Search Results (5,844)

Hybrid learning spaces may be described as physical environments enhanced by digital technologies, which enable learning scenarios involving both in-person and online participation. This article presents a hybrid learning space designed for higher education. The design of the space has been informed by Lefebvre’s design principles: (a) spatial practice enabling flexible usage scenarios, (b) representations of space conveying openness and adaptability, and (c) representational spaces supporting experiences of presence in both physical and digital form. The article describes design characteristics guiding the implementation of the hybrid learning space and explains corresponding design decisions, such as the use of a wall-sized projection. Further, the article introduces affordances and usage scenarios of the hybrid learning space developed. Moreover, an evaluation study of the hybrid learning space is conducted by means of a 360°-based virtual field trip (VFT). The VFT, led by an educator, serves as preparation for a field trip (FT) to a composting plant two weeks later. Participants of both VFT and FT (N = 11) completed a questionnaire addressing psychological constructs related to learning, including motivation, emotion, immersion, presence, and cognitive load. We report the results of the VFT alongside those of the FT as a baseline. Some notable differences, for example in social presence, suggest areas for further development of the hybrid learning space. Overall, the study characterises key features of hybrid learning spaces, identifies their contribution to high-quality teaching and provides inspirations for their further development. Full article

Objectives: This study aimed to identify the prevalence of gender-based violence experienced through social networks among adult women in Spain. Specific objectives included describing in-person sexual violence within the context of GBV and analyzing the relationship between GBV experienced on social networks and in-person sexual violence. Methods: This observational, cross-sectional, and correlational study surveyed 1177 adult women aged 18–59 years. Data were collected through validated instruments, including the Cyber Dating Abuse Questionnaire, Online Sexual Victimization Scale, and Dating Violence Questionnaire. Statistical analyses, including the Mann–Whitney U test, Kruskal–Wallis test, and Spearman’s Rho, were used to examine violence as a function of sociodemographic variables, social network usage, and pornography consumption. Results: Of participants, 68.2% reported experiencing GBV on social networks, 62.7% reported online sexual violence, and 66.0% reported in-person sexual violence. Gender-based violence was significantly correlated with online sexual violence (r = 0.390, p < 0.001) and in-person sexual violence (r = 0.463, p < 0.001). Women from lower socioeconomic backgrounds reported higher victimization rates for all forms of violence analyzed (p < 0.05). Increased daily social network usage and pornography consumption were associated with higher victimization rates (p < 0.05). Conclusions: Gender-based violence on social networks is pervasive among adult women in Spain and is closely linked to in-person sexual violence. Socioeconomic factors, time spent on social networks, and pornography consumption were key predictors of victimization. These findings highlight the need for targeted interventions addressing online violence to mitigate gender-based violence in broader contexts. Full article

Background/Objectives: This study evaluates students’ awareness and perceptions of interdisciplinary education. It focuses specifically on digital dentistry among students in the Department of Dental Technology. The findings aim to support the development of interdisciplinary courses and programs to enhance students’ skills in response to the growing digitalization of dental healthcare. Methods: A cross-sectional survey was conducted using a 23-item online questionnaire administered to a total of 203 students to collect data on general characteristics, perceptions of interdisciplinary education, the perceived necessity of such education, and the demand for interdisciplinary training, including topics related to CAD/CAM and 3D printing technologies. A t-test was performed to analyze grade-level differences in perceptions. Correlation analysis was conducted between perceptions and digital dental laboratory technology skills. Results: Despite the relatively low level of awareness regarding interdisciplinary education, students expressed a strong perceived need for it. A total of 76.6% of respondents preferred to collaborate with the Department of Dental Hygiene. No clear link exists between students’ perceptions of interdisciplinary education and their digital dental competencies. Practical training is more important than awareness. A significant difference in competencies was seen between lower- and higher-year students, indicating that advanced programs for higher-year students may be effective. Conclusions: Clear guidance on interdisciplinary education can enhance student understanding and acceptance. Interdisciplinary education with the dental hygiene department may increase engagement. Full article

