Search Results (2,551)

Colles fracture is a common type of wrist fracture, typically resulting from falling onto an outstretched hand. Postoperative patients often require long-term self-rehabilitation to restore wrist function. However, traditional rehabilitation relies on medical personnel and lacks real-time feedback and progress tracking, which may lead to poor rehabilitation or even deterioration of the condition. This article proposes an intelligent wearable system based on edge computing to enhance the efficiency of self-rehabilitation, improve system portability, and ensure comprehensive recording of rehabilitation data. The system performs real-time data processing and feedback to assist patients and healthcare providers in monitoring rehabilitation progress and optimizing recovery outcomes. The proposed system integrates an STM32 microcontroller, NanoEdge AI, and a 9-axis inertial sensor to detect and evaluate the accuracy of hand rehabilitation movements, ensuring the precision of self-rehabilitation. All rehabilitation movements are schemed under the guidance of professional physicians to ensure correctness and minimize the risk of secondary injuries caused by improper rehabilitation. Data such as motion records, training duration, and count are transmitted via Bluetooth to the Local database for further analysis. A custom web interface allows healthcare providers to monitor and analyze collected data. This approach improves diagnostic accuracy, supports personalized rehabilitation recommendations, and improves treatment outcomes and patient recovery success rates. Full article

PA is an important determinant of health and well-being; however, many university students, including healthcare students, do not achieve recommended activity levels despite their future role in health promotion. This study aimed to explore healthcare students’ perspectives on physical activity, including their habits, perceived barriers and facilitators, the relationship between physical activity and academic self-efficacy, and its role in their future professional identity. A qualitative descriptive design was applied using semi-structured individual interviews with 15 healthcare students. Data were analyzed using Braun and Clarke’s six-phase reflexive thematic analysis approach. Five interrelated themes were identified: physical activity as a resource for health, well-being, and academic functioning; academic demands shaping physical activity behavior; physical activity strengthening academic self-efficacy; physical activity as part of professional identity; and the university environment as a facilitator of physical activity. Students perceived physical activity as supporting physical and mental well-being, stress management, concentration, and daily functioning. Academic workload, limited time, fatigue, financial constraints, and motivational challenges were identified as barriers, whereas institutional support and flexible opportunities facilitated participation. Students also viewed physical activity as contributing to confidence, discipline, and their perceived credibility as future healthcare professionals. Supportive university environments may help healthcare students maintain active lifestyles and support the development of their role as health-promoting professionals. Full article

Nutrition is an essential component of colorectal cancer (CRC) care, influencing treatment tolerance, functional status, and quality of life, yet it remains inconsistently integrated into practice. This study examined experiences with nutrition management and gaps in nutrition care among patients with CRC, caregivers, and healthcare professionals across Canada through a multi-center, cross-sectional survey conducted from July 2025 to February 2026. A total of 243 participants completed the survey, including 121 patients, 45 caregivers, and 77 healthcare professionals. Among patients, 51.2% reported that nutritional status was discussed or assessed during treatment, while 24.0% reported it was never discussed. More than half of patients (55.4%) said they did not receive adequate information regarding weight loss during treatment. Caregivers described substantial nutrition impact symptoms and identified a need for clearer guidance, emotional support, and improved access to dietitians. Healthcare professionals rated nutrition care as highly important yet reported barriers to effective delivery, including limited staffing, lack of standardized screening, and reactive care processes. Across groups, respondents emphasized the importance of timely, personalized, and culturally relevant nutrition care. Overall, nutrition remains insufficiently embedded in CRC care, highlighting the need for routine screening, standardized referral pathways, earlier intervention, and integrated patient-centered nutrition care models to improve CRC care. Full article

Background: Health-related quality of life (HRQoL) and job satisfaction are important indicators of nurses and physicians’ wellbeing and system sustainability, particularly under conditions of high clinical demand. Although organizational determinants of nurses and physicians’ wellbeing have received increasing attention, evidence regarding protocol-based work as a specific organizational characteristic remains limited. Methods: A multicenter cross-sectional study was conducted in 11 Greek public hospitals between September 2022 and March 2023. The study included 405 nurses and physicians (214 nurses and 191 physicians). HRQoL was assessed with the SF-36 and job satisfaction with the MSQ-Short Form. Protocol-based work was assessed using a single self-reported dichotomous item referring to the use of standardized clinical protocols during the pandemic. Associations between workplace characteristics and outcomes were examined using multivariable linear regression models. Results: Vitality (57.24 ± 17.61 among nurses and 53.92 ± 16.93 among physicians) and general health (56.58 ± 19.81 and 53.42 ± 16.32, respectively) were the lowest-scoring HRQoL dimensions in both professional groups. Compared with physicians, nurses reported higher mental health (62.52 vs. 58.11, p < 0.05), social functioning (67.17 vs. 58.96, p < 0.05), and overall job satisfaction (3.23 vs. 2.98, p < 0.01), whereas physicians scored higher in physical functioning (83.47, p < 0.05) and bodily pain (72.87, p < 0.05). Conclusions: Several organizational characteristics were associated with wellbeing among nurses and physicians. Protocol-based work showed consistent associations with better HRQoL and job satisfaction across multiple outcomes. However, longitudinal studies are needed to determine whether these associations reflect causal relationships. Full article

