Search Results (8,088)

Background/Objectives: Medication-related harm is a leading global patient safety challenge, yet patients’ lived experiences of medication safety remain underexplored in Central and Eastern European healthcare systems, where structural constraints significantly shape everyday medication use. Methods: This study provides an in-depth qualitative analysis of Hungarian patients’ online narratives, building on a prior netnographic mixed-methods study. Using grounded theory-informed principles and a patient-centred medication safety framework, we inductively analysed 5174 publicly accessible Hungarian-language comments posted on health forums and social media platforms between August 2020 and August 2023. The COM-B model was applied as a secondary lens to map findings onto modifiable behavioural determinants. Results: Access to services and communication emerged as the dominant medication safety concerns. Patients reported long waiting times, limited rural emergency services, and brief consultations leading to delayed or inadequate treatment. Communication gaps included insufficient information on medication duration, side effects, and follow-up, as well as conflicting advice from multiple sources, all of which eroded trust and prompted treatment discontinuation or reliance on informal online communities. Community pharmacists were largely absent from patients’ mental models of care, representing a significant missed opportunity given their accessibility. Less frequently mentioned were medication shortages, healthcare professional workload, and systemic safety culture. Conclusions: Clear, respectful communication and timely access to care are central to medication safety from the patient perspective. Netnography combined with a grounded theory-informed methodology offers a valuable approach for capturing authentic patient perspectives in structurally burdened healthcare systems, with findings relevant beyond the Hungarian context. Full article

Building inclusive, high-density cities requires understanding vulnerable groups’ public space usage. While green exposure significantly impacts urban health, existing research frequently overlooks females’ specific needs regarding streetscape visual quality, green space structures, and daily travel experiences. To address this, the study investigates spatial disparities in Suzhou’s historic district. Utilizing multi-source data and mixed modeling strategies, including Partial Least Squares and Ordinary Least Squares (PLS-OLS) and eXtreme Gradient Boosting (XGBoost), the research analyzes how streetscape perceptions and green space characteristics affect female life satisfaction and expressed sentiment. Results indicate three main findings. (1) Streetscape visual features fundamentally drive subjective evaluations. Safe significantly enhances well-being, whereas boring and lively negatively impact life satisfaction, reflecting females’ acute sensitivity to environmental oppressiveness during daily travel. (2) Park diversity elevates expressed sentiment, while patch density positively influences life satisfaction, demonstrating the vital value of fragmented greenery for daily public space usage. (3) Boring precipitously diminishes life satisfaction after surpassing a specific threshold, while park diversity elevates expressed sentiment only after crossing a critical interval. The study establishes an integrated analytical framework linking visual perception, green space structure, emotional response, and satisfaction. These findings provide targeted strategies for enhancing inclusive urban design and optimizing green space allocation to improve streetscape safety and alleviate visual oppressiveness, thereby advancing gender social justice for vulnerable groups in historic districts. Full article

Within the Veteran’s Health Administration (VHA), peer support specialists (PSSs) have traditionally worked in mental health and behavioral health settings. PSS-facilitated cancer support groups are less common and underused in this setting. The purpose of this study was to understand the acceptability, feasibility, and perceived benefits of a PSS-facilitated peer support group for women veterans with breast cancer. Semi-structured interviews were conducted among veteran participants and health system leaders (HSLs) and were recorded, transcribed, and analyzed using rapid qualitative analysis. Key findings from interviews with veterans and HSLs emerged across several domains: The value of shared experiences, peer status and “matching”, virtual aspect, group structure, beneficial topics, and desired outcomes. Veteran participants greatly valued the ability to share experiences and connect with other women veterans with breast cancer and shared a desire for the facilitator to be a peer with an overlapping shared lived experience as they described benefits from peer interactions including supportive coping and instrumental coping. Veterans also reflected on the acceptability of the group being virtual, and uncovered attitudes and preferences regarding group structure, beneficial topics, and desired outcomes. HSLs noted that target outcomes might be linked to feeling connected with community and having an increased feeling of support. Findings suggest that cancer support groups, unlike more traditional mental health support groups at the VHA, may require greater specificity regarding programmatic content and PSS-cancer-experience-matching for group experience to feel authentic and meaningful. Full article

