Search Results (1,118)

Scientific conferences are invaluable for knowledge exchange, yet pose growing environmental concerns, especially through long-distance travel. This work quantifies and compares the environmental burdens of a national conference (30 delegates, Pisa, Italy) and an international conference (50 delegates, Athens, Greece) using ISO 14040/44-compliant Life-Cycle Assessment (LCA). A cradle-to-grave inventory combined primary data on participant travel, venue utilities, catering materials and waste handling with secondary datasets from Ecoinvent 3.8. Sixteen midpoint impact categories were calculated with the Environmental Footprint 3.1 method and normalized per delegate. The international meeting incurred 130 kg CO_2eq per delegate, compared with 11 kg CO_2eq per delegate for the domestic event, reflecting a ten-fold rise in fossil energy demand and comparable multiples across acidification, eutrophication and toxicity categories. Participant travel explained >85% of every global indicator in both cases, while venue energy and material flows together accounted for ≤12%. Further developments require harmonized functional units, improved digital-infrastructure inventories and integration of social impact metrics. The findings provide preliminary input for evidence-based guidelines for organizers and contribute to the standardization of LCA in the emerging field of event sustainability. Full article

Background/Objectives: Low back pain is considered one of the leading causes of disability. Up to 90% of cases are classified as non-specific, which, if prolonged for at least 12 weeks, is considered non-specific chronic low back pain (NSCLBP). Physical exercise is one of the selected treatments for NSCLBP. Interest in the use of remote interventions has recently emerged. The main objective was to analyze the effect of home exercise interventions to reduce pain intensity and functional disability in individuals with NSCLBP. Methods: A systematic review was conducted in April 2024. Both multivariate and univariate meta-analysis was performed with the difference before and after treatment, adjusting both models with a meta-regression that included the covariates age and body mass index (BMI). Heterogeneity was analyzed with Cochran’s Q test as well as with the I² estimator, and effect size was calculated with Hedges’G. Results: A total of six studies, with moderate–high methodological quality and a heterogeneous risk of bias, were included. There was a statistically significant pre-/post-treatment effect on functional disability (moderate effect: Hedge’s g = 0.69, p = 0.018) and pain intensity (large effect: Hedge’s g = 1.11, p = 0.007) in both univariate and multivariate (moderate effect: Hedge’s g = 0.77) meta-analyses when comparing unsupervised home exercise with supervised in-person exercise, in favor of the latter. This effect was significantly moderated by BMI (p = 0.003 for both outcomes) negatively. Conclusions: Unsupervised home exercise appears to be less effective than supervised in-person exercise in effectively reducing pain intensity and functional disability in the short term in individuals with NSCLBP. Full article

Background: Despite strong guideline recommendations, participation in cardiac rehabilitation (CR) among patients with chronic heart failure (CHF) remains low due to logistical, geographical, and psychosocial barriers. Telerehabilitation may help overcome these limitations by offering remote, structured exercise programs supported by digital technologies. Objective: The TELEREHAB-HF study aims to evaluate the efficacy of an 8-week, home-based cardiac telerehabilitation program compared to standard in-person rehabilitation in patients with CHF. Methods: This is a prospective, controlled cohort study involving 220 adult patients with CHF (NYHA class I–III) clinically stable and on optimized therapy. Participants are assigned to either a telerehabilitation group (remote CR via a digital platform with wearable sensors and real-time physiotherapist supervision) or a standard in-person rehabilitation group. The primary outcome is the change in peak oxygen uptake (VO₂max) at 8 weeks. Secondary outcomes include quality of life, functional performance, biochemical and echocardiographic parameters, and cognitive function, assessed at baseline and at 4, 8, 16, and 24 weeks. Expected Results: We hypothesize that telerehabilitation will be non-inferior to standard CR in improving functional capacity and secondary outcomes, with additional benefits in accessibility and adherence. Data from remote monitoring may also support a translational “rehabilomics” approach to exploring exercise-induced biomarker changes. Conclusions: This study seeks to assess the clinical effectiveness, safety, and feasibility of a home-based telerehabilitation model for CHF, with the goal of informing future strategies for broader implementation and personalized rehabilitation. Trial Registration: ClinicalTrials.gov Identifier: NCT07023536 Full article

