Search Results (3,485)

Stunting is a chronic growth disorder that not only affects height but may also impair craniofacial development. Facial proportions, especially in the vertical dimension, may provide additional anthropometric insight into growth status among children. Objectives: To assess and compare the vertical and horizontal facial proportions of stunted and non-stunted children, and to explore the potential of facial dimensions as supportive indicators for early-stunting detection in community-based settings. Methods: This cross-sectional analytical study involved 266 children aged 7–72 months (mean age 42.63 ± 13.82 months) from several community health centers in Bandung, Indonesia. Children were categorized as stunted or non-stunted based on WHO height-for-age Z-scores. Facial dimensions were measured directly by calibrated pediatric dentistry residents using manual instruments. The vertical dimensions included Nasion–Subnasale (N–SN) and Subnasale–Menton (SN–M), while horizontal dimensions included zygomatic width and intergonion width. Data were analyzed using the Mann–Whitney U test and Spearman correlation. Results: Significant differences were found in vertical facial dimensions between stunted and non-stunted children: median N–SN (32.4 mm vs. 33.6 mm; p = 0.003) and SN–M (42.5 mm vs. 45.1 mm; p < 0.001). No significant differences were observed in horizontal dimensions. All facial parameters showed a positive correlation with age (p < 0.001). No significant differences were found based on sex. Conclusions: Stunted children exhibited shorter vertical facial dimensions compared to their non-stunted peers, while horizontal dimensions remained stable across groups. Vertical facial proportions may serve as supportive indicators in the screening and monitoring of childhood stunting. This method has potential for integration into community-based growth monitoring using simple or digital anthropometric tools. Full article

Background/Objectives: The pain associated with invasive procedures is one of the most common experiences in the pediatric population. Its management remains insufficient due to gaps in healthcare training and knowledge. The aim of this study was to analyze the attitudes, beliefs, care practices, and training of healthcare professionals in relation to pediatric pain, through the development and application of the questionnaire ‘Humanisation of Pediatric Care in Pain Management with a Non-Pharmacological Approach (HUPEDCARE-Q)’. Methods: A cross-sectional, observational, and descriptive study with a quantitative approach was conducted to validate a questionnaire. The process was carried out in three phases: (1) design and initial development of the instrument; (2) evaluation of content validity through expert judgment, using the Content Validity Coefficient (CVC); (3) administration of the questionnaire to a large sample of healthcare professionals to assess its internal consistency and psychometric structure. Results: The evaluation involved five experts, and the items were assessed using the Content Validity Coefficient (CVC), with the overall CVC of the questionnaire exceeding 0.80. The average item scores given by the experts ranged from 0.88 to 0.95, indicating a high level of agreement in their evaluations. The results showed statistically significant positive correlations among most items (p < 0.001), indicating adequate internal consistency. Conclusions: The content validation and pilot study confirmed the theoretical relevance and appropriateness of the HUPEDCARE-Q questionnaire items in the Spanish context. The results support its usefulness as a valid and reliable tool to identify attitudes, beliefs, knowledge, and training needs in the humanized management of pediatric pain. Full article

Evaluation of the effectiveness of state policy instruments is a permanent element of economic science. This paper addresses the issue of investment support under the Common Agricultural Policy (CAP). Using data on Polish farms from 2015–2023, a Propensity Score Matching–Difference in Differences (PSM-DiD) analysis was conducted to assess changes in the economic results of agricultural producers that invest using this support. The comparison of the economic results achieved by supported investors with both non-investing agricultural producers and unsupported investors is a distinguishing element of this study. The relatively rarely used Competitivness Index (CI), which measures the ratio of earned income to the sum of the alternative use of the owned means of production, was used. The positive change in the CI during the analyzed period was 0.14 higher for supported investors than non-investors. No statistically significant change was found were compared to unsupported investors. A clear increase in income, total fixed assets, liabilities, and the level of production in the population of producers using support in relation to non-investors and investing without CAP support was also observed. However, in relationships with investors using their own funds, these differences were mainly due to the difference in the level of investments and were not statistically significant when introducing a correction regarding the scale of the investment. The obtained results remain in line with the results of research shown by a significant part of economists undertaking a similar issue. Full article

