Search Results (9,865)

Background/Objectives: Pancreatic cancer remains highly fatal, often diagnosed late with poor prognoses and worse psychological quality of life compared to other cancers. Globally, it is the twelfth most common cancer but the sixth leading cause of cancer-related deaths, with actual 5-year survival rates below 5%. Northern Ireland’s outcomes are among the worst, yet research on people’s experiences across the illness trajectory is scarce. Consequently, the unique needs of people with pancreatic cancer are poorly understood. It is crucial we develop deeper understanding of the entire pancreatic cancer journey to address this. This study aims to explore the lived experiences of people diagnosed with pancreatic cancer in Northern Ireland and generate a theory that explains their journeys, from pre-diagnosis through to survivorship or end of life. Methods: This study will adopt a grounded theory approach, incorporating multiple qualitative data generation methods: semi-structured interviews with patients and care partners, and focus groups with professionals. An optional photovoice (participatory photography) method will be offered to participants. Theoretical sampling principles and constant comparative analysis will guide recruitment, data collection, and analysis to ensure the explanatory theory is rooted in participants’ lived experiences. Conclusions: Establishing a holistic, in-depth understanding of people’s pancreatic cancer journeys will enable us to better comprehend, anticipate, and meet their needs. A theory grounded in empirical data about lived experiences can inform priorities for future care, support services, policy, and research, and contribute to the development of support interventions that help people to maintain the best possible quality of life, whether during a short-term, terminal illness; treatment journey; long-term symptom management; or survivorship. Full article

Pharmacist interventions (PIs) are central to optimising pharmacotherapy, preventing drug-related problems, and improving patient outcomes. In Portugal, the absence of a validated tool to consistently document and classify PIs limits data comparability and service development. Given these gaps, this study aimed to describe hospital pharmacists’ attitudes towards PI documentation and classification, following confirmatory factor analysis (CFA) of a survey instrument, and to provide a comprehensive overview of current practices and behaviours in hospital settings across Portugal. An online questionnaire, previously validated, was distributed online to all hospital pharmacists registered with the Portuguese Pharmaceutical Society (October–December 2024). Sociodemographic data and the cognitive and behavioural domains of pharmacists’ attitudinal model were analysed descriptively, and CFA tested the three-factor structure (Process, Outcome, Satisfaction) of the attitudinal affective domain. Of 1848 pharmacists, 260 responded (14%). Respondents reported performing a mean of 49 PIs/month (SD = 196), although many never recorded (28.8%), classified (56.2%), or analysed (52.3%) interventions. Only 2.7% declared to use a validated classification framework. The CFA supported the structural coherence of the Process factor but revealed some overlapping between Process and Outcome and instability in the Satisfaction factor. The nationwide scope and application of CFA provided partial support for the hypothesised model and highlighted areas for refinement, including revision of Satisfaction items and reconsideration of Process and Outcome as overlapping constructs. Findings highlight strong professional commitment to PIs but persistent barriers, including less clear procedures and satisfaction, underscoring the need for a unified, standardised national system to support consistent recording, classification, and evaluation. Full article

In today’s digital era, teachers are expected to incorporate artificial intelligence (AI) into the classroom. Teacher educators must therefore model its use while evaluating their own AI-related knowledge to guide future teachers effectively. Existing assessments often rely on self-reporting questionnaires, which may introduce bias, and the TPACK (Technological-Pedagogical-Content-Knowledge) framework, which overlooks distinctive AI characteristics. This study develops and validates an AI-TPACK assessment tool for teacher educators, grounded in authentic pedagogy and systematically designed through the ADDIE model (Analysis, Design, Development, Implementation, and Evaluation). The study aims to identify AI-relevant TPACK components and add new ones; test the tool’s validity; and analyze teacher-educator competency patterns. The development involved dual literature reviews (22 TPACK studies; 34 AI studies) and empirical analysis of 60 authentic instructional artifacts. Five experts confirmed their content validity (CVR = 0.86, CVI = 0.91) and the inter-rater reliability (ICC = 0.84, range 0.76–0.88). The tool comprises 4 components—AIK, AIPK, AICK, and Integration—14 criteria, and 65 indicators, and reveals four competency patterns: technological innovator; pedagogical integrator; content developer; and beginner. The strong correlation (r = 0.78) between AIPK and integration underscores the importance of synergy. The tool contributes theoretically and practically to advancing teacher-educators’ AI knowledge and competency assessments. Full article

