Search Results (1,142)

Background: Malnutrition is a universal challenge in long-term care, significantly affecting vulnerable populations. Residents with Intellectual Developmental Disability (IDD) rely heavily on Direct Support Professionals (DSPs) for assisted feeding. Understanding DSP’s mealtime experiences is essential for improving nutritional care and well-being. Objective: To examine multilevel factors associated with DSPs’ mealtime experiences. Methods: This exploratory cross-sectional case study used a survey administrated to DSPs working in a long-term residential setting. Statistical analyses examined the associations between multilevel factors and DSP’s positive and negative mealtime experiences. Results: The sample included 46 DSP’s (98% women) from a single facility in Israel. Although DSPs reported high levels of positive feelings and satisfaction with their daily work efficacy, negative feelings were significantly associated with some organizational, environmental and resident-related factors. Negative feelings were higher among DSPs caring for residents who use wheelchairs compared to those working with residents who do not use wheelchairs (t = −2.99, p < 0.01). Negative feelings were negatively associated with institutional support (r = −0.49, p < 0.001), and perceived accessibility and adaptability of the environment (r = −0.46, p = 0.001), and showed a more modest association with communication with residents (r = −0.38, p = 0.01). DSPs’ seniority, education level, and prior feeding-related training were not significantly associated with mealtime experience. Conclusions: The findings highlight that negative mealtime experiences among DSPs are associated with organizational, environmental, and resident-related factors, rather than with individual DSP’s characteristics. Policy and practical adjustments to address mealtime experiences for residents with IDD are suggested. Full article

Background: Minimally invasive interventional radiology (IR) offers effective, uterus-preserving treatments for several gynecologic and obstetric conditions such as uterine fibroids, adenomyosis and postpartum hemorrhage. Despite their efficacy, these methods remain underused, partly to limited awareness among clinicians and patients. Large language models (LLMs) may help bridge this gap by providing accessible, reliable information. Objective: To evaluate how current LLMs address knowledge gaps and promote awareness of minimally invasive IR methods in gynecology and obstetrics. Methods: A structured ten-question instrument was used to query three publicly available LLMs (OpenEvidence, ChatGPT, and Google Gemini). Responses were analyzed for accuracy, completeness, safety considerations, and patient-centered communication. Results: All three models accurately identified a range of medical, minimally invasive, and surgical treatments for uterine fibroids, adenomyosis, and postpartum hemorrhage, with OpenEvidence and ChatGPT providing more detailed and clinically nuanced responses. OpenEvidence achieved the highest scores overall, closely followed by ChatGPT, while Google Gemini scored lower, particularly in completeness and patient-centered communication. In more complex scenarios, performance differences became more pronounced, with OpenEvidence again leading, ChatGPT performing strongly, and Google Gemini lagging behind. Overall, OpenEvidence and ChatGPT demonstrated higher accuracy, completeness, and safety considerations, whereas Google Gemini showed comparatively weaker and less consistent performance. Conclusions: LLMs may endorse the promotion of minimally invasive IR methods in gynecology and obstetrics, but their outputs vary considerably in quality. Ongoing refinement and integration of evidence-based sources are essential before routine use in clinical practice. Therefore, effective collaboration between artificial intelligence (AI) developers and medical professionals is essential to harness this technology’s full potential. Full article

Background: Sexual Assault Care Centres (SACCs) in Belgium provide integrated medical and psychological care, a forensic examination and the option to report to the police to victims of sexual assault (SA). Understanding victims’ acceptability of these services is essential for improving SACC’s effectiveness and informing policy. Methods: In-depth interviews were conducted with 19 victims and 14 support persons to explore victims’ experiences with SACCs. The victims represented diverse characteristics (gender, age, SACC site and police reporting status). Data were analysed using thematic framework analysis, guided by Sekhon’s “Theoretical Framework of Acceptability”. Results: Participants viewed SACCs as a highly acceptable integrated model of specialised care for victims of recent SA. They expressed strong appreciation for the care provided at the SACC and its set-up (affective attitude), and they identified key professional qualities of SACC professionals (ethicality). Participants demonstrated good understanding of the functioning of the SACCs (intervention coherence). The model was perceived as effective in providing medical care, mental health support, and facilitating police reporting, though gaps were noted in linking victims with other actors in the criminal justice system (perceived effectiveness). Organisational strengths included the holistic, long-term, proactive, affordable and accessible nature of the care offered (perceived effectiveness, burden and opportunity cost). Victims faced challenges in linking to, engaging with and remaining in care due to distress post-SA, with support persons playing a crucial role in helping them navigate these challenges (self-efficacy). Conclusions: The study highlights the acceptability of an integrated, multidisciplinary approach to specialised SA care. Key elements include embedded psychological support, the option for forensic examination without mandatory reporting, and the possibility of police reporting at the SACC. These findings may inform the development of specialised SA services in other settings. Full article

