Search Results (4,945)

In professional water polo, understanding the effects of ball wettability on game dynamics is essential but remains insufficiently investigated. This research aims to evaluate how the surface wettability of various professional water polo balls could influence their behavior during play. The study employed a combination of laboratory measurements to assess the wettability of multiple ball brands using the sessile drop method under standardized conditions. FTIR spectroscopy was also performed to characterize the surface chemical composition and support the interpretation of wettability differences observed in contact angle measurements. Performance-related parameters, including static contact angle values and droplet behavior during measurement, were analyzed in relation to surface chemistry and material composition. Significant variability in wettability was observed across different ball brands. These differences indicate that surface properties may play an important role in modulating ball–water interaction mechanisms, which are influenced by both chemical composition and surface morphology. Based on these results, we propose including wettability-related parameters in the official water polo equipment guidelines, which currently cover only size, weight, and material composition. This adjustment could help standardize ball behavior across competitive play, leading to more consistent and fair conditions. This study extends current knowledge of the physical factors influencing sports performance and suggests practical improvements to enhance fairness and quality in water polo competitions. Full article

Background/Objectives: Oral diseases affect around 3.5 billion people worldwide and remain a major public health burden. Adolescence represents a critical stage for establishing lifelong oral health behaviours, particularly given the widespread use of smartphones in this age group. This review aimed to synthesise available evidence on the use of mobile health (mHealth) applications to promote oral health among adolescents, identify app features, evaluate their efficacy in improving oral health outcomes and behaviours, and explore barriers and challenges to their use. Methods: A comprehensive review was conducted across PubMed, Scopus, the Cochrane Library, and Web of Science. Studies published between 2010 and 2025 in English, Portuguese, or Spanish that evaluated oral health apps targeting adolescents were included. Data were extracted regarding study design, sample characteristics, app features, clinical and behavioural outcomes, and barriers to app use. Methodological quality was assessed using RoB 2, ROBINS-I, and the JBI checklist, as appropriate. Results: Twenty-five studies met the inclusion criteria, comprising 19 randomised controlled trials, 3 qualitative studies, and 3 non-randomised trials. Common app features included educational content, brushing timers, reminders, gamification, and communication with professionals. Most studies demonstrated improvements in plaque and gingival indices, brushing frequency, and oral health knowledge, particularly when apps incorporated behaviour change techniques. However, long-term adherence, usability issues, and lack of regulation remain major limitations. Conclusions: mHealth applications show promise as complementary tools for promoting oral health in adolescents. Their success depends on sustained engagement, evidence-based content, user-centred design, and integration with traditional preventive approaches. Full article

Background/Objectives: Refugee populations face significant barriers in accessing healthcare services, particularly in sexual and reproductive health (SRH), with important implications for menstrual health. Limited access to adequate menstrual products, safe sanitation facilities, and appropriate information contributes to period poverty among migrant and refugee women, exacerbating conditions of vulnerability and discrimination. The present study aims to explore the lived experiences, barriers, and facilitating factors in the management of menstrual health and menarche among refugee women and girls. Methods: A systematic meta-synthesis was carried out between January and May 2026 using the PubMed, Cochrane Library, Scopus and LILACS databases and grey literature sources. The SPIDER framework was applied to guide the research question and search strategy. Qualitative and mixed-method primary studies and grey literature reports containing qualitative findings describing experiences of menstruation among refugee women and girls were included. Studies published in English, Italian, Spanish, and Portuguese were eligible. Study quality was appraised using the Joanna Briggs Institute (JBI) critical appraisal checklist. Data were analysed using a thematic synthesis approach as described by Thomas and Harden. Results: A total of 24 studies were included. Six analytical themes were identified: (1) structural constraints affecting access to resources and services; (2) context-dependent menstrual management practices; (3) female support networks; (4) menstruation as a socially constructed and learned experience; (5) constrained agency and compromised dignity under conditions of stigma; and (6) physical and psychological impacts. Overall, menstrual health was shaped by the interaction of structural barriers and socio-cultural norms, which limited safe and dignified management. Significant gaps in knowledge and preparedness were observed, particularly prior to menarche. Women and girls relied on coping strategies and informal support networks despite associated trade-offs for health and dignity. Conclusions: Menstrual health among refugee women and girls is shaped by structural inequalities, socio-cultural norms, and conditions of displacement. Addressing these challenges requires integrated, multisectoral approaches that go beyond product provision to tackle underlying determinants. Strengthening menstrual health literacy, engaging communities, and supporting the role of healthcare professionals such as midwives is essential to support more equitable and sustainable menstrual health interventions. Findings should be interpreted in light of the heterogeneity of study contexts and methodological quality. Full article