Product mismatch, arising from consumers’ inability to physically experience products before purchase, is a major cause of returns in e-commerce, eroding e-tailer profits and intensifying consumers’ concerns about returns. To alleviate these concerns, e-tailers have increasingly adopted return insurance (RI), which reduces consumers’ return freight costs. However, RI may encourage consumers to defer product selection from the pre-purchase search stage to the post-purchase evaluation stage, thereby exacerbating mismatch and increasing return rates. As a countermeasure in live-streaming commerce, augmented reality (AR) provides an immersive product experience that can reduce mismatch and returns. This study develops a game-theoretic model to analyze the strategic interplay between an e-tailer’s RI decision and a live streamer’s AR decision while incorporating consumer search effort. The results show that consumer search effort changes the relationship between the two strategies. When search effort is low, RI and AR function as strategic substitutes; when search effort is high, they function as strategic complements. These findings indicate that the value of a return-management strategy depends on consumer behavior and on the presence of the partner’s AR strategy. The study contributes to the literature on interdependent return-management strategies and provides actionable insights for e-commerce practitioners. Full article

Informal waste picking and scrap collection constitute critical yet highly precarious livelihood strategies among economically marginalised women in rural South Africa. This article presents a cross-sectional mixed-methods study, guided by Sen’s Capability Approach as its analytical framework, examining the lived experiences, motivations, and livelihood outcomes of 126 Black African women engaged in scrap collection along the N2 Highway in the Eastern Cape, specifically in Mthatha, Xhora, and Qumbu. The study integrates quantitative descriptive statistics with qualitative thematic analysis derived from structured interviewer-administered questionnaires. The findings indicate that participation in scrap collection is overwhelmingly driven by structural economic constraints, including chronic unemployment, household poverty, and extensive caregiving responsibilities, rather than autonomous occupational choice. The sample is characterised by limited educational attainment, frequently disrupted by poverty, bereavement, early marriage, and early caregiving roles, which collectively constrain access to formal employment opportunities. Participants consistently described scrap collection as physically hazardous, economically insecure, and detrimental to both physical health and psychosocial wellbeing, while remaining indispensable for household survival. Through the lens of the Capability Approach, these conditions reflect severe restrictions in substantive freedoms, particularly in relation to economic security, bodily health and human dignity. Expressions of acceptance are interpreted as manifestations of adaptive preferences formed under conditions of prolonged structural deprivation rather than indicators of genuine agency. The study contributes to informal economy scholarship by demonstrating how intersecting structural inequalities constrain capability sets and limit livelihood trajectories and calls for targeted policy interventions to enhance occupational safety, income security and access to sustainable livelihood alternatives. Full article

This study examined how older adults living in public rental apartment complexes perceive and interpret information signs related to wayfinding, facility use, and safety. A questionnaire survey was conducted with 80 residents aged 65 years and older in two public rental apartment complexes in Nowon-gu, Seoul, and 12 participants with varying levels of cognitive function were selected for an eye-tracking experiment. The survey identified small sign and font sizes, insufficient color contrast and clarity, and inappropriate installation locations as the main problems. Time to First Fixation (TTFF) and dwell time were analyzed. Signs with clearer contrast against the background and increased sign size tended to elicit more favorable visual responses, whereas adjusting font size alone had limited effects. Heat map and scan path analyses also showed that the cognitively impaired group had more widely dispersed visual exploration patterns. Due to the limited sample size, statistical significance could not be sufficiently verified, and the findings cannot be generalized. Nevertheless, older adults’ subjective perceptions did not always correspond to the objective experimental results. Information sign improvements should therefore consider both rapid detection and ease of reading. Full article

