component of occupational health rather than solely an individual lifestyle behaviour. The proposed Workplace Nutritional Resilience framework highlights the potential contribution of educational, behavioural, and organizational strategies to occupational well-being. Further longitudinal and intervention studies in specific healthcare professions are warranted, particularly among dental professionals. Full article

Background/Objectives: Interprofessional education (IPE) supports collaborative practice, but educational exposure, self-rated knowledge, and collaboration are distinct constructs. We examined the adjusted associations between self-reported prior IPE experience and single-item self-rated IPE knowledge and perceived collaboration among health professions faculty and educators in Albanian and Italian work contexts. Methods: This quantitative-dominant cross-sectional mixed-methods study included 445 faculty members and educators. Collaboration was assessed using language-matched versions of the 23-item Assessment of Interprofessional Team Collaboration Scale II (AITCS-II). Self-rated IPE knowledge was assessed using a single author-developed 0–100 item. Heteroskedasticity-consistent type 3 standard errors in linear regressions examined adjusted associations and exploratory context interactions. Confirmatory factor analysis and reliability analyses examined preliminary evidence of internal structural validity and internal consistency in this sample. Directed qualitative content analysis with inductive expansion examined 341 responses from 114 participants and was integrated into the aggregate results. Results: A total of 47.2% of participants reported prior IPE experience; the mean single-item self-rated IPE knowledge score was 31.7/100, and the mean overall AITCS-II score was 3.95/5. Cooperation was rated highest and Partnership lowest. In the adjusted model (n = 417), self-reported prior IPE experience was associated with a 0.32-point higher overall AITCS-II score (95% CI 0.18–0.47), while each 10-point increase in the single-item knowledge rating was associated with a 0.03-point higher score (95% CI 0.002–0.058). No country-of-work interaction was statistically supported. The response covariance structure was compatible with the hypothesised three-factor model. Qualitative findings emphasised experiential and longitudinal learning and identified professional silos, hierarchies, curricular rigidity, limited resources, and weak organisational coordination as barriers. Conclusions: Self-reported prior IPE experience showed a clearer and more consistent association with perceived collaboration than did the single-item measure of self-rated IPE knowledge, whose association was small and less consistent across domains. Applied, repeated, and contextually embedded IPE, supported by faculty development and organisational structures, may facilitate collaborative practice. Causal and cross-country conclusions are not warranted. Full article

Empathy is essential to humanized nursing care, yet its relationship with emotional competence before professional entry remains insufficiently specified. This single-school cross-sectional study examined whether distinct dimensions of emotional competence were differentially associated with emotional empathy among 337 secondary-level vocational nursing students enrolled in a five-year Croatian program for general care nurses/medical technicians. Students completed the Emotional Skills and Competence Questionnaire (ESCQ-45) and the Emotional Empathy Scale from the E-Questionnaire, which primarily captures affective responsiveness to others’ distress and other negative-valence states. Spearman correlations, Kruskal–Wallis tests with Dunn–Holm post hoc comparisons, Welch tests, and hierarchical linear regression with heteroscedasticity-consistent type 3 robust standard errors were used. Emotional empathy correlated with emotion perception and understanding (ρ = 0.35, p < 0.001) and emotion management (ρ = 0.28, p < 0.001), but not with emotion expression and naming (ρ = 0.10, p = 0.070). In the fully adjusted regression model, emotion perception and understanding (β = 0.254, p < 0.001), emotion management (β = 0.254, p = 0.003), and female versus male reported sex (β = 0.277, p < 0.001) were statistically significant predictors, whereas clinical exposure was not (p = 0.429). Emotion expression and naming had a negative adjusted coefficient (β = −0.158, p = 0.040) after simultaneous control for the remaining predictors. The findings support a dimensional interpretation of emotional competence and indicate that negative-valence emotional empathy is more closely associated with recognizing, understanding, and managing emotions than with expressive emotional skills considered in isolation. Full article

