Search Results (485)

Background: Point-of-care ultrasound (POCUS) is gaining recognition as a valuable diagnostic tool in various fields of medicine, including pediatrics. Its application at the point of care enables real-time clinical decision-making, which is particularly advantageous in pediatric settings. Although global interest in POCUS is growing, many European countries—including Poland—still lack formal training programs for POCUS at both the undergraduate and postgraduate levels. Nevertheless, the number of pediatricians incorporating POCUS into their daily clinical practice in Poland is increasing. However, the extent of its use and perceived value among pediatricians remains largely unknown. This study aimed to evaluate the current level of POCUS utilization in pediatric care in Poland, focusing on pediatricians’ self-assessed competencies, perceptions of its clinical utility, and key barriers to its implementation in daily practice. Methods: This cross-sectional study was conducted between July and August 2024 using an anonymous online survey distributed to pediatricians throughout Poland via national professional networks, with a response rate of 7.3%. Categorical variables were analyzed using the chi-square test of independence to assess the associations between key variables. Quantitative data were analyzed using descriptive statistics, and qualitative data from open-ended responses were subjected to a thematic analysis. Results: A total of 210 pediatricians responded. Among them, 149 (71%) reported access to ultrasound equipment at their workplace, and 89 (42.4%) reported having participated in some form of POCUS training. Only 46 respondents (21.9%) reported frequently using POCUS in their clinical routine. The self-assessed POCUS competence was rated as low or very low by 136 respondents (64.8%). While POCUS was generally perceived as a helpful tool in facilitating and accelerating clinical decisions, the main barriers to implementation were a lack of formal training and limited institutional support. Conclusions: Although POCUS is perceived as clinically valuable by the surveyed pediatricians in Poland, its routine use remains limited due to training and systemic barriers. Future efforts should prioritize the development of a validated, competency-based training framework and the implementation of a larger, representative national study to guide the structured integration of POCUS into pediatric care. Full article

While IPV is often studied as a predictor of housing insecurity, few U.S. studies explore how different forms of housing instability may contribute to intimate partner violence (IPV) risk. Using a mixed-methods approach and a cross-sectional design, this study examined the association between four housing instability domains and IPV among a sample of tenants that had either experienced eviction or were at high risk for eviction. Tenants in Harris and Travis counties (Texas, USA) completed an online survey (n = 1085; March–July 2024). Housing instability was assessed across four domains: homelessness, lease violations, utility hardship, and poor housing quality. IPV was measured using the Hurt, Insult, Threaten, Scream Screener. Covariate-adjusted logistic regression models suggest indicators within the four housing instability domains were associated with IPV risk. Within the homelessness domain, experiences with lifetime homelessness (AOR = 1.92, 95%CI 1.61–2.28), in the past 12 months living in unconventional spaces (AOR = 2.10, 95%CI 1.92–2.29), and moving in with others (AOR = 1.20, 95%CI 1.06–1.36) were associated with IPV. Within the lease violations domain, missed rent payments (AOR = 1.69, 95%CI 1.68–1.71) and non-payment lease violations (AOR = 2.50, 95%CI 2.29–2.73) in the past 12 months were associated with IPV. Utility shutoffs (AOR = 1.62, 95%CI 1.37–1.91) and unsafe housing (AOR = 1.65, 95%CI 1.31–2.09) in the past 12 months were associated with IPV. Homelessness, housing-related economic hardships and substandard living conditions predict an elevated risk of IPV. Full article

This study focuses on the current service/care difficulties and challenges that social institutions in Hungary are facing during their daily operations; how they can react to them utilizing their internal resources, mechanisms, and capacities; and what concrete, tangible needs and demands are emerging in terms of methodological professional support, potential forms, interventions, and direction for professional development. A total of 24 general and 55 specific service and operational problems were identified and assessed in eight different service areas (family and child welfare services, family and child welfare centers, respite care for children, care for the homeless, addiction intervention, care for people with disabilities, care for psychiatric patients, specialized care for the elderly, and basic services for the elderly). The empirical base of the study uses a database of 201 online questionnaires completed by a professional target group working for social service providers in two counties (Győr-Moson-Sopron and Veszprém), representing 166 social service providers. The questionnaires were completed between November and December of 2022. The findings will be used to develop a professional support and development problem map. Social institutions face complex and serious service/care difficulties and challenges in their daily operations. Three distinctive basic problems clearly stand out in both severity and significance from the complex set of factors assessed. The biggest problem in the social care system is clearly the complex challenge of low wages, followed by the administrative burdens in the ranking of operational difficulties, and the third key factor was the psycho-mental workload of staff. Full article