Background: Stigma toward people with mental illness remains a major barrier to quality care, persisting even among mental health professionals. This study evaluated the effectiveness and feasibility of a structured anti-stigma intervention for psychiatry trainees. Methods: Outcomes were assessed at baseline, post-intervention, and 3-month follow-up using a knowledge quiz, the Attitudes to Addressing Stigma and Discrimination Scale (ASTAD), and an Objective Structured Clinical Examination (OSCE). Feasibility outcomes were also evaluated. Results: Significant improvements were observed across all measures immediately after training, with medium to large effect sizes. Knowledge scores increased post-intervention (+6.68; 95% CI 5.86–7.50) and remained significantly higher at follow-up (+6; 95% CI 4.99–7.01). Total ASTAD scores improved post-intervention (+5; 95% CI 3.26–6.74) but did not maintain at follow-up. OSCE scores increased by 0.95 points (95% CI 0.62–1.28) post-training. The intervention reached 40% of eligible trainees, with high satisfaction and perceived relevance to clinical practice. Participants reported increased awareness of stigma, improved communication skills, and greater confidence in addressing stigma in patient interactions. Experiential learning methods, including role-play and case discussions, were identified as the most impactful components. Barriers to participation included workload, scheduling constraints, and limited institutional support. Participants recommended integrating the intervention into formal training curricula. Conclusions: The intervention was feasible, acceptable, and effective in improving stigma-related knowledge, attitudes, and clinical skills among psychiatry trainees. While knowledge gains were sustained, attitudinal and behavioral changes were only partially maintained, highlighting the need for longitudinal integration and ongoing reinforcement. Full article

Background: While the consumer experience of psychosis has received significant attention in Western research, a substantial gap exists regarding the experiences of women in the Kingdom of Saudi Arabia (KSA). In this context, religious, cultural, familial, and gender-specific factors uniquely shape the experience of psychosis, help-seeking behaviors, and recovery. This study aimed to explore the lived experiences of Saudi women with psychosis across three phases: first-episode onset, hospitalization or follow-up, and community living after discharge. Methods: This hermeneutic phenomenological study, guided by van Manen’s methodology, employed all six lifeworld existentials: lived space, lived body, lived time, lived self-other, lived thing, and lived cyborg. Semi-structured interviews were conducted with 21 women diagnosed with psychosis at two hospitals in Riyadh, KSA. Data collection included 13 audio-recorded interviews and eight documented via field notes, supplemented by creative methods such as drawings, poems, and written texts analyzed using van Manen’s vocative method. All Arabic data were professionally translated and verified for accuracy. Results: Three overarching themes emerged. First, women’s lived experiences of first-episode psychosis highlighted the process of understanding causes and developing insight during onset. Second, experiences during admission and follow-up revealed the impact of clinical encounters, nursing care, and the critical need for therapeutic healing spaces. Third, living with psychosis in the community emphasized the complexities of medication adherence, family dynamics, and the pursuit of recovery through education, employment, and religious practice. Conclusions: The participants articulated user-based recovery perspectives, including empowerment, shared decision-making, and hope, which contrasted sharply with the service-based approaches they received. Culturally specific stressors and pervasive stigma shaped every phase of their journey. To the authors’ knowledge, no prior study has examined this population using a hermeneutic phenomenological framework; these findings provide a women-focused, culturally situated evidence base for developing gender-specific recovery models and enhanced discharge planning within the KSA mental health system. Full article