This structured narrative review aimed to synthesize the findings of various studies to determine the efficacy of Self-Regulated Learning (SRL) training programs for in-service and pre-service teachers on their knowledge and skills, and to evaluate the transfer to teaching practice and student outcomes. Following PRISMA guidelines, a search was conducted across Web of Science, Scopus, and PsycInfo, ultimately including 30 intervention studies. The results confirmed that professional development is effective in enhancing teachers’ knowledge, skills, and beliefs related to SRL. However, due to wide methodological diversity, the review identified varied intervention factors showing promise, but a unified association between sample type (in-service vs. pre-service) and overall impact was unattainable. While SRL training successfully improves teacher competency, the limited evaluation of student performance or long-term effects prevents the definitive claim that the training reliably changes teaching practice toward a more self-regulated approach. Future research should prioritize robust longitudinal designs and include student-level measures. Full article

This study examines how protective factors contribute to teacher resilience and sustainable wellbeing during remote teaching, focusing specifically on parent-teachers who are balancing professional responsibilities with childcare. Within the broader context of research on educator resilience and professional practice, it explores the associations between social and organizational support, work–family conflict (WFC), and parenting self-efficacy (SE) and satisfaction, factors linked to educators’ capacity to manage dual roles effectively. The hypotheses were that (1) WFC would negatively correlate with parenting SE and satisfaction; (2) support from friends and family and from the workplace would be associated with lower WFC and higher parenting SE and satisfaction; and (3) WFC would mediate the relationship between support and parenting outcomes. Using a mixed-methods design with quantitative scales combined with open questions, data were collected through retrospective self-report questionnaires in relation to the COVID-19 lockdowns. The sample included 474 teachers who teach in schools in Israel and have children aged 0–12. The predictive mediation model confirmed the first two hypotheses, with partial support for the third. Qualitative findings provide insight into parent-teachers’ experiences, including gender-based differences, and emphasize factors associated with their adjustment to remote instruction. These findings contribute to understanding how social and organizational support—forms of collaborative and resilience-promoting mechanisms—may have an important role in promoting educator wellbeing through their negative association with work–family conflict. The findings should be examined further in longitudinal or experimental research and in additional cultural and educational contexts to examine their generalizability, as well as causality. Nonetheless, the findings provide possible directions for policy and interventions aimed at fostering resilience and sustainable wellbeing among teachers, particularly those navigating dual roles in their personal and professional lives. Full article

Against the backdrop of uneven educational development and structural constraints in rural Mainland China, teacher agency is critical for driving professional growth and instructional improvement. Rural educators face distinct challenges—limited resources, isolated work contexts, and systemic pressures—that shape their capacity to enact change. While scholarship has documented the roles of contextual resources and individual beliefs in shaping teacher agency, less is known about the mediating mechanisms linking job resources and self-efficacy to agency within China’s rural educational landscape. This study examines how perceived job resources (teaching resources, administrative support, colleague support, parental support) and teaching self-efficacy collectively shape rural teachers’ agency, to inform policy and practice for strengthening their professional capacity. Drawing on a quantitative survey of 625 rural teachers, we employ a two-stage analytical approach: first, descriptive statistics, t-tests, ANOVA, and Pearson correlations to map baseline variable relationships; second, Hayes’ PROCESS macro (Model 4) with bootstrapping to test the mediating role of teaching self-efficacy between job resources and teacher agency. Findings reveal the following: (1) Rural teachers report moderate agency (M = 3.53/5), indicating room for growth; (2) All four job resource dimensions significantly and positively predict agency (β = 0.099–0.163); (3) Teaching self-efficacy is a robust predictor of agency (β = 0.785–0.822, p < 0.001) after controlling for resources; (4) Self-efficacy partially mediates the links between each job resource and agency, with indirect effects ranging from 0.269 (teaching resources) to 0.451 (colleague support), highlighting its central role in translating contextual resources into agentic action. We conclude that fostering rural teacher agency requires a holistic approach addressing both external job resources and internal self-efficacy. Policymakers and administrators should prioritize investments in teaching resources, collaborative support structures, and professional development to build educators’ confidence and competence. Limitations include self-report bias, cross-sectional design constraints on causal inference, and limited generalizability. Future research should use longitudinal designs and broader samples to deepen understandings of agency in structurally constrained educational settings. Full article