Background/Objectives: Lipedema is a chronic, progressive disorder of the adipo-fascial tissue characterized by abnormal subcutaneous fat accumulation, inflammation, fibrosis, pain, and edema. Despite its considerable impact on patients’ quality of life, it remains underdiagnosed. Recent studies have suggested a potential overlap between lipedema and hypermobility spectrum disorders (HSDs), both involving connective tissue dysfunction. This work explores the shared pathophysiological features of lipedema and HSD, highlighting clinical correlations, comorbidities, and the need for integrated diagnostic and therapeutic approaches. Methods: A cross-sectional observational study was conducted through an online survey targeting individuals with lipedema and a control group with lymphedema. The questionnaire assessed symptoms typically associated with HSD, including musculoskeletal, gastrointestinal, urogynecological, vascular, and neuropsychological manifestations. Descriptive statistics were used to evaluate clinical patterns in both groups. Results: Among the lipedema patients, 44% reported joint hypermobility and 60% recalled being hypermobile during childhood. High rates of pediatric overweight (50%), low muscle tone (55%), and exercise-induced fatigue (70%) were observed. Adult symptoms included joint pain (notably in the ankles, knees, cervical spine, sacrum, and feet), digestive issues (50%), and thyroid disorders (24.4%). Compared with the control group, patients with lipedema showed significantly more connective tissue-related motor deficits and systemic symptoms. Conclusions: Connective tissue laxity may play a critical role in the pathogenesis of lipedema, contributing to multisystemic manifestations through vascular, lymphatic, gastrointestinal, and musculoskeletal involvement. The high prevalence of HSD-like features calls for a paradigm shift in the understanding of lipedema as a systemic disorder. Early identification of connective tissue alterations, especially in children with familial predisposition, could enable timely interventions, potentially mitigating disease progression. A multidisciplinary, evidence-based approach is essential for accurate diagnosis and effective management. Full article

Urban streetscapes are among the most frequently encountered spatial environments in daily life, and their restorative visual features have a significant impact on well-being. Although existing studies have revealed the relationship between streetscape environments and perceived restorativeness, there remains a lack of scalable, data-driven methods for quantifying such perception at the street level. This study proposes an interpretable and replicable framework for predicting streetscape restorativeness by integrating semantic segmentation, perceptual evaluation, and machine learning techniques. Taking Liwan District of Guangzhou as a case study, street-view images (SVIs) were collected and processed using the Mask2Former model to extract the following five key visual metrics: greenness, openness, enclosure, walkability, and imageability. Based on the Perceived Restorativeness Scale (PRS), an online questionnaire was designed from four dimensions (fascination, being away, compatibility, and extent) to score a random sample of images. A random forest model was then trained to predict the perceptual levels of the full dataset, followed by K-means clustering to identify spatial distribution patterns. The results revealed that there were significant differences in visual characteristics among high, medium, and low restorativeness street types. The proposed framework enables scalable, data-driven evaluation of perceived restorativeness across diverse urban streetscapes. By embedding perceptual metrics into large-scale urban analysis, the framework offers a replicable and efficient approach for identifying streets with low restorative potential—thus providing urban planners and policymakers with a novel tool for prioritizing street-level renewal, improving public well-being, and supporting perception-oriented urban design without the need for labor-intensive fieldwork. Full article

Background and Objectives: Sciatica is a common condition associated with significant pain and reduced quality of life (QoL). However, its impact and associated determinants remain underexplored in Saudi Arabia. Therefore, this study aimed to examine determinants of quality of life among Saudi adults with sciatica. Materials and Methods: A cross-sectional study was conducted in Saudi Arabia between February and March 2024 using an online Arabic questionnaire disseminated via social media. Participants (n = 927) aged ≥18 years completed a 50-item questionnaire covering sociodemographic characteristics, clinical history, lifestyle factors, and the Short Form-12 (SF-12) QoL scale. Results: Of the 927 adults (mean age 30 ± 11 years), 76% (n = 706) were female and 24% (n = 221) male; 10% (n = 92) reported sciatica. Overall, 57% (n = 531) reported good QoL. Multivariate analysis revealed that increasing age (Odds ratio (OR) = 1.04; 95% CI: 1.01–1.07), urban residence (OR = 1.49; 95% CI: 1.11–2.00), and higher income (>15,000 Saudi Arabia Riyal (SAR); OR = 1.53; 95% CI: 1.03–2.27) were associated with better QoL. Conversely, diabetes (OR = 0.42; 95% CI: 0.22–0.79), arthritis (OR = 0.52; 95% CI: 0.32–0.83), and sciatica duration >1 year (OR = 0.29; 95% CI: 0.12–0.69) were associated with poorer QoL. Gender, body mass index (BMI), smoking, and physical activity showed no significant associations. Conclusions: Sciatica, prolonged symptom duration, and comorbidities such as diabetes and arthritis negatively affect QoL in Saudi adults, whereas socioeconomic and demographic factors contribute positively. The results underscore the importance of early intervention and tailored support for sciatica patients with long-standing symptoms or specific comorbidities to improve health outcomes. Longitudinal studies are warranted to assess causality and the impact of interventions. Full article

