Search Results (5,460)

Metacognitive monitoring plays a crucial role in self-regulated learning, as accurate monitoring enables effective control, which in turn impacts learning outcomes. Most studies on metacognitive monitoring have focused on learners’ monitoring abilities when they are explicitly prompted to monitor. However, in real-world educational settings, learners are more often prompted to control their learning, such as deciding whether to allocate additional time to a learning target. The primary goal of this study was to investigate whether retrieval is engaged when learners are explicitly prompted to control their learning processes by making study decisions. To address this, three experiments were conducted. In Experiment 1, participants (N = 39) studied 70 Swahili–English word pairs in a learning task. Each trial displayed a word pair for 8 s, followed by a distractor task (a two-digit mental addition) and a study decision intervention (choose “Study Again” or “Next”). After learning, participants provided a global judgment of learning (JOL), estimating their overall recall accuracy. Finally, they completed a cued recall test (Swahili cue). Responses were scored for accuracy and analyzed alongside study decisions, study decision reaction time (RT), and metacognitive judgments. Reaction times (RTs) for study decisions correlated positively with test accuracy, global judgments of learning (JOLs), and judgments of confidence (JOCs), suggesting retrieval likely underlies these decisions. Experiment 2 (N = 74, between-subjects) compared memory performance and intervention response time between single-study, restudy, retrieval (explicit recall prompt), and study decision (study decision prompt) groups to have better control over study time and cognitive processes. Although no significant group differences in test accuracy emerged, the retrieval group took longer to respond than the study decision group. Within-subject analyses revealed similar recall accuracy patterns: participants recalled successfully retrieved or “no restudy” items better than failed-retrieval or “restudy” items, implying shared cognitive processes underlying retrieval and study decision interventions. Experiment 3 (N = 74, within-subject, three learning conditions: single-study, retrieval, and study decision) replicated these findings, with no condition effects on test accuracy but longer RT for retrieval than study decisions. The similar recall accuracy patterns between retrieval and study decision interventions further supported shared cognitive processes underlying both tasks. Self-reports across experiments confirmed retrieval engagement in both retrieval and study decision interventions. Collectively, the results suggest that retrieval likely supports study decisions but may occur less frequently or less deeply than under explicit monitoring prompts. Additionally, this study explored objective, online measures to detect retrieval-based metacognitive monitoring. Full article

Background/Objectives: Health education plays a vital role in training health professionals and caregivers, supporting both prevention and the promotion of self-care. In this context, technology serves as a valuable ally by enabling continuous and flexible learning. Among the various domains of health education, nutrition stands out as a key element in the management of Amyotrophic Lateral Sclerosis (ALS), helping to prevent malnutrition and enhance patient well-being. Accordingly, this study aimed to evaluate the effectiveness of the teaching and learning processes within a learning pathway focused on food and nutrition in the context of ALS. Methods: This study adopted a longitudinal, quantitative design. The learning pathway, titled “Food and Nutrition in ALS,” consisted of four self-paced and self-instructional Massive Open Online Courses (MOOCs), offered through the Virtual Learning Environment of the Brazilian Health System (AVASUS). Participants included health professionals, caregivers, and patients from all five regions of Brazil. Participants had the autonomy to complete the courses in any order, with no prerequisites for enrollment. Results: Out of 14,263 participants enrolled nationwide, 182 were included in this study after signing the Informed Consent Form. Of these, 142 (78%) completed at least one course and participated in the educational intervention. A significant increase in knowledge was observed, with mean pre-test scores rising from 7.3 (SD = 1.8) to 9.6 (SD = 0.9) on the post-test across all courses (p < 0.001). Conclusions: The self-instructional, technology-mediated continuing education model proved effective in improving participants’ knowledge about nutrition in ALS. Future studies should explore knowledge retention, behavior change, and the impact of such interventions on clinical outcomes, especially in multidisciplinary care settings. Full article

Learning is occurring increasingly online, often asynchronously, and sometimes that presents a barrier to instructional delivery on metacognitive behaviors that might easily be modeled in traditional classrooms. However, such metacognitive behaviors are essential to engaging deeply with academic texts. The research team involved in this paper is part of ongoing design-based research exploring the use of social annotation to support students as metacognitive readers of digital, academic texts in online asynchronous contexts. In the most recent iteration of this research, the authors designed asynchronous instruction on metacognitive reading using the gradual release of responsibility (GRR) framework. This paper provides rich descriptions of instructors’ instructional moves to scaffold and support students as metacognitive readers of digital, academic texts in asynchronous online classes. Future research should explore the efficacy of GRR as a pedagogical approach used online. Full article