Background/Objectives: Irritable bowel syndrome (IBS) is one of the most common disorders of gut–brain interaction and one of the most frequent functional bowel disorders encountered in clinical practice. The lack of reliable biomarkers, coupled with inconsistent clinical presentations and variable therapeutic outcomes, creates a landscape of ongoing uncertainty for clinicians. Against this background, non-pharmacological and technological developments—such as digital health interfaces, sensor technologies, and medical devices—emerge as potential support tools for clinical management. This qualitative study explored how healthcare professionals manage diagnostic and therapeutic uncertainty in IBS across care settings while evaluating the potential role and value of integrating these technological and non-pharmacological innovations into routine practice. Methods: Fifteen semi-structured interviews were conducted with healthcare professionals involved in IBS care across primary and specialized settings and one expert patient with lived experience in the Barcelona metropolitan area. Data were analyzed using principles of grounded theory. Results: The notion of “catch-all category” articulates four interrelated themes that characterize IBS in clinical practice: persistent clinical uncertainty, pragmatic diagnostic strategies, patient engagement in biopsychosocial and longitudinal management, and the implementation and interpretability of digital and non-pharmacological support. Participants described IBS management as shifting from exclusionary, symptom-based diagnostics toward holistic biopsychosocial and gut–brain-axis models. This transition underscores the necessity for resources that empower patients through education, support clinicians through longitudinal monitoring, and facilitate shared management strategies. Conclusions: The findings suggest that IBS management is not a single diagnostic act but a longitudinal process of uncertainty management. Future digital or non-pharmacological support tools for IBS should prioritize longitudinal monitoring, clinically interpretable information, and low burden for professionals and patient–professional communication. Full article

Background/Objectives: Food exclusions in vegan and vegetarian diets may complicate the assessment of disordered eating and orthorexia. This study compared eating disorder risk, healthy orthorexia, and orthorexia nervosa across vegan, vegetarian, and omnivorous women and examined their adjusted associations with dietary pattern. Methods: This cross-sectional study used convenience sampling to recruit 305 women in Türkiye who self-identified as vegan (n = 64), vegetarian (n = 71), or omnivorous (n = 170). Participants completed the Eating Attitudes Test-26, Teruel Orthorexia Scale, and Food Choice Questionnaire. Associations with vegan and vegetarian patterns were examined using multinomial logistic regression, with omnivorous women as the reference group. Potential nonlinearity in the association between orthorexia nervosa and the vegan versus omnivorous contrast was examined using restricted cubic splines. Secondary exploratory food choice models were corrected for multiple testing. Results: Elevated eating disorder risk was not significantly associated with either the vegan or vegetarian pattern in the adjusted model. Higher healthy orthorexia scores were associated with greater odds of following a vegan pattern (adjusted odds ratio (aOR) = 1.177, 95% confidence interval (CI): 1.090–1.270), whereas the association between orthorexia nervosa and the vegan pattern was nonlinear (p for nonlinearity = 0.006), with the adjusted probability declining across low-to-moderate scores and the estimates becoming imprecise at higher scores. Neither orthorexia dimension was associated with the vegetarian pattern. In secondary exploratory analyses, weight control motivation was associated with lower odds of vegan (aOR = 0.424, 95% CI: 0.249–0.723) and vegetarian patterns (aOR = 0.610, 95% CI: 0.382–0.975), while familiarity was associated with lower odds of the vegan pattern (aOR = 0.466, 95% CI: 0.296–0.735). Conclusions: Healthy orthorexia and orthorexia nervosa showed distinct associations with the vegan pattern. Dietitians and healthcare professionals should not infer eating pathology from dietary pattern labels alone but should consider motivations for food exclusions, weight- and shape-related concerns, dietary rigidity, distress, and functional impairment. Full article