This study explores how school leadership styles are perceived to relate to teacher resilience during crises in Arab schools in Israel. Drawing on twenty semi-structured interviews with principals and vice-principals, findings show that transformational and participative leadership, characterized by emotional support, accessibility, active listening, and shared decision-making, are perceived to foster teachers’ sense of security, self-efficacy, and collective resilience. In contrast, authoritarian and rigid approaches are described as contributing to increased stress, reduced motivation, and diminished coping capacity. The study highlights the significance of socio-cultural and political contexts, indicating that effective leadership in crises involves not only professional guidance but also cultural awareness, flexibility, and responsiveness to staff needs. These findings underscore the value of integrative leadership approaches and targeted professional development to support teacher well-being and organizational resilience in crisis-prone settings. By focusing on leaders’ perspectives, the study contributes to understanding how culturally sensitive and adaptive leadership practices may support educational stability under conditions of uncertainty. Full article

Background: Conventional analyses of physiological recovery often rely on discrete metrics that assume independence across time points, thereby ignoring intrinsic temporal continuity and masking substantial interindividual heterogeneity. This proof-of-concept study assesses the efficacy of Functional Data Analysis (FDA) as a promising framework for characterizing individual response dynamics following a functional threshold power (FTP) test. Methods: Physiological time-series data (including blood lactate, heart rate, blood pressure, and glucose levels) collected from 21 trained cyclists (10 professionals, 11 amateurs) were represented as functional objects using FDataGrid on the original sampling grid (0, 3, 5, 10, 20 min), without basis expansion or smoothing. We conducted unsupervised functional clustering (K-means; Fuzzy K-means) and supervised classification (Maximum Depth with Modified Band Depth, K-Nearest Neighbors, Nearest Centroid, functional QDA with parametric Gaussian covariance). Model performance was estimated via Repeated Stratified 5-Fold Cross-Validation with 10 repetitions (50 folds), reporting accuracy, balanced accuracy (mean ± SD), 95% CIs, permutation p-values, and sensitivity/specificity from aggregated confusion matrices. Results: Lactate (CL) and diastolic blood pressure (DBP) provided useful and statistically significant discrimination across several classifiers (e.g., KNN, Nearest Centroid, functional QDA), whereas heart rate showed modest discriminative value and glucose intermediate performance. Unsupervised analyses revealed distinct lactate recovery profiles and graded membership for hemodynamic/metabolic variables, supporting the value of FDA for resolving heterogeneity beyond group-average trends. Conclusions: FDA offers a feasible and informative approach for classifying recovery phenotypes while preserving temporal structure. Findings are promising but should be interpreted with caution due to the small sample size, sparse time points, and the need for external validation in larger, independent cohorts before translation into routine decision-making. Full article

Background/Objectives: Stress echocardiography (SE) had been recommended by professional societies for assessing patients with suspected angina. SE protocols are variable across hospitals and countries in the recommendation of the cessation of rate-controlling medication (RCMx) prior to SE. Some expert opinion papers recommend the cessation of beta receptor blockers (BBs) and rate-controlling calcium channel blockers 48 h prior to SE to improve the diagnostic accuracy of the test. There is no evidence that the continuation of RCMx can affect the outcome of SE and short-term major adverse cardiovascular events (MACEs). To investigate the efficacy of Dobutamine SE in a cohort of patients where the cessation of rate-controlling medication has not been mandated, we reviewed our data over a one-year period in patients investigated for suspected coronary artery disease (CAD). Methods: A retrospective data analysis was performed on 227 consecutive patients who underwent Dobutamine SE between January 2022 and January 2023 in a single centre. In addition to dobutamine, the protocol allowed the administration of intravenous atropine (maximum dose of 1.2 mg) and a “top up” handgrip exercise at the discretion of the performing cardiologist. We assessed the Dobutamine SE outcome (positive vs. negative), target heart rate (THR, 85% of maximum age predicted), and the achieved peak HR in the two groups with RCMx and without RCMx. We analysed the patients’ characteristics and 12-month outcomes of a combined MACE of death, non-fatal MI, stroke, admission with angina, and unplanned revascularisation. Results: Of the 227 patients, 61% were on No-RCMx (male 40%). Ninety-three percent of the patients on RCMx were on BB and 7% on other rate-controlling medications. The THR was achieved in 74% of the patients with-RCMx and 90% in the without-RCMx groups p = 0.0018. Positive Dobutamine SE was observed in 48% (43/89) of patients on RCMx vs. 28% (39/138) on No-RCMx (p = 0.0022). Patients who did not reach THR 43% (16/37) had positive Dobutamine SE compared to 35% (66/190) who reached THR (p = 0.626). There was no difference between groups in the peak WMSI. Logistic regression analysis showed that being on RCMx was independently associated with positive Dobutamine SE (OR 2.03, 95% CI 1.06–3.91, and p = 0.034). The MACE rate was higher in patients where the THR was not achieved (9/37, 24.0%) vs. where THR was achieved (9/190, 4.7%), p < 0.001, in both the with-RCMx (7/30, 23% vs. 6/66, 9.1%, p = 0.013) and without-RCMx (2/14, 14% vs. 3/124, 2.4%; p = 0.025) groups, respectively. RCMx was independently associated with MACE (OR 3.68, 95% CI 1.227–11.046, and p = 0.020). Conclusions: The use of RCMx proved to be a predictor of both SE and MACE outcomes irrespective of the achieved THR. Our data supports the practice that patients referred for Dobutamine SE on RCMx can continue taking them without impact on the test accuracy. Full article