In recent decades, European countries have seen a substantial increase in home cultivation of cannabis. In France, the prevalence of cannabis use continues to increase despite its possession, sale, and cultivation being strictly illegal. The present study aimed to describe the profile and motivations of people in France who cultivate cannabis at home. We separately analyzed data from two convenience samples of people who use cannabis daily in France, based on two online cross-sectional surveys. In the first analysis (N = 3840), we used a multivariable logistic regression model to assess factors associated with home cultivation as the main source of cannabis supply. In the second analysis (N = 574), we described participants’ motivations for home cultivation and their cultivation patterns. In the two samples, 11% and 16% reported home cultivation as their main source of supply, respectively. Age, male gender, stable housing, living with a partner, consuming cannabis in herbal form, smoking joints with little or no tobacco, smoking cannabis from a bong or pipe, non-smoking modes of cannabis administration, and using cannabis exclusively for therapeutic reasons were all positively associated with home cultivation, while urban area of residence and at-risk alcohol use were negatively associated. The main reason reported for home cultivation was to manage quality. Few reported selling some of their crop, and most were self-sufficient. Finally, we interpret this practice as a personal response to cannabis prohibition and the unregulated market. Accordingly, possible harm reduction strategies are discussed. Full article

Form-based design codes have emerged as a planning tool aimed at shaping the physical form of neighborhoods to reinforce local character and enhance sense of place (SoP). However, their effectiveness in delivering these outcomes remains underexplored. This study investigates the extent to which Buffalo’s Green Code—a form-based zoning ordinance—enhances SoP in residential environments, using Elmwood Village as a case study. A multi-scalar analytical framework assesses SoP at the building, street, and neighborhood levels. Empirical data were gathered through an online survey, while the neighborhood was systematically mapped into street segment blocks categorized by Green Code zoning. The study consolidates six Green Code classifications into three overarching categories: mixed-use, residential, and single-family. SoP satisfaction is analyzed through a two-step process: first, comparative assessments are conducted across the three zoning groups; second, k-means clustering is applied to spatially map satisfaction levels and evaluate SoP at different scales. Findings indicate that mixed-use areas are most closely associated with place identity, while residential and single-family zones (as defined by the Buffalo Green Code) yield higher satisfaction overall—though satisfaction varies significantly across spatial scales. These results suggest that while form-based codes can strengthen SoP, their impact is uneven, and more scale-sensitive zoning strategies may be needed to optimize their effectiveness in diverse urban contexts. This research overall offers an empirically grounded, multi-scalar assessment of zoning impacts on lived experience—addressing a notable gap in the planning literature regarding how form-based codes perform in established, rather than newly developed, neighborhoods. Full article

This position paper proposes a conceptual framework (CF-BIAI-SXT) for integrating blockchain with AI to enhance ethical governance, transparency, and privacy in high-risk AI applications that ensure societal resilience through the mitigation of sexual exploitation. Sextortion is a growing form of digital sexual exploitation, and the role of AI in its mitigation and the ethical issues that arise provide a good case for this paper. Through a combination of systematic and narrative literature reviews, the paper first explores the ethical shortcomings of existing AI systems in sextortion prevention and assesses the capacity of blockchain operations to mitigate these limitations. It then develops CF-BIAI-SXT, a framework operationalized through BPMN-modeled components and structured into a three-layer implementation strategy composed of technical enablement, governance alignment, and continuous oversight. The framework is then situated within real-world regulatory constraints, including GDPR and the EU AI Act. This position paper concludes that a resilient society needs ethical, privacy-first, and socially resilient digital infrastructures, and integrating two core technologies, such as AI and blockchain, creates a viable pathway towards this desideratum. Mitigating high-risk environments, such as sextortion, may be a fundamental first step in this pathway, with the potential expansion to other forms of online threats. Full article