Introduction: Increased life expectancy and the growing prevalence of disability have led grandmothers and grandfathers to assume a significant role in the care of grandchildren with disabilities. However, their experiences have been scarcely explored from a qualitative and occupational perspective. Objective: To examine the experiences of grandmothers and grandfathers in relation to their participation in caregiving tasks for grandchildren with disabilities. Methods: A qualitative exploratory study framed within a constructivist–interpretive paradigm was conducted. Eleven grandparents of children with disabilities participated and were selected through criterion-based purposive sampling complemented by snowball recruitment. Data were collected through flexible semi-structured interviews and a field diary and were analyzed using inductive thematic analysis. Results: Three main themes emerged: (1) caregiver time, characterized by constant availability and occupational reorganization; (2) emotional impact, with predominant feelings of satisfaction, fulfillment, and strengthening of the emotional bond; and (3) adaptation to change, described as a progressive process of learning, acceptance, information seeking, and negotiation of family roles. Conclusions: The caregiving experience profoundly transforms the daily lives of grandmothers and grandfathers, constituting a highly demanding yet meaningful occupation. The findings highlight the need to recognize their role within the family system and to incorporate an occupational perspective into the support provided to this population. Full article

Systematic trend-following strategies applied to equity markets are widely studied, yet most reported performance statistics are non-reproducible in live trading. This paper makes three contributions. First, we introduce a formal taxonomy of look-ahead bias organised around point-in-time correctness: a strategy is point-in-time correct if, for every decision time t, its information set lies in the natural filtration ${\mathcal{F}}_t$. Three bias classes—universe-membership contamination, price-data forward leakage, and stop-exit sequencing violations—are characterised as filtration breaches. Second, we formalise the average true range (ATR) trailing stop as a stochastic recurrence and codify its monotonic non-decreasing ratcheting property (Lemma 1), providing a structural per-trade loss bound. Third, we exhibit a closed-form construction (Theorem 1) of two return sequences with identical Sharpe ratios but arbitrarily divergent maximum consecutive negative-year runs, establishing investor-experience metrics as independent optimisation objectives. We complement these contributions with an 18-year empirical study (2008–2025) on the NASDAQ-100 with reconstructed point-in-time index constituency (Class I compliant) and measured residual Class II exposure, applying combinatorially symmetric cross-validation (CSCV) to a 14-configuration ATR-multiplier grid. The grid exhibits a stop-multiplier-insensitive, CAGR-flat region across $k\in [3.5,7.0]$ (CAGR 10.28–10.39%, net of Dutch progressive tax) and a uniform maximum consecutive negative-year run of 1 across all 14 configurations. The correlation-matrix eigenvalue spectrum of the grid is dominated by a single mode (${\lambda }_1=13.91$ of 14), yielding an effective independent-test count of $M_{\mathrm{eff}}=1.09$. This near-degeneracy persists in a parallel grid with the regime classifier disabled, establishing the ATR multiplier as a structurally near-redundant parameter for this strategy class. The associated PBO value of $=0.9351$ co-occurs with this near-degeneracy under the CSCV maximum-selection rule. The plateau-level performance survives Bonferroni correction for both $M=14$ and $M_{\mathrm{eff}}$. The combined evidence supports a region-based interpretation of robust strategy parameters rather than single-point optimisation. Full article

Background/Objectives: Dental anxiety (DA) is a well-known obstacle affecting dental care in children. Children living in orphanages are a special population with healthcare needs. The aim of the study was to assess DA among children living in orphanages compared to those living with both biological parents. Methods: This frequency-matched case–control study included 61 children living in orphanages in Jeddah city and 122 age- and gender-matched peers living with both parents in Jeddah, Saudi Arabia. Demographic and background data, including medical history, dental visit history, and Adverse Family Experiences (AFEs), were completed by the caregiver. Dental anxiety was assessed subjectively using the self-reported Abeer Children Dental Anxiety Scale (ACDAS) and objectively by the Venham Clinical Anxiety Rating Scale (VCARS). Results: The prevalence of children with DA in the study sample among those living in orphanages was 18%. AFEs were significantly higher among children living in orphanages (96.7% vs. 32%, p < 0.001). ACDAS and VCARS showed fewer children with DA living in orphanages compared to children living with both parents. Logistic regression showed that living in orphanages decreased the adjusted odds ratio (AOR) of dental anxiety according to ACDAS (AOR = 0.36; p = 0.06) and VCARS (AOR = 0.43, p = 0.040). Conclusions: Although children living in orphanages presented with lower DA than those living with both parents, this may point to differences in emotional expression rather than true emotional state. Clinicians should not rely only on behavioral observations when treating institutionalized children. Full article