Seafood plays a key role in a healthy diet due to its high content of essential nutrients. However, its global trade and complex supply chains expose it to frequent mislabeling and food fraud. This study investigates Italian consumers’ willingness to pay (WTP) for traceable seafood products, exploring how blockchain technology (BT) can enhance transparency and economic sustainability in the fish supply chain. An online questionnaire, administered in 2022 and 2024, gathered responses from a diverse demographic, focusing on four representative seafood species: farmed sea bass, striped venus clams, giant red shrimp, and albacore tuna. Results indicate that most respondents—primarily with higher education levels—value traceability and are willing to pay a premium for certified, traceable seafood. The study models the economic feasibility of implementing BT at both national and regional levels and finds that the consumer’s WTP exceeds the additional costs incurred by adopting BT. These findings support the viability of traceability systems in improving food safety and sustainability, while reinforcing consumer trust. The results also underscore the importance of providing clear information at the point of purchase, particularly regarding species, origin, and production methods—factors critical to informed seafood choices and advancing more sustainable consumer behavior in Italy. Full article

Collaborative Online International Learning (COIL) has become an innovative pedagogical strategy that promotes the internationalization of curricula and the development of transversal competencies. In architecture, its implementation is particularly relevant because there is a growing need to train professionals capable of leading and collaborating in global and interdisciplinary contexts. However, evidence of COIL’s impact during the early stages of higher education in Latin America remains limited. This study analyzed the experience of 39 architecture students from the Universidad Nacional de San Agustín de Arequipa (Peru), who collaborated with peers from Mexico in a five-week COIL project focused on design methodologies for vulnerable populations. Using a mixed-methods approach, the study assessed students’ competencies in leadership, self-regulation in virtual learning, and emotional intelligence and teamwork through pre- and post-experience questionnaires complemented with open-ended questions. Findings indicate that although students’ self-perceptions of their competencies remained at medium-to-high levels overall, changes occurred differently among groups: students with initially low self-assessment scores showed improvements, whereas those with initially high scores tended to moderate their self-assessment. Qualitative analysis highlighted barriers such as limited communication, time zone differences, and unequal participation. Overall, the results suggest that the COIL experience not only supported the development of competencies but also fostered critical reflection and a more realistic self-assessment of students’ competencies in virtual and intercultural contexts. Full article

Background: The digital transition is reshaping healthcare systems through the adoption of telemedicine and electronic health records (EHRs). While these innovations enhance efficiency and access, their implementation unfolds within overstretched organizational settings characterized by workforce shortages, bureaucratic demands, and heightened psychosocial risks. Burnout, impostor syndrome, and the quality of organizational support have thus become pivotal constructs in understanding healthcare professionals’ digital preparedness. Methods: A cross-sectional online survey was conducted among 111 professionals employed at two San Donato Group facilities in Bologna, Italy. The battery included socio-demographic and occupational data, perceptions of digitalization, and validated instruments: the Maslach Burnout Inventory (MBI), the Clance Impostor Phenomenon Scale (CIPS), and the Work Organization Assessment Questionnaire (WOAQ). Descriptive analyses were complemented by Classification and Regression Trees (CART) to identify predictors of perceived digital preparedness. Results: Most respondents (88%) acknowledged the relevance of digitalization, yet 18% felt unprepared, especially women and administrative staff. Burnout levels were high, with 51% reporting emotional exhaustion, most notably among nurses and female participants. Impostor syndrome affected 43% of the sample, with nurses exhibiting the highest prevalence. CART analysis identified emotional exhaustion, impostor syndrome, and age as principal discriminators of digital preparedness. Conclusions: Our findings highlight the role of emotional exhaustion, impostor syndrome, and age in shaping perceived digital preparedness, underscoring the need for tailored training and supportive practices to ensure a sustainable digital transition. Full article