Drawing on Self-Determination Theory, this study examines how perceived learning support, smartphone addiction, and user resistance jointly shape online learning outcomes among Chinese pre-service teachers. Data from 1134 participants enrolled in China’s government-funded targeted teacher education program-primarily oriented toward strengthening the supply of teachers for basic education, especially in central and western China, were analyzed using Mplus 8.3. The results showed that perceived learning support was positively associated with learning outcomes, whereas smartphone addiction was negatively associated with them. The role of user resistance was more complex in the full structural model and should therefore be interpreted with caution. Self-regulated learning (SRL) strategies served as a key mediator: perceived learning support improved learning outcomes partly by fostering SRL, while smartphone addiction hindered learning outcomes by weakening SRL. By examining a distinctive cohort of pre-service teachers, this study highlights the importance of supportive learning conditions and institutional context in online learning, and identifies SRL as a key learning process through which learning support and digital constraints are associated with learning outcomes. Full article

Menopause represents a major neuroendocrine transition characterized by substantial hormonal, metabolic, vascular, and inflammatory changes that may increase vulnerability to cognitive decline and neurodegenerative disease. Declining estrogen levels during the menopausal transition influence multiple neural processes, including synaptic plasticity, cerebral glucose metabolism, mitochondrial function, neuroinflammatory signaling, and cerebrovascular regulation. Women account for nearly two-thirds of individuals diagnosed with Alzheimer’s disease, and mounting evidence suggests that menopause may represent a period of heightened neurological vulnerability. Physical exercise has emerged as one of the most promising non-pharmacological strategies for preserving cognitive health and reducing neurodegeneration risk in aging women. Current evidence demonstrates that exercise interventions after menopause are associated with improvements in executive function, memory performance, attention, and global cognition. These benefits appear to result from converging biological mechanisms that include enhanced neurotrophic signaling, increased brain-derived neurotrophic factor (BDNF) expression, improved cerebrovascular function, reduced systemic inflammation, improved insulin sensitivity, enhanced metabolic regulation, and preservation of structural brain integrity. Neuroimaging studies further demonstrate exercise-associated increases in hippocampal volume, cortical thickness, functional connectivity, and cerebral blood flow. Different exercise modalities appear to produce distinct but complementary neurological benefits. Aerobic exercise is strongly associated with improved cerebrovascular function and hippocampal integrity, resistance training demonstrates favorable effects on executive function and white matter preservation, and multimodal interventions combining aerobic, resistance, balance, and cognitively engaging activities appear to produce the broadest cognitive benefits. Emerging evidence further suggests that the timing of exercise initiation relative to menopause may influence outcomes, with earlier interventions potentially conferring greater neuroprotection. This review synthesizes current evidence regarding the effects of exercise on cognitive function in postmenopausal women, with emphasis on biological mechanisms, neuroimaging findings, exercise modality, timing considerations, and implications for neurodegeneration prevention. Understanding these relationships provides a scientific rationale for positioning exercise as a foundational strategy for preserving cognitive health and reducing neurodegenerative disease burden in postmenopausal women. Full article

Background/Objectives: The integration of nutrition into the psychological sciences and mental healthcare has gained increasing attention with the emergence of Nutritional Psychology as an interdisciplinary field. However, little is known about how professionals approach this interface or the barriers they face. This study aimed to explore the extent to which mental health and nutrition professionals engage with each other’s domains. Methods: This cross-sectional study analyzed survey responses from 196 professionals, including mental health professionals, nutrition professionals, and individuals from related fields recruited through the individual and institutional professional network of the Center for Nutritional Psychology, San Jose, CA, USA. The goal was to examine training, practices, perceived barriers, and interest in collaboration between these professions. Descriptive statistics summarized categorical and quantitative variables. Mann–Whitney U tests with rank-biserial correlation examined ordinal data. Exploratory factor analysis (principal axis factoring, varimax rotation) was applied to barrier ratings. Results: A total of 78.3% of participating mental health professionals reported addressing nutrition in their practice at least occasionally, while a similar percentage (78.5%) of participating nutrition professionals discussed mental health with clients at least occasionally. Despite this engagement, 25% of all participating nutrition professionals and 51% of all participating mental health professionals reported no formal training in the complementary field, with most of their knowledge acquired informally through self-study or workshops. A total of 11 mental health professionals and 13 nutrition professionals did not answer the question about formal education in the complementary field. The highest-rated perceived barriers included a lack of training, unclear professional boundaries, and a lack of a common language, whereas a lack of evidence was perceived as the least critical. Importantly, 99% of respondents who answered the question (n = 84, while 112 participants did not respond), or 42% of all participants, expressed interest in evidence-based interdisciplinary training. A total of 96% of those who answered the question (n = 133, while 63 participants did not answer) or 65% of all participants agreed that collaboration would improve patient outcomes. However, only 49% of all participating nutrition professionals and 50% of all participating mental health professionals reported having collaborative experience. A total of 7 mental health professionals and 16 nutrition professionals did not answer the question about collaborative experiences. Conclusions: Within this self-selected sample, respondents reported frequent cross-disciplinary engagement, limited formal training, and interest in interdisciplinary education and collaboration. These exploratory findings require confirmation in independently recruited and better-characterized samples. Full article

