Search Results (3,208)

Home has been recognized as a health infrastructure through hospital-at-home, home care, and direct-to-consumer wellness and fitness products. However, the patient home environment has been largely overlooked by healthcare as a means to improve therapy outcomes for difficult-to-treat chronic conditions, such as migraine; high-impact pain; and treatment-resistant depression, anxiety, or insomnia. Growing research evidence enables the formulation of a therapeutic home environment standard consisting of three pillars: biophilic design, indoor environmental quality, and intentional self-care spaces that serve as habit cues and foster sleep hygiene, stress management, relaxation, physical activity, and social interactions. Together, these environmental and behavioral interventions can transform real-world inputs into clinical benefits through autonomic, circadian, and emotional regulation. We also highlight the converging roles of self-management, self-efficacy, self-regulation, and self-compassion in sustaining patient engagement and healing at home. The applicability of the therapeutic home environment as an adjunct is illustrated in the case of chronic migraine, a debilitating neurological condition commonly associated with comorbidities. Current challenges in achieving migraine freedom with FDA-approved pharmacotherapies, neuromodulation devices, and digital health technologies are underscored by the high prevalence of refractory, chronic, episodic, and pediatric migraine. Perspectives on developing a personalized, multimodal cure for migraine are illustrated through a hypothetical drug + digital combination therapy comprising anti-CGRP drugs and an AI-powered digital health platform that promotes daily self-care practices within the therapeutic home environments. In conclusion, achieving sustained freedom from high-morbidity conditions requires end-to-end care ecosystems that integrate pharmacological, cognitive, behavioral, and environmental interventions into real-world settings. Full article

Background: Research on the well-established association between maternal mental health problems and poorer child outcomes has focused on negative parenting behaviour and overlooked psychosocial stimulation as a potential mediating mechanism. Additionally, whether the same association exists for fathers has been understudied. Methods: We addressed these gaps using data from the nationally representative UK-based Millennium Cohort Study, including n = 15,623 children and their mothers (n = 14,922) and fathers (n = 12,408). Parental mental health and the home learning environment (HLE) were measured using the parent-reported Rutter Malaise Inventory at 9 months of age and the HLE Index at age 3, respectively. At 5 years of age, socio-emotional functioning was measured using the parent-reported Strengths and Difficulties Questionnaire, and cognitive and language abilities were assessed directly using British Ability Scales subtests. Results: Structural equation modelling indicated that the HLE significantly mediated the negative associations between PMH and children’s cognitive abilities (mother: β = −0.01, 95% CI [−0.01, −0.01], p < 0.001; father: β = −0.004, 95% CI [−0.008, −0.001], p = 0.025), socio-emotional functioning (mother: β = −0.01, 95% CI [−0.01, −0.01], p < 0.001; father, β = −0.004, 95% CI [−0.007, −0.001], p = 0.022), and language skills (mother: β = −0.01, 95% CI [−0.01, −0.01], p < 0.001; father: β = −0.005, 95% CI [−0.010, −0.001], p = 0.020). Conclusions: These findings support our hypotheses, with stronger associations identified for mothers than for fathers. The findings suggest that further research is needed on the impact of positive parenting, including the home learning environment, in the context of parental depression, using measurement instruments that provide insight in the quality of positive parenting. Full article

Background/Objectives. Low functional literacy in adulthood is a growing issue, yet the cognitive profiles of struggling adult readers in transparent orthographies remain under-researched. This study investigated the cognitive and reading-related predictors of reading comprehension in Polish adults using the Simple View of Reading framework. Methods. We analyzed data from 158 adults recruited as typical readers (TRs, n = 76) and low readers (LRs, n = 82) based on functional reading comprehension scores. Participants completed comprehensive behavioral assessments measuring decoding, listening comprehension, phonological awareness and memory (PA&M), rapid automatized naming (RAN), and language abilities. Results. Path analysis indicated that both decoding and listening comprehension independently and significantly distinguished TRs from LRs (McKelvey-Zavoina R² = 43.6%). However, multigroup analysis revealed differing mechanisms between the two groups: reading comprehension in TRs was driven primarily by listening comprehension, whereas comprehension in LRs was constrained by decoding, which was heavily influenced by RAN and PA. Furthermore, latent profile analysis uncovered significant heterogeneity among the struggling readers, identifying three distinct subgroups: a language-deficit profile (53.8%), a cognitively typical profile (37.5%), and a dyslexic profile (8.8%). These distinct subprofiles aligned with varied background factors, including self-reported dyslexia and early home literacy environment. Conclusions. This study demonstrates that functional reading difficulties in Polish adults are not homogeneous. The identification of three distinct profiles among low readers - language deficit, cognitively typical, and dyslexic - highlights that interventions must be tailored to specific cognitive needs. These findings underscore the necessity for specialized adult-literacy support in Poland to address the growing challenge of low functional literacy and its associated social and economic risks. Full article

