Search Results (337)

While electroencephalography (EEG) is effective for assessing stress and mental workload, its widespread adoption is currently hindered by the complex setup of most existing EEG systems. This article presents a new in-ear EEG system and investigates its feasibility for developing robust models to quantify stress and mental workload levels. The system consists of a single-channel EEG acquisition device that has a similar form factor as user-generic earpieces. All electrodes including passive, reference and bias electrodes were put on the ear, which optimized the device’s usability. We validated the system through two experiments with 66 subjects to collect EEG data under varying stress and mental workload conditions. We developed classification and regression models to predict stress and mental workload levels from the data. Cross-subject stress classification achieved 77% accuracy, while within-subject stress regression yielded an average R2 of 0.76 ± 0.20. Two-class mental workload level classification reached accuracies between 70% and 80% for the arithmetic and finger tapping tasks. Feature importance analysis revealed that frequency-domain EEG features, particularly in the alpha and beta bands, significantly contributed to the models’ performance. However, we observed lower within-subject feature variation and model accuracy for the mental rotation, potentially due to the distance between brain regions engaged and the device’s recording site. Our findings demonstrate the potential of using the presented EEG device to monitor stress and mental workload in real-time. Full article

Diabetes self-management education (DSME) programs are evidence-based interventions that improve glycemic control and self-care behaviors, yet their effectiveness may be limited by unaddressed health-related social needs (HRSN) (e.g., food insecurity, housing or utility instability, transportation barriers). This qualitative multiple case study examined the feasibility of integrating HRSN assessments into DSME delivery within three community-based organizations (CBOs) across urban and rural U.S. settings. Guided by the Consolidated Framework for Implementation Research, semi-structured interviews were conducted with 15 DSME facilitators and program leadership to identify contextual factors influencing implementation. Findings revealed that while DSME’s structured, manualized design promotes fidelity and client autonomy, it constrains responsiveness to the client’s HRSN. Facilitators expressed openness to integrating HRSN screening, particularly during intake, yet cited limited infrastructure, role clarity, and training as key barriers. CBOs were recognized as trusted, accessible spaces for holistic care, but growing expectations to address HRSN without adequate resources for referral created sustainability concerns. Participants recommended a parallel support model involving navigators or community health workers to manage HRSN screening and referrals alongside DSME sessions. Integrating HRSN assessment processes into DSME may enhance engagement, reduce attrition, and extend the reach of diabetes education to populations most affected by HRSN. However, successful implementation requires dedicated funding, workforce development, and cross-sector coordination. Findings underscore the importance of supporting CBOs as critical partners in bridging diabetes education and social care to advance whole-person, chronic disease management. Full article

Background/Objectives: The Adhera^® Caring Digital Program (ACDP) is a digitally delivered intervention aimed at enhancing the mental and physical well-being of family caregivers of children with chronic conditions. Tailored for the context of childhood obesity, ACDP leverages the Adhera AI Precision Digital Companion to support caregivers in promoting effective treatment adherence and healthy behaviors at home. While children in this study received GLP-1 receptor agonist treatment as part of their obesity management, the ACDP was designed to empower caregivers through educational, behavioral, and emotional support tools. The aim of this study was to determine the relationship between engagement with the ACDP as a DHI and clinical outcomes in participants receiving GLP-1 receptor agonist treatment for obesity. Methods: This study analyzed data from approximately 40 pediatric patients receiving GLP-1-based pharmacological treatment for obesity and their caregivers enrolled in the ACDP. Caregiver engagement was assessed through a composite score derived from digital activity metrics and classified as low, medium, or high. Children’s clinical parameters (BMI, weight, fat mass %, muscle mass %, and waist circumference) were collected at baseline and Day 150. Biometric, physical activity, and sleep data were also collected through a wearable device, enabling continuous and objective monitoring of participants’ physiological and behavioral patterns in real-world conditions. Statistical analyses included paired comparisons, Pearson correlations, and group comparisons by engagement level. Results: Data from 40 pediatric participants and their caregivers were analyzed over 150 days. Observed changes over the time in children showed a reduction in waist circumference (−6.0%, p = 0.0056) and a modest decrease in BMI. Higher levels of caregiver engagement with the Adhera^® Caring Digital Program correlated with reduction in body fat (ΔFat% r ≈ 0.5, p = 0.091) representing the strongest correlation observed in the study, albeit not reaching statistical significance. From baseline to Day 150, significant improvements were observed across all clinical outcomes, including reductions in BMI (−4.51 kg/m²), body weight (−11.42 kg), body fat percentage (−5.63%), and waist circumference (−8.69 cm), alongside an increase in muscle mass (+4.47%) (all p < 0.0001). Conclusions: At the mid-point of the intervention, combined GLP-1 pharmacotherapy and the Adhera^® Caring Digital Program led to meaningful improvements in BMI, adiposity, and central obesity. While caregiver engagement was not significantly associated with short-term outcomes, observed trends suggest that digital support may provide complementary benefits to pharmacological treatment, warranting further evaluation at Day 300. Full article