This study investigates the acceptance of an AI-powered decision-support chatbot among professionals in a marketing and sales context, addressing a gap in technology acceptance research by examining data-intensive decision environments that remain underexplored. Building on the Unified Theory of Acceptance and Use of Technology (UTAUT), the study proposes an extended model incorporating Behavioral Intention, Performance Expectancy, Effort Expectancy, Social Influence, Output Quality, Time Saving, Source Trustworthiness, Cognitive Load, and Chatbot Self-Efficacy. An experimental study was conducted with 106 professionals using a chatbot-enhanced business analytics platform to complete marketing KPI analysis tasks. Data were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM). The results demonstrate that Behavioral Intention to use decision-support chatbots is significantly influenced by Performance Expectancy, Effort Expectancy, and Social Influence. Performance Expectancy is strongly driven by Output Quality, Time Saving, and Source Trustworthiness, while Effort Expectancy is significantly shaped by reduced Cognitive Load and higher Chatbot Self-Efficacy. The findings suggest that chatbot acceptance in professional decision-making depends not only on usability and performance beliefs but also on cognitive relief, trust in information sources, and efficiency gains, highlighting important implications for both theory and the design of AI-based decision-support systems. Full article

As classrooms become increasingly diverse, achieving equitable and inclusive education is central to the United Nations Sustainable Development Goals (SDGs), particularly SDG 4.7, and to advancing social sustainability in education. Teachers’ multicultural teaching efficacy is a key psychological resource shaping inclusive classroom practice. This study conceptualizes multicultural teaching efficacy as a multidimensional belief system and adopts a person-centered approach to identify latent efficacy profiles among Korean lower secondary school teachers. Using data from the OECD Teaching and Learning International Survey (TALIS) 2024, latent profile analysis was conducted based on seven efficacy indicators, with teachers’ social and emotional learning self-efficacy (TSEL-SE) and participation in multicultural education-related professional learning included as covariates. Five distinct efficacy profiles were identified, revealing heterogeneity in both level and configuration. TSEL-SE consistently predicted profile membership, whereas the effects of professional learning varied across profiles and were strongest among teachers with high TSEL-SE, indicating a conditional interaction effect between psychological and experiential resources. Notably, over one-third of teachers belonged to a structurally low efficacy profile, indicating systemic vulnerability. These findings highlight the importance of differentiated and emotionally responsive teacher education strategies for advancing inclusive practice and contributing to SDG 4.7 and broader social sustainability goals. Full article