This experiment aimed to explore the effects of different doses of compound probiotics (a 1:1:1 mixture of Saccharomyces cerevisiae, Lactobacillus acidophilus, and Bacillus subtilis) added to the diet on pregnant sows and weaned piglets. The experiment was carried out in two stages. Experiment with pregnant sows: thirty-six second-parity Large White sows at 80 d of late gestation were randomly divided into a control group, experimental group I, and experimental group II. The control group was fed a basal diet, while experimental groups I and II were fed the basal diet supplemented with 2 g/kg and 3 g/kg of compound probiotics, respectively. The pre-experiment lasted 7 d, and the formal experiment continued until the end of lactation. The results showed that the numbers of live piglets per litter, healthy piglets per litter, litter birth weight and litter weaning weight in the experimental groups were significantly higher than those in the control group (p < 0.05). Colostrum IgG concentration in experimental group I was significantly higher than that in the control group and experimental group II (p < 0.05). Compound probiotics significantly increased colostrum immunoglobulin levels (p < 0.05). The concentrations of ammonia, carbon dioxide and PM2.5 in the barns of the experimental groups all showed a decreasing trend. Experiment with weaned piglets: a total of 160 Landrace × Yorkshire crossbred weaned piglets at 30 d of age with an initial body weight of (8.01 ± 0.13) kg were randomly assigned to four groups. The control group was fed a basal diet, while the treatment groups were supplemented with 2, 3, and 4 g/kg of compound probiotics, respectively. The results indicated that average daily gain and average daily feed intake in experimental group III were significantly higher than those in the control group, while the feed-to-gain ratio and diarrhea rate were significantly lower (p < 0.05). The apparent digestibility of crude fiber was significantly higher than that in the control group (p < 0.05), and serum IgA was significantly higher than in the other groups (p < 0.05). In conclusion, dietary supplementation with 2 g/kg compound probiotics for sows in late gestation showed the optimal effect, improving reproductive performance, colostrum immune indices and reducing harmful gases in the barn. For weaned piglets, supplementation with 4 g/kg compound probiotics improved growth performance, nutrient digestibility and serum immune indices. Full article

The consumption of functional foods, especially enriched by probiotics, is appreciated by a growing group of consumers. In this comprehensive review, the comparison of food probiotics’ health advantages between adult healthy women and healthy men was demonstrated with the aim of indicating the target group of consumers. Based on clinical studies and meta-analyses, in the context of sex differences, the impact of functional foods with probiotics on selected disease development and disease course, as well as on the potential health benefits, was discussed. Significantly population-related and most common health abnormalities, such as obesity, metabolic disorders, hypertension, irritable bowel syndrome, and functional gastrointestinal disorders, were analysed. There is a sex-dependent variety of gut microorganisms, and a greater diversity of the gut microbiome is found in women. The major differences between men and women considered in the study included higher prevalence of irritable bowel syndrome and obesity in women, a different lipid profile, and different age-related hypertension occurrence in both groups. Life expectancy has also been taken into account. According to the statistical data, women live longer, experience more health problems in the course of life, and therefore will probably more frequently seek functional food. In general, consumption of functional foods should be supported and recommended for the entire population. The open questions that need to be clarified are if the sex-dependent strategy is justified for choosing specified functional foods and probiotic strains. Full article

Ants, plants, and hemipterans in tritrophic mutualisms represent closer approximations to real ecosystems compared to twofold mutualisms, playing a critical role in ecosystem functioning. Although habitat degradation is a useful framework for investigating the stability of mutualisms, few studies have focused on such mutualistic interactions in degraded grassland. In this study, we conducted both a field and a greenhouse experiment to assess the effect of grassland degradation on the organization of ant–plant networks and ant-hemipteran-plant tritrophic interactions in the light and severely degraded grassland of Songnen Plain, China. In general, we found that severe degradation of grassland changed the spatial distribution pattern of ant–plant networks from uniform to aggregation and increased the species diversity within these networks and facilitated the Lasius flavus-aphid/mealybugs-Artemisia scoparia tritrophic mutualisms. L. flavus improves individual plant performance by increasing plant height, reducing soil moisture content, and facilitating seed transportation of A. scoparia. These advantages enhance plant fitness and population spread of A. scoparia, consequently boosting its dominance within degraded grassland habitats. In turn, the well-developed root of A. scoparia attracted more L. flavus and aphid/mealybugs by providing living space and food. Our findings enhance the understanding of tritrophic mutualisms and their mechanisms in the context of grassland degradation, thus providing valuable information for the conservation, management, and restoration of degraded grassland. Full article