Telemedicine has transformed obstetrics and gynecology (OB/GYN), accelerated by the COVID-19 pandemic. This study aims to synthesize evidence on the adoption, effectiveness, barriers, and technological innovations of telemedicine in OB/GYN across diverse healthcare settings. This scoping review synthesized 63 peer-reviewed studies (2010–2023) using PRISMA-ScR guidelines to map global applications, outcomes, and challenges. Key modalities included synchronous consultations, remote monitoring, AI-assisted triage, tele-supervision, and asynchronous communication. Results demonstrated improved access to routine care and mental health support, with outcomes for low-risk pregnancies comparable to in-person services. Adoption surged >500% during pandemic peaks, stabilizing at 9–12% of services in high-income countries. However, significant disparities persisted: 43% of rural Sub-Saharan clinics lacked stable internet, while socioeconomic, linguistic, and cultural barriers disproportionately affected vulnerable populations (e.g., non-English-speaking, transgender, and refugee patients). Providers reported utility but also screen fatigue (41–68%) and diagnostic uncertainty. Critical barriers included fragmented policies, reimbursement variability, data privacy concerns, and limited evidence from conflict-affected regions. Sustainable integration requires equity-centered design, robust policy frameworks, rigorous longitudinal evaluation, and ethically validated AI to address clinical complexity and systemic gaps. Full article

Background/Objectives: Family caregivers in palliative care often face complex physical, emotional, and logistical challenges, which can result in a significant caregiving burden. Dyadic interventions—designed to support both the patient and the caregiver simultaneously—have emerged as a promising holistic approach to enhancing well-being and quality of life. This systematic review aimed to evaluate the effects of dyadic support interventions in reducing caregiver burden among middle-aged and older adults receiving palliative care. Methods: A systematic literature search was conducted following PRISMA guidelines across five databases (CINAHL, MEDLINE, Web of Science, Scopus, and Google Scholar for grey literature) covering the period from 2019 to January 2025. Results: Of 653 records identified, 8 studies met the inclusion criteria. Interventions were typically delivered by multidisciplinary teams and included weekly in-person consultations, telephone follow-up, telemedicine, physical exercise sessions, laughter therapy, and music therapy over durations ranging from 16 weeks to 6 months. These programs resulted in reduced anxiety and depressive symptoms (PHQ-4, HADS, SDS, BAI, SAS), improved functional and social performance (SF-36), and/or enhanced quality of life (MQLQ, QOL-AD, KCCQ-12, EORTC QLQ-C30). In patients, they contributed to better symptom control (ESAS, CFS), while in caregivers, they effectively reduced burden (ZBI-12, FCBSI, CBI) and/or supported the anticipatory grief process (PGQ, AGS). However, not all studies reported consistently positive outcomes. Conclusions: Structured dyadic interventions that involve both patients and caregivers significantly improve outcomes in palliative care for middle-aged and older adults. Future research should examine their long-term impact and explore the integration of artificial intelligence to optimize intervention delivery. Full article

Background/Objectives: Although people with schizophrenia appear to experience emotions like healthy individuals, previous studies suggest that their ability to engage in empathic emotional responses might be impaired. As per our knowledge, no studies in the Arab world have investigated empathy in patients with schizophrenia, which is likely due to the lack of valid and reliable measures to assess the empathy construct among Arabic-speaking people. The aim of this research is to validate the Arabic version of the Pictorial Empathy Test (PET) in patients with schizophrenia from Lebanon. Methods: A two-month cross-sectional study was carried out at the Psychiatric Hospital of the Cross during January and February of 2024. The average age of the 113 participants in this study was 57.52 ± 10.35 years and 63.5% of them were men. Data were collected through in-person interviews. A confirmatory factor analysis (CFA) was conducted using SPSS AMOS version 29. Parameter estimation utilized the maximum likelihood approach. In order to examine sex invariance in PET scores, a multi-group CFA was conducted. Measurement invariance was assessed across configural, metric, and scalar levels. Evidence of invariance was determined based on the criteria: ΔCFI ≤ 0.010, ΔRMSEA ≤ 0.015, or ΔSRMR ≤ 0.010. Results: CFA revealed that the Arabic PET exhibited a unidimensional factor structure. The PET demonstrated solid internal consistency (ω = 0.93, α = 0.93). Measurement invariance testing confirmed that the scale performed equally well across sexes. A linear regression analysis found that female sex and higher levels of alexithymia were significantly correlated with lower levels of affective empathy. Conclusions: The findings indicate that the Arabic version of the PET is a reliable and valid tool for measuring affective empathy in Arabic-speaking patients with schizophrenia. The culturally adapted and validated Arabic PET would help detect affective empathy deficits, design and implement context-tailored interventions, and encourage future research in this area in the Arab region. Future research should aim to validate the PET against behavioral tasks like the Empathic Accuracy Task to improve its ecological validity. Full article

