Search Results (598)

In this article, digital transformation is examined as a key driver of structural and pedagogical change in higher education. This process is shown to expand access to learning, increase flexibility, support personalized educational trajectories, and enhance data-driven decision-making. At the same time, the effectiveness of digital transformation depends on institutional readiness, the quality of technological infrastructure, and the professional competencies of teaching staff. This research of this study is to assess the influence of digital transformation on the quality of higher education. This research employs a mixed-methods approach. Quantitative data from surveys of 4971 students and 483 instructors were analyzed using descriptive statistics, analysis of variance ANOVA, and multivariable regression, while qualitative focus group findings were examined through thematic analysis. The results indicate generally positive attitudes toward digitalization. The respondents emphasized flexibility and improved conditions for independent learning as key advantages of digital environments. However, this study also identifies several challenges, including infrastructural inequality, limited digital skills, and insufficient pedagogical adaptation. The article concludes that successful digital transformation requires a comprehensive strategic vision and sustained institutional support. For universities, strengthening digital competencies, modernizing infrastructure, and implementing management models focused on continuous improvement are essential conditions for ensuring sustainable development and enhancing the quality of education. Full article

The global shift toward digital pathology necessitates accessible and cost-effective training tools, posing a significant challenge for resource-constrained veterinary faculties. The objective of this study was to evaluate the academic impact of a cost-effective, in-house-developed digital pathology platform implemented at a Romanian Veterinary Faculty during the 2024–2025 academic year. Grade data from six academic years (2018–2025) were used as historical controls. Statistical analysis, including independent-samples t-tests, ANOVA, and multivariable regression, was performed on individual student grade data to assess changes in academic performance and grade distribution. Results demonstrate a statistically significant increase in mean grades and a higher proportion of top-performing students following platform adoption. The 2024–2025 cohort outperformed four of five prior cohorts, showing a marked shift toward higher grades and fewer low grades. We conclude that this low-cost digital pathology platform may significantly enhance student academic outcomes in veterinary pathology education. These findings validate a scalable and sustainable model for improving pedagogical delivery in resource-conscious institutions worldwide. Further longitudinal research is essential to track the long-term sustainability of these academic gains and confirm the platform’s impact across multiple graduating cohorts. Full article

Background: People experiencing homelessness (PEH) face significant health disparities and systemic barriers to healthcare, elevating their risk for cancer and other chronic diseases. To tackle PEHs’ challenges in accessing cancer preventive care, the CANCERLESS project implemented the Health Navigator Model (HNM)—a person-centered intervention that utilizes trained Health Navigators to provide tailored support and facilitate service access. Recognizing housing as a key determinant of health, this analysis assessed changes in housing status associated with participation in the HNM among CANCERLESS participants in Austria, Greece, Spain, and the UK. Methods: This was a secondary analysis of cross-national data collected during a single-arm interventional study. Of 652 enrolled PEH, 277 (42.5%) completed the HNM intervention follow-up and were included in the analysis. Changes in housing status from baseline to follow-up were categorized using the European Typology of Homelessness and Housing Exclusion (ETHOS) and treated as an ordered outcome. Descriptive statistics were complemented by a cumulative link mixed model with a participant random intercept to estimate the association between time (follow-up vs. baseline) and housing transitions among completers, adjusting for age, residence/legal status, and daily smoking. Results: Participants had a mean age of 47.4 (SD 13.8), primarily identified as male (64.1%), reported upper secondary education (33.9%), and were from Western European countries (39.7%), with varying housing situations. Among intervention completers, time (follow-up vs. baseline) was associated with higher odds of being in a higher ETHOS category (OR = 1.49, 95% CI = 1.02–2.20, p = 0.042), consistent with a modest improvement in housing status. Larger estimates were observed among migrants without legal documents (OR = 24.13, 95% CI = 6.41–90.89, p < 0.001), while daily smoking was associated with lower odds (OR = 0.33, 95% CI = 0.11–0.96, p = 0.041); other residence status categories were not statistically significant. Conclusions: Suggesting that tailored, navigation-based models, such as the HNM, may be linked to improved housing stability for PEH, these findings can inform piloting and context-aligned integration of the HNM within public health strategies as an alternative approach to address the complex, interconnected health and social needs of PEH. However, the lack of a comparison group and high attrition limit the results’ conclusiveness, and future evaluations should aim to include assessments of housing-associated contextual factors. Full article