Background/Objectives: Fruit and vegetable (FV) availability/accessibility are associated with increased intake of FVs and are important determinants of intake. The aim of this analysis was to evaluate the pre-post changes in an FV accessibility intervention and examine cross-sectional associations between accessibility domains and diet quality categories at pre- and post-intervention. Methods: Thirty parent–child dyads (mean age = 41.2 ± 4.7; 9.2 ± 1.9) completed an 8-week pre-post intervention. Assessments included perceptions of accessibility, the Home Food Inventory with added accessibility domains, and three-day diet records used to calculate HEI-2020 scores. Stuart–Maxwell tests were used to evaluate changes in categorical responses, paired t-tests assessed pre-post changes, and independent t-tests compared accessibility by HEI category. Results: Parents reported a perceived increase in frequency of having the form of FVs prepared/ready for use (p = 0.034). No significant pre–post changes were observed in objective FV availability/accessibility domains, FV intake, or HEI scores for children and parents. Exploratory analyses showed that children and parents with HEI-total scores above national averages had higher mean FV location and visibility, with post-intervention visibility being significantly associated with higher HEI among children (p = 0.048) and location being significantly associated with higher HEI among parents at pre- (p = 0.033) and post-intervention (p = 0.046). Conclusions: The FV accessibility intervention did not significantly improve objective HFE accessibility or diet quality in this small sample. Exploratory findings suggest that FV accessibility domains may be associated with diet quality; however, these observations are preliminary. Larger and longer-term studies are needed to determine whether modifying FV accessibility can meaningfully improve children’s dietary intake. Full article

Costa Rica is a small country in terms of land area, but it is rich in natural resources and home to between 5 and 6 percent of the world’s biodiversity. The country is a leader in the conservation and sustainable use of protected areas through tourism, which is considered a pillar of the national economy and has become one of the most important activities for generating revenue. However, like any other activity, it can exert pressure on the environment in which it takes place, making it essential to analyze and understand how protected areas are used to implement effective management strategies. This study evaluates the frequency of tourism-related use of Corcovado National Park, considering the implementation of three key elements: 1. the frequency with which companies use the park for their tourism activities, 2. visitor density per kilometer by ranger station, and 3. the frequency of trail use based on voluntary geographic information. The research enabled the collection, analysis, and visualization of data using GIS, which facilitated the identification of tourism usage patterns by highlighting the most visited areas and establishing correlations regarding visitor density within the protected area. Among the most significant findings are sites that may be experiencing increased tourism pressure, offering the possibility of managing usage restrictions in specific areas of each station. Spatial analysis has identified areas with lower visitor concentrations, which can be leveraged to promote new attractions and disperse tourist flow throughout the park, thereby reducing pressure on the ecosystem. Full article