Strategic Autobiographical Narrative is a pedagogical concept designating the deliberate and structured use of self-narration as a tool for learning, identity reconstruction and community engagement in contexts of social exclusion. Its strategic dimension lies in the conscious articulation of memory, language and transformative action: converting lived experience into pedagogical material capable of resignifying biographical trajectories, sustaining the openness of identity to new readings, and projecting possible futures from a critical and communal perspective. The concept operates through three synchronic registers: as temporal mediation, reopening biographical time where institutions tend to freeze it; as identity mediation, sustaining the mobility of the self against classificatory fixation; and as relational mediation, creating the conditions for the intersubjective event of recognition within a space of non-judgmental listening. Against the disciplinary institution’s tendency to fix identity under a single classificatory reading, the concept recovers the subject’s capacity to reinscribe their past within an open narrative and project a future not prefigured by their carceral present. Its operational methodology is structured around the ELCEN method—listen, read, converse, write and narrate—and deploys diverse autobiographical pathways oriented toward both the reconstruction of the subject’s identity and the community’s sensibilisation in the process of social reintegration. At its core lies a conviction safeguarded by oral tradition for millennia before anyone theorised it: to narrate is to coexist. Full article

Individuals living with mental illness face disproportionately higher COVID-19 morbidity and mortality than the general population. Despite their prioritisation in Australia’s national vaccination rollout, vaccination rates among this population are significantly lower than those without mental illness. No previous study has employed a qualitative research paradigm to explore the barriers and facilitators to COVID-19 vaccination among people with mental illness in the Australian context. This qualitative study will employ Braun and Clarke’s reflexive thematic analysis framework. Participants will be recruited through Western Health Mental Health and Wellbeing Services in Victoria, Australia. Semi-structured individual interviews will be conducted with approximately 17–20 participants (aged 18–65) who have a DSM-5 diagnosed mental illness and any experience (vaccinated or unvaccinated) with COVID-19 vaccination. Interviews will be audio-recorded, transcribed, and then analysed and collated into themes using NVivo software. Code saturation will guide the final sample size. This study aims to produce a rich thematic map that captures the experience of individual, illness, and system-level barriers and facilitators to COVID-19 vaccination in this cohort. Findings are anticipated to inform targeted public health interventions to improve equitable vaccine uptake and contribute to closing the mortality gap for those with mental illness. This protocol has been approved by the Western Health Low Risk Ethics Panel (ERM ID: 113351). Full article

Background/Objectives: The family constitutes a primary ecological system shaping infant emotional and mental health. Parent responsiveness in particular shapes early regulatory capacities in the developing child. Added contextual stress such as that associated with natural disasters may strain caregiving relationships. Brief, universally accessible parenting interventions offer scalable support for strengthening early relational health and may be useful in contexts of natural disaster-related stress as well as in the general population. This qualitative study examined the perceived impact and contextual relevance of MERTIL (My Early Relational Trust-Informed Learning) for Parents, a brief digital psychoeducational parenting program targeting early relational health, among families raising young children in disaster-affected communities. Methods: Fourteen parents residing in the Hunter New England and Central Coast region of New South Wales, Australia, with young children aged 0–5 years, participated in semi-structured interviews conducted approximately 6 months after completing MERTIL for Parents. Interviews explored lived experiences of parenting in the context of natural disaster (analysed via applied phenomenological methods) and parents’ perceptions of program components that supported everyday caregiving (analysed via reflexive thematic analysis and content analysis). Results: Parents described interconnected personal, relational, and environmental stressors that influenced aspects of the parent–infant relationship. Key retained knowledge from the program included a normalisation of parenting challenges, a strengthened understanding of attachment, trust, safety and repair, and attuned, emotion-focused parenting practices. Conclusions: This pilot study illuminates the lived experience of parenting in disaster prone regions and highlights the potential for this brief, universal digital parenting program to provide support for early relational health in such contexts. Full article