Search Results (724)

Background: In recent years, virtual consultations have emerged as a crucial approach for continuity of chronic care provision, indicating a promising avenue for the future of smart healthcare systems. However, reversions to in-person care highlight persistent limitations, despite notable advantages of remote modalities. In parallel, recent developments in artificial intelligence (AI) indicate the potential to enhance remote chronic care, but user perceptions of such assistance and the corresponding human factors remain underexplored. Objective: This mixed methods study aims to better understand the virtual consultation experiences and attitudes toward AI-assisted tools in remote care among patients with noncommunicable chronic conditions and their healthcare professionals (HCPs). It conducts an in-depth examination of the associated human–computer interaction and usability elements of virtual consultations and of potential AI assistance. Methods: Public and Patient Involvement was integrated to run pilots and refine documentations. Semi-structured interviews with patients (n = 10), focus groups with HCPs (n = 15), and an online survey (n = 83) were conducted. Qualitative data was analysed through a reflexive thematic approach. The survey comprised the Telehealth Usability Questionnaire (TUQ) and bespoke items on user AI views, and the data was used to triangulate the qualitative findings. Nonparametric Kruskal–Wallis tests and ε² effect sizes compared TUQ and AI views scores between current and former virtual consultation user groups. Results: Seven themes emerged from the qualitative data, which were supported by the quantitative findings. The statistical analyses resulted in a mean TUQ total score of 90.6 (SD = 15.0), which indicates high usability and user satisfaction; however, they failed to detect a difference between groups (p > 0.05; ε² = 0.002–0.032). There was a clear preference for hybrid models, while a lack of empathy was identified during remote interactions. While a notable proportion of users indicated a literacy gap towards AI use in healthcare settings, they expressed cautious openness towards AI assistance, contingent upon transparency, human oversight, and data integrity; indicating a potential gap between competence to judge the technology and willingness to use it. Significant differences in views on AI assistance across groups failed to be detected (p > 0.05; ε² = 0.005–0.065). Conclusions: Virtual consultations for chronic conditions are widely usable and acceptable, particularly through hybrid approaches. Addressing empathic engagement, holistic patient status, and transparent AI integration can enhance clinical quality and user experiences during remote interactions. However, the low statistical power and failure to detect a difference between groups (likely due to the small sample size) indicate the need for caution when interpreting the quantitative findings. There is also the implicit need to address potential AI literacy gap among users, indicating the need for robust safeguard measures. This study has also identified evidence-based assistive AI features that can potentially enhance virtual consultations. These insights can inform the co-design of evidence-based virtual care platforms, policies and supportive AI tools to sustain remote chronic care delivery. Full article

(1) Background: Regulations governing food supplements vary considerably across countries, allowing products that are prohibited in one jurisdiction to be legally sold in another. Furthermore, online sales enable and facilitate this practice. Regarding pharmaceutical malpractice, the absence of a standardized European framework complicates the evaluation of pharmacist liability. As a result, the specific elements of the liability framework are defined by the national legislation of each Member State. The aim of our review is to map the global regulatory landscape of food supplements and to examine the pharmacist’s professional responsibilities, including instances of malpractice related to this area. (2) Methods: A literature review covering publications from January 2020 to December 2024 was performed using four databases: Scopus, PubMed, Embase, and Web of Science. The search retrieved 8243 records, of which 77 studies fulfilled the eligibility criteria. The extracted data were organized into five main themes: pharmacist responsibility and malpractice, food supplement regulation, consumer safety, health claims, and pharmacist knowledge. (3) Results: The literature reviewed indicated a relatively low number of malpractice cases within the pharmacy profession compared to other professions. A higher incidence of cases is observed among male pharmacists and those practicing in the private sector. Notably, no cases have been identified addressing pharmacists’ responsibilities in the dispensing of food supplements. In the context of food supplement regulation, the reviewed literature highlights a lack of standardized terminology and harmonized legislation across different jurisdictions. Therefore, products may be classified differently across jurisdictions. Another observed barrier is the considerable variation in market access requirements across countries. Regarding consumer safety, several irregularities have been observed. Substantial non-compliance in both product composition and labeling has been observed, reflecting insufficient quality control measures. Concerning health claims, significant regulatory non-compliance with European Union regulations has been documented. In addition, widespread misleading advertising practices have been observed. With respect to pharmacists’ knowledge, the reviewed literature identifies several professional challenges within pharmacy practice, particularly those concerning the dispensing of food supplements. (4) Conclusions: This research offers a comprehensive analysis of the literature published over the past five years concerning pharmaceutical malpractice cases, as well as an examination of food supplement regulation and the professional responsibilities of pharmacists. A recurring barrier identified is the absence of unified regulatory frameworks worldwide. This results in uncertainty concerning the pharmacist’s professional role and responsibilities. Full article