Objective: To map the scientific evidence and identify knowledge gaps regarding the health of Black and Sexual and Gender Minority populations within the global context of health education. Introduction: Health education curricula should explicitly recognize, define, and address the specific needs and health disparities affecting Black and Sexual and Gender Minority populations to ensure that healthcare provision is comprehensive and inclusive in diverse settings. Eligibility criteria: Studies related to professional health training at undergraduate and graduate levels, as well as other educational modalities addressing healthcare provision for Black and Sexual and Gender Minority populations, were included. Methods: This scoping review was conducted following the JBI methodology. Studies were retrieved from Scopus, Web of Science, PubMed, Embase, MEDLINE, Virtual Health Library, CINAHL, ERIC, Cochrane Library, Brazilian Digital Library of Theses and Dissertations, ProQuest Dissertations & Theses Global, EBSCO databases, and the Networked Digital Library of Theses and Dissertations, without language or time restrictions. Two independent reviewers screened the studies and extracted data using a standardized form developed for this review. Concepts, definitions, structures, results, and applications of professional health education for the care of Black and Sexual and Gender Minority populations were systematically synthesized. The results were organized and presented in tabular and graphical formats, accompanied by a narrative summary. Results: A total of 104 studies were included. The evidence was predominantly concentrated in North America, particularly in the United States, with limited representation from other regions. Most studies were published after 2020, indicating a recent expansion of research interest. The methodological profile was characterized by a predominance of quantitative and descriptive designs, alongside qualitative and mixed-methods approaches. Thematic analysis revealed a concentration of studies addressing gender-affirming care, workforce diversity, social determinants of health, and discrimination, while intersectional approaches and long-term educational outcomes remained less explored. Conclusions: The available evidence indicates that health education has increasingly incorporated themes related to equity and diversity; however, the integration of structured and mandatory curricular approaches addressing the intersectional health needs of Black and Sexual and Gender Minority populations remains limited. The findings highlight the need for broader geographic representation, stronger methodological designs, and the development of comprehensive educational strategies capable of addressing structural inequalities within health training contexts. Full article

Electroencephalography (EEG) is a noninvasive tool used by healthcare professionals to measure brain electrical activity. EEG analysis can indicate various anomalies linked to different brain pathologies, including seizures. Traditionally, the analysis is confined to two-dimensional displays and relies exclusively on the visual modality, limiting a comprehensive overview. EEG analysis through visualisation is challenging and time-consuming, and artificial intelligence (AI) is increasingly used to aid the process of seizure detection. However, the educational value of AI-assisted seizure detection models depends on the explainability of the underlying models. Explainable AI can help learners understand the features and patterns associated with seizure detection and also support informed use of AI-based decision support systems. M2EEG-VR leverages the focus and immersive capabilities of virtual reality (VR) with the aim of developing a multi-modal platform for EEG seizure detection analysis with a human-in-the-loop. The ability to understand EEG and seizure patterns is key to addressing and effectively treating many neurological conditions. Neonatal seizure detection is particularly challenging where seizure patterns are subtle and context dependent. This study advances toward multi-modal analysis by encoding EEG signals into auditory representations using AI that aids in the acoustic detection of the presence of neonatal seizures in EEG. The platform also introduces a 3D brain model with a spatial mapping of seizure regions. In a user study (N = 20, 4 prior EEG experience, 16 no prior EEG experience), participants achieved higher seizure detection accuracy in the combined visual and auditory condition (mean = 7.6 ± 1.2) than in visual-only or audio-only modes. These preliminary findings suggest that a multi-modal environment may improve the accuracy of detection. However, further controlled studies are needed to ascertain the performance benefits. Usability was rated excellent (SUS = 83 ± 11), and task load remained moderate (NASA-TLX = 36.6). The findings suggest that VR multi-modal interaction can reduce cognitive load and enhance the explainability of complex EEG data in a focused virtual environment. The analysis of the diagnostic accuracy showed that participants without prior EEG knowledge performed similarly across all modalities to those with prior EEG knowledge. This implies that the accessibility barrier is reduced for novice users using the tool for the EEG review/detection task. This, together with high usability and moderate task load scores, indicates that the tool may be suitable for medical training applications. A multi-modal EEG in VR may prove useful in education and also be used as a test bench to further explore AI with human-in-the-loop paradigms for seizure detection. Full article

