Search Results (1,826)

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

Racket sports are very popular not only in professional sports but also among recreational players. As a result, their impact on the field of education has grown significantly in recent years. Table tennis (TT) offers significant advantages in terms of skill acquisition and health improvement. Nevertheless, its application within physical education (PE) curricula remains undetermined. The aim of this systematic review was to analyze the use of TT as educational content in the subject of PE in primary school. The PRISMA 2020 methodology was used to conduct the systematic review. Six databases (ERIC, Pubmed, ScienceDirect, Scopus, Sport Discus, and Web of Science) were used during the search process. The search cutoff date was December 31, 2024. After applying the eligibility criteria, 3595 articles were found. Only seven studies were selected for the final analysis and the data included 1526 students from primary school. The results indicate that TT is rarely used in primary education during PE classes. Research indicates interest among teachers and students in playing it during PE. Furthermore, due to the benefits, motivation, and interest this sport generates, educational experiences have been developed, such as roundtable discussions, table top tennis, balloon TT, and TT triathlon. A lack of materials, facilities, and teacher training for teaching this sport is notable. The teaching experiences analyzed in this review confirm that TT is a highly versatile and interesting sport as a subject matter in school PE. The use of TT allows for innovative, comprehensive, and inclusive PE, thanks to the sport’s multiple possibilities. Given its adaptability and low entry barrier, TT could serve as an effective tool for increasing children’s physical activity levels, improving motor skills, and fostering social–emotional development. However further research is needed to quantify its impact on health outcomes such as cardiovascular fitness or obesity prevention. Full article

Background: It is well-established that, for adolescents to adopt sustainable healthy lifestyle behaviors, not only access to information but also the skills required to translate that information into action are critical. In this field, research that examines the relationship between e-health literacy and sustainable healthy lifestyle behaviors within the context of physical literacy is notably scarce. In this context, the aim of this study is to examine the effect of e-health literacy on a sustainable healthy lifestyle and to evaluate the mediating role of physical literacy in this relationship. Methods: A total of 835 adolescents from high schools across Türkiye voluntarily participated in this study. During the data collection process, the e-Health Literacy Scale, the Perceived Physical Literacy Scale, and the Healthy and Sustainable Lifestyle Scale were utilized. Data were analyzed using the JASP (version 0.18.3.0) software. Correlation analysis and structural equation modeling were conducted, and the bootstrap method (n = 5000) was employed for mediation analysis. Results: The effect of e-health literacy on a sustainable healthy lifestyle was found to be positive and statistically significant (β = 0.452, p < 0.001). Similarly, e-health literacy significantly predicted physical literacy (β = 0.755, p < 0.001), and physical literacy significantly predicted a sustainable healthy lifestyle (β = 0.310, p < 0.001). The mediating effect was also statistically significant (β = 0.234, p < 0.001). The model explained 32% of the variance in healthy lifestyle behaviors. Conclusions: The findings indicate that evaluating e-health literacy and physical literacy together provides a holistic approach to fostering sustainable healthy lifestyle habits among adolescents. It is recommended that intervention programs be structured to encompass both areas of competence. Full article

Background/Objectives: International students pursuing higher education in the United States face unique challenges that increase their risk of food insecurity, including limited financial resources, employment restrictions, and cultural barriers. While food insecurity among domestic students has been widely studied, limited research focuses on the lived experiences of international graduate students. This study explores the challenges, perceptions, and coping strategies related to food insecurity among international graduate students at a large public university in North Texas. Methods: This qualitative, ethnographic study involved 20 semi-structured interviews with international graduate students who were clients of the university’s food pantry. Participants were recruited using purposive convenience sampling. Interviews focused on students’ experiences with food access, financial constraints, campus resources, and cultural food preferences. Data were analyzed using thematic coding in MAXQDA. Two standardized food insecurity measures—the USDA and FAO scales—were also administered and analyzed using SPSS. Results: Findings revealed that 85% of participants experienced limited access to nutritious and culturally appropriate foods, with 70% reporting hunger due to financial constraints. Themes included lack of cooking skills, limited campus food options, difficulty accessing familiar groceries, and limited job opportunities. Students expressed that food insecurity significantly impacted their physical health, mental well-being, and social lives, though many continued to prioritize academics over personal nourishment. Conclusions: Food insecurity among international graduate students is multifaceted, shaped by financial, cultural, and institutional barriers. Addressing this issue requires culturally sensitive interventions, improved access to diverse food options, tailored student support services, and institutional efforts to better understand and meet the needs of international students. Full article