This study aims to validate the Online Sexual Harassment Perpetration among Peers (OSHP-P) instrument for assessing online sexual harassment among adolescents in two different countries, Spain and Italy, considering both new forms of online sexual harassment and gender differences. The instrument was validated by means of a Confirmatory Factor Analysis (CFA) with a sample of 1041 Spanish (M_age = 15.0, SD = 0.88) and 1385 Italian (M_age = 14.8, SD = 0.87) adolescents, demonstrating factorial invariance across both country and gender. The best-fitting model was two-dimensional, with ambiguous and direct Sexual Cyber Perpetration (SCP) and Non-Consensual Sharing Perpetration (NCSP) factors. Co-involvement (i.e., involvement in both types of aggression) rates were 10.3% in Spain and 7.8% in Italy. No significant gender differences were found for involvement in either the overall scale (46.4% for girls, 44.1% for boys) or the NCSP subscale (3.0% girls vs. 2.2% boys), although significantly higher co-involvement was found among boys (7.7% girls vs. 10.1% boys). This study contributes to the existing body of research on online sexual harassment among peers in adolescence by presenting a new assessment tool that has been shown to be invariant between Spanish and Italian adolescents, as well as between boys and girls. Full article

Engaging in nightlife activities is an essential form of leisure, especially among young people. However, it also presents considerable risks associated with the occurrence of various forms of violence. Recently, increasing attention has been directed toward sexual violence occurring in nightlife settings. Despite numerous preventive efforts, such as awareness raising, bystander intervention training, alcohol policies, and situational preventive measures, sexual violence remains a persistent issue in nightlife contexts. With the extended usage of smartphones, mobile apps represent a promising approach that complements sexual violence prevention. This article presents findings from a systematic literature review and an online overview of mobile apps aimed at the intervention and prevention of sexual violence, focusing on identifying features suitable for nightlife contexts. The literature review revealed limited academic resources addressing such mobile apps, with only six articles found across four databases. An online review highlighted a wide range of mobile apps that tackle violence. However, when it comes to sexual violence, only 18 apps explicitly focus on prevention or intervention. Although many apps address some aspects of the problem, we noticed a lack of a comprehensive approach that would target all relevant stakeholders. Based on the conducted mobile app’s feature assessment, we propose a set of functionalities that should be incorporated into a holistic mobile app for nightlife sexual violence prevention, which may complement existing educational, community-based, and structural prevention efforts. Full article

Background: Pediatric Crohn’s Disease (CD) affects more than physical health, influencing emotional well-being, social integration, and developmental milestones, with an impact on disease management. This study aimed to explore adolescents’ lived experiences with CD and identify factors influencing their motivation for self-management. Methods: A descriptive, cross-sectional qualitative study was conducted using a semi-structured, self-administered online questionnaire. Participants (n = 10) were adolescents with CD who had been diagnosed for over three years and were recruited from a tertiary pediatric gastroenterology center. Data included demographics, clinical characteristics, IMPACT-III (HRQOL), and PROMIS short forms. Open-ended responses underwent thematic analysis using the framework developed by Braun and Clarke. Results: Participants (80% female, median age 16.2 years, median disease duration 4.6 years) were all in clinical remission (median PCDAI = 2) and with good quality of life (median IMPACT-III = 80.7). Six themes emerged: (1) disease knowledge, (2) emotional responses, (3) coping and adaptation, (4) social support, (5) daily life and school impact, and (6) transition to adult care. Most participants demonstrated strong disease literacy and reported effective coping strategies. Emotional responses to diagnosis ranged from relief (60%) to distress (40%); relapses commonly triggered anxiety and fear. Therapeutic changes and disease monitoring were perceived as beneficial (100%) but with concern. Diagnostic procedures were viewed as burdensome by 70% of respondents. School performance and extracurricular participation were negatively affected in 40% during flares. Concerns regarding the future were reported by 40% of participants, with 30% believing that CD might limit life aspirations. While 60% managed their disease independently, 30% relied on parental support. All acknowledged the need for transition to adult care, though readiness varied. Conclusions: This study illustrates the overall impact of disease on pediatric CD patients. It reports significant emotional challenges and difficulties, as well as an impact on daily life, despite good disease knowledge. The findings underscore the importance of psychosocial well-being, ongoing mental health assessment, non-invasive monitoring, and holistic care, emphasizing the patient perspective, in managing pediatric CD. Full article