By combining social, ecological, and communal elements, urban parks significantly improve the quality of urban life. This paper explores the revitalization proposal for Areos Park in Tripoli, Greece, viewing it as an urban palimpsest reflecting layers of history, culture, and nature. While historically evolving from exclusive enclaves to vital public spaces fostering social equity and well-being, many urban parks, including those in Greece, suffer from neglect and underfunding, diminishing their landscape value and necessitating revitalization. Areos Park exemplifies these challenges, making it an ideal case study for exploring effective urban park revitalization strategies and demonstrating how urban areas can host critical landscape functions. Utilizing a design-based research (DBR) methodology, a design plan is proposed. The architectural concept focuses on revamping key areas, restoring historical features, adding small constructions, and repurposing existing buildings for community and educational uses. Concurrently, the landscape concept emphasizes biodiversity enrichment and ecological restoration through permeable surfaces and native Mediterranean vegetation, contributing to urban resilience to climate change. The overall design prioritizes accessibility and spatial connectedness to create an inclusive, resilient, and adaptable urban park addressing contemporary sustainability challenges and biodiversity loss. The project aims to establish Areos Park as a model for sustainable urban park regeneration in small cities, blending ecological enhancement with historical preservation. Full article

In recent years, European cities have implemented numerous initiatives to reduce the use of resources and improve the resilience of climate change by promoting shifts toward the circular economy (CE). This comparative case study investigated the results of the applications of the CE model in the built environment from two different national approaches and perspectives of strategic planning in capitals that represent the “old” (Copenhagen) and “new” (Ljubljana) European Union (EU) member states. This paper introduces the original methodology to assess the implementation of the strategic approaches in the adaptation of the CE in architecture and urban design using a set of 10 selecting indicators. Although both cities have ambitious strategic goals and are undertaking actions aimed at shifting to the CE, they are driven by different motivations (climate crisis vs. urban revitalization and zero waste policy) and exhibit different implementation patterns (top-down systemic/institutional vs. gradual/sectoral). The results highlight the key role of a comprehensive approach to CE implementation, particularly the development of institutional frameworks and dedicated infrastructure and digital tools for transition management, the involvement of external stakeholders in the circular vision, wide-range educational activities, and the promotion of CE initiatives. However, limitations resulting from the lack of a comprehensive and standardized measurement framework pose a challenge to effectively accelerate progress in the shift toward a CE in the built environment. The main contributions of this study are: (1) to identify and verify the methods and strategies undertaken by European cities for the adaptation of a CE in the built environment and (2) demonstrate the different dimensions, levels, and the most relevant factors in the strategic management of the processes of transformation toward the CE. In addition, recommendations for future implementations based on CE systems are indicated. Full article

International postgraduate students enrich higher education institutions and host societies, contributing economically, socially, and culturally. However, much less is known about how to improve their academic outcomes compared with their undergraduate counterparts. This study explores the impact of a non-traditional form of learning, a six-week immersive block model underpinned by guided, active learning pedagogy, on the academic success, satisfaction, and experiences of international postgraduate students at an Australian university. A convergent mix-methods design was used. Chi square tests and generalised estimating equations were used to compare the students’ success rates (N = 14,340) and unit satisfaction (N = 4903) in traditional semester and immersive block learning over five years. Qualitative insights were gathered via student focus groups (N = 9). Significant positive changes in success were observed after controlling for gender, age, discipline, and home region, with particularly strong positive effects for male and information technology students. Despite some challenges with depth of learning and placement organisation, focus group participants valued the clear timelines and flexible delivery, reporting that this supported effective time management and study-work–life-balance. Immersive block learning appears to be an effective strategy for transforming the experiences and outcomes of international postgraduate students in higher education. Full article