This study aimed to evaluate the effects of the COVID-19 pandemic on food service operations in a Brazilian tourist area. It is a longitudinal observational study. Data collection was performed through telephone interviews with owners or managers of 54 food service establishments concerning the pre-pandemic period (T0) and two time points during the pandemic (T1 and T2). Findings revealed a reduction in the number of establishments providing on-site service at T1 compared to T0, followed by an increase at T2. A reduction in operating hours (56.7%) and profits (100%) affected more establishments at T1 than at T2 (26.7% and 76.7%, respectively) (p < 0.05). At T2, with the resumption of in-person activities, there was a significant decrease in the use of sales channels such as telephone (p < 0.001), messaging applications (p = 0.0012), and websites/apps/social media (p = 0.009) compared to T0 and T1. The pandemic also caused an increase in mask use by employees (p < 0.01) and the availability of hand sanitizer dispensers at establishments (p < 0.01) during T1 and T2. At T2, there was also an increase in the supply of disposable cutlery, cups (p = 0.02), and gloves for customers (p = 0.015) compared to the pre-pandemic period. Full article

The COVID-19 pandemic exacerbated mental illness, accelerated cognitive decline, and deepened social inequalities. In low and middle-income countries (LMIC) such as Panama, it is unclear as to whether, and to what extent, the pandemic lockdowns affected cognitive, mental, and physical health of older adults. This study investigated changes in cognitive function, mental health, and physical health in a sample of Panamanian older adults assessed before and during the pandemic, and examined whether sociodemographic variables were associated with cognition and mental health. Participants completed in-person interviews between 2018 and early 2020 and a follow-up telephone interview between February and May 2021. Repeated measures analyses showed no significant changes in cognitive function or depression; however, participants reported fewer chronic illnesses. Linear regression analysis indicated that higher cognitive function during the pandemic was associated with younger age, higher education, and having sufficient income. An attrition analysis compared participants who completed both interviews to those who were lost to follow-up, revealing that participants who dropped out of the study had lower socioeconomic status and greater impairment at baseline. These findings highlight the need for targeted support for vulnerable older adults during public health crises. Full article

Background/Objectives: Mild Cognitive Impairment (MCI), a condition between normal aging and dementia, is characterized by cognitive changes that do not significantly affect instrumental activities of daily living. The Memory Support System (MSS), an evidence-based behavioral intervention developed by the Mayo Clinic, has been shown to aid those living with MCI and their support partners in coping with cognitive challenges. However, the MSS has not been offered clinically within the Canadian context. Therefore, we conducted a study assessing the feasibility of the MSS from the perspectives of individuals living with MCI and their support partners. Methods: Participants from an institutional registry of research participants, patients, and support partners at a memory clinic, as well as members of a local Dementia Society, were approached to complete an online or paper version of a survey assessing feasibility dimensions. Responses were compared between and within groups for differences in mean scores and associations between linked binary choice response questions. Results: A total of 77 responses were received; 39 surveys were completed by participants with MCI, and 38 by support partners. Respondents found the MSS to be acceptable and practical. On average, participants thought it would be more difficult to train in using the MSS than support partners. Both groups expressed interest in the intervention. On average, participants with MCI and support partners preferred virtual MSS training to in-person and indicated more interest in participating in training over six weeks as compared to two weeks. Conclusions: Flexibility in duration and format when offering the MSS are important considerations when offering the intervention as part of a clinical program. Future research should evaluate cost-effectiveness (e.g., financial, staff resources, etc.) of the MSS approach if it were to be institutionalized in the Ontario healthcare system. Full article

