Search Results (1,204)

Background/Objectives: Institutionalized aging is associated with severe physical deconditioning, a high risk of falls, and a pervasive fear of falling. Physical exercise mitigates these factors, but the comparative efficacy of different training methodologies in this specific population remains unclear. The objective of this study was to compare the impact of a multicomponent exercise program versus a dual-task (cognitive-motor) training program on reducing fall risk, decreasing the fear of falling, and improving physical performance in institutionalized older adults. Methods: A randomized, parallel group controlled trial involving 21 older adults residing in a nursing home (Mean age = 83.67 ± 6.17 years). Participants were allocated to either a Multicomponent Group (n = 11) or a Dual-Task Group (n = 10) for a 12-week intervention (2 sessions/week). Fall risk, fear of falling, and global physical performance were assessed at baseline and post-intervention. Results: No significant improvements were observed in fall risk assessment execution time for either group. The Multicomponent Group showed a significant reduction in the fear of falling (−29.1%; 95% CI [−17.27, −1.27], p = 0.025) and a clinically significant improvement in physical performance (+40.9%; 95% CI [1.11, 3.43], p < 0.001), supported by large time effects (FES-I: F(1, 19) = 4.52, η²p = 0.192; SPPB: F(1, 19) = 13.68, η²p = 0.419). The Dual-Task Group achieved no significant changes in these dimensions. Furthermore, a marginally significant time-by-group interaction was observed for physical performance, favoring the multicomponent approach (F(1, 19) = 3.83, p = 0.065, η²p = 0.168 [large effect]). Conclusions: Multicomponent training proved superior in improving physical performance and reducing the fear of falling. In a frail, institutionalized population, the attentional cost demanded by dual-task training appears to limit the physical and psychological benefits of exercise. Full article

Integrating sustainability into higher education is a strategic priority of the 2030 Agenda, although its effective implementation remains uneven and understudied from internal institution comparative perspectives. This study analyzes the perceptions of faculty and students regarding the integration of sustainability at a higher education institution in Ecuador, using a convergent–complementary mixed-methods design that triangulates descriptive quantitative analysis and qualitative thematic content analysis. The quantitative component included 597 students and 88 faculty members, who responded to structured questionnaires of 15 items organized into five dimensions: curriculum and teaching, participation and engagement, resources and institutional support, impact and expectations, and vision for the future. The qualitative component was based on semi-structured interviews analyzed using thematic coding. The results show a generally favorable perception in both groups (Student Perception Index = 2.35; Faculty Perception Index = 2.23), with greater consensus in the impact and expectations dimension and significant gaps in resources and institutional support. Qualitative analysis revealed distinct relational models: faculty members articulate sustainability through professional responsibility and curriculum management, while students construct it from fragmented experiences and extra-university references. Triangulation of both components reveals a duality between solid normative legitimation and incipient structural institutionalization. These findings contribute to the debate on sustainable transition processes in Latin American universities and provide comparative empirical evidence for the design of institutional policies in emerging contexts. Full article

Background/Objectives: Anticholinergic burden is an important risk marker in older adults, associated with cognitive decline, falls, and increased mortality. This study aimed to assess anticholinergic burden in institutionalized elderly individuals using two tools (ACB calculator and CALS—CRIDECO Anticholinergic Load Scale), as well as to analyze its relationship with pharmacotherapeutic variables like polypharmacy. Methods: A descriptive cross-sectional study was conducted by analyzing the pharmacotherapeutic profiles of institutionalized elderly individuals (≥65 years) utilizing individualized medication preparation services from a community pharmacy in Alentejo (Portugal). Participants agreed to the study and had complete, up-to-date pharmacotherapeutic profiles. Results: The pharmacotherapeutic profiles of 75 institutionalized elderly people were analyzed; the sample comprised mostly women (72%) who had experienced excessive polypharmacy (≥10 medications) (56%) and had an average age of 85.62 ± 7.62 years. It was found that 90.7% (ACB) and 89.3% (CALS—CRIDECO) of the elderly had anticholinergic burden, with mean values of 3.60 ± 2.84 and 3.33 ± 2.51, respectively. Women exhibited higher anticholinergic burden in unadjusted analyses (p < 0.05). The burden correlated moderately with the total number of medications (p < 0.05). Conclusions: The results show high exposure to anticholinergic medications in the institutionalized elderly population, reinforcing the rationale for systematic therapeutic reviews focused on the pharmacological safety of institutionalized older adults in community pharmacies. Full article