Background: Undercover police work is a psychologically high-risk profession that exposes officers to chronic stress, identity conflicts, and moral dilemmas. The aim of the present review is to evaluate the psychological consequences associated with undercover police work, focusing on specific psychopathological risk factors. Methods: A systematic search was conducted in PubMed, PsycINFO, Web of Science, and Scopus databases. Studies were conducted in the United States, the United Kingdom, New Zealand, and Canada. The present systematic review analyzed data from 380 current undercover operatives, 372 former UCOs, 578 officers without undercover experience, and 60 pre-operational agents. Results: From an initial pool of 365 records, 10 studies were identified, of which 6 met the inclusion criteria. The most frequently reported psychological risk factors included anxiety, hypervigilance, identity issues, dissociative symptoms, and substance misuse. These were assessed using validated self-report instruments (e.g., SCL-90), structured interviews, and clinical evaluations. Long-term consequences were more prominent post-deployment, particularly among former UCOs. Conclusions: Undercover work is associated with an elevated risk of mental health problems, especially after the end of operations. Future research should focus on standardizing assessment tools and identifying protective factors. The findings support the development of targeted interventions such as pre-deployment psychological screening, ongoing monitoring, and structured reintegration programs to safeguard UCOs’ well-being. Full article

Background: The interaction between prosthetic restorations and periodontal health is a critical factor for the long-term success of dental treatments. A biologically compatible prosthetic design supports periodontal stability, whereas neglecting periodontal principles can compromise treatment outcomes. This study aimed to validate a questionnaire designed to assess dentists’ perceptions regarding the influence of prosthetic restorations on the periodontium. Material and Methods: An observational cross-sectional study was conducted using a self-administered questionnaire distributed to licensed dentists across Romania. The questionnaire underwent expert review, pilot testing (n = 50), and statistical validation, including the Content Validity Index (CVI), Cronbach’s alpha for internal consistency, and Exploratory Factor Analysis (EFA) using Principal Component Analysis (PCA) with Varimax rotation. The final sample included 39 respondents. Data was analyzed using SPSS v26.0. Results: The questionnaire demonstrated excellent internal consistency (Cronbach’s alpha = 0.900; standardized alpha = 0.917). Most items had corrected item-total correlations > 0.40. EFA revealed eight coherent factors explaining 81.68% of total variance, with high communalities (0.549–0.966), strong Kaiser–Meyer–Olkin test (KMO) values, and significant Bartlett’s test values, confirming construct validity. Descriptive statistics showed predominantly positive attitudes among dentists regarding the periodontal considerations in prosthetic treatment. The highest-rated items emphasized oral hygiene, periodontal stability, and biological adaptation of restorations. Lower scores were associated with routine use of periodontal indices and recognition of failures due to insufficient evaluation. Conclusions: The validated instrument proved reliable and demonstrated strong psychometric properties in this exploratory validation, supporting its use in research and education. Romanian dentists demonstrated a favorable perception of the role of periodontal health in prosthetic success. This tool can inform curriculum development and interdisciplinary clinical protocols in prosthodontics and periodontology. Full article

Background: Clinical assessment of balance and postural disorders is usually carried out through several common practices including tests such as the Subjective Visual Vertical (SVV) and Limit of Stability (LOS). Nowadays, several cutting-edge technologies have been proposed as supporting tools for stability evaluation. Extended Reality (XR) emerges as a powerful instrument. This proof-of-concept study aims to assess the feasibility and potential clinical utility of a novel MR-based framework integrating HoloLens 2, Wii Balance Board, and Azure Kinect for multimodal balance assessment. An innovative test is also introduced, the Innovative Dynamic Balance Assessment (IDBA), alongside an MR version of the SVV test and the evaluation of their performance in a cohort of healthy individuals. Results: All participants reported SVV deviations within the clinically accepted ±2° range. The IDBA results revealed consistent sway and angular profiles across participants, with statistically significant differences in posture control between opposing target directions. System outputs were consistent, with integrated parameters offering a comprehensive representation of postural strategies. Conclusions: The MR-based framework successfully delivers integrated, multimodal measurements of postural control in healthy individuals. These findings support its potential use in future clinical applications for balance disorder assessment and personalized rehabilitation. 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