Introduction: According to the Alzheimer Society of Canada, over 770,000 people in Canada are living with dementia. This number is expected to rise to nearly 1 million people by 2030. Although the provision of team-based interprofessional assessment in gerontological care is critical for the early detection and prevention of dementia, its planning and delivery can be a challenge. In Saskatchewan, previous assessments have identified significant gaps between actual and best practices in dealing with this medical condition. The emergence of Geriatric Services Resource Teams (GSRTs), which apply an innovative, team-based model to improve the diagnosis and care of older adults with complex health practices, can be proven beneficial in this regard. The purpose of this study is to compare the efficacy of the care provision process between a GSRT and a traditional medical care channel (i.e., primary health) with respect to dementia patients. Methods: A retrospective patient chart review was conducted by collecting data from a large Primary Care practice (n = 90) and the GSRT in Regina (n = 75). Collected data included information on patient demographics and treatment, and the diagnosis process itself. Results: While demographic characteristics between patient groups were similar, significant differences (p < 0.05) were found in the involvement of pharmacy and other healthcare professionals, prescriptions for memory loss, and in who made the diagnosis. Moreover, although the dementia diagnosis was usually made first in Primary Care, further clarification of the type of dementia, counseling of diagnosis, review of medication, and assessment of functions and social supports were better managed in the GSRT group. Discussion: The use of Geriatric Services Resource Teams is a relatively new concept in Saskatchewan. As these teams are established, initial results show that their role in complex care management has beneficial outcomes for dementia patients. Full article

Video-based teacher professional development (TPD) offers teachers structured opportunities to examine their classroom practice, yet its role in supporting differentiated instruction (DI) in fully online formats remains underexplored. This longitudinal case study investigates how participation in a facilitated, fully online video-based TPD was associated with changes in the cognition and classroom practice of one lower-secondary mathematics teacher, with a specific focus on DI. Drawing on Major and Watson’s four-dimensional model of teacher cognitive change, we analyse developments in the teacher’s self-efficacy, self-evaluation, knowledge of teaching, and instructional beliefs, and link these to observable changes in differentiated classroom practice. Data were collected through six classroom observations, as well as a semi-structured interview focused on DI. The findings show that sustained engagement in structured video reflection and online professional learning community discussions supported a shift from predominantly teacher-centred instruction to more adaptive, student-centred teaching characterised by tiered tasks, embedded scaffolding for struggling students, enrichment for advanced learners, and increased collaborative problem solving. Full article

Vulvodynia is a chronic gynecological condition characterized by unexplained vulvar pain, which may significantly impact every aspect of women’s quality of life, encompassing physical, psychological, and social well-being. Due to its heterogeneous clinical presentation and associated comorbidities, vulvodynia is often misdiagnosed and/or not adequately treated. This descriptive observational study was conducted using an anonymous questionnaire, which was distributed through social media channels and included 29 questions (25 multiple-choice and four open-ended questions) and aimed to investigate participants’ most frequent symptoms, comorbidities, impact on quality of life, and treatment efficacy and costs. Analyzing a total of 221 answers, we found that burning (85%) and abrasion/irritation sensation (73%) are the most common symptoms, and they are most frequently localized in the vestibular area, while irritable bowel syndrome (35%) is the most common comorbidity. A significant negative effect on individual functioning was confirmed, also due to a noticeable diagnostic delay (4.5 years on average) and treatments’ prohibitive costs potentially impairing participants’ compliance. Our study provides valuable insights into self-reported aspects of women affected by vulvodynia, raising healthcare professionals’ awareness of this issue. Better knowledge of peculiar aspects of vulvodynia may help improve its diagnosis and promote a more personalized and efficient therapeutic approach. Full article

Background: Home-based digital healthcare interventions are increasingly used to support people living with dementia (PLWD) and their family caregivers. However, evidence regarding their effectiveness across patient and caregiver outcomes remains heterogeneous. Methods: This systematic review followed PRISMA 2020 guidelines and was prospectively registered in PROSPERO (CRD420261302166). Six databases (PubMed, Embase, CINAHL, PsycINFO, Web of Science, and Scopus) were searched from January 2000 to October 2025. Randomized and quasi-experimental quantitative studies evaluating home-based or remotely delivered digital interventions for PLWD and/or informal caregivers were included. Risk of bias was assessed using RoB 2 and ROBINS-I. Due to heterogeneity, findings were synthesized narratively. Results: Fourteen studies met the inclusion criteria. Interventions included web-based psychoeducation, telecoaching, digital cognitive training, assistive technologies, and multicomponent programs. Caregiver outcomes demonstrated the most consistent benefits, including reduced burden and stress, improved self-efficacy, and improved sleep efficiency in technology-supported trials. For PLWD, small-to-moderate improvements were observed in global cognition and selected neuropsychiatric symptoms, particularly in interactive and personalized programs. Multicomponent interventions combining caregiver education with patient activation and professional feedback showed more durable effects. Conclusions: Home-based digital interventions appear feasible and beneficial, particularly for caregiver outcomes. Future large-scale trials with longer follow-up and standardized outcome measures are needed to confirm durability, equity, and cost-effectiveness. Full article