Background/Objectives: Improvements in depression and anxiety, associated with moderate increases in physical activity, might induce reductions in emotional eating, especially in women with obesity, where emotion-driven eating is highly problematic. This pilot, field-based study sought to assess whether physical activity increase, itself, primarily predicts improved mood (biochemical theories) or if psychosocial factors associated with cognitive–behavioral treatment are principal correlates (behavioral theories). An aim was to inform improved treatment processes. Methods: Women with obesity participated in 6-month community-based behavioral obesity treatments emphasizing either: (a) standard education in weight-reduction methods (n = 28), (b) eating-related self-regulation methods (n = 24), or (c) self-regulation + relaxation training (n = 24). They completed a series of behavioral and psychological self-reports at baseline and Months 3 and 6. Results: Findings confirmed no significant difference in 3-month increases in physical activity, by group. There were significantly greater overall improvements in depression, emotional eating, self-regulation, and self-efficacy across the two self-regulation-focused groups (ps < 0.02), with anxiety improvement not reaching significance (p = 0.055). Separate significant paths from 3-month changes in depression and anxiety → self-efficacy change → emotional eating change were found. The same significant path was detected emanating from 6-month anxiety change; however, the hypothesized path of 6-month changes in depression → self-regulation → self-efficacy → emotional eating was, rather, significant. Weight reduction was considerably greater in the two self-regulation-based groups (~6% reduction), with simultaneously entered changes in self-regulation and self-efficacy significant predictors of those weight changes. Conclusions: Findings suggested viability in behavioral theory-driven explanations of the physical activity-mood improvement relationship. Future treatment foci on self-regulatory skills development leading to improvements in eating-related self-efficacy, emotional eating, and weight were suggested to extend the findings of this pilot study. Full article

Background/Objectives: The rapid ageing of the European population presents growing challenges for mental health, highlighting the need to identify factors that can prevent or delay psychological decline and promote a higher quality of life in later life. This study aims to provide an updated and comprehensive overview of mental health among older adults in Europe by examining the prevalence of depressive symptoms and identifying key associated factors. Methods: We analysed data from individuals (n = 45,601) aged 65 years and older across 27 European countries and Israel who participated in Wave 9 of the Survey of Health, Ageing and Retirement in Europe (SHARE). This study assessed the prevalence of depressive symptoms, which were evaluated using the EURO-D scale (score range: 0–12), with a cut-off of ≥4 indicating clinically relevant symptoms. It also explored associations with sociodemographic characteristics, physical health, behavioural factors, social participation, internet skills and living conditions. Results: Our findings confirm that depressive symptoms remain highly prevalent among older adults in Europe, with 35.1% of women and 21.5% of men affected, reflecting persistent gender disparities in mental health. Depression in later life was significantly associated with poor physical health, loneliness and lower quality of life. Conversely, moderate involvement in grandchild care and in social participation emerged as potential protective factors. Conclusions: Late-life depression has substantial implications for both mental and physical well-being. Our findings suggest that social integration, gender related factors and physical health are closely associated with depressive symptoms in older adults. These associations highlight the importance of considering these domains when designing interventions and policies aimed at promoting mental health in ageing populations. Full article

