Search Results (1,424)

Background/Objectives: Mild Cognitive Impairment (MCI), a condition between normal aging and dementia, is characterized by cognitive changes that do not significantly affect instrumental activities of daily living. The Memory Support System (MSS), an evidence-based behavioral intervention developed by the Mayo Clinic, has been shown to aid those living with MCI and their support partners in coping with cognitive challenges. However, the MSS has not been offered clinically within the Canadian context. Therefore, we conducted a study assessing the feasibility of the MSS from the perspectives of individuals living with MCI and their support partners. Methods: Participants from an institutional registry of research participants, patients, and support partners at a memory clinic, as well as members of a local Dementia Society, were approached to complete an online or paper version of a survey assessing feasibility dimensions. Responses were compared between and within groups for differences in mean scores and associations between linked binary choice response questions. Results: A total of 77 responses were received; 39 surveys were completed by participants with MCI, and 38 by support partners. Respondents found the MSS to be acceptable and practical. On average, participants thought it would be more difficult to train in using the MSS than support partners. Both groups expressed interest in the intervention. On average, participants with MCI and support partners preferred virtual MSS training to in-person and indicated more interest in participating in training over six weeks as compared to two weeks. Conclusions: Flexibility in duration and format when offering the MSS are important considerations when offering the intervention as part of a clinical program. Future research should evaluate cost-effectiveness (e.g., financial, staff resources, etc.) of the MSS approach if it were to be institutionalized in the Ontario healthcare system. Full article

Objectives: Diabetes Mellitus involves demanding challenges that interfere with family functioning and routines. In turn, family and social context impacts individual glycemic control. This study aims to identify this recursive interplay, the mutual influences of family systems and diabetes management. Design: Data was collected through a cross-sectional design comparing patients, aged 22–55, with and without metabolic control. Methods: Participants filled out a set of self-report measures of sociodemographic, clinical and family systems assessment. Patients (91) were also invited to describe their perception about disease management interference regarding family functioning. We first examined the extent to which family variables grouped dataset to determine if there were similarities and dissimilarities that fit with our initial diabetic groups’ classification. Results: Cluster analysis results identify a two-cluster solution validating initial classification of two groups of patients: 49 with metabolic control (MC) and 42 without metabolic control (NoMC). Independent sample tests suggested statistically significant differences between groups in family subscales- family difficulties and family communication (p < 0.05). Binary logistic regression shed light on predictors of explained variance to no metabolic control, in four models: Sociodemographic, Clinical data, SCORE-15/Congruence Scale and Eating Behavior. Furthermore, groups differ on family support, level and sources of family conflict caused by diabetes management issues. Considering only patients who co-habit with a partner for more than one year (N = 44), NoMC patients score lower on marital functioning in all categories (p < 0.05). Discussion: Family-Chronic illness interaction plays a significant role in a patient’s adherence to treatment. This study highlights the Standards of Medical Care for Diabetes, considering caregivers and family members on diabetes care. Full article

The integration of artificial intelligence (AI) in education offers novel opportunities to enhance critical thinking while also posing challenges to independent cognitive development. In particular, Human-Centered Artificial Intelligence (HCAI) in education aims to enhance human experience by providing a supportive and collaborative learning environment. Rather than replacing the educator, HCAI serves as a tool that empowers both students and teachers, fostering critical thinking and autonomy in learning. This study investigates the potential for AI to become a collaborative partner that assists learning and enriches academic engagement. The research was conducted during the 2024–2025 winter semester within the Pedagogical and Teaching Sufficiency Program offered by the Audio and Visual Arts Department, Ionian University, Corfu, Greece. The research employs a hybrid ethnographic methodology that blends digital interactions—where students use AI tools to create artistic representations—with physical classroom engagement. Data was collected through student projects, reflective journals, and questionnaires, revealing that structured dialog with AI not only facilitates deeper critical inquiry and analytical reasoning but also induces a state of flow, characterized by intense focus and heightened creativity. The findings highlight a dialectic between individual agency and collaborative co-agency, demonstrating that while automated AI responses may diminish active cognitive engagement, meaningful interactions can transform AI into an intellectual partner that enriches the learning experience. These insights suggest promising directions for future pedagogical strategies that balance digital innovation with traditional teaching methods, ultimately enhancing the overall quality of education. Furthermore, the study underscores the importance of integrating reflective practices and adaptive frameworks to support evolving student needs, ensuring a sustainable model. Full article