This paper leverages Google Trends search volume data from 2004 to 2008 as a proxy for investor information demand. The analysis documents that greater search activity prior to earnings announcements is positively associated with future market reaction to earnings announcements, pre-earnings announcement drift, and buying pressure. The results are consistent with investors gathering value-relevant information through online research, which is subsequently incorporated into prices through trading around earnings announcements. Notably, search volume is positively associated with market reaction to earnings announcements and pre-announcement drifts for more obscure firms where data is scarce. Overall, this paper provides large-sample evidence validating theoretical models where dispersed private information is incorporated into stock prices. The findings suggest that broader data access may facilitate pricing efficiency by promoting more informed market participation. Full article

The rapid escalation of Russia’s war in Ukraine prompted many European countries to implement emergency sponsorship schemes for displaced Ukrainians. In the United Kingdom, the Homes for Ukraine scheme emerged as a prominent example enabling non-related hosts to accommodate refugees in private homes or other settings While widely praised for its humanitarian intent, the British Association of Social Workers raised early concerns about safeguarding risks within the scheme’s infrastructure. Key issues included the absence of a centralized matching system, reliance on informal arrangements via social media, and limited expert-led placement assessments. These gaps posed significant risks not only to refugees and hosts but also to frontline professionals tasked with addressing safeguarding concerns. Despite these challenges, research documenting their impact on practitioners is scarce. This article reports on findings from an online survey capturing professionals’ experiences of identifying and managing these safeguarding issues and the implications on their well-being. Results indicate that, although practitioners expressed pride in delivering the scheme, its rapid rollout, uneven local implementation, and lack of clear guidance contributed to safeguarding vulnerabilities and professional strain. These insights highlight the need for robust planning, clearer accountability, and culturally informed practices in future emergency initiatives. Full article

In an e-learning platform, information retrieval plays an enormous role through efficient processing. Recently, the education sector has increased its trend in online learning systems by generating a large amount of educational content based on student’s criteria. For this sophisticated data analysis scheme, several methods have been employed in recent studies; however, they have suffered from various limitations, including reliability issues, security problems, unauthorized disclosure of data, cost consumption, and interpretability challenges. To tackle these issues, a proposed framework, named the war strategy optimization-based bidirectional long short-term memory (WSO-BiLSTM) model, is designed in this research to reduce sensitivity to local optima and improve convergence stability, thereby achieving robust retrieval performance. With this perspective, the BiLSTM model captures the semantic information of documents in a dual direction for effective retrieval outcomes. Moreover, the model’s key features are extracted effectively by various feature extraction methods. The dynamic movement towards the optimal solution of the WSO algorithm enables the proposed model to retrieve the information more accurately in the information retrieval system. Experiments on an e-learning dataset show that, with a 90% training split, the proposed method achieves 97.90% accuracy, 98.45% precision, 97.90% F1-score, and 97.35% recall. Full article

Greenery and nature are used as symbols in city branding. These symbols have been well documented to be effective in improving physical and mental health. Especially in a country like Japan where natural disasters occur frequently, there may be differences in the impact of these two factors on the intention to live in an urban area. Second, the literature on the impact of greenery and nature on residential intentions is limited to observational studies of existing cities, with a surprising lack of empirical studies encompassing other urban components. Therefore, we address the following research question: ‘Do greenery and nature contribute to the residential intentions of Tokyo residents?’ Orthogonal arrays were adopted to generate 18 patterns of city designs targeting five attributes (residential areas, public facilities, greenery/nature, shopping areas, and station buildings). A randomized controlled trial with 1000 online survey participants revealed that parks were more effective than mountains in increasing people’s intention to live in a city. The effect was greater in more developed cities or among residents with a more urban orientation. In countries where natural disasters occur frequently, it is important to recognize that greenery and nature are similar but differ in their elements. Full article