Background: The Kidney Disease and Quality of Life Short Form (KDQOL-SF™ 1.3) is widely used to assess health-related quality of life (HRQoL) in patients with end-stage renal disease. However, no prior validation had been conducted in Kazakhstan, where both Kazakh and Russian are commonly spoken. This study aimed to validate the Kazakh and Russian versions of the KDQOL-SF™ 1.3 and to identify predictors of HRQoL among hemodialysis patients in Kazakhstan. Methods: A cross-sectional survey was conducted among 217 adult hemodialysis patients from February to April 2025 using a mixed-methods approach (in-person interviews and online data collection). Psychometric testing included Cronbach’s alpha, floor and ceiling effect analysis, and Pearson correlations with self-rated overall health. Multiple linear regression was used to identify predictors of the Kidney Disease Component Summary (KDCS), Physical Component Summary (PCS), and Mental Component Summary (MCS) scores. Results: Both language versions demonstrated acceptable to excellent internal consistency (Cronbach’s α = 0.692–0.939). Most subscales were significantly correlated with self-rated health, supporting construct validity. Regression analyses revealed that greater satisfaction with care, better economic well-being, and more positive dialysis experiences were significant predictors of higher KDCS and MCS scores. Lower PCS scores were associated with female gender, comorbidities, and financial burden. Importantly, financial hardship and access challenges emerged as strong negative influences on HRQoL, underscoring the role of socioeconomic and care-related factors in patient well-being. Conclusions: The KDQOL-SF™ 1.3 is a valid and reliable tool for assessing quality of life among Kazakh- and Russian-speaking hemodialysis patients in Kazakhstan. Integrating this instrument into routine clinical practice may facilitate more personalized, patient-centered care and help monitor outcomes beyond traditional clinical indicators. Addressing economic and access-related barriers has the potential to significantly improve both physical and mental health outcomes in this vulnerable population. Full article

Driven by the environmental benefits associated with reduced greenhouse gas emissions, oil companies have intensified research efforts into reassessing the strategies used to meet the electrical demands of offshore production platforms. Among the various alternatives available, the deployment of onshore–offshore interconnections via High-Voltage Direct Current (HVDC) transmission systems has emerged as a promising solution, offering both economic and operational advantages. In addition to reliably meeting the electrical demand of offshore facilities, this approach enables enhanced operational flexibility due to the advanced control and regulation capabilities inherent to HVDC converter stations. Based on the use of interconnection through an HVDC link, aiming to evaluate the operation of the electrical system as a whole, this study focuses on evaluating dynamic events using the PSCAD software version 5.0.2 to analyze the direct online starting of a large induction motor and the sudden loss of a local synchronous generating unit. The simulation results are then analyzed to assess the effectiveness of both Grid-Following (GFL) and Grid-Forming (GFM) control strategies for the converters, while the synchronous generators are evaluated under both voltage regulation and constant power factor control operation, with a particular focus on system stability and restoration of normal operating conditions in the sequence of events. Full article

As global energy production progressively turns toward a green environment and economy, one of the safety challenges to the maritime industry that has arisen lies within offshore wind farms (OWFs). As renewable sources of energy whose numbers are rapidly expanding, their impact to the safety of navigation of the ships that navigate in their vicinity ought to be examined further. An ever-growing number of OWFs has led to safety concerns that have never been taken into consideration before. This article gives a structured quantitative analysis and an in-depth review of the literature connected to the safety of navigation, collision probability, and risk assessment that OWFs pose to all maritime industry agents. In this article, the main concerns of the impact of OWFs to the safety of navigation are analyzed using a combination of both the PRISMA and PICOC methodologies. Various types of scientific papers such as journal articles, conference proceedings, MSc theses, PhD theses, and online works of research are collated into a detailed bibliometric analysis and categorized by the most relevant parameters providing valuable perspectives on the current state of art in the field. The findings of this research emphasize the need for a further and more thorough analysis on the theoretical installment of OWFs and their inevitable impact on increasing maritime traffic complexity. The results of this article can form a strong basis for further scientific development in the field and can give useful insights to all maritime industry stakeholders dealing with OWFs. Full article