Background: Family caregivers are a vital yet often under-recognized part of the healthcare system. They provide essential emotional, physical, and logistical support to individuals with illness, disability, or frailty, and their contributions improve continuity of care and reduce system strain. However, many healthcare and social service providers are not equipped to meaningfully engage caregivers as partners. In Alberta, stakeholders validated the Caregiver-Centered Care Competency Framework and identified the need for a three-tiered education model—Foundational, Advanced, and Champion—to help providers recognize, include, and support family caregivers across care settings. This paper focuses on the development and early evaluation of the Advanced Caregiver-Centered Care Education modules, designed to enhance the knowledge and skills of providers with more experience working with family caregivers. The modules emphasize how partnering with caregivers benefits not only the person receiving care but also improves provider effectiveness and supports better system outcomes. Methods: The modules were co-designed with a 154-member interdisciplinary team and grounded in the competency framework. Evaluation used the first three levels of the Kirkpatrick–Barr health workforce education model. We analyzed pre- and post-surveys from the first 50 learners in each module using paired t-tests and examined qualitative feedback and SMART goals through inductive content analysis. Results: Learners reported a high level of satisfaction with the education delivery and the knowledge and skill acquisition. Statistically significant improvements were observed in 53 of 54 pre-post items. SMART goals reflected intended practice changes across all six competency domains, indicating learners saw value in engaging caregivers as partners. Conclusions: The Advanced Caregiver-Centered Care education improved providers’ confidence, knowledge, and skills to work in partnership with family caregivers. Future research will explore whether these improvements translate into real-world practice changes and better caregiver experiences in care planning, communication, and navigation. Full article

The sharing economy is considered to be a potentially efficacious approach for promoting sustainable production and consumption (SPC). This study utilizes dockless bike sharing (DBS) in Beijing as a case study to examine how sharing economy policies and business practices advance SPC. It also dynamically quantifies the environmental and economic performance of DBS practices from a life cycle perspective. The findings indicate that effective SPC practices can be achieved through the collaborative efforts of multiple stakeholders, including the government, operators, manufacturers, consumers, recycling agencies, and other business partners, supported by regulatory systems and advanced technologies. The SPC practices markedly improved the sustainability of DBS promotion in Beijing. This is evidenced by the increase in greenhouse gas (GHG) emission reduction benefits, which have risen from approximately 35.81 g CO₂-eq to 124.40 g CO₂-eq per kilometer of DBS travel. Considering changes in private bicycle ownership, this value could reach approximately 150.60 g CO₂-eq. Although the economic performance of DBS operators has also improved, it remains challenging to achieve profitability, even when considering the economic value of the emission reduction benefits. In certain scenarios, DBS can maximize profits by optimizing fleet size and efficiency, without compromising the benefits of emission reductions. The framework of stakeholder interaction proposed in this study and the results of empirical analysis not only assist regulators, businesses, and the public in better understanding and promoting sustainable production and consumption practices in the sharing economy but also provide valuable insights for achieving a win-win situation of platform profitability and environmental benefits in the SPC practice process. Full article