Objective: This study aimed to investigate whether the subjective assessments of strong and weak muscles in the Functional Myodiagnosis muscle test (FMD-MT) can be objectively and reproducibly verified using physically measurable parameters. Additionally, we sought to evaluate the reliability of the manual muscle test in order to reinforce the scientific evidence supporting this accepted, yet not widely adopted, complementary medicine method. Methods: In a crossover observational study, three experienced medical practitioners conducted the FMD-MT of the rectus femoris muscle on 24 healthy participants using a specially designed therapy bench, with all measurements recorded via an oscillogram. The study investigated the force–time integral, joint angle change, additional force load, mean force turning point 1, as well as the interrater reliability and validity of both examiner assessments and instrumental analyses for the two muscle reaction variants: strong and weak. Results: A significant difference between the response pattern of strong and weak muscles was identified for the force–time integral (p = 0.005), the change in joint angle (p < 0.001), and the additional force load (p = 0.001). No difference between strong and weak muscles could be detected regarding the force turning point 1 (p = 0.972). The examiners demonstrated 100% accuracy in identifying weak muscle reactions as weak, and 99.2% accuracy in identifying strong muscle reactions as strong (p = 0.316). The overall intra-class correlation coefficient was 0.984. The oscillogram correctly visualized weak muscle reactions in weak muscles with an accuracy of 81.7%, and strong muscle reactions in strong muscles with an accuracy of 86.7% (p = 0.289). Conclusions: The Functional Myodiagnosis muscle test (FMD-MT) enables a clear and objective differentiation between strong and weak muscles, with statistically significant differences observed in the force–time integral, additional force load, and joint angle changes. Under rigorously standardized testing conditions, the FMD-MT of the rectus femoris muscle demonstrates a validity rate of 99.6% and an excellent reliability (ICC 0.984). Consequently, the FMD muscle test proves to be a reliable, reproducible, and objective diagnostic method. Trial registration: German Register of Clinical Studies U1111-1212-6622. Full article

Addressing global challenges such as climate change and inequality requires convergence competencies that enable learners to devise sustainable solutions. Such competencies have been emphasized in Science, Technology, Engineering, Mathematics (STEM) fields, but empirical research and assessment tools tailored to Humanities, Arts, and Social Sciences (HASS) remain scarce. This study aimed to develop and validate a self-assessment tool to measure convergence competencies among HASS learners. A three-round Delphi survey with domain experts was conducted to evaluate and refine an initial pool of items. Items with insufficient content validity were revised or deleted, and all retained items achieved a Content Validity Ratio (CVR) of ≥0.800, with most scoring 1.000. The validated instrument was administered to 455 undergraduates participating in a convergence education program. Exploratory factor analysis identified five key dimensions: Convergent Commitment, Future Problem Awareness, Future Efficacy, Convergent Learning, and Multidisciplinary Inclusiveness, explaining 69.72% of the variance. Confirmatory factor analysis supported the model’s goodness-of-fit (χ² (160) = 378.786, RMSEA = 0.054, CFI = 0.952), and the instrument demonstrated high internal consistency (Cronbach’s α = 0.919). The results confirm that the tool is both reliable and valid for diagnosing convergence competencies in HASS contexts, providing a practical framework for interdisciplinary learning and reflective engagement toward sustainable futures. Full article

The Statistics Anxiety Rating Scale (STARS) is a 51-item scale commonly used to measure college students’ anxiety regarding statistics. To date, however, limited empirical research exists that examines statistics anxiety among ethnically diverse or first-generation graduate students. We examined the factor structure and reliability of STARS scores in a diverse sample of students enrolled in graduate courses at a Minority-Serving Institution (n = 194). To provide guidance on assessing dimensionality in small college samples, we compared the performance of best-practice factor analysis techniques: confirmatory factor analysis (CFA), exploratory structural equation modeling (ESEM), and Bayesian structural equation modeling (BSEM). We found modest support for the original six-factor structure using CFA, but ESEM and BSEM analyses suggested that a four-factor model best captures the dimensions of the STARS instrument within the context of graduate-level statistics courses. To enhance scale efficiency and reduce respondent fatigue, we also tested and found support for a reduced 25-item version of the four-factor STARS scale. The four-factor STARS scale produced constructs representing task and process anxiety, social support avoidance, perceived lack of utility, and mathematical self-efficacy. These findings extend the validity and reliability evidence of the STARS inventory to include diverse graduate student populations. Accordingly, our findings contribute to the advancement of data science education and provide recommendations for measuring statistics anxiety at the graduate level and for assessing construct validity of psychometric instruments in small or hard-to-survey populations. Full article

This research aims to investigate financing decisions of capital-constrained small and medium-sized enterprise (SME) manufacturers and distributors under a Green Supply Chain (GSC) framework. By evaluating the impact of Supply Chain Finance (SCF) instruments, this study utilizes Stackelberg game model to explore a decentralized decision-making system. To our knowledge, this investigation represents the first exploration of game models that uniquely compares financing through trade credit, where the manufacturer offers zero-interest credit without discounts with reverse factoring, while also considering distributor’s efforts on sustainable marketing under the impact of supportive government policies. Our study suggests that manufacturers should adopt reverse factoring for optimal profits and actively participate in distributors’ financing decisions to address inefficiencies in decentralized systems. Furthermore, the distributor’s demand quantity, profits and sustainable marketing efforts show significant increase under reverse factoring, aided by favorable policies. Finally, the results are validated through Python 3.8.8 simulations in the Anaconda distribution, offering meaningful insights for policymakers and supply chain managers. Full article