Background/Objectives: Antimicrobial stewardship programs (ASPs) play a vital role in combating antimicrobial resistance (AMR). However, their implementation in Zambia remains variable despite some notable progress. This study assessed healthcare professionals’ awareness of the Multisectoral National Action Plan (NAP) on AMR, alongside their perceptions, barriers, and implementation practices related to ASPs. Methods: A cross-sectional survey conducted between August and December 2024 included 364 healthcare professionals (HCPs) in 58 randomly selected public healthcare facilities in Zambia. Data were analysed using IBM SPSS 25.0. Results: Findings revealed that while 75.3% of respondents were aware of the Zambian NAP on AMS, only 68.1% of the respondents reported that their hospitals had established AMS committees. Conversely only 41.2% of the respondents stated that their hospitals possessed hospital-specific treatment guidelines. Encouragingly, 97.5% believed ASPs could enhance clinical outcomes and reduce AMR. Key barriers included limited funding (75.9%), inadequate IT infrastructure (64.1%), limited access to essential data (64%), and healthcare workforce shortages (53.8%). Conclusions: Whilst HCPs in Zambia demonstrated high awareness of the NAP and supported ASP implementation, systemic challenges hindered their consistent execution across health facilities. Gaps in treatment guideline development, AMR data usage, and the integration of antimicrobial susceptibility recording systems into clinical activities must be addressed to strengthen ASP efforts nationwide. Full article

Background: Zambia, like many low- and middle-income countries, faces a growing burden of antimicrobial resistance (AMR), driven by the misuse of antimicrobials in both human and animal health, a limited diagnostic capacity, and weak regulatory enforcement. To address this challenge, Standard Treatment Guidelines (STGs) were developed for the veterinary sector, which represents a major milestone in the country’s AMR containment strategy. STGs are evidence-based protocols that guide veterinary professionals in consistently and appropriately diagnosing and treating animal diseases. They promote the rational use of veterinary medicines, and can mitigate AMR and improve animal health outcomes. By translating the best evidence into best practices, STGs also provide a practical foundation for antimicrobial stewardship (AMS) programs. Until 2023, Zambia lacked nationally adopted STGs for the veterinary sector. The introduction and standardization of these guidelines are expected to promote prudent antimicrobial use and raise the standard of care delivered to animal patients across the country. Objective: The aim of this paper is to provide a practical reference for future revisions of STGs and outline the successful methodology used to create STGs in the Zambian animal sector. Methods: A situational analysis was conducted to identify priority animal health conditions and existing treatment gaps within the veterinary sector. A multidisciplinary expert committee was then formed, comprising veterinarians, veterinary paraprofessionals, academics, regulatory authorities, and private sector stakeholders, to lead the development of the STGs. The process was guided by the WHO methodology for developing treatment guidelines, including a comprehensive review of the clinical evidence, local disease patterns, antimicrobial resistance data, and existing treatment practices. Draft STGs were developed with clearly defined, species-specific treatment protocols tailored to the Zambian context. For the validation process, the AGREE II instrument was used to assess the quality, clarity, and applicability of the guidelines. Structured stakeholder consultations with practitioners, policy-makers, and technical experts were held to ensure that the guidelines were practical, evidence-based, and aligned with national priorities. The validated drafts were then disseminated and piloted in selected districts. Conclusions: The development of the species-specific STGs represents an essential turning point in the country’s efforts to promote responsible veterinary care and contain AMR. STGs have become a prominent key support in the delivery of quality animal care. Further, the guidelines will assist in the optimization of antimicrobial use in animal health in Zambia. Full article