Against the backdrop of a multi-tiered governance system and increasingly institutionalized norms, China’s historical and cultural preservation policies have long emphasized institutional standardization and hierarchical uniformity. Local policy texts are typically viewed as localized replicas of central institutional logic, overlooking internal variations and differences in information structure. Accordingly, this study examines the Regulations on the Protection of Historical and Cultural Cities, Towns, and Villages issued by 13 provincial-level administrative regions in China. It conceptualizes provincial regulatory texts as institutionalized policy information systems, constructs a cross-regional corpus, and develops a comparative information structure analytical framework based on the Latent Dirichlet Allocation (LDA) topic model. This study operationalizes LDA-derived topic-weight distributions into a comparative analytical framework that captures structural prominence, dispersion, concentration, and priority hierarchy in provincial policy texts. The findings reveal that provincial-level historical and cultural preservation regulations in China exhibit a highly institutionalized information backbone, centered on administrative procedures, legal norms, and macro-level planning controls, and demonstrate significant institutional similarity across provinces. However, within this unified institutional framework, provinces exhibit structural differences in the distribution of thematic weights, information prioritization, and internal textual sequencing, resulting in multiple distinguishable information organization patterns. Consequently, this study highlights the coexistence of formal institutional uniformity and structural differentiation in provincial regulatory texts, providing a more precise basis for understanding variation in local policy expression within China’s historical and cultural governance field. Full article

Creative tourism is increasingly discussed as a pathway for tourism development in rural and peripheral destinations, yet empirical evidence remains uneven and is still drawn mainly from contexts where it is already explicitly labelled and institutionally supported. This article examines whether and how creative tourism-aligned practices are present in Kupiškis District, a peripheral rural municipality in north-eastern Lithuania where creative tourism has not been formally institutionalised as a tourism development category. The study adopts a qualitative single-case design combining a multi-stakeholder focus group and semi-structured interviews with municipal, intermediary, and private-sector actors. The findings reveal a meaningful but weakly integrated experiential base shaped by educational activities, water-based leisure, symbolic narratives, routes, and micro-entrepreneurial initiatives. Although these practices are rarely named locally as creative tourism, they display several of its defining characteristics, including participatory learning, host involvement, small-scale interaction, and local embeddedness. The study suggests that the main development challenge lies not in the absence of creative resources, but in limited coordination, weak articulation, and the difficulty of translating dispersed practices into coherent and consistently bookable visitor experiences. The article conceptualises this condition as a latent experiential portfolio and, in doing so, makes three contributions: it offers a sensitising concept for describing pre-consolidation stages of creative tourism where relevant practices exist but remain only partly articulated; it supports a practice-based rather than label-based identification of creative tourism in weakly institutionalised settings; and it extends the empirical scope of creative tourism research to a peripheral rural case in the Baltic region. Full article

Social support is generally assumed to buffer ego threat and reduce aggressive behavior in organizations. However, emerging research suggests that support may not always function as intended, particularly in contexts where support can also signal evaluation or control. Drawing on ego threat theory and a conceptualization of narcissism as a self-regulatory system, the present study examines when and for whom social support inhibits or facilitates workplace aggression. Specifically, the study investigates how perceived supervisor and organizational support moderate the relationships between ego threat and power harassment—a culturally institutionalized form of workplace aggression in Japan—and how the moderation effects differ across narcissistic self-regulatory strategies. Survey data of 600 Japanese employees were classified into distinct types reflecting narcissistic self-regulatory strategies, and hierarchical multiple regression analyses were conducted for each type. The results indicated that ego threat has no significant main effect on power harassment tendencies across any narcissistic type. However, among individuals characterized by superiority-based narcissistic strategies, a significant moderation effect emerged indicating that higher levels of perceived supervisor support amplified aggressive responses under ego threat. These findings challenge the universal assumption that social support is inherently protective and demonstrate that its effects depend on how support is interpreted within personal and cultural contexts. Full article