Background: In psychiatry, gambling is classified as an addiction-related disorder and is characterized by a persistent, problematic pattern of behaviour that leads to significant distress and functional impairment. This study aims to explore the prevalence, underlying motivations, and potential academic impact of gambling behaviours among medical students in Poland. Methods: An anonymous online survey was conducted among students from multiple medical universities across Poland. Participants completed a sociodemographic questionnaire and the South Oaks Gambling Screen (SOGS). Respondents who reported any past or current gambling activity were additionally asked about their motivations and potential academic consequences. Results: The study included 281 participants. Active or past gambling was reported by 55% of respondents, with men significantly more likely to gamble currently. Women were predominantly non-problem gamblers, whereas men more often scored within the “some problems” range on the SOGS. Motivations also differed: women emphasised financial gain, while men cited fun, socializing, and competition. Lottery and scratch cards were most popular overall, though men preferred skill-based and casino activities. Conclusions: Although participants showed relatively low levels of gambling involvement, their risk of developing pathological gambling was comparable to that of the general population. Gender influenced involvement in different gambling patterns. Full article

Objectives: To evaluate dental students’ and recent graduates’ perceptions of the integration, effectiveness, quality, and clinical relevance of orofacial pain (OFP) and temporomandibular disorders (TMDs) education in the Oral Medicine (OM) course at Umm Al-Qura University’s Faculty of Dental Medicine (UQUDENT), and to identify educational gaps and opportunities for curriculum improvement. Methods: This cross-sectional study was conducted using a self-administered online questionnaire distributed via Google Forms to 117 participants, including fourth- to sixth-year students, interns, and recent (2022–2024) graduates. Respondents provided demographic information and assessed the effectiveness (10 items), quality (4 items), and value/relevance (4 items) of the OM course using a 5-point Likert scale. Results: Respondents provided moderate ratings for course effectiveness (mean = 35.2/50) and quality (mean = 13.5/20), and rated OFP/TMD content as having high clinical value (mean = 16.1/20). They had limited confidence in OFP/TMD diagnosis (mean = 3.09/5) and management (mean = 3.19/5). More than 80% believed the curriculum should include more OFP/TMD content. No significant differences were observed by gender, sector, study/work area, clinical exposure (all p > 0.05). Conclusions: Students recognize the importance of OFP/TMD education, but the current curriculum may be insufficiently structured to build competence. Improvement of curricular depth, teaching methods, and clinical exposure is recommended. Full article

Background: The digitalization of medical services is promoted as a solution for improving access, quality, and efficiency within healthcare systems. In this context, the study investigates the extent to which digitalization in Romania meets the current needs of patients through a convergent analysis of user perceptions and managerial perspectives. Based on the specialized literature, the research tests two hypotheses: (H1) the implementation of digital technologies significantly contributes to improving the quality of medical services and operational efficiency; (H2) digitalization has a positive impact on patient satisfaction by facilitating access to care and improving communication with medical personnel. Methods: The study adopted methodology is cross-sectional and mixed, including an online mixed-methods questionnaire for patients, distributed between 6 and 14 May 2025, and a qualitative questionnaire with open-ended questions distributed via e-mail to managers from public hospitals through The Administration of Hospitals and Medical Services of Bucharest, between 3 and 24 March 2025. Results: In total, 125 patients and 15 hospital managers participated in the study. Statistical analysis (χ², ordinal regression) and data triangulation highlight a predominantly positive, yet heterogeneous, patient perception of digitalization, with Hypothesis H1 only partially supported (weak, inconsistent, and in some cases negative associations between technology use and perceived service quality). By contrast, H2 was robustly validated, with patient satisfaction strongly linked to tangible benefits, particularly easier access and online appointment scheduling. However, use remains limited to administrative functions, while advanced technologies such as telemedicine or electronic health records are poorly adopted. From an institutional perspective, hospitals predominantly use IT systems for internal purposes, without real patient access to their own data, no interoperability between medical units, and marginal implementation of telemedicine. This reveals a significant gap between user perception and organizational realities, emphasizing the lack of a patient-oriented digital infrastructure. Conclusions: The results highlight the potential of digitalization to enhance patient experience and service efficiency, while also pointing out structural limitations that hinder the full realization of this potential. Patient satisfaction is strongly associated with tangible benefits, particularly easier access and online scheduling, whereas the effect on perceived quality is weaker and sometimes inconsistent. There are significant disparities in digitalization levels between healthcare providers, perceived by patients as public–private differences, and gaps among public hospitals are also confirmed by managerial data. These findings suggest that a successful digital transformation of the medical system in Romania must address both technological infrastructure gaps and organizational barriers, within a coordinated national strategy that ensures interoperability, patient-centered design, and sustainable implementation. Full article