Cancer-related pain remains one of the most frequent and burdensome symptoms in oncology, significantly impairing patients’ quality of life and functional status. Despite advances in treatment and the availability of evidence-based guidelines, pain continues to be undertreated worldwide. In Italy, legislative efforts such as Law 38/2010 have not fully translated into consistent clinical practice. On 28 March 2025, a national roundtable held in Rome, Italy, brought together experts from medical oncology, radiation oncology, palliative care, anesthesiology, and pain medicine, representing the main Italian scientific societies involved in oncology and supportive care, to examine the current status of cancer pain management and develop a consensus on actionable priorities. Four key gaps were identified: insufficient education and training of healthcare providers in pain management; fragmented care pathways and limited interdisciplinary integration; lack of clarity regarding professional roles; and challenges in implementing shared diagnostic and therapeutic care pathways (Percorsi Diagnostico Terapeutici Assistenziali). The roundtable proposed coordinated strategies to address these gaps, including expanding interdisciplinary educational initiatives and integrating pain management into undergraduate and specialty curricula; establishing local oncology orientation centers to provide joint, patient-centered assessments; promoting cross-specialty collaboration through congress sessions, educational activities, and practical workshops; and developing adaptable therapeutic frameworks to ensure standardized yet context-sensitive care delivery. This congress report formalizes a joint framework aimed at embedding pain management within comprehensive cancer care. Its implementation will require sustained advocacy, structured education, and alignment of clinical practice with policy support. By addressing these barriers through pragmatic, evidence-informed actions, the proposed strategies aim to optimize timely, integrated, and effective pain care, ultimately improving outcomes for patients with cancer. Full article

Miniaturised sampling and extraction are redefining therapeutic drug monitoring (TDM) by enabling low-volume sampling, simplifying collection, and improving patient acceptability, while also promoting decentralised workflows and more sustainable laboratory practices. This review critically appraises the current landscape, with emphasis on analytical performance, matrix compatibility, and readiness for clinical implementation. It examines validation requirements, the extent of alignment and existing gaps across major regulatory guidelines, and recurrent challenges such as haematocrit bias, real-world stability and transport, incurred sample reanalysis, device variability, commutability with conventional matrices, and inter-laboratory reproducibility. To make the evidence actionable, operational recommendations are distilled into a practical ten-point checklist designed to support validation and translation of miniaturised approaches into routine laboratory practice. Looking ahead, priorities include automation and portable platforms, advanced functional materials, and integration with digital tools and biosensors, alongside the development of harmonised frameworks tailored to miniaturised methods and prospective clinical studies that demonstrate impact on dosing decisions, adherence, and clinical outcomes. Overall, this review aims to equip researchers, laboratory professionals, and regulators with the knowledge to implement miniaturised bioanalysis and advance personalised medicine through TDM. Full article

Background/Objectives: Nurses’ professional values are closely linked to job satisfaction, organizational commitment, and establishing objectives at work. During the COVID-19 pandemic, these relationships became especially crucial, yet they remain underexplored in the context of Southeast Asia. This study aimed to examine how these organizational and motivational factors influence professional values among nurses in a large public hospital in Thailand. Methods: A cross-sectional survey was conducted with 336 registered nurses who had at least six months of experience caring for COVID-19 patients. Standardized instruments were employed to measure job satisfaction, organizational commitment, establishing objectives at work, and professional values, and correlation analyses were conducted to assess associations between variables. Results: Job satisfaction correlated positively with professional values (r = 0.505, β = 0.097), while organizational commitment showed the strongest association (r = 0.620, β = 0.528). Establishing objectives at work was also positively related, though to a lesser extent (r = 0.236, β = 0.086). Conclusions: These findings underscore the importance of supportive work environments that foster motivation, recognition, and career development in sustaining nurses’ professional values, especially in times of crisis. This study also serves as a reference for the development of the nursing workforce in post-pandemic healthcare systems, with implications for international health policy and workforce planning. Full article