Family life education (FLE) is a social support and educational practice that encompasses all efforts to equip individuals, families, or community members with information, resources, skills, and examples of best practices to ensure the healthy functioning of families and prevent or minimize problems. It is grounded in social science, specifically family sciences, but evidence-based research exists in multidisciplinary or interdisciplinary studies across many other domains. Family life educators are professional helpers who focus on supporting, educating, and teaching the community to empower families and improve the quality of personal and family life. Studies state that FLE is a transdisciplinary or global field, it should sustain the quality of families’ lives: subjective well-being, optimism, health, and standard of living, while reducing aspects of family deprivation and maintaining a work–life balance. FLE should integrate educational knowledge and practices for a simple way of living in families and society. Full article

Background/Objective: The H-HT represents a critical vulnerability for patient–family caregiver dyads. This study developed and content-validated a middle-range nursing theory, the Adaptarte Model, designed to guide dyadic adaptation during the H-HT within the Latin American healthcare context. Methods: A sequential exploratory multimethod design was executed in two phases. Phase 1 integrated three evidence streams: clinical practice insights, a JBI-guided scoping review, and two focus groups with transitional care professionals. Qualitative content analysis and iterative consensus refined the model’s core concepts, assumptions, and propositions. Phase 2 evaluated the model’s content, structure, functionality, and projection using an international panel of eleven Latin American experts meeting strict eligibility criteria. Data were analyzed using Lawshe’s Content Validity Ratio (CVR) modified by Tristán (cutoff = 0.58) and the overall Content Validity Index (CVI). Reporting followed PRISMA-ScR and GRAMMS guidelines. Results: Expert consensus confirmed the essential model components. Item-level CVR values ranged from 0.90 to 0.99, yielding an overall CVI of 0.96, while external functionality and conceptual projection achieved an average rating of 0.88. Conclusions: The Adaptarte Model demonstrates high content validity and structural clarity, establishing a rigorous theoretical foundation for subsequent empirical research. Rather than being ready for immediate clinical implementation, it provides a structured blueprint for prospective protocol development. Systematic empirical testing and longitudinal studies are now imperative to evaluate its clinical utility and drive future healthcare transformations. The scoping review protocol was prospectively registered on the Open Science Framework (OSF) URL (accessed on 23 September 2024). Full article

Thailand has become a prominent destination for contemporary Chinese mobility through international education, employment, entrepreneurship, family relocation, retirement, and lifestyle-oriented movement. However, these pathways are usually studied separately, obscuring how education, work, legal status, digital infrastructures, everyday adaptation, and belonging interact over time. This article reports a structured integrative review of 53 empirical, theoretical, methodological, and policy sources identified through targeted searches of publisher platforms, scholarly discovery services, Thai journal repositories, and institutional sources, supplemented by citation chaining. The synthesis develops a framework of layered belonging under negotiated mobility. Mobility begins with aspirations and capabilities situated within a regional opportunity structure; educational and other entry pathways provide uneven access to linguistic, social, and professional resources; and the conversion of these resources is mediated by language, digital and interpersonal networks, institutional support, and everyday competence while being filtered through visa rules, work authorization, employer dependence, occupational access, and public narratives. Belonging is therefore differentiated across six interdependent dimensions: affective-place, relational-social, functional-everyday, professional-economic, legal-institutional, and future-temporal. This framework explains why migrants may feel emotionally at home and socially connected in Thailand while remaining legally temporary, professionally dependent, or uncertain about long-term residence. The review clarifies the added value of the framework relative to place-belongingness, integration domains, social anchoring, and differentiated embedding; proposes six empirically testable propositions; and identifies implications for universities, employers, public agencies, and migrant-serving organizations. Full article