This study investigates the effectiveness of contact and online biology teaching by assessing student performance and gathering perceptions from students, teachers, and parents. Conducted in autumn 2021 with 3035 students, 124 biology teachers, and 719 parents, this study combined post-instruction assessments of student performance in knowledge reproduction and conceptual understanding with questionnaires examining perceptions of contact and online biology teaching effectiveness across students, teachers, and parents. To investigate how various teaching-related factors influence perceived understanding of biological content, we applied a CHAID-based decision tree model to questionnaire responses from students, teachers, and parents. Results indicated that students value engaging, flexible instruction, sufficient time to complete tasks and support for independent thinking. Teachers emphasized their satisfaction with teaching and efforts to support student understanding. In contact lessons, students preferred problem-solving, teacher guidance, and a stimulating environment. In online learning, they preferred low-stress, interesting lessons with room for independent work. Parents emphasized satisfaction with their child’s learning and the importance of a focused, stimulating environment. This comparative analysis highlights the need for student-centered, research-based biology teaching in both formats, supported by teachers and delivered in a motivating environment. The results offer practical insights for improving biology instruction in different teaching modalities. Full article

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

Background: Cochlear implantation (CI) in pediatric patients with cochlear nerve deficiencies (CND) remains controversial due to a highly variable clinical population, lack of evidence-based guidelines, and mixed research findings. This study assessed current clinical perspectives and practices regarding CI candidacy in children with CND among hearing healthcare professionals in the USA. Methods: An anonymous 19-question online survey was distributed to CI clinicians nationwide. The survey assessed professional background, experience with aplasia and hypoplasia, and perspectives on CI versus auditory brainstem implant (ABI) candidacy, including imaging practices and outcome expectations. Both multiple-choice and open-ended responses were analyzed to identify trends and reasoning. Results: Seventy-two responses were analyzed. Most clinicians supported CI for hypoplasia (60.2%) and, to a lesser extent, for aplasia (41.7%), with audiologists more likely than neurotologists to favor CI. Respondents cited lower risk, accessibility, and the potential for benefit as reasons to attempt CI before ABI. However, many emphasized a case-by-case approach, incorporating imaging, electrophysiological testing, and family counseling. Only 22.2% considered structural factors the best predictors of CI success. Conclusions: Overall, hearing health professionals in the USA tend to favor CI as a first-line option, while acknowledging the limitations of current diagnostic tools and the importance of individualized, multidisciplinary decision-making in CI candidacy for children with CND. Findings reveal a high variability in clinical perspectives on CI implantation for pediatric aplasia and hypoplasia and a lack of clinical consensus, highlighting the need for more standardized assessment and imaging protocols to provide greater consistency across centers and enable the development of evidence-based guidelines. Full article

CareCoach seeks to enhance self-efficacy in family caregivers of people living with dementia and has been feasibility tested in a multicentre randomised controlled trial. The intervention offers two face-to-face sessions with a trained coach and access to an online platform with nine modules. This paper reports findings from an embedded qualitative process evaluation assessing implementation from the implementer’s (‘coach’s’) (n = 8) perspective using individual interviews and implementer group discussions. Qualitative data were transcribed verbatim, inductively coded and analysed using Normalisation Process Theory. Implementers demonstrated (1) ‘Coherence’ by seeking to understand how CareCoach compared to current practice, highlighting the importance of supporting coaches to differentiate and identify boundaries between their new ‘coach role’ and usual practice; (2) ‘Cognitive Participation’ by reviewing training and resources to understand their role own responsibilities and facilitate delivery of coaching sessions; group supervision and peer support were also emphasised; (3) ‘Collective Action’ through interactions with carers to deliver key behavioural aspects such as goal setting, problem solving, and providing feedback; and (4) ‘Reflexive Monitoring’ by appraising the intervention to gain useful insights that could facilitate refinement of CareCoach training and delivery. This study provides a theoretically informed understanding of the implementation of CareCoach for caregivers of people living with dementia and provides recommendations to enhance training for coaches, intervention delivery and carer engagement. Full article

The search for the biomarkers of Alzheimer’s disease (AD) may prove essential in the diagnosis and prognosis of the pathology, and the differential expression of key proteins may assist in identifying new therapeutic targets. In this proof-of-concept (POC) study, a new approach of data mining and matching combined with the biochemical analysis of proteins was applied to AD investigation. Three influential online open databases (UniProt, AlzGene, and Allen Human Brain Atlas) were explored to identify the genes and encoded proteins involved in AD linked to mitochondrial and iron dysmetabolism. The databases were searched using specific keywords to collect information about protein composition, and function, and meta-analysis data about their correlation with AD. The extracted datasets were matched to yield a list of relevant proteins in AD. The biochemical analysis of their amino acid content suggested a defective synthesis of these proteins in poorly oxygenated brain tissue, supporting their relevance in AD progression. The result of our POC study revealed several potential new markers of AD that deserve further molecular and clinical investigation. This novel database search approach can be a valuable strategy for biomarker search that can be exploited in many diseases. Full article