This study provides a comprehensive evaluation of six volatility forecasting models applied to twelve dominant and less dominant cryptocurrencies across multiple time horizons using high-frequency intraday data. The exponential generalized autoregressive conditional heteroskedastic (EGARCH), integrated GARCH (IGARCH), standard GARCH, GJR-GARCH, lagged realized volatility (LRE), and heterogeneous autoregressive (HAR) models are systematically compared using 5 min computed return data from September 2018 to September 2020. Our analysis encompasses three forecast horizons (1-day, 7-day, and 30-day) to assess model performance under varying temporal constraints. Through univariate Mincer–Zarnowitz regressions, encompassing tests, and out-of-sample evaluation using root mean squared error (RMSE) and quasi-likelihood loss (QLIKE) functions, we identify significant performance heterogeneity across models and cryptocurrencies. The HAR model exhibits stronger predictive accuracy at short horizons, while EGARCH exhibits relatively stronger performance at longer horizons, although overall explanatory power declines as forecast horizon increases. Importantly, no single model consistently provides optimal forecasts across all cryptocurrencies. Consistent with prior evidence suggesting model performance varies across assets. Encompassing regressions reveal that combining HAR with EGARCH specifications significantly enhances explanatory power across all temporal frames. Out-of-sample Diebold–Mariano tests indicate that HAR generates the lowest forecast errors for most cryptocurrencies, though EGARCH performs exceptionally well for high-market-capitalization assets. These findings provide regime-conditional insights into horizon- and asset-specific volatility dynamics during the pre-institutionalization phase of cryptocurrency markets. The study contributes to emerging literature by incorporating less-dominant cryptocurrencies and offering robust empirical evidence on the asymmetric and persistent volatility characteristics unique to digital asset markets. These findings should be interpreted within the context of the 2018–2020 sample period, representing a pre-institutionalized phase of cryptocurrency markets, and may not fully generalize to structurally different market regimes characterized by increased institutional participation and regulatory development. Full article

This conceptual article examines how special education in Greece is governed through the redistribution of institutional responsibility to families. It operationalises familialisation by specifying institutionally produced parental roles through which provision is organised under fragmented and contingent conditions. By tracing how these roles relate and shift across placement arrangements (e.g., parallel support, inclusion units, special assistants, home-based instruction, segregated schools), the article argues that parental labour can be understood as a structural condition shaping access to mainstream placement and support. It concludes that familialised governance converts formally equal rights within public education into unequal possibilities of realisation by making mainstream participation dependent on households’ differential resources and institutional capacity. Full article

This study contributes to research on teacher education and professional identity formation. Drawing on a longitudinal corpus of 2311 thesis titles produced between 1989 and 2024 within a single teacher education context, the analysis conceptualises titles as institutionally regulated academic practices through which students position themselves in relation to teaching, research, and professional knowledge. Methodologically, the study employs a thesis title analysis combining document analysis with discourse analytic sensitivity. Titles were coded along four analytical dimensions: thematic orientation, professional versus academic orientation, level of discursive abstraction, and implied student positioning. Rather than assuming a linear progression from practice-oriented to academic work, the analysis foregrounds parallel, hybrid, and non-linear patterns over time. The findings show that thesis titles consistently maintain strong connections to professional practice while increasingly incorporating analytical and abstract framings. Hybrid titles, which combine concrete teaching contexts with academic problematisation, emerge as a stable and recurring pattern. These titles reflect a liminal identity position in which student teachers negotiate professional relevance and academic legitimacy. These findings have implications for supervision practices and research-based learning design in teacher education programmes. Full article