Background: Artificial intelligence (AI) is increasingly discussed as a means of improving procurement efficiency and supply chain agility, yet its role in supplier evaluation remains insufficiently understood, particularly when decisions depend on fragmented information, cross-functional coordination, explainability, and managerial accountability. This study examines how AI may augment decision-making agility in supplier evaluation. Methods: An exploratory qualitative single-case study was conducted in a large multinational manufacturing company. Data were collected through 18 semi-structured interviews with procurement, logistics, quality, operations, and ERP/process actors, and analyzed through a Gioia-inspired thematic analysis, complemented by a descriptive assessment of theme recurrence. Results: The findings show that supplier evaluation is constrained by informational fragmentation, weak organizational memory, limited explainability, and the need to preserve contextual human judgement. AI was not perceived as a substitute for procurement professionals but as a decision-support infrastructure that may reconnect dispersed supplier knowledge, detect recurring problems earlier, and support transparent recommendations. Conclusions: The study develops a preliminary conceptualization of AI-augmented procurement agility as a bounded, process-level capability composed of AI-enabled supplier sensing, AI-supported interpretive integration, explainable decision support, and human-supervised responsiveness. The findings remain context-dependent and require further validation through comparative and longitudinal research. Full article

Background/Objectives: Improving the prevention and management of pressure injuries requires adequate nursing knowledge. In this context, understanding the current knowledge levels of nurses is important for informing educational and organizational strategies. This study aimed to assess the pressure injury knowledge of nurses at the national level and examine differences according to their educational, professional, and informational characteristics. Methods: A national cross-sectional quantitative study was conducted in public secondary-level hospitals in the Republic of Croatia. A total of 1139 participants from 19 hospitals across all four geographical regions of Croatia participated. The PZ-PUNKT instrument was used, and an analysis was conducted using descriptive and bivariate inferential statistics. Results: Participants with bachelor’s and master’s degrees achieved higher PZ-PUKT scores than those with secondary education (p = 0.026 to < 0.001), although the effect sizes were very small (ε² = 0.008–0.017). Significant differences were observed across clinical departments (p < 0.001; ε² = 0.03–0.04), whereas no statistically significant differences were found according to the frequency of working with patients with pressure injuries (p > 0.05). Participants who reported recently attending educational activities, consulting the professional literature, or searching for information achieved higher knowledge scores across all domains (p < 0.001); however, the effect sizes remained small (ε² = 0.034–0.060; rpb = 0.133–0.214). Conclusions: Although the observed effect sizes were generally small, higher knowledge scores were observed among nurses who reported recent engagement with educational activities, the professional literature, and information-seeking behaviors. No significant differences were identified according to the frequency of working with patients with pressure injuries. These findings provide a national overview of pressure injury knowledge among Croatian nurses and may inform future educational initiatives and research. Full article

Road traffic crashes remain a major global public health and economic challenge, with heavy vehicle drivers disproportionately involved in severe incidents, particularly in low- and middle-income countries. In Ethiopia, limited access to continuous professional training constrains efforts to improve drivers’ safety-related knowledge and awareness. This study explored the impact potential and user acceptance of gamified e-learning modules designed to enhance heavy vehicle drivers’ knowledge and awareness of fatigue management, speed-related behavior, and eco-driving practices. A randomized pretest–post-test control-group design was employed, in which professional drivers were assigned to either an intervention group that completed three gamified e-learning modules or a control group that received no training. Data were analyzed using mixed repeated-measures analysis of variance. The results revealed significant time × group interaction effects across all domains (p < 0.001), with substantially greater improvements in the intervention group and large effect sizes. Participants also reported high perceived usefulness, behavioral intention, and trust in the system. These findings provide preliminary evidence that gamified e-learning may be a feasible and promising approach for improving short-term safety-related knowledge among professional heavy vehicle drivers. Further research is needed to determine whether these improvements are sustained over time and translate into behavioral change and measurable road safety outcomes before broader implementation can be recommended. Full article