Education for sustainable development (ESD) plays a pivotal role in facilitating a sustainable transformation. A prerequisite for the successful implementation of ESD is the coordinated cooperation of stakeholders from different levels of the education system. The present study explores the perceptions of key stakeholders in education in Germany concerning (a) the conceptual framework of ESD, (b) the present status of ESD implementation, and (c) the ideal governance of ESD implementation. An exploratory, qualitative approach was selected as the study design. A total of eleven interviews were conducted with stakeholders representing various levels of the German education system, including representatives from ministries, state institutes, associations, and school practice. The findings indicate that the stakeholders have a shared understanding of ESD, with varying degrees of elaboration and areas of emphasis. All acknowledge the advancement in the implementation of ESD, concurrently recognizing the necessity for substantial enhancement. This study’s main contributions are a better understanding of stakeholders’ perceptions on ESD implementation and an ideal governance model that allocates specified responsibilities across all relevant system levels and actors. A combined bottom-up and top-down approach is proposed as essential in the pursuit of fostering sustainability within and through education, encompassing professionalism, profoundness, and persistence. Full article

In recent years, the concept of artificial intelligence (AI) has garnered increasing scholarly and professional interest, particularly regarding its implementation across various domains, including journalism. As with any emerging technological paradigm, AI must be examined within its contextual framework to elucidate its potential advantages, challenges, and transformative implications. This study, situated within the theoretical lens of Actor–Network Theory, employs a mixed methods approach and, specifically, an explanatory sequential design to explore the integration of AI in contemporary Greek journalism. Primary data were collected through a structured questionnaire (N = 148) administered to professional journalists in Greece, followed by semi-structured interviews with a subset of participants (N = 7). The findings indicate that journalists perceive AI as a tool capable of enhancing work efficiency, minimizing human error, and facilitating the processing of unstructured data. However, respondents also expressed concerns that AI adoption is unlikely to lead to improved financial compensation and may contribute to job displacement within the sector. Additionally, participants emphasized the necessity of regular professional development initiatives, advocating for the organization of seminars on emerging technologies on a biannual or annual basis. Full article

Sustainable community development depends not only on economic and environmental factors but also on effective local leadership. This study examines the key factors shaping leadership competencies among Ecuadorian local leaders, focusing on the influence of socioeconomic conditions, individual attributes, and access to professional development opportunities. A cross-sectional survey of 60 leaders from diverse regions was analyzed using Principal Component Analysis (PCA) and biplot visualizations to uncover latent competency structures relevant to sustainable governance. The results highlight sharp disparities between urban and rural contexts: urban leaders exhibited stronger competencies, largely supported by institutional resources and training access, while rural leaders relied more on informal governance and community legitimacy. Strategic vision, decision-making, and resilience emerged as pivotal competencies for effective local leadership. Strengthening these competencies is a prerequisite for achieving socially and institutionally sustainable governance, directly supporting the implementation of the Sustainable Development Goals (SDGs), particularly Goals 11, 16, and 17. Full article

Nuclear medicine is a highly specialized field that combines advanced technology and multidisciplinary collaboration. Despite its complexity, the role of nurses in this context remains underexplored, especially regarding their clinical and administrative activities. This is a scoping review protocol developed according to the Joanna Briggs Institute (JBI) methodology and reported in accordance with the PRISMA-ScR guidelines, as recommended by the EQUATOR Network. The research question was structured using the PCC mnemonic (Population, Concept, and Context): What are the clinical and administrative activities performed by nurses in nuclear medicine services? A comprehensive search will be conducted in Web of Science, PubMed, Embase, Cochrane, SciELO, LILACS, Scopus, and CINAHL, complemented by grey literature sources such as Google Scholar and ProQuest Dissertations & Theses Global. No restrictions on language or publication date will be applied. Study selection and data extraction will be performed independently by two reviewers. This protocol is registered on the Open Science Framework (OSF) and is publicly accessible. The selection process will be detailed in a PRISMA-ScR flow diagram. A descriptive table will summarize the characteristics of the included studies, including the authors, year, country, study type, objectives, population, main nursing activities, and key findings. The anticipated results are expected to clarify nurses’ contributions to patient safety and service quality in nuclear medicine. This review may also support the development of an assessment tool for nursing activities, guide professional training, and inform policies to strengthen nursing practice in this specialized field. Full article