This study examines the evolution of sustainability reporting research by integrating financial market dynamics, regulatory frameworks, and digital transformation into a unified analytical lens. It explores how these forces shape the credibility, comparability, and strategic relevance of sustainability disclosure. A bibliometric analysis of 683 publications indexed in the Web of Science (2006–2025) was conducted. Performance indicators and science-mapping techniques were applied to identify the intellectual structure of the field. Four major thematic clusters were detected: (i) corporate social responsibility and disclosure performance, (ii) governance and accountability, (iii) regulatory and institutional frameworks, and (iv) financial market and digital innovation drivers. Findings reveal that Disclosure, corporate social responsibility, and performance remain the field’s core anchors, while governance, accountability, innovation, and strategy increasingly shape reporting credibility. Sustainability reporting reduces information asymmetry, lowers financing costs, and builds stakeholder trust; however, persistent fragmentation, greenwashing, and weak assurance highlight the need for global harmonization. Regulatory initiatives and market instruments are converging to institutionalize sustainability disclosure. The study advances a policy and managerial agenda advocating stronger governance oversight, harmonized disclosure frameworks, and technology-enabled assurance mechanisms to enhance transparency, accountability, and investor confidence. Full article

As populations age, micronutrient deficiencies increase and are linked to frailty, functional decline, cognitive impairment, anemia, and a higher healthcare burden. This review synthesizes evidence from the past five years on adults ≥65 years, comparing residents of nursing homes/assisted-living facilities with community-dwelling peers. Community-dwelling older adults show high prevalence of deficiencies—particularly vitamin D, calcium, magnesium, folate, and zinc—while vitamin B12 deficiency is less common overall but increases with age due to malabsorption. Institutionalized adults face higher risk, driven by limited dietary variety, reduced sunlight exposure, greater multimorbidity, and polypharmacy. Reported rates include vitamin D deficiency in 70–94% of institutionalized adults (≈6.3-fold higher odds), zinc deficiency in 50–66% (vs. 31–49% in the community), iodine deficiency in 67–78% (vs. 22% in the community), and a Mini Nutritional Assessment classification of severe malnutrition/at risk in 67.9% (vs. 28% in the community). Consequences encompass frailty, falls, infections, higher costs, and increased institutionalization. Recommended actions include routine biomarker screening, improving access to vitamin D (supplementation/fortification), individualized care for micronutrient deficiencies—including vitamin B12 when relevant—multidisciplinary nutrition support, and long-term targeted research to guide best practices for healthy aging and equity. Full article

Background: Alzheimer’s disease (AD) is a progressive neurodegenerative disorder that severely affects cognitive, behavioral, and functional abilities, creating a substantial burden for family members who provide continuous care. Caregivers often experience role changes, occupational imbalance, emotional distress, and reduced quality of life, although some report personal growth. These experiences extend beyond active caregiving and include anticipatory grief during disease progression and grief after the relative’s death. Despite this continuum, few studies have examined caregiving, loss, and bereavement from an integrative perspective. This protocol describes a mixed-methods study aimed at exploring the lived experiences of family caregivers of individuals with AD, focusing on how evolving relational, occupational, and identity-related losses influence their well-being and adaptation. Methods: A parallel convergent mixed-methods design will be used. The quantitative component consists of a cross-sectional observational study including 66 caregivers recruited through purposive sampling across kinship categories (spouse/partner, adult child, grandchild) and care settings (home care with day-center attendance vs. institutionalized care). Data will be collected using the Zarit Burden Interview, Role Checklist, Short Form-36 Health Survey, and Occupational Balance Questionnaire. Descriptive and subgroup analyses will be conducted using SPSS (version 27). The qualitative component comprises a multiple-case study with approximately 36 participants across three groups: caregivers living with individuals with AD, caregivers of institutionalized relatives, and bereaved family members. Semi-structured interviews (45–80 min) will be conducted online or in person, transcribed verbatim, and analyzed thematically using MAXQDA (version 26). Integration will follow a concurrent approach, combining quantitative and qualitative results through joint narratives and displays to produce a comprehensive interpretation. Discussion: This study aims to deepen understanding of the caregiving–grief continuum in families affected by AD by integrating quantitative indicators of burden, health status, and occupational balance with qualitative accounts of adaptation and meaning-making. Findings are expected to support the development of holistic, evidence-based interventions that promote caregiver well-being throughout the care trajectory and during bereavement. Ethics and Dissemination: Ethical approval was granted by the Research Ethics Committee of Universidad Rey Juan Carlos (Code: 041220246522024; 15 October 2025). ClinicalTrials.gov Identifier: NCT07251738. Registered November 2025. Protocol version: Version 2. Full article