Abnormal gait associated with neuromuscular and musculoskeletal disorders represents a growing clinical burden, particularly in aging populations. This study presents a modular, low-cost Smart Rehabilitation Walker (SRW) that integrates multimodal sensing and real-time haptic feedback to enable simultaneous gait monitoring and corrective intervention in both clinical and home environments. The system combines force-sensing resistors for bilateral load symmetry assessment, inertial measurement units for fall detection, and surface electromyography (sEMG) for neuromuscular activity monitoring within a closed-loop assistive feedback architecture. A 15-day pilot study involving ten individuals with rheumatoid arthritis and clinically observed neurological gait abnormalities demonstrated measurable improvements in gait biomechanics. The Force Symmetry Index (FSI), calculated using the Robinson symmetry metric, decreased from an average of 0.9691 to 0.2019, corresponding to a 79.26% average reduction in inter-limb load asymmetry. Concurrently, sEMG measurements showed a substantial increase in neuromuscular activation (ΔEMG = 4.28), with statistical analysis confirming a significant improvement across participants (paired t-test: t(9) = 13.58, p < 0.001). To model rehabilitation trajectories, a nonlinear predictive framework based on Gaussian Process Regression achieved high predictive accuracy (R² ≈ 0.9, with a mean RMSE of 0.0385), while providing uncertainty-aware trend estimation. Validation using an independent amyotrophic lateral sclerosis gait dataset further demonstrated the transferability of the analytical pipeline. These results highlight the potential of sensor-enabled assistive walkers as scalable platforms for quantitative gait rehabilitation, adaptive feedback, and long-term mobility monitoring. Full article

This paper presents a systematic review, conducted in accordance with PRISMA guidelines, synthesising evidence on how visual and spatial features of classical concert settings—such as performer visibility, seating position and sightlines, stage layout, lighting, and vibrotactile cues—shape listeners’ engagement and judgments. RILM, APA PsycNet, PubMed, and Scopus were searched for peer-reviewed experimental studies that manipulated or compared visual/spatial dimensions and reported subjective or physiological outcomes relevant to live, non-amplified contexts. Titles, abstracts, and full texts were screened, and data were extracted and analysed with respect to study design, stimulus environment, outcome measures, and main effects. Heterogeneity across studies precluded meta-analysis; therefore, a narrative synthesis was conducted. A total of 23 publications—22 experiments and one meta-analysis—met the inclusion criteria: the reviewed studies primarily examined issues related to visual presence and spatial configuration. Most studies relied on laboratory or home-based audiovisual reproductions, with only one study collecting data in a naturalistic performance setting. The evidence is limited by methodological heterogeneity, the predominance of simulated environments, and variability in outcome measures. Overall, visual and spatial factors substantially shape classical music listening and the audience experience, underscoring the need for more field-based and methodologically standardised research. Full article

Timely classification of cardiovascular diseases is crucial to improve medical outcomes. Emerging remote patient monitoring systems help achieve this by enabling continuous monitoring of electrocardiogram signals in home environments. However, these systems struggle with unique challenges like missing genuine medical emergencies, rising energy demands, scalability challenges, handling vast medical databases, data processing delays, and safeguarding patient records. To overcome these challenges, we propose a single framework with three main phases: (a) an embedded hardware-driven K-Nearest Neighbor (KNN)-assisted real-time ECG monitoring and classification method; (b) a differentiated communication strategy (DCS) formed with a priority-based ECG data packaging framework and multi-layered security protocols; and (c) a multi-level blockchain network (MLBN) architecture armed with adaptive security mechanisms and real-time cross-chain medical data communication bridges. Simulations are conducted using the ECG signals (1000 fragments) dataset and the Ganache Ethereum development framework. The classification accuracies obtained for patient urgent categories U1 to U5 are 91.43%, 95.71%, 94.23%, 90.00%, and 91.43%, respectively. The performance evaluation results of the KNN-guided classification method, along with DCS and MLBN simulation results obtained from average gas consumption analysis, confirms reliability and viability of our framework, while also revolutionizing remote patient monitoring technology and addressing critical challenges in existing systems. Full article

Working from home has become an increasingly common feature of contemporary working life. The present study examined how different degrees of working from home relate to employees’ perceptions of the work environment, job satisfaction, and health. The analyses were based on a national probability sample of Swedish employees (N = 2331). A multivariate regression model was estimated to examine associations between three working arrangements—office, hybrid, and predominantly home-based work—and multiple employee outcomes. The results showed that hybrid work and predominantly home-based work were associated with different patterns of employee outcomes. Hybrid work was primarily related to higher role ambiguity and lower job satisfaction, whereas predominantly home-based work was associated with a broader set of outcomes, including poorer general health, more sleep problems, lower job satisfaction, higher role ambiguity, and lower perceived workload. Taken together, the findings suggest that patterns of associations differ across working-from-home arrangements rather than simply reflecting the mere presence of remote work. The study highlights the importance of distinguishing between different degrees of working from home when examining how remote work relates to employees’ work experiences and well-being. Full article