Background/Objectives: Self-medication and keeping medicine inventory in households are common practices, even among healthcare professionals and healthcare professions students. Despite their knowledge of appropriate medicine use and storage, these practices are not always responsible and may pose health risks. This study aimed to describe self-medication practices, contents of home pharmacies, and habits of keeping medicine inventories in households of medical and pharmacy students at the Faculty of Medicine, University of Rijeka. Methods: In this cross-sectional study conducted in 2025, 60 third-year medical and pharmacy students interviewed members of their households regarding contents of home pharmacies and self-medication practices and compiled inventories of medicines kept at home. Results: Of the participating students, 70.0% were female. Healthcare professionals (physicians or pharmacists) were present in 23.3% of households. Medicines were stored in a designated location (“home pharmacy”) in 65.0% of households, whereas only one household reported having no medicines. Expired medicines and/or medicines with an unknown purpose were found in 41.6% of households. No household reported that medicines were accessible to children younger than 14 years. Inventories of stored medicines were obtained from 54 households (90.0%). Analgesics and antipyretics were present in 92.6% of households and were used for self-medication in 96.0% of them. Cough and cold preparations were found in 35.2% of households and used for self-medication in 94.7%. Antibiotics were present in 31.5% of households and used for self-medication in 52.9%, while anxiolytics were found in 16.7% of households and used for self-medication in 33.3%. Conclusions: Stocking medicine supplies and practicing self-medication are common among households of third-year medical and pharmacy students at the Faculty of Medicine, University of Rijeka. Analgesics and antipyretics were the most frequently stored medicines used for self-medication. The presence of expired medicines and the self-medication of prescription-only medicines highlight the need for greater emphasis on responsible self-medication, safe medicine storage, and rational medicine use within healthcare professions education. Full article

Positionality refers to a researcher’s stance within the social context of their research study. It can include information such as gender, race and class, and other characteristics like location. In addition, positionality statements can also include researchers’ personal traits, such as their thoughts, feelings and behaviors. They convey a researcher’s position and are incorporated within research articles to make readers aware of the beliefs and assumptions that a scholar may be bringing into the study. Describing one’s positionality can be particularly beneficial within health professions education (HPE) research, where complex power dynamics often exist between the researcher and participants. However, there is currently limited literature on how positionality statements should be written for HPE research. This paper aims to present an introductory guide on how a novice researcher can write a positionality statement within HPE research, including elements such as reflexivity, location and context, power dynamics, and insider–outsider positioning, as well as the potential risks tied to positionality statements. Additionally, this paper provides readers with a practical step-by-step guide and a real-life example to follow when developing their own positionality statement. By practicing reflexivity and considering how their location and presence impact the research process and participants, a scholar can articulate how their identity and context shape their research approach. Consequently, adding a positionality statement can increase trustworthiness and enhance transparency of a study when they are reflexive, context-specific, ethically constructed and integrated into the research process. Full article