Introduction: The health emergency caused by the pandemic led to severe health issues in populations across many countries worldwide, including widespread morbidity and significant mortality. Nevertheless, several countries succeeded in keeping infection rates remarkably low before the approval of vaccines and the initiation of vaccinations in early 2021. We aim to identify the success factors of health policies in managing the impact of the health emergency across a selection of countries, focusing on how they protected their populations. Our study presents outcomes of sustainable health policy measures, along with health and social system challenges, and economic responses during the global health emergency. We sometimes found it difficult to define what counted as a success factor in some countries. Method: Our study draws upon a selection of reports and documents published by various ministries and economic, social, and health authorities, which we collected online. We structured our study into three phases to frame and contextualize the impact of health policy measures and countermeasures as follows: (i) observations and content analysis; (ii) empirical support through illustrative examples; and (iii) development of a health emergency toolkit of assessment. The documents were not always easy to compare because they differed in format and detail. Results: Our study outlines ten success factors for sustainable health policy measures and countermeasures: (i) preparedness; (ii) control; (iii) precaution; (iv) proactive decision-making; (v) synchronization; (vi) adequate legislation; (vii) goal fulfillment; (viii) digital health technology; (ix) empirical evidence; (x) ethical and moral virtues. Sometimes we struggled to separate what was ethical guidance from what was simply practical advice. Conclusion: We argue that the relevance of the health emergency toolkit of assessment outlined in our study demonstrates clearly that the success factors related to sustainable health policy measures and countermeasures can be applied and adapted to the societal conditions of individual countries. These factors may form a foundation for the development of a health emergency toolkit of assessment for future health emergencies. We also maintain that these factors may serve as a platform for establishing sustainable plans across health, social, and economic domains, with clear guidelines for implementation, management, and control. It is our hope that future health systems will make use of these findings before the next crisis emerges. Full article

Background/Objectives: Quiet Quitting (QQ) describes a state of reduced workplace engagement characterized by a lack of motivation and initiative. Employees practicing QQ typically limit their efforts to fulfilling only their assigned tasks, expending the minimum necessary energy, while still ensuring the completion of their core responsibilities. QQ is an emerging phenomenon in healthcare settings following the COVID-19 pandemic and is still relatively unexplored in the literature. The aim of this study is to assess QQ among nurses in a northern Italian hospital. Methods: A cross-sectional study with a convenience sample of 91 nurses in a single-specialist orthopedic hospital was conducted. Data were collected in August 2024 using an online form of the Quiet Quitting Scale (QQS). Demographic data were collected, including gender, age, years of work experience and department. Results: A response rate of 83.50% was recorded. Data analysis revealed that 46.06% of the sample (35 nurses) was identified as quiet quitters. Fewer years of service and a younger age were associated with a higher probability of Quiet Quitting. The highest average score was observed for “Lack of motivation” subscale at 2.40 (SD = 1.14). Conclusions: The findings establish QQ as a significant issue requiring urgent attention in healthcare. To guarantee high-quality nursing care, healthcare organizations must prioritize interventions focused on enhancing employee support and work environment. Longitudinal research is necessary to explore the long-term effects of QQ on patient outcomes and to evaluate the success of targeted interventions. Full article

Attaining psychosocial health for learners self-identifying as burned out is challenging. Yet, positive psychosocial outcomes are possible. Learner burnout is reducible if learners accept their and others’ rights to self-direct their learning. This acceptance requires a community that demonstrates team mindfulness. Successful self-directed learning with team mindfulness is possible at diverse academic levels and in various public education settings. The author co-founded three such educational initiatives aiming to reduce burnout in learners. To reveal the results, the author assesses the total works published since 2020 regarding these initiatives, using narrative methodology. Some form of consensus decision-making is imperative for team mindfulness—it may take different forms. For these initiatives to succeed online, a participant-trusted facilitator who takes on the role of an authentic leader is necessary. If one is lacking, the participants may achieve positive psychological outcomes but not the positive social consequences of a decision-making method upholding team mindfulness. In working with burned-out learners, positive sociological outcomes are possible when a group focuses on self-directed learning and has a learning-related team mindfulness goal in common. By summarizing the positive psychosocial effects regarding burnout and outlining the difficulties of these publicly supported programs for self-directed learning, future research directions are suggested on this topic. Full article