Background: Iatrogenic injuries of the inferior alveolar nerve (IAN) and lingual nerve (LN) are among the most relevant complications in oral surgery. Although most cases show spontaneous recovery, a significant proportion of patients develop persistent post-traumatic trigeminal neuropathies (PTNs). The aim of this narrative review is to critically analyze current diagnostic approaches for IAN and LN injuries, highlighting the limitations of conventional assessment tools and evaluating the potential role of emerging neurophysiological and imaging techniques in improving early diagnosis, prognostic stratification and medico-legal management. Methods: A structured narrative review was conducted using PubMed/MEDLINE, Scopus and Web of Science for English-language studies published up to 23 March 2026. Evidence on trigeminal nerve injuries, neurosensory assessment, quantitative sensory testing (QST), advanced imaging techniques and medico-legal implications was qualitatively synthesized. Results: The prognosis of iatrogenic PTNs of both IAN and LN is influenced by the severity of nerve injury and the timing of diagnosis and management. Although conventional neurosensory testing (NST) is widely used in the clinical assessment of trigeminal nerve injuries, its ability to objectively characterize the extent and severity of nerve damage is limited. Complementary neurophysiological and quantitative sensory approaches may provide additional functional information, while magnetic resonance neurography (MRN) offers direct structural assessment of the injured nerve. Early objective identification of nerve injury may support prognostic evaluation and timely clinical decision-making. Conclusions: An integrated approach combining clinical assessment, neurophysiology and advanced imaging is essential for early characterization of iatrogenic trigeminal nerve injuries. MRN may provide structural information, contributing to early stratification of injury severity. Quantitative sensory and neurophysiological techniques may complement conventional clinical testing. These diagnostic advances may also have important medico-legal implications, as delayed diagnosis may lead to loss of therapeutic opportunity and increased professional liability. Full article

Engineering literacy research has been dominated by static, competence-based frameworks that fail to explain how attributes evolve dynamically and systematically underrepresent two critical dimensions: engineering consciousness as a cognitive precursor to decision-making, and engineering culture as a value-laden, inherited dimension sustaining professional identity across generations. These gaps are particularly consequential for STEM teacher preparation, where cultivating comprehensive engineering literacy in future educators is hypothesized to create a multiplier effect on societal STEM engagement. This study develops a theoretical model through a systematized literature retrieval and critical synthesis of engineering literacy literature (2005–2025; N = 113 publications), combined with theoretical deduction grounded in system theory and synergy theory. Two research questions guide the study: (1) How is the connotation of engineering literacy systematically reconstructed under multiple transformations? (2) What is the synergistic evolution logic among its constituent elements, and how can this logic inform curriculum design for STEM teacher preparation? The design utility of the model is illustrated through a curriculum design case. The analysis yields a “multi-driver, five-dimension synergy” dynamic model comprising five interconnected elements (knowledge, competence, consciousness, ethics, and culture) that co-evolve through a “consciousness–action–culture” spiral cycle, in which culture functions as the slow variable governing the long-term evolution of the entire system. The curriculum design case (a 64 h course for pre-service teachers centered on the Hong Kong–Zhuhai–Macao Bridge) illustrates how the model guided curricular decisions in four areas: consciousness activation before skill training, distributed cultural integration, multidimensional assessment, and operationalization of the multiplier effect through a teaching transformation module. The study advances engineering literacy theory by upgrading it from a static competence inventory to a culturally embedded, consciousness-driven adaptive ecosystem and provides a potentially transferable curriculum design framework for STEM teacher preparation. As a design case, the curriculum blueprint awaits implementation and empirical validation; claims about learning outcomes, multiplier effects, and cross-cultural applicability are theoretical hypotheses rather than empirically validated findings. Full article

This study examines how Saudi Vision 2030 is reshaping architectural design and practice in Riyadh amid the challenge of balancing rapid urban development with local architectural identity. The study is framed by the concept of transformative resilience, defined here as the capacity of an urban system not merely to absorb disturbance but to deliberately reconfigure its structure, function and identity while sustaining cultural continuity. The research investigates Vision 2030’s impact across four analytical dimensions; design, implementation, functional performance, and socio-cultural context; and explores whether evaluative perceptions differ according to sociodemographic characteristics, including gender, age, nationality, educational level, professional background, and length of residency. A descriptive analytical methodology was adopted, employing a structured questionnaire. Instrument reliability was established with a Cronbach’s alpha of 0.70. Data were collected from a stratified random sample of 384 residents and professionals in Riyadh (response rate 93.7%). Because the instrument records perceived rather than objectively measured performance, the two evidence streams are reported separately: the survey data establish social legitimacy and acceptance, while the case studies supply the physical, technical and documentary evidence base. To contextualise the survey findings, three projects were purposively selected and examined as representative case studies, supported by field photographic documentation. Quantitative results demonstrate a strong consensus regarding the positive influence of Vision 2030 on architectural development, with mean scores ranging from 4.07 (design) to 4.13 (functional and socio-cultural dimensions). The highest-rated item (mean = 4.23) related to strengthening sense of place. Inferential analysis, now reported with effect sizes, revealed statistically significant differences across all sociodemographic variables, with age being the most influential factor, although all effects were small in magnitude. Qualitative findings identify preserving architectural identity and heritage as the main challenge, while diversifying contemporary design approaches is the most frequently proposed future direction. The study concludes that achieving Vision 2030’s architectural objectives requires regulatory frameworks that embed local identity, supported by community capacity building and sustained institutional commitment to culturally responsive and environmentally sustainable design. The principal contribution is an operationalised assessment framework that translates transformative resilience from a descriptive narrative into a set of architectural indicators applicable to other vision-led urban transformations. Full article