Background/Objectives: Studies have reported that female athletes often exhibit low levels of nutritional knowledge and inadequate dietary intake to meet their nutritional needs. The aim of this study was to evaluate the effect of a nutritional education intervention on nutrition knowledge, dietary intake, and body composition in female handball players (n = 45; age, 17.6 ± 2.1 years). Methods: A quasi-experimental intervention design was implemented, consisting of a 3-week educational program delivered through six in-person sessions led by a registered dietitian. Nutrition knowledge, dietary intake, adherence to the Mediterranean diet, and anthropometric and body composition measurements were assessed. Results: Nutrition knowledge levels were significantly higher both immediately post-intervention and three months later compared to baseline (p < 0.05, ES > 0.8). A total of 36 participants completed a 3-day dietary record at baseline and at follow-up. Initial assessments revealed insufficient energy (31 kcal/kg/day) and carbohydrate intake (3.0 g/kg/day) and a high intake of total fats (1.4 g/kg/day). During follow-up, a significant decrease in the consumption of foods rich in sugar was observed (p = 0.0272). A total of 82.2% of the players needed to improve their adherence to the Mediterranean diet. No significant changes were found in Mediterranean diet adherence or body composition following the intervention. Conclusions: The nutritional education intervention significantly improved athletes’ nutritional knowledge and significantly decreased their consumption of sugary foods; however, further studies are needed to evaluate its impact on dietary intake and body composition, considering the study’s limitations. Full article

Temperature is a key physiological indicator of plant health, influenced by factors including water status, disease and developmental stage. Monitoring changes in multiple factors is helpful for early diagnosis of plant growth. However, there are a variety of complex light interference phenomena in the greenhouse, so traditional detection methods cannot meet effective online monitoring of strawberry health status without manual intervention. Therefore, this paper proposes a leaf soft-sensing method based on a thermal infrared imaging sensor and adaptive image screening Internet of Things system, with additional sensors to realize indirect and rapid monitoring of the health status of a large range of strawberries. Firstly, a fuzzy comprehensive evaluation model is established by analyzing the environmental interference terms from the other sensors. Secondly, through the relationship between plant physiological metabolism and canopy temperature, a growth model is established to predict the growth period of strawberries based on canopy temperature. Finally, by deploying environmental sensors and solar height sensors, the image acquisition node is activated when the environmental interference is less than the specified value and the acquisition is completed. The results showed that the accuracy of this multiple sensors system was 86.9%, which is 30% higher than the traditional model and 4.28% higher than the latest advanced model. It makes it possible to quickly and accurately assess the health status of plants by a single factor without in-person manual intervention, and provides an important indication of the early, undetectable state of strawberry disease, based on remote operation. Full article

Job stress and burnout are major challenges in today’s workplaces. While most interventions adopt a clinical or deficit-based approach, this meta-analysis takes a positive perspective by examining the effectiveness of Positive Psychological Interventions (PPIs). A total of 24 studies conducted in workplace settings were analyzed to assess the impact of PPIs on psychological well-being, subjective well-being, and job performance. The results showed significant and sustained improvements across all three outcomes, with moderate effect sizes: subjective well-being (g = 0.50, 95% CI [0.18, 0.81]), psychological well-being (g = 0.46, 95% CI [0.15, 0.78]), and performance (g = 0.42, 95% CI [0.21, 0.62]). Higher effects were found for in-person interventions and those conducted in Western contexts. No significant moderation was observed for structural factors (e.g., implementation level: Individual, Group, Leader, or Organization [IGLO]) or sample characteristics (e.g., gender), among other variables examined. These findings highlight the relevance of PPIs for promoting well-being and sustaining performance, which may reflect the preservation of personal resources in the face of occupational stressors. Regardless of type, well-designed interventions may be key to fostering healthier workplace environments—especially when delivered face-to-face. Full article