Background: The Healthy Japan 21-Phase III dietary recommendations comprise a staple food, main dish, and side dish to maintain nutritional balance and support healthy child growth. The relationship between the frequency of such balanced meals and early adiposity rebound (AR), a predictor of obesity, remains unclear. Objective: This study aimed to examine the association between the frequency of balanced meals (staple food, main dish, and side dish) and early AR in preschool children. Methods: In this cross-sectional secondary analysis of nationwide online survey data of 688 mothers of children aged 3–6 years, dietary habits were assessed using a validated NutriSTEP-based 22-item Japanese Nutrition Screening Questionnaire. AR constituted a body mass index (BMI) increase from the 18- to 36-month health checkups recorded in the Maternal and Child Health Handbook. Risk scores reflecting lower frequency of balanced meals were calculated for staple foods, main dishes, and side dishes. Logistic regression evaluated associations between dietary risk scores and AR, adjusting for the child’s sex, age, gestational age, birth weight, daycare attendance, and parental obesity. Results: Among 688 children, 193 (28.1%) exhibited early AR and had significantly higher BMI at age 3 and the most recent measurement (both p < 0.01). A higher total dietary risk score was independently associated with AR (adjusted odds ratio; 2.58 [95% CI: 1.08–6.16]). In addition, the absolute risk difference between high- and low-risk groups was 8.5% (95% CI: 1.7–15.2%). Conclusions: A lower frequency of balanced meals is associated with early AR. These findings suggest that a simple, meal-balance screening tool could potentially aid in the early identification of the risk of later obesity and timely nutritional guidance. Full article

Purpose: This study aimed to evaluate retrospectively self-reported changes in tinnitus severity and distress associated with the COVID-19 pandemic and vaccination using validated self-report instruments. It further explored patient-reported onset of tinnitus following vaccination, gender differences in symptom severity, and associations with psychological distress. Method: A cross-sectional online survey was completed by 189 adults between December 2023 and April 2024. Participants retrospectively self-reported tinnitus onset and severity before, during, and after the COVID-19 pandemic using the Tinnitus Handicap Inventory (THI) and the Tinnitus Reaction Questionnaire (TRQ). Additional items assessed COVID-19 vaccination history, infection status, and adverse vaccine reactions. Repeated measures ANOVAs and chi-square tests were used to examine retrospectively reported longitudinal changes and group differences. Results: Mean THI scores increased significantly over time—before (M = 9.57, SD = 16.00), during (M = 29.97, SD = 32.30), and currently (M = 36.92, SD = 28.04)—with large effect sizes across functional, emotional, and catastrophic subscales (p < 0.001). TRQ scores also were reported to rise from before (M = 7.86, SD = 15.29) to during (M = 26.38, SD = 29.58) and remained elevated at the current time (M = 29.79, SD = 24.00), p < 0.001. Approximately 25.9% and 27.0% of respondents reported new or worsened tinnitus after the first and second vaccine doses, respectively. No significant gender differences in symptom severity were observed. TRQ severity classification revealed a marked shift, with moderate or greater distress increasing from 5.8% (before) to 35.6% (current). Conclusions: Retrospective self-reports indicated that tinnitus burden significantly increased during the COVID-19 pandemic and remained elevated at the time of survey completion. A notable proportion of individuals reported new-onset tinnitus following vaccination, though causality cannot be inferred. These findings highlight the need for continued monitoring and comprehensive care addressing both audiological and psychological components of tinnitus. Full article

This study examines the key factors influencing the quality of distance learning in higher education during the COVID-19 pandemic, a period when online learning became the dominant mode of education. Using a descriptive method and a 26-item questionnaire, data were collected from a representative sample of 360 students in Vojvodina, Serbia. The factors analyzed include computer literacy and technology access (Ph1), students’ ability to balance life obligations with study demands (Ph2), and their motivation for distance learning (Ph3). The results show that 89% of students had adequate IT access, 47% were able to reconcile study and personal obligations, and 70% reported strong motivation. Correlation analysis confirmed a statistically significant positive relationship between all three factors and students’ perceptions of well-organized distance learning, thus supporting the main research hypothesis. Beyond these findings, this study interprets digital literacy as adaptability, time management as resilience, and motivation as value orientation and future thinking—core dimensions of sustainability competences outlined in the European GreenComp framework. Distance learning is therefore positioned not only as an emergency response but also as a transformative pedagogy that integrates brain (knowledge), hands (skills), heart (values), and spirit (purpose), contributing to sustainable and resilient higher education. Full article