Background/Objectives: Early experiences can significantly influence brain development, particularly when they occur during specific time windows known as sensitive or critical periods. Therefore, the early promotion of neurodevelopmental functions is crucial in children at risk for neurodevelopmental disabilities, such as those with cerebral palsy. This article introduces AMIRA (A Multidimensional and Integrated Rehabilitation Approach), a rehabilitative framework designed for infants at risk of neurodevelopmental disabilities. Methods: AMIRA is intended to guide clinical–rehabilitation reasoning rather than prescribe a rigid sequence of predetermined activities for the child. The theoretical foundation and structure of AMIRA are presented by formalizing its criteria, objectives, tools, and intervention procedures. The framework comprises four distinct sections, each supported by adaptive strategies to facilitate access to materials and to promote play-based interactions among the child, their environment, and communication partners. Particular attention is given to optimizing both micro- and macro-environments for children with, or at risk of, co-occurring visual impairment. Each rehabilitative section includes three progressive phases: an initial observation phase, a facilitation phase to support the child’s engagement, and an active experimentation phase that gradually introduces more challenging tasks. Results: The intervention pathways in AMIRA are organized according to six core developmental domains: behavioral–emotional self-regulation, visual function, postural–motor skills, praxis, interaction and communication, and cognitive function. These are outlined in structured charts that serve as flexible guidelines rather than prescriptive protocols. Each chart presents activities of increasing complexity aligned with typical developmental milestones up to 24 months of age. For each specific ability, the corresponding habilitation goals, contextual recommendations (including environmental setup, objects, and tools), and suggested activities are provided. Conclusions: This study presents a detailed intervention approach, offering both a practical framework and a structured set of activities for use in rehabilitative settings. Further studies will explore the efficacy of the proposed standardized approach. Full article

Background/Objectives: Despite the importance of parent mental health for child health, there are no global prevalence data on parental mental health symptoms when children are hospitalized. We aimed to describe depression and anxiety symptom prevalence and associated factors among parents of hospitalized children. Methods: We conducted this 14-country prospective cohort survey with parents/primary caregivers staying at a nearby Ronald McDonald House^® during their child’s hospital treatment. We used the Hospital Anxiety and Depression Scale to measure depression and anxiety symptoms and validated scales and theory-based questions to measure parent, family, and child covariates. We calculated the prevalence of clinically significant or concerning symptoms of depression and anxiety, and used multivariable regression analyses to examine associations between covariates and outcomes. Results: Among 3350 participants, 1789 (49.7%) reported depression symptoms and 2286 (69.0%) reported anxiety symptoms. Worry about housing and poorer ratings of their child’s health were associated with increased risk of depression symptoms. Poorer rating of the child’s health, living with a partner, and discrimination in daily life were associated with increased risk of anxiety symptoms. Higher levels of self-care, hospital family-centered care, and social support were associated with reduced risk of depression symptoms. Higher levels of self-care and social support were associated with reduced risk of anxiety symptoms. Conclusions: Clinically significant or concerning depression and anxiety symptoms are common among parents of hospitalized children globally. Hospitals should consider offering routine mental health symptom screening and preventative mental health and support services to all parents. Full article

Background: Parents of children with type 1 diabetes play a key role in managing their child’s self-management, which can be stressful and burdensome. High involvement can lead to reactions such as emotional, cognitive, and physical exhaustion in parents. Understanding parents’ psychosocial impact due to their child’s disease is crucial for the family’s overall well-being. The purpose of this study was to describe stress and burden experienced by parents in families with children living with type 1 diabetes. Methods: This study utilized a qualitative approach, analyzing interviews with 16 parents of children aged 10 to 17 years living with T1D through qualitative content analysis. The data collection occurred between January and February 2025. Results: Managing a child’s Type 1 diabetes can be tough on family relationships, affecting how partners interact, intimacy, and sibling relationships. The constant stress and worry might leave parents feeling exhausted, unable to sleep, and struggling to think clearly, on top of the pain of losing a normal everyday life. The delicate balance between allowing a child with type 1 diabetes to be independent and maintaining control over their self-management renders these challenges even more demanding for the parents. Conclusions: Parents’ experiences highlight the need for robust support systems, including dependable school environments, trustworthy technical devices, reliable family and friends, and accessible healthcare guidance. These elements are essential not only for the child’s health and well-being but also for alleviating the emotional and practical burdens parents face. Full article