During the coronavirus 2019 pandemic, sports activities were restricted, raising concerns about their impact on the physical condition of adolescent athletes, which remained largely unquantified. This study was designed with two primary objectives: first, to precisely quantify and elucidate the differences in the physical condition of adolescent athletes before and after activity restrictions due to the pandemic; and second, to innovatively develop and validate a non-contact medical checkup application. Medical checks were conducted on 563 athletes designated for sports enhancement. Participants were junior high school students aged 13 to 15, and the sample consisted of 315 boys and 248 girls. Furthermore, we developed a smartphone application and compared self-checks using the application with in-person checks by orthopedic surgeons to determine the challenges associated with self-checks. Statistical tests were conducted to determine whether there were statistically significant differences in range of motion and flexibility parameters before and after the pandemic. Additionally, items with discrepancies between values self-entered by athletes using the smartphone application and values measured by specialists were detected, and application updates were performed. Student’s t-test was used for continuous variables, whereas the chi-square test was used for other variables. Following the coronavirus 2019 pandemic, athletes were stiffer than during the pre-pandemic period in terms of hip and shoulder joint rotation range of motion and heel–buttock distance. The dominant hip external rotation decreased from 53.8° to 46.8° (p = 0.0062); the non-dominant hip external rotation decreased from 53.5° to 48.0° (p = 0.0252); the dominant shoulder internal rotation decreased from 62.5° to 54.7° (p = 0.0042); external rotation decreased from 97.6° to 93.5° (p = 0.0282), and the heel–buttock distance increased from 4.0 cm to 10.4 cm (p < 0.0001). The heel–buttock distance and straight leg raising angle measurements differed between the self-check and face-to-face check. Although there are items that cannot be accurately evaluated by self-check, physical condition can be improved with less contact by first conducting a face-to-face evaluation under appropriate guidance and then conducting a self-check. These findings successfully address our primary objectives. Specifically, we demonstrated a significant decline in the physical condition of adolescent athletes following pandemic-related activity restrictions, thereby quantifying their impact. Furthermore, our developed non-contact medical checkup application proved to be a viable tool for monitoring physical condition with reduced contact, although careful consideration of measurable parameters is crucial. This study provides critical insights into the long-term effects of activity restrictions on young athletes and offers a practical solution for health monitoring during infectious disease outbreaks, highlighting the potential for hybrid checkup approaches. Full article

The rise in online learning, accelerated by the COVID-19 pandemic, has led to greater use of synchronous hybrid learning (SHL) in higher education. SHL allows simultaneous teaching of in-person and online learners through videoconferencing tools. Previous studies have identified various benefits (e.g., flexibility) and challenges (e.g., student engagement) to SHL. Whilst systematic reviews have emerged on this topic, few studies have considered the experiences of staff. The aim of this review was threefold: (i) to better understand how staff experiences and perceptions are assessed, (ii) to understand staff experiences in terms of the benefits and challenges of SHL and (iii) to identify recommendations for effective teaching and learning using SHL. In line with the PRISMA guidance, we conducted a systematic review across four databases, identifying 14 studies for inclusion. Studies were conducted in nine different countries and covered a range of academic disciplines. Most studies adopted qualitative methods, with small sample sizes. Measures used were typically novel and unvalidated. Four themes were identified relating to (i) technology, (ii) redesigning teaching and learning, (iii) student engagement and (iv) staff workload. In terms of recommendations, ensuring adequate staff training and ongoing classroom support were considered essential. Additionally, active and collaborative learning were considered important to address issues with interactivity. Whilst these findings largely aligned with previous work, this review also identified limited reporting in research in this area, and future studies are needed to address this. Full article

As an example of pedagogical approaches that blend online and face-to-face instruction, the flipped classroom model has seen exponential growth in business schools. To explore its effectiveness, expectancy-value theory and cognitive load theory were employed to develop a framework linking students’ perceived usefulness of the online and in-person content to their pre-class preparation, class participation, perceived learning, and skills development. A preliminary test of this framework was conducted using a flipped Organizational Behavior course within a business diploma program at a publicly funded Canadian college. The perceived usefulness of the online component was positively associated with students’ pre-class preparation, which, in turn, was positively related to both their perceived learning and skills development. Implications for practice and directions for future research are discussed. Full article