Background: Spinal muscular atrophy (SMA) is a neuromuscular disorder that frequently affects bulbar function, including feeding and swallowing. Although disease-modifying therapies have improved motor outcomes, little is known about the persistence of oromotor difficulties, particularly with regard to solid food intake. Objective: This study aimed to evaluate mastication and swallowing performance in children with SMA undergoing treatment, and to investigate the association between tongue strength and feeding efficiency. Methods: Twenty-two children with SMA types 1–3 were assessed using the Test of Masticating and Swallowing Solids in Children (TOMASS-C) and the Iowa Oral Performance Instrument (IOPI). Key TOMASS-C outcomes included the number of bites, chewing cycles, swallows, and total eating time. Tongue strength was measured in kilopascals. Results: Most participants showed deviations from age-specific normative values in at least one TOMASS-C parameter. Tongue strength was significantly lower than reference values in 86% of participants and correlated negatively with all TOMASS-C outcomes (p < 0.001). Children with weaker tongue pressure required more swallows, more chewing cycles, and longer eating times. Conclusions: Despite pharmacological treatment, children with SMA experience persistent difficulties in eating solid foods. Tongue strength may serve as a non-invasive biomarker for bulbar dysfunction and support dietary decision-making and therapeutic planning. Full article

In the context of increasing Artificial Intelligence integration in higher education, understanding the factors influencing university teachers’ adoption of AI tools is critical for effective implementation. This study adopts a perception–intention–behavior framework to explores the roles of perceived usefulness, perceived ease of use, perceived trust, perceived substitution crisis, and perceived risk in shaping teachers’ behavioral intention and actual usage of AI tools. It also investigates the moderating effects of peer influence and organizational support on these relationships. Using a comprehensive survey instrument, data was collected from 487 university teachers across four major regions in China. The results reveal that perceived usefulness and perceived ease of use are strong predictors of behavioral intention, with perceived ease of use also significantly influencing perceived usefulness. Perceived trust serves as a key mediator, enhancing the relationship between perceived usefulness, perceived ease of use, and behavioral intention. While perceived substitution crisis negatively influenced perceived trust, it showed no significant direct effect on behavioral intention, suggesting a complex relationship between job displacement concerns and AI adoption. In contrast, perceived risk was found to negatively impact behavioral intention, though it was mitigated by perceived ease of use. Peer influence significantly moderated the relationship between perceived trust and behavioral intention, highlighting the importance of peer influence in AI adoption, while organizational support amplified the effect of perceived ease of use on behavioral intention. These findings inform practical strategies such as co-developing user-centered AI tools, enhancing institutional trust through transparent governance, leveraging peer support, providing structured training and technical assistance, and advancing policy-level initiatives to guide digital transformation in universities. Full article

This study investigates the relationship between the dynamic capabilities of university administration and students’ awareness of artificial intelligence (AI) tools within a higher education context. Drawing on data from 139 students at the College of Education, Sultan Qaboos University, the research employed two validated instruments, one measuring the dynamic capabilities of university administration and another assessing students’ awareness and perception of AI tool use. Understanding this relationship is critical, as universities increasingly face pressure to guide responsible and effective AI use among students. Findings reveal significant correlations between the university administration’s dynamic capabilities, particularly technological agility, and students’ engagement with AI tools. Notably, technological dynamic capabilities within the administration significantly predicted two specific dimensions of student awareness: effectiveness of using AI tools and perceived faculty members’ efficiency in AI. These results highlight the critical role of institutional leadership in promoting equitable and sustainable integration of AI in education. The study contributes to the broader discourse on AI for sustainable development by illustrating how institutional strategies can enhance innovation, inclusion, and student readiness in support of SDG 4. Full article

Family empowerment is a key component of effective family-centered practices in healthcare, mental health, and educational services. The Family Empowerment Scale (FES) is the most commonly used instrument to evaluate empowerment in families raising children with emotional, behavioral, or developmental disorders. Despite its importance, the FES for diverse populations, especially Latinx parents, has rarely been evaluated using innovative psychometric approaches. In this study, we evaluated key dimensions and psychometric evidence of the Family Empowerment Scale (FES) for 96 Latinx parents of children with intellectual and developmental disabilities (IDD) in the United States using an exploratory graph analysis (EGA). The EGA identified a five-dimensional structure, and EGA models outperformed the original CFA 3-factor models for both parents of children with autism and other disabilities. This study identified distinct, meaningful dimensions of empowerment that reflect both shared and unique empowerment experiences across two Latinx parent groups. These insights can inform the design of culturally responsive interventions, instruments, and policies that more precisely capture and boost empowerment in Latinx families. This study contributes to closing a gap in the literature by elevating the voices and experiences of Latinx families by laying the groundwork for more equitable support systems in special education and disability services. Full article