This paper applies a multi-level social network analysis to examine Aragón’s innovation ecosystem, focusing on a decade of competitive public projects (2014–2023) aligned with the region’s Smart Specialisation Strategy (S3) 2021–2027. By mapping and weighting the participation of regional entities across regional, national, and European calls, the study uncovers how all types of local actors organise themselves around key specialisation areas. Moreover, a comparative benchmark is introduced by analysing more than 33,000 Horizon 2020 and Horizon Europe initiatives without Aragonese partners, revealing how to fill structural gaps and enrich the regional ecosystem through international collaboration. Results show strong funding concentration in four fields—Energy, Health, Agri-Food, and Advanced Technologies—while other historically strategic areas like Hydrogen and Water remain underrepresented. Although leading institutions (UNIZAR, CIRCE, ITA, AITIIP) play central roles in connecting academia and industry, direct collaboration among them is limited, pointing to missed synergies. Expanding previous SNA-based assessments, this study introduces a diagnostic tool to guide policy, proposing targeted actions such as challenge-driven calls, dedicated support programs, and cross-border consortia with top EU partners. Applied to two contrasting specialisation areas, the method offers sector-specific recommendations, helping policymakers align Aragón’s innovation capabilities with EU priorities and strengthen its position in both established and emerging domains. Full article

Sexuality and intimacy are essential aspects of the human experience for all people, contributing significantly to physical and emotional connections, well-being, and quality of life. Despite their importance, these topics are frequently overlooked in stroke rehabilitation, especially for those with cognitive and perceptual impairments. Existing research on post-stroke sexual rehabilitation tends to focus on sexual dysfunction and the secondary physical and psychological stroke symptoms, with little attention to cognitive and perceptual impairments. Cognitive deficits, such as decreased memory, generalized attention, and executive function not only can hinder sexual participation but also raise the complex issue of capacity to consent. This paper argues that it is imperative for researchers and healthcare practitioners to address cognitive and perceptual challenges, understand consent laws in their respective regions, and consider the influence of culture and social norms in order to support the sexual rights and well-being of all stroke survivors. Furthermore, this article provides some practical recommendations, from an occupational therapy perspective, that healthcare practitioners can provide to clients and their partners. Full article

Background/Objectives: Despite advancements in surgery, esophagectomy remains one of the most challenging and complex gastrointestinal surgical procedures, burdened by significant perioperative morbidity and mortality rates, as well as high financial costs. Recognizing the need for standardized care provided by a multidisciplinary healthcare team, the EUropean PErioperative MEdical Networking (EUPEMEN) initiative developed a dedicated protocol for perioperative care of patients undergoing esophagectomy, aiming to enhance recovery, reduce morbidity, and homogenize care delivery across European healthcare systems. Methods: Developed through a multidisciplinary European collaboration of five partners, the protocol incorporates expert consensus and the latest scientific evidence. It addresses the entire perioperative pathway, from preoperative preparation to hospital discharge and postoperative recovery, emphasizing patient-centered care, risk mitigation, and early functional restoration. Results: The implementation of the EUPEMEN esophagectomy protocol is expected to improve patient outcomes through a day-by-day structured prehabilitation plan, meticulous intraoperative management, and proactive postoperative rehabilitation. The approach promotes reduced postoperative complications, earlier return to oral intake, and shorter hospital stays, while supporting multidisciplinary coordination. Conclusions: The EUPEMEN protocol for esophagectomy provides a comprehensive guideline framework for optimizing perioperative care in esophageal surgery. In addition, it serves as a practical guide for healthcare professionals committed to advancing surgical recovery and standardizing clinical practice across diverse care environments across Europe. Full article