Background/Objectives: Human papillomavirus (HPV) is now responsible for the majority of oropharyngeal squamous cell carcinomas (OPSCCs), an HPV-related cancer of direct relevance to the dental profession; oral-health providers may be well-positioned to perform routine oral examination, recognize suspicious signs, refer appropriately, and educate patients about HPV-related oropharyngeal cancer and HPV vaccination. This study assessed knowledge, attitudes and practices regarding sexually transmitted infections (STIs), HPV, HIV/AIDS and HPV-related oral and oropharyngeal cancer among secondary-school students in Apulia, Italy, with particular attention to the dental setting. Methods: A cross-sectional study was conducted by the University of Foggia among 1224 students from three secondary schools at the end of the 2025/2026 school year) using a self-administered 108-item questionnaire. A 63-item composite knowledge score was computed; “don’t know” answers were scored as incorrect and adequate knowledge defined a priori as ≥60% (Bloom’s cut-off). The minimum required sample (737) was derived using Cochran’s formula adjusted for a cluster-sampling design effect. Results: Overall knowledge was low (mean 28.5%, SD 18.2); only 5% reached the ≥60% threshold (Bloom’s cut-off). Only 14.8% of students were aware that HPV can cause oropharyngeal cancer, the lowest figure among all oncogenic outcomes assessed and significantly lower in boys (11.2%) than girls (17.3%; p = 0.003), despite boys carrying the higher OPSCC risk. Knowledge was independently associated with female sex, age and sexual experience. Despite poor knowledge, 61.2% of students would like to receive the HPV vaccine. Conclusions: The dental visit may represent an under-used opportunity to address this oral-cancer-prevention knowledge gap; the integration of oral-health professionals into school-based and clinical HPV-prevention strategies is a plausible public-health implication. Full article

Background/Objectives: Therapeutic adherence remains a critical challenge in the management of chronic conditions, yet most research has focused on pharmacological adherence from the perspective of physicians and pharmacists. The views of non-physician healthcare professionals—particularly physiotherapists, podiatrists, psychologists, and nurses—remain underrepresented. This study aims to explore how these four healthcare disciplines perceive the factors influencing therapeutic adherence, the strategies they use to support it, and how they address patient resilience in clinical practice. Methods: An exploratory qualitative study was conducted using semi-structured interviews with 32 healthcare professionals (8 per discipline) recruited through purposive sampling across diverse care settings across Spain. Data were analyzed using reflexive thematic analysis following a hybrid deductive–inductive approach. Quality criteria were applied in accordance with the standards proposed by Lincoln and Guba. Results: Three thematic domains emerged. Patient-related factors, especially motivation, health literacy, illness beliefs, and socioeconomic constraints, emerged as central determinants across all disciplines. Health system barriers, particularly limited consultation time and fragmented continuity of care, also constituted significant barriers. Discipline-specific strategies ranged from the teach-back technique and customized visual aids in nursing and podiatry to functional goal-setting and group-based dynamics in physiotherapy and expectation-setting and digital follow-up in psychology. Resilience was consistently described as a key mediating factor enabling patients to sustain adherence despite adversity. Conclusions: Therapeutic adherence is a multifactorial and discipline-sensitive phenomenon. The complementary strategies identified across professions support the value of coordinated interdisciplinary approaches. Resilience-informed interventions and profession-specific adherence training represent promising directions for improving clinical practice and professional education. Full article

This article examines the impact of the EU Directive on the recognition of professional qualifications (2005/36/EC) on the development and strengthening of midwifery in countries that joined the European Union in recent decades, with a particular focus on Central and Eastern Europe. Focusing on experiences from Croatia, Poland, Slovenia, Bulgaria, and the Czech Republic, the paper explores how alignment with the Directive influenced education reform, professional recognition, and scope of practice. Drawing on the experiences presented, we argue that the Directive has functioned as more than a technical requirement for EU accession. By establishing minimum educational standards, it supported the transition from vocational to university-level education, facilitated pathways for the existing workforce to align with new qualification requirements, and contributed to the recognition of midwifery as a distinct regulated profession. It also provided a clear framework for defining midwives’ competencies and scope of practice within health systems, acting both as a protective mechanism, by safeguarding professional standards, autonomy, and professional identity, and as an enabling framework by supporting workforce development, educational reform, and the integration of midwives into health systems during periods of institutional transition. The lessons drawn from these national experiences can inform the ongoing update of the Directive, led by the EU Commission, by illustrating how legislative alignment can strengthen midwifery education and professional recognition, while also supporting countries undergoing or preparing for EU accession. Full article