This study investigates how early childhood education and care (ECEC) professionals in Austria perceive opportunities and risks associated with artificial intelligence (AI). While AI has gained increasing attention in educational research, empirical evidence in the ECEC context remains scarce. A quantitative online survey (May–June 2025) was administered to 292 Austrian ECEC teachers. While only 9.6% fully integrate AI into their practice, 34.3% use it at least occasionally. In contrast, 65.6% recognise its potential to support pedagogical processes like documentation, observation, or language education. Non-parametric group comparisons indicated significant differences in opportunity perceptions by age, education, and professional experience, whereas no systematic differences emerged in critical attitudes. The results suggest that professional experience and qualifications shape openness to AI, yet scepticism remains widespread across groups. For practice, the findings highlight the need for targeted PD formats, collegial learning opportunities, and pilot projects that enable professionals to explore AI tools in a reflective manner. Structural support in terms of infrastructure, regulation, and resources is essential to prevent additional strain. This study emphasises the significance of integrating AI into broader professionalisation processes. Full article

Background/Objectives: The COVID-19 pandemic exposed global weaknesses in healthcare preparedness and highlighted the pivotal role of the World Health Organization (WHO) in coordinating responses and issuing technical guidance. Among these, the document “Rational use of personal protective equipment (PPE) for COVID-19 and considerations during severe shortages” (December 2020) aimed to standardize PPE use amid global scarcity. This study assessed the awareness, implementation, and perceived usefulness of this WHO guidance among Polish healthcare personnel and evaluated discrepancies between the WHO expectations and workplace realities. Methods: A cross-sectional, anonymous online survey was conducted between July and September 2025 among employees of 243 randomly selected healthcare facilities in Poland (constituting 20% of all hospitals). The original 24-item questionnaire covered the demographics, awareness and implementation of the WHO PPE guidelines, and perceptions of their effectiveness during and after the pandemic. Data were analyzed descriptively. Results: A total of 542 healthcare workers participated, predominantly nurses (56.8%) and physicians (12.2%), with 86.8% being female and 59.3% having over 20 years of experience. Most respondents (76.5%) reported familiarity with the WHO PPE document, and 63.1% confirmed its implementation in their institutions. Over two-thirds (68.0%) reported that the guidelines improved their sense of safety at work. The main barriers to implementation included staff shortages (52.9%) and insufficient local guidance (20.6%). In 2025, 52.3% continue to apply the WHO recommendations, and 70.8% believe they remain relevant in current practice. However, 80.2% indicated that the WHO guidance should be more closely adapted to local conditions. Conclusions: The WHO PPE guidance was widely recognized and reported as implemented by respondents from participating healthcare facilities, contributing to improved preparedness. Nonetheless, limited institutional support and inadequate local adaptation reduced implementation effectiveness. Future WHO recommendations should better align with national healthcare contexts to enhance preparedness for future crises. Full article

This report describes the development and deployment of the Public Health Quality Tool (PHQTool), an online resource designed to help mobile health clinics (MHCs) assess and improve the quality of their public health services. MHCs provide essential clinical and public health services to underserved populations but have historically lacked tools to assess and improve the quality of their work. To address this gap, the PHQTool was developed as an online, evidence-based, self-assessment resource for MHCs, hosted on the Mobile Health Map (MHMap) platform. This report documents the collaborative development process of the PHQTool and presents preliminary evaluation findings related to usability and relevance among mobile health clinics. Drawing from national public health frameworks and Honore et al.’s established public health quality aims, the PHQTool focuses on six aims most relevant to mobile care: Equitable, Health Promoting, Proactive, Transparent, Effective, and Efficient. Selection of the six quality aims was guided by explicit criteria developed through pilot testing and stakeholder feedback. The six aims were those that could be directly implemented through mobile clinic practices and were feasible to assess within diverse mobile clinic contexts. The remaining three aims (“population-centered,” “risk-reducing,” and “vigilant”) were determined to be less directly actionable at the program level or required system-wide or data infrastructure beyond the scope of individual mobile clinics. Development included expert consultation, pilot testing, and iterative refinement informed by user feedback. The tool allows clinics to evaluate practices, identify improvement goals, and track progress over time. Since implementation, 82 MHCs representing diverse organizational types have used the PHQTool, reporting high usability and identifying common improvement areas such as outreach, efficiency, and equity-driven service delivery. Across pilot and post-pilot implementation phases, a majority of respondents agreed or strongly agreed that the tool was user-friendly, relevant to their work, and appropriately scoped for mobile clinic practice. Usability and acceptance were assessed using descriptive statistics, including percentage agreement across Likert-scale items as well as qualitative feedback collected during structured debriefs. Reported findings reflect self-reported perceptions of feasibility, clarity, and relevance rather than inferential statistical comparisons. The PHQTool facilitates systematic quality assessment within the mobile clinic sector and supports consistent documentation of public health efforts. By providing a standardized, accessible framework for evaluation, it contributes to broader efforts to strengthen evidence-based quality improvement and promote accountability in MHCs. Full article