Understanding luxury tourists required a more comprehensive approach than traditional expenditure-based segmentation, which often overlooked travelers’ financial capacity. This study therefore aimed to develop and validate a new typology of luxury tourists by jointly analyzing income and expenditure patterns using the International Visitor Survey of South Korea. The study addressed the need to capture both tourists’ economic capability and consumption behavior to enhance the precision of market segmentation and support sustainable destination management. Using the Jenks natural breaks classification and logistic regression, four distinct tourist types were identified: economy, spurious, scrooge, and premier, each reflecting unique combinations of income and expenditure. The results revealed that age, nationality, occupation, and trip purpose significantly influenced tourists’ classification. Younger and middle-aged professionals from East Asia were more likely to belong to high-income and high-expenditure groups, whereas Western tourists tended to spend more relative to their income. This income–expenditure typology advanced theoretical understanding of luxury tourism segmentation and provided practical insights for destination marketing organizations. The findings offered new insights for understanding how the alignment between tourists’ financial capacity and spending behavior can redefine strategies for sustainable and inclusive tourism development. Full article

This article explores how gender stereotypes and institutional practices influence the development and public image of women’s football in Romania, framing the case within debates on social sustainability (SDG 5), media representation, and sports governance. Using a mixed-methods approach, we triangulate (1) a qualitative content analysis of DigiSport online coverage (n = 57 articles; 2022–2025), (2) public testimonies collected at a national conference on gender and sport held in Timișoara in 2025 and (3) two in-depth, semi-structured interviews with one professional player whose multi-club career offers cross-organizational insights and one professional player who is still a student at the start of her career. The findings reveal systematic symbolic exclusion: in our sample, stories about women’s football make up approximately 2% of total football coverage and are mostly limited to results-only briefs, with little contextual information about athletes, resources, or structures. Historically, post-socialist policy changes have led to formal recognition but limited material support, resulting in symbolic compliance, such as UEFA/FRF mandates without corresponding investments. Current initiatives, like FRF’s Modele de Femeie campaign and UEFA-supported GOALSCORE, increase visibility but coexist with persistent gendered framings in media narratives and public discourse. The interviews support the media findings, highlighting recurring barriers—such as precarious funding, limited pathways, gendered disrespect in stadiums, and the psychological impact of marginalization—alongside stories of resilience and agency. We argue that achieving sustainable inclusion in women’s football requires more than regulatory measures; it calls for media parity, stable resources, and gender-competent leadership. Aligning policy with cultural change through equitable coverage standards, transparent funding, and accountability measures can transform football from a symbol of inequality into a space of social empowerment. Full article

This study explores a six-month professional development program implemented in four schools offering prevocational education, a group often overlooked in literacy research. Over six months, teachers participated in structured training aimed at improving their competence in teaching reading and promoting students’ reading motivation. The program responded to international concerns about declining literacy and reading motivation among adolescents in vocational tracks. Data from pre- and post-program semi-structured group interviews were thematically analyzed to identify shifts in teachers’ knowledge and beliefs. Two key findings emerged. First, most schools showed noticeable growth in teachers’ understanding of reading comprehension and its instruction and evolving beliefs. Second, teachers continued to struggle with how to promote reading motivation both before and after the program, indicating a need for more targeted support in this area. These results highlight the importance of ongoing professional development focusing on both instructional strategies and motivational practices. Full article