External shocks and uncertainty have increased the need for urban economic resilience. As an institutionalized form of digital trade, China’s cross-border e-commerce (CBEC) Comprehensive Pilot Zones may strengthen cities’ adaptive capacity by lowering trade frictions and improving network connectivity. Using the staggered establishment of China’s CBEC Comprehensive Pilot Zones as a quasi-natural experiment, this study examines the causal and spatial effects of CBEC policy on urban economic resilience. Based on a balanced panel of 297 Chinese cities from 2011–2023, we construct a GDP-based counterfactual resilience index and estimate policy impacts with a multi-period difference-in-differences (DID) model, complemented by a spatial Durbin model (SDM). Results show that CBEC pilot zones significantly enhance urban economic resilience, with event-study estimates indicating that the effect emerges after implementation and strengthens over subsequent years. Mechanism tests suggest that the resilience gains operate through increased entrepreneurial vitality, deeper financial development, and higher green innovation output. Spatial estimates further reveal pronounced positive spillovers: policy-induced improvements in one city raise resilience in neighboring cities within the urban network. Heterogeneity analyses indicate stronger effects in large cities and in eastern and central regions, while effects are weaker in western cities. These findings highlight CBEC-oriented digital governance as an effective lever for building resilient urban economies and support cross-city coordination to amplify regional resilience dividends. Full article

Background: Artificial intelligence (AI) is transforming leadership and raising critical questions about decision-making, leadership capabilities, and ethical accountability in increasingly digitalized organizations. Objective: This systematic review synthesizes peer-reviewed evidence to answer: How does AI integration transform leadership and decision-making in organizations? Methods: A PRISMA 2020-compliant systematic review was conducted using structured Boolean searches in Scopus and Web of Science Core Collection on 26 February 2026. Eligibility was restricted to English-language, peer-reviewed, open-access journal articles with an explicit AI–leadership integration signal. Records were deduplicated and screened by two reviewers, with full-text assessment conducted against predefined criteria. A qualitative, narrative (conceptual) synthesis integrated heterogeneous empirical and conceptual contributions. Results: From 452 records, 84 studies met inclusion criteria. The synthesis identified three recurring analytical dimensions: (i) AI-augmented decision-making, (ii) leadership competencies and role shifts, and (iii) ethical challenges (accountability, transparency/opacity, fairness, privacy, and human agency). Integrating these dimensions, the review conceptualizes AI-driven leadership as a hybrid decision phenomenon in which AI accelerates and expands decision cycles, leaders reconfigure roles toward decision architecture and orchestration, and ethical conditions shape legitimacy, adoption, and authority dynamics. Conclusions: The review advances theory by specifying a mechanism-oriented model of AI-driven leadership and proposing testable propositions linking AI modality, role reconfiguration, and ethically conditioned legitimacy under key boundary conditions (e.g., sectoral stakes, governance capacity, and data/infrastructure readiness). Practically, it outlines an implementation pathway emphasizing decision criticality assessment, formalized human–AI task allocation, and institutionalized oversight mechanisms. Limitations: Findings are bounded by database selection and the open-access full-text constraint, which may under-represent paywalled scholarship. Full article

The dynamic process through which latent differences in business models of partners escalate into daily operational conflicts within exploitation alliances remains insufficiently explained. This study examines how alignment in partner business models influences operational conflicts, a key determinant of exploitation alliance sustainability. Questionnaire data from 110 experts in Chinese residential joint ventures (JVs) were used to test the proposed hypotheses. The findings indicate that key resources (KRs) and profit formula (PF) indirectly affect operational conflicts through jointly established core business standards (CBSs). Counterintuitively, these standards significantly increase operational conflict risks (OCRs) when they institutionalize underlying misalignments, thereby acting as a full mediator. The results advance theory by clarifying the micro-process of institutionalized misalignment and refining the Resource-Based View (RBV) in alliance contexts. Practically, the study highlights the importance of conducting thorough ex-ante business model analysis, co-creating operational standards, and undertaking continuous alignment reviews to mitigate conflict and enhance JV viability. Full article