Human-Robot Collaboration (HRC) is pivotal for flexible, worker-centric manufacturing in Industry 5.0, yet dynamic task allocation remains difficult because operator states—fatigue and skill—fluctuate abruptly. I address this gap with a hybrid framework that couples real-time perception and double-estimating reinforcement learning. A Convolutional Neural Network (CNN) classifies nine fatigue–skill combinations from synthetic physiological cues (heart-rate, blink rate, posture, wrist acceleration); its outputs feed a Double Deep Q-Network (DDQN) whose state vector also includes task-queue and robot-status features. The DDQN optimises a multi-objective reward balancing throughput, workload and safety and executes at 10 Hz within a closed-loop pipeline implemented in MATLAB R2025a and RoboDK v5.9. Benchmarking on a 1000-episode HRC dataset (2500 allocations·episode⁻¹) shows the hybrid CNN+DDQN controller raises throughput to 60.48 ± 0.08 tasks·min⁻¹ (+21% vs. rule-based, +12% vs. SARSA, +8% vs. Dueling DQN, +5% vs. PPO), trims operator fatigue by 7% and sustains 99.9% collision-free operation (one-way ANOVA, p < 0.05; post-hoc power 1 − β = 0.87). Visual analyses confirm responsive task reallocation as fatigue rises or skill varies. The approach outperforms strong baselines (PPO, A3C, Dueling DQN) by mitigating Q-value over-estimation through double learning, providing robust policies under stochastic human states and offering a reproducible blueprint for multi-robot, Industry 5.0 factories. Future work will validate the controller on a physical Doosan H2017 cell and incorporate fairness constraints to avoid workload bias across multiple operators. Full article

Interdisciplinary teaching plays an important role in modern physics education by improving students’ understanding, problem-solving skills, and engagement through the integration of multiple disciplines. This study examines pre-service physics teachers’ perceptions of interdisciplinary teaching, focusing on their confidence in implementing interdisciplinary approaches, perceived benefits, and the challenges they expect. A Likert-scale survey was administered to 292 pre-service teachers from two universities in Kazakhstan. Findings indicate that students’ confidence in interdisciplinary teaching increases over time, while their recognition of its benefits remains consistently high across all academic years. However, barriers such as lack of training and feeling unprepared persist, even at the master’s level, indicating the need for structured interdisciplinary training. Institutional differences significantly impact students’ perceptions, with students from one university showing higher confidence levels than those from another, showing variations in curriculum and support systems. Gender differences in confidence were minimal. Additionally, perceptions of interdisciplinary teaching do not follow a linear trajectory, as students in their second and third years experienced a temporary decline in confidence before recovering in later years. Our findings indicate the need for structured interdisciplinary training in teacher education programs, institutional support to reduce disparities in confidence levels, targeted interventions during academic transitions, and ongoing professional development to address persistent barriers. Full article

Background/Objectives: Health literacy plays a fundamental role in adolescents’ health-related decisions and behaviors. The aim of our study was to assess the level of health literacy among 16–17-year-old students in Southern Hungary and to examine the associations between sociodemographic characteristics and health behaviors. Methods: This cross-sectional quantitative study was conducted in the autumn of 2024 in Baranya and Somogy counties. A total of 133 students completed a self-administered questionnaire including sociodemographic variables and health behaviors. Health literacy was measured using the validated HELMA-H instrument. Statistical analysis included chi-square tests, t-tests, and ANOVA (p < 0.05). Results: Overall, 62.7% of the students demonstrated adequate, while 37.3% demonstrated inadequate levels of health literacy. No significant association was found between overall health literacy and sociodemographic variables; however, partial associations were observed on specific subscales. Boys reported better access to health information (p = 0.037), while children of mothers with higher educational attainment scored better in comprehension (p = 0.042) and appraisal (p = 0.036). In the case of the numeracy subscale, children of mothers with the lowest educational level showed significantly better results (p = 0.006). Students with higher health literacy levels were less likely to smoke or consume caffeine; however, a reverse trend was observed regarding alcohol consumption. Physical activity showed a positive association with healthier behaviors (p < 0.05). Discussion: The use of digital technologies, interactive learning strategies, and the involvement of family members—especially mothers—may support the development of health-conscious decision-making in adolescents. Consequently, health education programs should focus not only on knowledge transfer but also on fostering critical thinking and decision-making skills. Full article