Background: Dentinal hypersensitivity (DH) significantly impacts oral health-related quality of life. While global prevalence estimates range from 10–15%, region-specific data from Saudi Arabia remain limited. This study also aligns with Saudi Vision 2030’s mental health initiatives, as DH-associated anxiety impacts overall well-being. This study assessed DH prevalence and quality of life impact among Saudi adults. Methods: A cross-sectional online survey was conducted among 748 Saudi adults aged ≥ 18 years between April and May. Data were collected using a validated Arabic Dentinal Hypersensitivity Experience Questionnaire (DHEQ) alongside socio-demographic variables. Participants reporting DH symptoms within 12 months were included in impact analyses. Descriptive statistics and one-way ANOVA examined associations between DHEQ scores and participant characteristics. Results: Self-reported DH prevalence was 54.3% (n = 406), substantially exceeding global estimates. Among affected individuals, mean DHEQ score was 0.56 ± 0.19, indicating moderate-to-substantial quality-of-life impact. Functional limitations were most affected, particularly enjoyment of eating and drinking (0.72 ± 0.21). Significant associations were identified between higher DHEQ scores and age extremes (<18 and >35 years; p < 0.001), higher income levels (p = 0.032), fewer teeth (p = 0.040), and dental pain presence (p = 0.009). Sex, residence, education, and employment showed no significant associations. Conclusions: More than half of Saudi adults reported DH symptoms, representing a significant public health concern with substantial quality of life implications. Prevalence substantially exceeds global estimates, highlighting the need for targeted interventions. Age, income, tooth count, and pain presence emerged as key factors. These findings support developing population-specific prevention strategies, particularly targeting younger and older adults with tooth loss. Full article

Background: Brain health is a growing public health priority due to the high global burden of neurological and mental disorders. Promoting brain health across the lifespan supports individual and societal well-being, creativity, and productivity. Objective: To address the need for specialized education in this field, the University of Bern developed a Certificate of Advanced Studies (CAS) in Brain Health. This article outlines the program’s rationale, structure, and goals. Program Description: The one-year, 15 ECTS-credit program is primarily online and consists of four modules: (1) Introduction to Brain Health, (2) Brain Disorders, (3) Risk Factors, Protective Factors and Interventions, and (4) Brain Health Implementation. It offers a multidisciplinary, interprofessional, life-course approach, integrating theory with practice through case studies and interactive sessions. Designed for healthcare and allied professionals, the CAS equips participants with skills to promote brain health in clinical, research, and public health contexts. Given the shortage of trained professionals in Europe and globally, the program seeks to build a new generation of brain health advocates. It aims to inspire action and initiatives that support the prevention, early detection, and management of brain disorders. Conclusions: The CAS in Brain Health is an innovative educational response to a pressing global need. By fostering interdisciplinary expertise and practical skills, it enhances professional development and supports improved brain health outcomes at individual and population levels. Full article

Objectives: The present study investigated proclivity for non-consensual intimate-image distribution and its related dimensions—enjoyment and acceptance—in relation to key demographic and relational variables, including gender, age, sexual orientation, frequency of dating app use, and current romantic relationship status. Methods: A total of 1735 Greek university students (mean age = 22 years, standard deviation = 6.18; 35.2 percent male) participated in an anonymous online survey. Pearson correlation analyses and multiple linear regression models were conducted to examine the associations and predictive value of the demographic variables on proclivity, enjoyment, and acceptance of non-consensual intimate-image distribution. Results: Men, younger participants, and those who reported more frequent use of dating applications or websites demonstrated higher proclivity for non-consensual intimate-image distribution. Gender and frequency of dating app use were also significant predictors of enjoyment, with men and frequent users reporting greater enjoyment. Regarding acceptance, sexual orientation was the only significant predictor, with non-heterosexual individuals indicating higher levels of acceptance. Romantic relationship status did not significantly predict any of the three outcome variables. Conclusions: These findings highlight the significance of gender, age, sexual orientation, and dating app engagement in understanding the psychological and behavioral dimensions of non-consensual intimate-image distribution. The results support the need for targeted prevention efforts and further research into the contextual and psychosocial factors associated with this form of image-based abuse. Full article