The growing prevalence of home education necessitates exploration of parental involvement outside traditional schooling environments. This paper conceptualises parental involvement within home education decision-making. Core elements of decision making, including Choices, Contexts, Challenges and Changes, are integrated with Bronfenbrenner’s bioecological systems theory to create the 4Cs model of parental decision-making in home education. The 4Cs model is developed from integrating findings from the literature with previous empirical work on how parents make and explain decisions in home education. The present paper uses this model to organise and explain parental decision-making in a structured way. Building on critiques of school-centric parental involvement models, the 4Cs model steps away from assumptions that position parents as passive participants in schools’ agendas to instead illustrate parents’ active collaboration and involvement in their children’s education. The paper goes on to use the 4Cs model to help reframe Epstein’s typology of parental involvement to bridge home education research and broader scholarship on parental involvement. It provides a structured lens to analyse the decision-making processes that underpin why families choose home education and how it is enacted in practice. Central to this framework is the concept of parental agency, which is decoupled from school-based imperatives and positioned as the driving force in constructing tailored learning environments. This theorisation offers a critical lens for examining how parents navigate educational trade-offs, socioecological constraints, and adaptive strategies. We reframe parental involvement as deliberative, context-responsive praxis, creating potential for the 4Cs framework to act as a transferable model for analysing agency-driven parental engagement across diverse educational settings. Full article

Maintenance is crucial for the durability of the existing building stock and should be perceived as an opportunity to improve the built environment. The implementation of thermal retrofitting measures to the building’s envelope enhances global energy performance, which is economically and environmentally beneficial. Building-related energy consumption during the operation phase is key to tackling carbon neutrality and climate change. Introducing thermal retrofitting within the context of maintenance planning can be cost-optimizing, as it reveals the technical–economic synergy between building pathology and energy efficiency. Maintenance activities and energy demand throughout the building’s service life influence life-cycle costs (LCCs). Decision-making based on LCC awareness is an advantage for owners. This study discusses the impact of implementing an optimal retrofitting solution (ORS), according to different maintenance strategies, on the LCC of an existing single-family home. The ORS comprises the following measures: adding an external thermal insulation composite system (ETICS) to external walls, extruded polystyrene (XPS) panels to the roof, and replacing the existing windows with others with improved thermal performance. The three maintenance strategies involve different complexity levels, concerning the type, number and timing of activities. Moving beyond isolated assessments, this study develops an integrated framework that bridges based on two existing background methodologies, involving optimal thermal retrofitting and condition-based maintenance planning, which, combined with new research, enable the assessment of maintenance, energy and global LCC for a time horizon of 100 years. The evaluation of energy-related LCC is based on simulations. The results indicate that these costs represent the majority of the global LCC. The ORS has a considerable positive impact on energy and global LCC. Adopting a maintenance strategy characterized by fewer planned activities and an earlier schedule of replacement interventions, which determines the implementation of the retrofitting measures, is better in terms of LCC savings. Full article

Children’s affinity for natural elements, or biophilic preferences, has gained increasing recognition as a cornerstone of family-centered sustainability. This study examines how parental factors, specifically environmental attitudes and in-home biophilic design plus guidance, directly shape children’s preference for nature-infused environments. A cross-sectional survey (N = 397) for parents collected data on household greenery, animal care, parental attitudes toward environmental responsibility, and the degree of child involvement with natural elements. Using Partial Least Squares Structural Equation Modeling (PLS-SEM), the analysis identified proactive parental mindsets and frequent biophilic home modifications as significant predictors of stronger child affinity for plants, water features, and other nature-inspired components. The findings highlight several key parental and environmental factors that contribute to the development of children’s biophilic preferences, underscoring the importance of coordinated efforts among families, communities, and policymakers to nurture children’s environmental consciousness. By highlighting how indoor greenery, small-scale animal care, and intentional parental support can foster early engagement with nature, this research offers fresh insights into the synergy between biophilic design and sustainable family practices. Emphasizing the potential role of home-based natural elements in enhancing children’s environmental awareness, the study concludes that nature-rich living spaces and holistic sustainability interventions are essential for empowering the next generation to shape a more sustainable future. Full article