The sustainable management of chemical fumigants in intensive horticulture represents one of the most complex challenges in European agricultural policy, requiring the integration of agronomic knowledge, regulatory frameworks, economic viability, and stakeholder perspectives. This study proposes and tests a multi-phase consultation methodology designed to bridge the gap between individual expert knowledge and collective, evidence-based consensus, moving from qualitative field-based elicitation to structured multidisciplinary engagement and incorporating both scientific data and practical experience. A total of 72 experts were involved across two phases. In phase 1, in-depth face-to-face interviews (n = 18) captured field-level knowledge on integrated pest management strategies, risk perception, and decision-making criteria, including the economic sustainability of production systems, a dimension prioritized in the European Commission’s Vision for Agriculture and Food. Phase 2 consisted of a one-day multistakeholder event (n = 54)—bringing together researchers, regulators, industry representatives, and farmers—to confront qualitative findings with experimental data on operator safety, groundwater protection, and consumer residues. This deliberate transition from individual perception to informed, shared consensus represents the methodological core of the approach and its most distinctive contribution. The phase 1 results showed that the majority of experts considered chemical fumigants currently indispensable, while recognizing complementary strategies—particularly solarization and natural substances—as valuable supporting tools. The phase 2 experimental data confirmed operator exposure below regulatory thresholds, no groundwater contamination under professional application conditions, and the absence of detectable residues in treated crops. The results demonstrate that this structured consultation can generate actionable knowledge for integrated nematode and soil-borne disease management, with a methodology replicable across other complex regulatory and agronomic contexts within the European framework. Full article

Background: Complementary Medicine and Therapies (CMTs) are increasingly used worldwide, particularly in Saudi Arabia, due to growing interest in holistic and integrative healthcare. However, concerns regarding safety, regulatory awareness and evidence-based use persist, while comparative knowledge data between family physicians and the general population remain limited. This study aimed to compare knowledge of CMTs between family physicians and the general population in Saudi Arabia. Methods: A comparative cross-sectional analysis was conducted using two independent datasets collected in Saudi Arabia from a total of 1307 participants. Variables related to the participants’ demographic characteristics, and their knowledge of and information sources on CMTs, were harmonised prior to analysis. Between-group comparisons were performed using Chi-square and Fisher’s exact tests, with statistical significance set at p < 0.05. Results: The family physicians demonstrated significantly higher levels of knowledge of CMTs than the general population. While 35.5% of the physicians demonstrated good knowledge levels, 82.0% of the public participants exhibited poor or low knowledge. However, knowledge of regulatory and quality control measures governing CMTs remained limited among both the physicians (21.0%) and the public (24.6%). Both the physicians (66.1%) and the members of the public (34.8%) primarily relied on healthcare professionals as major sources of information on CMTs. Significant associations were observed between the participant group and the knowledge-related variables, overall knowledge levels and information sources (p < 0.001). Conclusions: Strengthening public education, physician training and regulatory awareness may support safer and more evidence-based integration of CMTs within healthcare systems. Full article