Background/Objectives: Children with severe physical and communication disabilities face many challenges. They have very limited opportunities for upright, hands-free, self-initiated mobility. Current findings in neuroscience and theories on child development suggest that self-initiated mobility can have positive cascading effects on various developmental areas, including language and communication. This study was conducted to examine the current use of hands-free support walkers with children who have severe physical and communication disabilities and use augmentative and alternative communication and to identify the benefits and problems perceived by their parents and professionals from different disciplines. Methods: Online surveys were utilized to collect information from 127 participants, including 31 parents and 96 professionals or paraprofessionals. Results: The participants reported that these children could perform various motor activities in the hands-free support walkers to achieve different goals. Benefits identified by both parents and professionals included providing a way to exercise and stay active, improving motor control, enhancing independence, and bringing enjoyment. Professionals also observed positive impacts on communication, vocalization, use of eye contact, and problem solving. Conclusions: Results suggest that children with severe physical and communication disabilities can benefit from the upright, hands-free, self-initiated mobility provided by hands-free support walkers. Clinical implications and needs for future research are discussed. Full article

As ad-supported subscription models proliferate across over-the-top (OTT) media platforms, understanding the psychological mechanisms and perceptual factors that underlie consumers’ transition decisions becomes increasingly consequential. This study integrates the Uses and Gratifications framework with a contemporary motivation-based perspective to examine how users’ media consumption motivations and advertising attitudes predict intentions to adopt ad-supported OTT plans. Data were collected via a nationally representative online survey in South Korea (N = 813). The sample included both premium subscribers (n = 708) and non-subscribers (n = 105). The findings reveal distinct segmentation in decision-making patterns. Among premium subscribers, switching intentions were predominantly driven by intrinsic motivations—particularly identity alignment with content—and by the perceived informational value of advertisements. These individuals are more likely to consider ad-supported plans when ad content is personally relevant and cognitively enriching. Conversely, non-subscribers exhibited greater sensitivity to extrinsic cues such as the entertainment value of ads and the presence of tangible incentives (e.g., discounts), suggesting a hedonic-reward orientation. By advancing a dual-pathway explanatory model, this study contributes to the theoretical discourse on digital subscription behavior and offers actionable insights for OTT service providers. The results underscore the necessity of segment-specific advertising strategies: premium subscribers may be engaged through informative and identity-consistent advertising, while non-subscribers respond more favorably to enjoyable and benefit-laden ad experiences. These insights inform platform monetization efforts amid the evolving dynamics of consumer attention and subscription fatigue. Full article

In the attention-driven environment of online video platforms, understanding the factors that influence content selection and channel subscriptions is crucial for creators, marketers, and platform managers. This study investigates how thumbnails, view counts, video length, genre, and the number of advertisements affect user decision-making on YouTube. Grounded in random utility theory and reference-dependent preference theory, this study conducted a choice experiment with 525 respondents and employed a combined model of rank-ordered and binary logit methods to analyze viewing and subscription behaviors. The results indicate a significant preference for thumbnails with subtitles and shorter videos. Notably, we found evidence of reference-dependent effects, whereby a higher-than-expected number of ads decreased viewing probability, while a lower-than-expected number significantly increased subscription probability. This study advances our understanding of the factors that influence user behavior on social media, specifically in terms of viewing and subscribing, and empirically supports prospect theory in the online advertising market. Our findings offer both theoretical and practical insights into optimizing video content and monetization strategies in competitive social media markets. Full article

Background: This study examines current trends in Canada using data from the Canadian Joint Replacement Registry (CJRR) and includes a national survey to understand the varied uptake of cement for femoral stem fixation. Methods: The survey was available online and the website link was distributed to all orthopaedic surgeons through the Canadian Orthopaedic Association between September and December 2022. The CJRR obtained data from the Canadian Institute for Health Information (CIHI), and information pertaining to patients 55 years of age and older who underwent hemiarthroplasty for hip fracture in Canada between April 2017 and March 2022 was used. Results: Most respondents practiced in an academic community setting (52%). Only 53% of respondents reported using cement, and 71% indicated that cemented fixation was the best practice. The main reasons for using uncemented stems were less operative time (23%), cement disease concerns (11%), and surgeons’ comfort (10%). Similarly, CJRR data showed only 51% cemented fixation among 42,386 hemiarthroplasties performed between 2017 and 2022. The proportion of cemented implants varied by province, but overall, the increase in the use of cement from 2017 to 2022 was from 42.9% to 57.7%. Conclusions: This study demonstrates variability in the use of cement for femoral fixation despite solid evidence showing improved outcomes using cement. Some of the main reasons in favour of uncemented stems include operative time, surgical training, and concerns about cement disease. Establishing clear position statements and guidelines supporting cemented fixation may be prudent to build universal consensus on this practice. Full article