Sleep quality is closely associated with cardiovascular, metabolic, and mental health outcomes, yet the clinical gold standard, polysomnography (PSG), is costly and intrusive for long-term home monitoring. Ballistocardiography (BCG) enables unobtrusive in-bed sensing and is therefore attractive for low-burden sleep assessment in natural environments. However, most existing BCG studies are PSG-referenced and mainly focus on sleep staging, while movement and out-of-bed episodes are often treated as artifacts rather than modeled jointly. In this study, we propose an interpretable unsupervised proxy-state modeling framework for three-state in-bed monitoring from BCG signals under an unlabeled setting. BCG recordings were segmented into 30 s windows with 50% overlap, and multi-domain features were extracted from waveform morphology, spectral power, heart rate-related dynamics, and wavelet energy distribution. K-means clustering (K = 3) was used to construct cluster-derived proxy labels, TreeSHAP-based feature ranking together with inner-CV-guided Top-N subset selection was used for training-only feature screening, and multiple classifiers were compared under a strict leave-one-subject-out protocol, with an ROA-optimized RBF-SVM achieving the best overall performance. Using data from 32 volunteers, the framework achieved an accuracy of 0.9932 ± 0.0047 (mean ± SD), together with consistently strong Macro-F1 and MCC scores. Overall, it outperformed the alternative methods compared in this study. Full article

Antibiotic resistance genes (ARGs) are prevalent in livestock environments due to antimicrobial use, yet their airborne dispersal into human-occupied indoor spaces remains poorly characterized. We investigated whether airborne ARGs disperse from livestock stables into farmers’ homes and surrounding outdoor environments. Electrostatic dust collectors were deployed in paired pig and cow stables and their associated homes in Jutland, Denmark, to collect settled airborne dust. Pooled samples were analyzed using shotgun metagenomic sequencing. ARG dispersal patterns were assessed using FEAST source tracking and ecological similarity metrics, including shared ARG ratios and Jaccard indices. Pig production systems exhibited higher antibiotic use and stronger resistome continuity with farmers’ homes than cow systems, reflected by greater FEAST contributions (P = 0.029) and Jaccard similarity (P = 0.029). Beta-diversity analysis supported higher compositional similarity between pig stables and homes (PERMANOVA R² = 0.23, p = 0.052), whereas cow environments showed greater divergence (R² = 0.41, P = 0.035). Across environments, tetracycline, macrolide–lincosamide–streptogramin B, and aminoglycoside resistance genes dominated, consistent with livestock-specific antibiotic use patterns. Supplementary indoor–outdoor comparisons across cow, pig, and chicken stables (from an independent 2024 sampling campaign not directly comparable to the 2008 EDC-based survey) revealed contrasting dispersal dynamics, with higher bacterial species spillover from cow stables but stronger ARG overlap from pig stables. Collectively, these findings are consistent with airborne ARG connectivity across occupational and environmental interfaces and support consideration of air as a potential pathway in One Health AMR surveillance. Full article

The level and development of cognitive ability are associated with parental socioeconomic status (SES). Some of these cognitive differences are presumably due to individual differences in genetic predispositions, but the potential mechanisms and influencing factors are still relatively unclear. Previous research has identified factors that show a relation with both cognitive abilities and SES (e.g., parental cognitive ability, home environment, and polygenic scores). Regarding these factors, we analysed three age cohorts (N = 6715; 5, 11, and 17 years old) at a 6-year interval using multiple regressions and decomposition analyses. Firstly, results indicated that cognitive differences linked to SES emerged particularly between the ages of 5 and 11. A substantial part of the SES effect was associated with parental cognitive ability. Secondly, particularly in the oldest cohort, the polygenic score for cognitive ability was related to the SES-associated change in cognitive ability. Finally, in several analyses, the influence of SES on cognitive ability was no longer significant after considering the attendance of the academic track in secondary school. This pattern could indicate that SES-associated differences in secondary school recommendations shown in previous studies may also be associated with SES-related differences in cognitive ability, which should be investigated in future studies. Full article