Background/Objectives: Ulcers affect people of all ages worldwide, and hard-to-heal ulcers require extensive management. Patients with hard-to-heal ulcers often receive care across multiple healthcare settings, which may increase risks to patient safety. There is limited knowledge of how healthcare professionals maintain patient safety when patients with hard-to-heal ulcers transition across healthcare settings. The aim of this study was to explore healthcare professionals’ experiences of patient safety in ulcer management in primary and secondary healthcare settings. Methods: A qualitative research design was adopted. Fifteen semi-structured interviews were conducted, transcribed, and analysed, using qualitative content analysis. The healthcare professionals represented various professional roles and worked in either primary or secondary care. Results: The study resulted in one overarching theme and three categories. Given the complexity and demands of ulcer management, healthcare professionals needed to ensure safe care. In an organisation with unclear structures, professionals felt compelled to safeguard and develop their expertise themselves. Limited formal training in ulcer management, along with a reliance on a few more experienced colleagues, contributed to a sense of inadequacy among healthcare professionals. In ulcer management, professionals acted in the patient’s best interests, helping address gaps in patient safety. Conclusions: The findings of the present study illustrated how healthcare professionals are largely left alone in ulcer management. Challenges due to organisational structures posed patient safety risks, which were, to a large extent, mitigated by the professionals’ dedication to patient care. This study highlights the need for stronger structural support to complement individual competence in promoting safe and effective ulcer management. Patient safety should not depend solely on individual professionals, but on structured, organisation-level guidelines. Full article

Improving the quality of science and mathematics teaching remains a persistent challenge in resource-constrained education systems, highlighting the need for effective, sustainable professional development approaches. This study employed a quantitative cross-sectional survey designed to investigate science and mathematics teachers’ retrospective perceptions of the sustainability and professional value of lesson study professional development. Data were collected from 117 teachers who had participated in a lesson study intervention facilitated through a university–school partnership. The lesson study intervention occurred between 2012 and 2014, and data were collected retrospectively in 2018 to examine teachers’ sustained perceptions of its professional value. Descriptive and inferential statistical analyses revealed that teachers generally experienced lesson study as a meaningful, collaborative, and school-embedded professional development approach. Participants reported perceived improvement in content knowledge, pedagogical practices, lesson planning, reflective teaching, and professional collaboration. Strong positive correlations were found among teachers’ understanding of lesson study, collaboration, preparation, implementation, and professional learning. However, time constraints and the need for sustained institutional support were identified as key challenges to implementation. The findings suggest that teachers perceived lesson study as having sustained professional value within their school contexts. While based on retrospective self-reports, the results suggest that lesson study may contribute to collective professional cultures when supported institutionally. By fostering collaborative learning cultures and embedding professional learning into everyday teaching practice, lesson study may strengthen education systems and align with broader sustainable development goals. It is recommended that lesson study be institutionalised as a sustainable, school-embedded professional development approach, with future research examining its long-term impact on authentic teaching practices and learning outcomes. Full article

Automated clash detection in Building Information Modelling (BIM) has reached operational maturity; however, subsequent stages of clash management, including filtering, prioritisation, resolution, and prevention, remain largely dependent on manual expert judgement. Artificial intelligence (AI) has been increasingly applied to address these limitations, yet focused synthesis remains limited on how AI techniques support different stages of BIM-based clash management, what levels of automation they achieve, and how ready they are for professional deployment. This review follows PRISMA 2020 and synthesises 21 empirical studies published between 2019 and 2026, providing one of the first focused syntheses of AI applications across the BIM-based clash management lifecycle. Several AI technique families are identified, including rule-based and knowledge-based systems, classical supervised machine learning, deep learning and computer vision, graph-based and relational methods, and reinforcement learning and generative AI approaches. The results show that research is concentrated on filtering, while resolution and prevention remain underexplored despite their greater coordination significance. A structured automation taxonomy is developed, revealing that systems described as autonomous are evaluated only in simulated environments. The synthesis further indicates that progress is constrained primarily by structural rather than algorithmic limitations, as most studies rely on single-project validation, report performance without class-level metrics, and produce black-box outputs that cannot meet the accountability requirements of professional coordination practice. The primary barrier to deployment is therefore not model capability but the absence of shared benchmark datasets, rigorous cross-project validation, interpretable outputs, and sociotechnical integration with professional practice. Full article