Water scarcity poses a growing challenge in the Al Kharj region of Saudi Arabia, driven by rising water demand, climatic shifts, and unsustainable use of non-renewable resources. This study investigates the key factors contributing to water scarcity and climate vulnerability using a quantitative approach and Structural Equation Modelling (SEM) on data from 525 respondents. The findings reveal that climate change (β = 0.426), land use changes (β = 0.247), and population growth (β = 0.153) significantly affect water availability, while economic development (β = 0.145) and poor water management practices (β = 0.066) also contribute to the problem. In addition, population growth and climate change were strongly associated with increased climate risks. These insights suggest that water scarcity in Al Kharj is driven by a nexus of ecological, demographic, and institutional pressures. The implications are that effective policy responses, such as improved land use regulation, investment in climate-resilient infrastructure, sustainable water governance frameworks, and public education campaigns, are essential to enhance long-term water security. These findings support the water-related goals of Saudi Arabia’s Vision 2030 and offer practical strategies for managing climate-adaptive water resources in arid regions. Full article

Background/Objectives: Gamification and game-based learning (GBL) have recently emerged as fresh and appealing ways of health education, and they have been shown to perform better in knowledge acquisition than traditional teaching approaches. Digital serious games are developing as innovative tools for cancer education and behaviour change, yet no review has systematically synthesized their use across key populations. This scoping review aimed to map evidence on serious games for cancer prevention, care, and survivorship among the public, patients, and healthcare professionals, framed through the Capability, Opportunity, Motivation-Behaviour (COM-B) model. Methods: Following Joanna Briggs Institute methodology, we searched Web of Science, MEDLINE, CINAHL, and PsycINFO. Eligible studies evaluated a serious game with a cancer focus and reported outcomes on knowledge, awareness, engagement, education, or behaviour. Data extraction and synthesis followed the PRISMA-ScR checklist. Results: Thirty-five studies met the inclusion criteria, covering diverse cancers, populations, and platforms. Most reported improvements in knowledge, engagement, self-efficacy, and communication. However, heterogeneity in study design and limited assessment of long-term behaviour change constrained comparability. Conclusions: Digital serious games show promise for enhancing cancer literacy and supporting behavioural outcomes across patients, professionals, and the public. By integrating multiple perspectives, this review highlights opportunities for theory-driven design, robust evaluation, and implementation strategies to maximize their impact in cancer education and awareness. Full article

Background: Sexual and reproductive health promotion is a political and social process that involves not only individual actions but also strategies to change social, environmental and economic factors. It is necessary to know the characteristics of effective interventions in order to design new evidence-based programmes. However, programmes need to follow a holistic approach, hence the importance of Comprehensive Sexuality Education. Methods: An extensive bibliographic search was carried out. Twenty systematic reviews between 2015 and 2025 were selected following PRISMA 2020. Results: This review shows that interventions to promote SRH are effective and have significant results in increasing SRH knowledge, attitudes and skills, the competencies of professionals and improving access to SRH services. It has been possible to extract that it is necessary to promote SRH with the inclusion of young people, the adaptation of interventions according to the needs of each person, the coordination between different areas, the application of the intersectional and gender perspective, the application of a rights-based approach, the use of comprehensive and inclusive education models, the training of professionals and the carrying out of evaluations to disseminate the results. Furthermore, there are shortcomings in the evidence, such as the lack of an intersectional perspective, the lack of inclusion of certain groups and the lack of rigorous evaluations following quality standards. Conclusion: Programmes based on Comprehensive Sexuality Education are effective and have certain common characteristics. Full article