Background/Objectives: Exercise intolerance is clinically important but conceptually unstable in cardiovascular care. Its relationship with exercise tolerance, exercise capacity, functional capacity and the nursing concept of activity intolerance remains unclear, and the term entered nursing from other disciplines without corresponding conceptual scrutiny. This protocol will examine how these concepts are used in adults with cardiovascular disease, how use varies across conditions, care settings, pathway phases and time, and which attributes, antecedents, consequences and related concepts are reported, to determine what these concepts can mean for nursing. Methods: The study has two interconnected phases: a scoping review following Joanna Briggs Institute methodology and PRISMA-ScR and PRISMA-S reporting, followed by Rodgers’ evolutionary concept analysis. Searches will cover MEDLINE, CINAHL, Embase, Web of Science and Scopus, complemented by gray literature and standardized nursing terminologies. Expected Results: The review will map how exercise intolerance, activity intolerance and neighboring terms are used and will chart which defining attributes and empirical referents are recognizable through routine nursing assessment, require instrumented testing or both. Whether a stable nursing formulation can be derived is treated as an open question: convergence, divergence, instability and insufficient evidence are all possible, and attributes recognizable only through instrumented testing will be reported as a null result for nursing operationalization. Conclusions: The review will determine how the concept has evolved for the discipline of nursing and whether nursing assessment can operationalize it. It will not establish professional consensus, diagnostic thresholds, measurement validity or device specifications. Registration: This study was registered in the Open Science Framework (OSF) Registries before screening and data charting commenced. Full article

Population ageing, social isolation, and limited opportunities for meaningful contact between generations pose important challenges to healthy ageing and community well-being. This mixed-methods pilot study examined the feasibility, acceptability, co-creation process, and preliminary outcomes of the P-IN Programme, a community-based intergenerational intervention involving preschool children and older adults living in residential care. The programme was developed and implemented in partnership with a preschool and a residential care facility in Portugal and comprised ten intergenerational sessions shaped through an iterative co-creation process involving participants, professionals, and researchers. Twenty-three children, eighteen older adults, and five professionals contributed to the study. Quantitative pre–post assessment explored fluency in both generations and cognitive functioning, quality of life, subjective well-being, and social participation in older adults. Qualitative data examined intergenerational beliefs, participants’ experiences, relationships, and reciprocal learning, while also informing the co-creation process. Most quantitative outcomes remained stable, although cognitive functioning showed a moderate, non-significant effect. Perceived quality of life changed significantly in an unfavourable direction. In contrast, qualitative findings revealed broader and more relational representations of the other generation, alongside shared experiences and clearer recognition of reciprocal learning. The integration of both components showed that positive relational and experiential changes were not necessarily accompanied by changes in broader standardised outcomes. Overall, the P-IN Programme was feasible to implement and generally well received within the two participating community settings. These findings support further evaluation of co-created intergenerational programmes using larger samples, controlled designs, and longer-term follow-up. Full article

Relay protection operation and maintenance (O&M) involves multi-source documents such as device manuals, O&M records, and industry regulations, with dense professional terminology and dispersed knowledge, making traditional retrieval methods inadequate for precise association. This paper proposes a knowledge graph construction and application method for relay protection O&M that incorporates a neighborhood gating mechanism. First, a domain schema is established covering five core entity types, primary equipment, protection functions, functional components, setting parameters, and secondary circuit signals, along with the semantic relationships between entities. Second, a MacBERT-GNF-CRF entity recognition model is proposed, which introduces a gated neighborhood feature fusion (GNF) mechanism on the basis of pre-trained semantic encoding to enhance local semantic representations near entity boundaries; experimental results show that this model achieves an F₁ score of 0.946. A MacBERT-GNF-RC relation extraction model is constructed to realize automatic discrimination of semantic associations between entity pairs. After entity disambiguation and knowledge fusion, knowledge graph storage and visualization are completed based on Neo4j. Furthermore, a knowledge graph-enhanced alarm question-answering prototype is developed and evaluated using a representative 220 kV composite alarm case and 50 historical alarm cases. Expert evaluation shows that KG augmentation significantly improves alarm interpretation quality and evidence traceability compared to direct LLM answering. Full article