Effective signaling in instructional materials—through cues such as highlights, arrows, and annotations—can guide learner attention, reduce cognitive load, and enhance comprehension in multimedia-rich online courses. While the benefits of signaling are well documented, little is known about how combinations of signaling strategies influence both the average performance and the consistency of student outcomes. In this study, we propose a data-driven approach to evaluate and optimize signaling strategies in online teaching. Using lecture materials from three semesters of introductory and intermediate statistics courses, we extracted multiple features of textual and visual signaling, including highlighted words, annotated formulas, arrows, and notes. Principal Component Analysis identified four distinct signaling strategies employed by the instructor. We then applied a heteroscedastic beta regression model to link these strategies to topic-level exam performance, allowing simultaneous assessment of mean learning outcomes and their variability. Results show that strategies combining formula highlighting with arrows and detailed notes improve both the average proportion of successful learners and the stability of outcomes, while relying solely on formula highlighting increases variability. Our findings provide actionable guidance for instructors to design effective signaling strategies, and demonstrate a flexible framework for data-driven evaluation of teaching practices in online learning environments. Full article

Background/Objectives: Postoperative Delirium (POD) is a frequent complication in older patients undergoing elective surgery. Although multicomponent interventions are effective, deficits in interdisciplinary communication and intersectoral collaboration persist. This study developed and evaluated the “Geriatric Delirium Pass (GeDePa)”, a paper-based tool to systematically document risk factors for POD across care settings. Methods: A multi-method design was applied, comprising (i) a structured literature review, (ii) semi-structured expert interviews, and (iii) a standardized online survey utilizing the RAND/UCLA Appropriateness Method (RAM). A total of 21 healthcare professionals (general practitioners, geriatricians, anaesthetists, surgeons, and nurses) were recruited from Salzburg, Austria, and South Tyrol, Italy (2023–2024). Results: Healthcare professionals confirmed the GeDePa’s practical applicability for early POD risk detection across care settings. The expert rating using the RAM Disagreement Index (DI) method deemed all 45 risk factors as sufficiently relevant and, with the exemption of two risk factors (alcohol use, intraoperative complications), feasible. A detailed analysis provided a more differentiated picture, with full consensus reached for only 18 items. Several factors with uncertain consensus (e.g., cognitive impairment and polypharmacy) were retained based on strong evidence in the literature. Others were excluded despite high ratings if they were considered redundant or impractical (e.g., detailed intraoperative complications). In total, 38 of the 45 risk factors were retained. Conclusions: The GeDePa is a feasible and relevant tool for structured delirium risk assessment and enhancing interdisciplinary communication between primary and hospital care. The finalized German and Italian versions are now available and will undergo further testing and implementation in clinical practice. Full article

This study examines the relationship between Wasta—a social network based on family, lineage, tribe, and extended family ties—as practiced by senior HRM employees, and its effects on entrepreneurial creativity, innovation, and sustainable development in the MENA region. The study also explores why entrepreneurs and countries in the MENA region are not ranked among the top 100 innovators in the Global Innovation Index. Additionally, it addresses why Wasta, as practiced by HRM employees, can impede sustainable development. The author drew on Amabile’s Componential Theory of Organizational Creativity and Model of Creativity and Innovation in Organizations. Evidence was gathered from articles on Wasta, secondary data from the Global Innovation Index (GII) for 2023, and the Global Entrepreneurship Monitor (GEM NECI) in 2024. Secondary datasets were analyzed using constant comparative analysis of documents. These datasets included accessible online indices, the Global Innovation Index in 2023, the World’s Most Innovative Companies Index by Forbes, and the Top 100 Global Innovators 2024 Rankings by Clarivate. The study develops a theoretical framework for the link between Wasta and sustainable development. It concludes that Wasta, when practiced by senior HRM employees, is likely a reason why MENA entrepreneurs fall short in achieving sustainable development and why the region’s countries are not among the top 100 innovative countries globally. The study answers why Wasta hinders sustainable development among MENA entrepreneurs. This study recommends that entrepreneurs recognize the importance of fair HRM practices in hiring, supervisor selection, candidate selection, and promotions to foster innovation and sustainable development. The conclusions may also encourage policymakers to create and enforce new rules to reduce Wasta if they aim to stimulate innovation, sustainable development, and economic advantage in the MENA region. Full article