Purpose: Integrated neuromuscular training (INT) is a multidimensional training method that integrates strength, balance, core stability, flexibility, and motor skill development. The aim of this study was to systematically evaluate the effects of INT on various physical performance indicators in athletes to provide evidence supporting the application of INT in training practices. Method: A systematic search was conducted in accordance with PRISMA guidelines across nine databases—including PubMed, Web of Science, EMBASE, Scopus, Cochrane Library, Ovid MEDLINE, WILEY, and Springer Nature Link—from inception to 26 March 2025 to identify randomized controlled trials (RCTs) examining the effects of INT on athletic performance. Result: A total of 19 randomized controlled trials were included, comprising 783 participants aged 11–25 years. The meta-analysis results indicated that INT significantly improved jump performance (SMD = 0.26, 95% CI [0.15, 0.37], p < 0.001, I² = 75%), sprint performance (SMD = −0.76, 95% CI [−0.93, −0.58], p < 0.001, I² = 76%), balance performance (SMD = 0.23, 95% CI [0.14, 0.31], p < 0.001, I² = 78%), and agility performance (SMD = −0.72, 95% CI [−1.23, −0.21], p < 0.05, I² = 74%). Sensitivity analyses revealed no substantial changes in jump, sprint, agility, or balance performance outcomes. Conclusions: INT was found to significantly improve sprint, jump, balance, and agility performance in athletes. Analysis of the included training protocols suggested that improvements in each performance indicator required emphasis on specific training components. Moreover, greater improvements in sprint and balance performance were observed in female athletes compared to their male counterparts. Subgroup analysis revealed significant differences in training effects across populations, with female athletes showing superior improvements in sprint and balance performance following INT interventions. Additionally, interventions lasting fewer than eight weeks, with training sessions shorter than 30 min and frequencies of more than three times per week, were associated with more pronounced effects. Full article

Background/Objectives: Aging is often accompanied by physical and cognitive decline, affecting older adults’ mobility. Virtual reality (VR) offers innovative opportunities to safely practice everyday tasks, such as street crossing. This study was designed as a feasibility and pilot study to explore acceptance, usability, and preliminary effects of a VR-based road-crossing intervention for older adults. It investigates the use of virtual reality (VR) as an innovative training tool to support senior citizens in safely navigating everyday challenges such as crossing roads. By providing an immersive environment with realistic traffic scenarios, VR enables participants to practice in a safe and controlled setting, minimizing the risks associated with real-world road traffic. Methods: A VR training application called “Wegfest” was developed to facilitate targeted road-crossing practice. The application simulates various scenarios commonly encountered by older adults, such as crossing busy streets or waiting at traffic lights. The study applied a single-group pre-post design. Outcomes included the Timed Up and Go test (TUG), Falls Efficacy Scale-International (FES-I), and Montreal Cognitive Assessment (MoCA). Results: The development process of “Wegfest” demonstrates how a highly realistic street environment can be created for VR-based road-crossing training. Significant improvements were found in the Timed Up and Go test (p = 0.002, d = 0.784) and fall-related self-efficacy (FES-I, p = 0.005). No change was observed in cognitive function (MoCA, p = 0.56). Participants reported increased subjective safety (p < 0.001). Discussion: The development of the VR training application “Wegfest” highlights the feasibility of creating realistic virtual environments for skill development. By leveraging immersive technology, both physical and cognitive skills required for road-crossing can be effectively trained. The findings suggest that “Wegfest” has the potential to enhance the mobility and safety of older adults in road traffic through immersive experiences and targeted training interventions. Conclusions: As an innovative training tool, the VR application not only provides an engaging and enjoyable learning environment but also fosters self-confidence and independence among older adults in traffic settings. Regular training within the virtual world enables senior citizens to continuously refine their skills, ultimately improving their quality of life. Full article

Background: Cancer is one of the leading causes of morbidity and mortality worldwide and in Spain. Individuals with cancer are at a higher risk of suicide compared to the general population due to both general and disease-specific risk factors. Objective: To update knowledge on nursing care measures to address the risk of suicide in cancer patients. Methods: A narrative review was conducted by searching PubMed, WOS, Scopus, and CINAHL during February and March 2025. The inclusion criteria comprised original qualitative, quantitative, and/or mixed-methods studies related to the topic of the review. Results: Of the 289 identified studies, 23 were selected. Twelve studies of cancer patients, ten studies of healthcare professionals, and one study of caregivers and survivors were included. Regarding suicide risk factors, eight studies addressed demographic aspects, fifteen socio-economic factors, twenty-one psycho-emotional factors, and seventeen physical factors. Key risk factors included male sex, advanced age, social isolation, lack of social support, hopelessness, and physical deterioration. Seventeen studies highlighted the need for continuous and comprehensive nursing care using validated tools for systematic assessment of suicide risk. Eight emphasised the importance of ongoing training in suicide prevention, which is essential for developing communication skills and improving therapeutic relationships. Five studies underscored the relevance of a holistic approach that addresses the physical, emotional, social, and spiritual dimensions of patient care. Six extended this approach to include family members and caregivers. Conclusions: Suicide risk in cancer patients is associated with multiple risk factors. Emotional support and a comprehensive, continuous nursing approach—based on systematic assessments, specialised training, and a holistic focus—are key to effective suicide prevention. Full article