This study examines how students perceive factors contributing to their sense of belonging (SoB) in an online project-based master’s course in social innovation, incorporating collaboration with external stakeholders and structured around real-world challenges from external partners. SoB has been shown to impact academic outcomes positively, but online teamwork and collaboration outside the institution walls present unique challenges. The study adopts a qualitative approach and an interpretivist standpoint to find meaningful aspects and generate an understanding of positions among the students. Data was gathered through interviews, allowing students to express their unique experiences and perspectives on SoB in the context of a master’s course, with participants from several countries. Thematic analysis of the interview data identified the following seven categories related to students’ perceived belonging: team formation and trust, personal introductions, group continuity, access to teachers, use of informal communication channels, shared tools, and digital fluency. Furthermore, working towards a common challenge or goal seems to promote SoB among team members. The results indicate that SoB was shaped by multiple interrelated factors, with team-based collaboration and structured group dynamics playing a central role. The study contributes to ongoing research on student belonging by identifying specific practices that may support SoB in digitally supported, team-oriented learning environments. Full article

Despite advances in cancer care, disparities persist. The collection of the social determinants of health (SDOH) is fundamental to addressing disparities. However, SDOH are inconsistently collected in many regions of the world. This two-phase multiple methods study examined patient and community perspectives regarding SDOH data collection in Canada. In phase 1, a survey was administered to patients at a cancer centre (n = 549) to assess perspectives on an SDOH data collection tool. In phase 2, broader perspectives were sought through a community consultation with patient partners experiencing structural inequality (n = 15). Most participants were comfortable with SDOH data collection. Of survey respondents, 95% were comfortable with the collection of language, birthplace, sex, gender, education, and disability, and 82% to 94% were comfortable with SES, sexual orientation, social support, and race/ethnicity. Discomfort levels did not differ across subgroups, except women were more uncomfortable disclosing SES (OR: 2.00; 95%CI: 1.26, 3.19). Most (71%) preferred face-to-face data collection with a healthcare professional and only half were comfortable with storage of SDOH in electronic health records. Open-ended survey responses (n = 1533) and the community consultation revealed concerns about privacy, discrimination, relevance to care, and data accuracy. SDOH data collection efforts should include a clear rationale for patients, training for providers, strong data privacy and security measures, and actionable strategies to address needs. Full article

This study investigates how demographic characteristics, severity of intimate partner violence (IPV), social support, gender equality awareness, and demographic factors (e.g., living with children at home) influence help-seeking behaviors among 2527 IPV-experienced women in Beijing, Shanghai, Guangzhou, and Shenzhen. Drawing on the help-seeking model and conservation of resource theory, the study distinguishes between formal (e.g., police, legal aid) and informal (e.g., family, friends) help-seeking. Logistic regression results reveal that greater violence severity, stronger perceived social support, and higher gender equality awareness significantly increase both formal and informal help-seeking. Notably, living with children is associated with a higher likelihood of seeking formal help, possibly due to increased concerns for children’s safety and the desire to change the abusive environment. While help-seeking behavior is on the rise overall, particularly among women with strong support networks and progressive gender attitudes, structural and cultural barriers remain. The findings underscore the need to improve public education, reduce stigma, and enhance accessibility of support systems. This study contributes to the growing literature on IPV in China and provides evidence for refining policy interventions and service delivery. Full article

The TOWCHED project explores how arts and heritage-based educational methodologies can support sustainable development by enhancing key transversal competencies in learners, particularly children and youth. In response to the global challenges outlined in the sustainable development goals (SDGs), this project promotes inclusive and participatory approaches to education that foster social cohesion, intercultural understanding, and civic engagement. Partnering with museums, TOWCHED develops cross-curricular pedagogical interventions, such as experiential, blended, and collection-mediated learning, that link cultural heritage with contemporary social and environmental concerns. These approaches aim to strengthen creativity, critical thinking, collaboration, and self-awareness. TOWCHED demonstrates that heritage collection-based education can play a vital role in transforming schools and other learning environments into hubs for sustainable, lifelong learning. By embedding cultural expression and heritage into educational practices, the project offers a compelling model for empowering individuals to navigate and shape a more equitable and interconnected world. This paper has two aims. First, we introduce TOWCHED, an interdisciplinary project recently funded by the Horizon Europe program of the European Union to preserve and promote education for sustainability in the heritage context. Second, we introduce a set of tools related to the project. Full article