Access to practice opportunities for history-taking in undergraduate medical education can be resource-limited. Large language models are a potential avenue to address this. This study sought to characterize changes in learner self-reported confidence with history-taking before and after a simulation with an LLM-based patient and understand learner experience with and the acceptability of virtual LLM-based patients. This was a multi-method study conducted at McMaster University. Simulations were facilitated with the OSCEai tool. Data was collected through surveys with a Likert scale and open-ended questions and semi-structured interviews. A total of 24 participants generated 93 survey responses and 17 interviews. Overall, participants reported a 14.6% increase in comfort with history-taking. Strengths included its flexibility, accessibility, detailed feedback, and ability to provide a judgement-free space to practice. Limitations included its lower fidelity compared to standardized patients and at times repetitive and less clinically relevant feedback as compared to preceptors. It was overall viewed best as a supplement rather than a replacement for standardized patients. In conclusion, LLM-based virtual patients were feasible and valued as an adjunct tool. They can support scalable, personalized practice. Future work is needed to understand objective metrics of improvement and to design curricular strategies for integration. Full article

Inflammatory bowel disease (IBD) affects not only patients but also their informal caregivers. Enhancing caregiver resilience may improve both caregiver well-being and patient outcomes. This study aimed to assess resilience levels in caregivers of individuals with IBD and identify key psychological and contextual predictors, including caregiver contributions to self-care, self-efficacy, and perceived care load. A multicentre cross-sectional study was conducted across nine IBD outpatient clinics in Italy. Caregiver resilience was measured using the Connor–Davidson Resilience Scale (CD-RISC 25). Additional tools included the Caregiver Contribution to Self-Care of Chronic Illness Inventory (CC-SC-CII) and Caregiver Self-Efficacy in Contributing to Patient Self-Care Scale (CSE-CSC). Robust regression models identified predictors of total resilience and its subdomains. Among 275 caregivers (median age 53; 58.2% female) CD-RISC-25 levels were moderately high (median = 74 [IQR = 65–84]), with no significant differences between those caring for patients with Crohn’s disease or ulcerative colitis. SEM analyses showed that self-efficacy significantly predicted contributions to disease monitoring and management, but not maintenance. In turn, the management dimension was significantly associated with higher levels of resilience across four of five domains (trust, control, acceptance of change, and spirituality), while maintenance was uniquely associated with personal competence. Predictors including education and employment status showed no significant direct or indirect effects on CC-SC-CII. In conclusion, caregiver resilience in IBD is positively associated with self-efficacy and active engagement in disease management. Targeted support strategies may strengthen caregiver resources and promote sustainable care. Full article

Background: Unintended adolescent pregnancy and sexually transmitted infections (STIs) remain pressing public health concerns in Northeastern Thailand. Although school-based sexuality education is widespread, risk behaviors persist, underscoring the need for innovative approaches. This study evaluated the SESS (System–Empowerment–Support–Social Network) model, a multi-component framework designed to strengthen adolescent sexual health. Methods: A quasi-experimental, two-school study was conducted among 240 students aged 15–19 years in Nakhon Ratchasima Province. One school (n = 120) implemented a 16-week SESS program, while a comparison school (n = 120) continued with the standard curriculum. The SESS model combined system coordination, empowerment workshops, peer and institutional support, and digital platforms (Facebook, LINE). Data were collected with validated questionnaires and analyzed using ANCOVA, adjusting for baseline values. Exploratory analyses reported mean differences with 95% confidence intervals (CIs). Results: Groups were comparable at baseline. Post-intervention, the intervention school showed higher perception scores (mean difference = +13.0; 95% CI: 10.5–17.0) and preventive practice scores (mean difference = +14.0; 95% CI: 10.1–17.9). Attitudes showed minimal change. No pregnancies or self-reported STI cases were documented among intervention participants during the follow-up period. Conclusions: In this two-school quasi-experimental evaluation, the SESS model was associated with improvements in perceptions and practices, though attitudinal changes were limited. Findings suggest the feasibility of integrating empowerment, social support, and digital engagement into school-based programs while highlighting the need for multi-school trials to establish effectiveness. Full article