Context: Child-focused healthcare professionals serve as primary providers of both physical and psychosocial care to pediatric patients and their families. Consequently, they are exposed to substantial occupational and emotional challenges in the course of their practice. Objectives: This study examined the levels and multidimensional aspects of occupational stress, coping strategies, and resilience among healthcare professionals providing care to pediatric patients and their families in Greece. Methods: Socio-demographic characteristics, perceived occupational stress, coping strategies (WCQ), and resilience were assessed in a sample of 202 child-focused healthcare (physicians and nurses) and social care professionals (social workers, psychologists, and special education professionals) employed across a range of health and psychosocial services in Greece. Multiple linear regression analyses using the enter method were performed to examine the associations among resilience, occupational stress, and coping strategies while controlling for relevant demographic and occupational variables. Results: Social support was significantly associated with gender. Positive coping was associated with age, work experience, and the WCQ subscales Social Support, Daydreaming, and Avoidance. Avoidance coping was positively associated with profession and Daydreaming. Significant differences were also observed according to age, occupational stress, positive coping, social support, and resilience. Hierarchical multiple regression analysis demonstrated that, positive coping was independently and most strongly associated with resilience (p < 0.001), whereas work stress was independently and negatively associated with resilience (p = 0.001), with higher perceived stress corresponding to lower levels of resilience. Conclusions: The findings highlight the central role of positive coping in relation to resilience among child-focused healthcare professionals, while demonstrating the negative association between occupational stress and resilience. These results underscore the need for interventions that strengthen effective coping strategies, reduce work-related stress, and enhance resilience among healthcare professionals. They also identify important knowledge gaps and support the need for future research examining occupational stress, its long-term consequences, and the coping mechanisms and resilience among professionals working with children and families. Full article

Background: Educational environments grounded in respect, empathy, and fair treatment are vital for effective learning and clinical safety. Cultivating this positive culture is essential for improving professional practices and future development. The aim was to develop strategies collaboratively to promote good treatment practices within health programs across six Chilean universities. Methods: This study utilized a qualitative action research (AR) approach. Researchers conducted 23 co-creation workshops involving 188 students and 158 faculty members. The resulting data were analyzed using CAQDAS MAXQDA, version 24. Results: Participants favored short-term actions (61.6%; n = 94) over medium-term (17%; n = 26) or long-term (20.9%; n = 32) initiatives. Proposed short-term actions focused on curricular changes, faculty development, and well-being initiatives. Medium-term plans emphasized support systems and committees, while long-term goals targeted broader policies, labor conditions, and teaching hospitals, which presented the lowest frequency. The study identified three domains of actors involved: beneficiaries, groups, and those responsible for implementation. Conclusions: These community-driven, collaborative efforts provide a constructive framework for institutional intervention. By engaging stakeholders directly, the co-creation process allows for a comprehensive understanding of the scope and limitations of educational initiatives, effectively grounding them within the specific needs of the academic context. Full article

Background: Nursing regulation is a key component of health system governance; however, its role in structuring the development and deployment of professional competencies remains insufficiently examined, particularly in emerging health systems. Objective: To map and synthesize the evidence on nursing regulation and its relationship with professional competencies across the nursing profession, including the development of advanced nursing roles, and to analyze the Mexican regulatory framework within an international context. Methods: A scoping review was conducted using a structured and transparent approach. Searches in Scopus, Web of Science, and PubMed identified 194 records. After duplicate removal and screening, 17 studies met inclusion criteria based on relevance to regulation, scope of practice, and competency development. In parallel, 13 regulatory instruments in Mexico were identified through targeted searches of official sources; 9 key documents were selected based on specificity and relevance. Data were analyzed using a policy-oriented framework. Results: Regulatory frameworks consistently define scope of practice and enable the translation of competency-based education into recognized clinical roles. Regulatory coherence was associated with expanded professional autonomy, advanced role development, and improved workforce integration. Fragmented regulatory environments were linked to misalignment between education and practice and underutilization of competencies. In Mexico, a broad but fragmented regulatory architecture was identified, lacking a unified regulatory axis and an autonomous professional body. Conclusions: Nursing regulation functions as a structural determinant of professional competency deployment. Strengthening regulatory coherence is essential to align education, practice, and health system needs, with implications for workforce performance, patient safety, and system sustainability. Full article