Objective: The objective of the study was to investigate the relationship between the level of physical activity and body composition, and the levels of motor skills and strength in overweight and obese men. Methods: The research involved 64 men. Body composition, physical activity, motor control, Motor Control Test (MCT), and strength variables were evaluated. Body composition was assessed by DXA, and the participants were classified into two groups according to the percentage of total fat mass: greater and less than 27.65%. Physical activity was assessed using accelerometry, and motor control was measured with posturography, which provided a composite score of motor performance and postural control effectiveness. Strength was assessed using hand, leg, and back dynamometers. Results: The participants with a higher percentage of body fat had a lower DSI (Dynamic Strength Index) (p < 0.001) and significantly reduced PAL (physical activity level) and energy expenditure (p < 0.001). No significant differences were found in the muscle strength of the upper limbs (p = 0.06) and lower limbs (p = 0.419). With regard to MCT, there was a significant difference between groups in the backward direction (p = 0.041), with the group with the highest percentage of body fat showing lower values. Conclusions: Individuals with a higher percentage of body fat tend to have lower levels of strength, physical activity, and energy expenditure, which can lead to impaired balance. The findings highlight the need for targeted interventions to improve body composition and levels of strength and physical activity, with a positive impact on general health and quality of life. Emphasis should be placed on improving physical activity levels in male individuals with a higher percentage of fat mass to improve their body composition and dynamic strength levels, which are beneficial to life, particularly to help improve postural control. Full article

Background/Objectives: Physical activity (PA) during preschool is vital for supporting physiological development, enhancing cognitive abilities and fostering socio-emotional growth. However, consistent disparities in meeting PA guidelines have been observed. This systematic review aims to identify studies that compared preschoolers’ PA, as measured by technological devices, with recommended PA guidelines. Specifically, it examines (i) factors associated with meeting PA guidelines and (ii) the outcomes observed when children meet these guidelines. Methods: The search strategy was designed based on the PICOS framework. Then, a systematic review was conducted using four databases to identify studies that included children from 0 to 6 years old participating in PA sessions recorded through technological devices. PA is compared with guidelines, and correlations were reported. Results: Of the 52 studies reviewed, most found that meeting PA guidelines in preschool-aged children was linked to favourable outcomes across multiple domains. Children who met the guidelines tended to show better motor competence, emotional regulation and cognitive skills, particularly in areas like working memory and social understanding. However, the relationship with body composition and body mass index was inconsistent, suggesting that the benefits of PA in early childhood extend beyond weight-related measures. Conclusions: Meeting PA guidelines in early childhood is strongly associated with cognitive development, emotional regulation, motor skills and social behaviours. However, adherence varies significantly due to a complex mix of individual, familial, socioeconomic and environmental factors. Full article

In the context of Industry 4.0, Total Productive Maintenance (TPM) is undergoing a major shift driven by digital technologies such as the IoT, AI, cloud computing, and Cyber–Physical systems. This study explores how these technologies reshape traditional TPM pillars and practices through a two-phase methodology: bibliometric analysis, which reveals global research trends, key contributors, and emerging themes, and a systematic review, which discusses how core TPM practices are being transformed by advanced technologies. It also identifies key challenges of this transition, including data aggregation, a lack of skills, and resistance. However, despite the growing body of research on digital TPM, a major gap persists: the lack of a standardized model applicable across industries. Existing approaches are often fragmented or too context-specific, limiting scalability. Addressing this gap requires a structured approach that aligns technological advancements with TPM’s foundational principles. Taking a cue from these findings, this article formulates a systematic and scalable framework for TPM 4.0 deployment. The framework is based on four pillars: modular technological architecture, phased deployment, workforce integration, and standardized performance indicators. The ultimate goal is to provide a basis for a universal digital TPM standard that enhances the efficiency, resilience, and efficacy of smart maintenance systems. Full article