Background/Objectives: Coupling mobile health (mHealth) technology with community-based nutrition programs may enhance diet quality in adolescents. This pilot study evaluated the feasibility, acceptability, and preliminary efficacy of integrating PortionSize Ed (PSEd), an image-assisted dietary assessment and education app, into the six-week Hawaii Food and Lifeskills for Youth (HI-FLY) curriculum delivered via Supplemental Nutrition Assistance Program Education (SNAP-Ed). Methods: Adolescents (grades 6–8) from two classrooms were cluster-randomized into HI-FLY or HI-FLY + PSEd. Both groups received HI-FLY and completed Youth Questionnaires (YQ) and food records (written or app-based) at Weeks 0 and 7. Feasibility and acceptability were assessed via enrollment, attrition, and User Satisfaction Surveys (USS). Diet quality was measured using Healthy Eating Index-2020 (HEI-2020) scores and analyzed via mixed-effects models. Results: Of 50 students, 42 (84%) enrolled and attrition was minimal (2.4%). The sample was 49% female and 85% at least part Native Hawaiian or Pacific Islander (NHPI). PSEd was acceptable, with average USS scores above the scale midpoint. No significant HEI-2020 changes were observed, though YQ responses indicated improvements in sugary drink intake (p = 0.03) and use of nutrition labels in HI-FLY + PSEd (p = 0.0007). Conclusions: Integrating PSEd into SNAP-Ed was feasible, acceptable, and demonstrated potential healthy behavior change among predominantly NHPI youth in Hawaii. Full article

Continuous technological, ecological, and digital transformations reshape urban mobility systems. While sustainable mobility has become a dominant keyword, there are many different approaches and policies to help achieve lasting and properly functioning change. This study applies a comprehensive qualitative policy analysis to influential and leading sustainable mobility approaches (i.a. Mobility Justice, Avoid–Shift–Improve, spatial models like the 15-Minute City and Superblocks, governance frameworks such as SUMPs, and tools ranging from economic incentives to service architectures like MaaS and others). Each was assessed across structural barriers, psychological resistance, governance constraints, and affective dimensions. The results show that, although these approaches provide clear normative direction, measurable impacts, and scalable applicability, their implementation is often undermined by fragmentation, Policy Layering, limited intermodality, weak Future-Readiness, and insufficient participatory engagement. Particularly, the lack of sequencing and pacing mechanisms leads to policy silos and societal resistance. The analysis highlights that the main challenge is not the absence of solutions but the absence of a unifying paradigm. To address this gap, the paper introduces CalmMobility, a conceptual framework that integrates existing strengths while emphasizing comprehensiveness, pacing–sequencing–inclusion, and Future-Readiness. CalmMobility offers adaptive and co-created pathways for mobility transitions, grounded in education, open innovation, and a calm, deliberate approach. Rather than being driven by hasty or disruptive change, it seeks to align technological and spatial innovations with societal expectations, building trust, legitimacy, and long-term resilience of sustainable mobility. Full article

Small landslides, though frequent, are often overlooked despite their significant potential impact on human-affected areas. This study presents an analysis of the Bella Orxeta landslide in Alicante, Spain, a rotational landslide event that occurred in March 2017 following intense and continued rainfall. Utilizing multitemporal datasets, including LiDAR from 2009 and 2016 and drone-based photogrammetry from 2021 and 2023, we generated high-resolution digital terrain models (DTMs) to assess morphological changes, estimate displaced volumes of approximately 3500 cubic meters, and monitor slope activity. Our analysis revealed substantial mass movement between 2016 and 2021, followed by relatively minor changes between 2021 and 2023, primarily related to fluvial erosion. This study demonstrates the effectiveness of UAV and DTM differencing techniques for landslide detection, volumetric analysis, and long-term monitoring in urbanized settings. Beyond its scientific contributions, the Bella Orxeta case offers pedagogical value across academic disciplines, supporting practical training in geomorphology, geotechnical assessment, GIS, and risk planning. It also highlights policy gaps in existing territorial risk plans, particularly regarding the integration of modern monitoring tools for small-scale but recurrent geohazards. Given climate change projections indicating more frequent high-intensity rainfall events in Mediterranean areas, the paper advocates for the systematic documentation of local landslide cases to improve hazard preparedness, urban resilience, and geoscience education. Full article