This paper presents the design, implementation, and evaluation of a low-code document management and approval system developed on the Microsoft Power Platform. The solution integrates Power Apps, Power Automate, SharePoint Online, and Azure Active Directory to enable secure, traceable, and device-independent workflows for managing organizational documents. By combining graphical interfaces, automated approval logic, and enterprise-grade identity management, the system supports real-time collaboration and compliance with records’ governance standards. A comparative analysis with traditional enterprise content management and open-source web architectures demonstrates substantial advantages in deployment speed, scalability, and auditability. Empirical results from a six-week pilot involving multiple users indicate a reduction in approval cycle time, high user satisfaction, and strong cost-efficiency relative to conventional development models. The findings highlight how low-code ecosystems operationalize digital transformation by empowering non-technical users to automate complex workflows while maintaining security and governance integrity. This work contributes to the understanding of information system democratization, showing that low-code platforms can extend digital participation, improve organizational agility, and support sustainable operational efficiency across distributed environments. Full article

Network security tools are indispensable in testing and evaluating the security of computer networks. Existing tools, such as Hping3, however, offer a limited set of options and attack-specific configurations, which restrict their use solely to well-known attack patterns. Although highly parameterizable libraries, such as Scapy, provide more options and scripting capabilities, they require extensive manual setup and often a steep learning curve. The development of powerful AI models, capitalizing on the transformer architecture, has enabled cybersecurity researchers to develop or incorporate these models into existing cyber-defense systems and red-team assessments. Prominent models such as NetGPT, TrafficFormer, and TrafficGPT can be effective, but require extensive computational resources for fine-tuning and a complex setup to adapt to proprietary networking environments and protocols. In this work, we propose AgentRed, a lightweight tool for generating network attack traffic with minimal human configuration and setup. Our tool integrates an AI agent and a large language model with fewer than a billion parameters into the network traffic generation process. Our method creates lightweight Low-Rank Adaptation (LoRA) adapters that can learn specific traffic patterns in a particular network environment. Our agent can autonomously train the LoRA adapters, search online documentation for attack patterns and parameters, and select appropriate adapters to generate network traffic specific to the user’s needs. It utilizes the LoRA adapters to create an intermediate traffic representation that can be parsed and executed by tools such as Scapy to generate malicious traffic in a virtualized test environment. We assess the performance of the proposed approach on six popular network attacks, including flooding attacks, Smurf, Ping-of-Death, and normal ICMP ping traffic. Our results validate the ability of the proposed tool to efficiently generate network packets with 97.9% accuracy using the LoRA adapters, compared to 95.4% accuracy using the base pre-trained Qwen3 0.6B model. When the AI agent performs online searches to enrich the LoRA adapters’ context during traffic generation, our method maintains an accuracy of 96.0% across all tested traffic patterns. Full article

The COVID-19 pandemic necessitated the transition of physiotherapy programmes from traditional face-to-face anatomy teaching to fully online delivery. Studies conducted during this period have documented students’ positive adaptation to online anatomy learning, highlighting benefits such as increased flexibility and reduced stress, while also noting challenges, including diminished practical exposure. Although much of the existing research centres on medical and dental education, there is a relative paucity of studies examining physiotherapy students’ perspectives. In this study, a purposive sample of 53 entry-level physiotherapy students (Years 1–3) completed a questionnaire evaluating their experiences with anatomy education during the pandemic. Responses were compared between groups (Years 1 and 2 versus Year 3) using the Mann–Whitney U test and effect-size calculations. Year 3 students who experienced both face-to-face and online learning preferred practical sessions with silent mentors in the anatomy hall, citing greater active engagement and deeper learning. Conversely, all year groups reported that online assessments, such as the online Objective Structured Practical Examination, were less stressful than traditional formats. Year 1 and 2 students, lacking prior face-to-face practical experience, expressed neutral views regarding online practical components. Overall, while online theory and assessment components were well received, hands-on practical experience remains highly valued for promoting student engagement. These findings support the development of blended anatomy pedagogy that leverages the strengths of both modalities to enhance resilience and adaptability in the face of future educational disruptions. Full article