This study examines how real photographs and AI-generated photographs shape sustainable engagement and travel intention in tropical island tourism. We used a one-factor between subjects survey experiment with two independent conditions, real images and AI images, with 357 participants in each group. Guided by the SOR framework, we measured perceived authenticity, cognitive destination image, emotional comfort, and perceived information diagnosticity, together with sustainable engagement and travel intention. Structural equation modeling shows that under both visual conditions the four perceptual factors are positively associated with travel intention. In the real photo condition, sustainable engagement partially mediates the effects of all four factors on travel intention. In the AI photo condition, sustainable engagement mediates the effects of cognitive destination image, emotional comfort, and perceived information diagnosticity on travel intention, while the indirect pathway from perceived authenticity to travel intention through sustainable engagement is not significant. These findings support an actionable dual-track visual strategy. Use AI images to expand reach at low ecological cost, then use real images with verifiable cues to strengthen credibility and encourage responsible choices. Full article

Enhancing sexual literacy through sex education from an early age is vital for preventing unintended pregnancies and sexually transmitted infections. The “Beginning of Life” section of sex education presents a crucial opportunity to educate students on fertilization and fetal development. This study aimed to determine the feasibility and usability of the Beans Education Project Card (BEPC), a novel teaching tool for this section, in a real-world educational setting. Five midwives with sex education experience were provided with the BEPC for use with elementary, middle, and high school students over an approximate 3-month period (October 2024 to January 2025). Subsequently, group interviews were conducted with the midwives to gather feedback on the design, feasibility, and usability of the tool. The interview transcripts were analyzed using qualitative analysis, with large language model-assisted thematic exploration employed as a supplementary method to identify key themes. The analysis showed that the BEPC was highly regarded for its visual appeal, ease of use, and potential to engage families. The hierarchical design and visual representations, such as the use of small holes and beans to represent different stages of fetal development, were particularly effective in facilitating student understanding. The findings suggest that the BEPC has the potential to be a visually engaging tool for interactively teaching the process of fertilization and fetal development in the “Beginning of Life” part of sex education. Future research should focus on collaborations with parents and the development of strategies for reaching out to absent or home-schooled students. Full article

This paper presents Greenopoli, an innovative framework for sustainability and waste management education that has engaged over 600 schools and 90,000 students since 2014. Greenopoli is founded on the idea that children and youth can grasp environmental issues as well as adults and act as agents of change within their families and communities. The Greenopoli approach combines scientific accuracy with playful, creative pedagogy to simplify complex topics and stimulate peer-to-peer learning. It includes storytelling, games, field visits, and “green raps” (original environmental songs co-created with students). The framework is adaptive, with content and activities tailored to education stages from kindergarten through university. Educators adopt the role of moderators or facilitators, encouraging students to discuss and discover concepts collaboratively. Greenopoli’s participatory method has been implemented across all age groups, yielding enthusiastic engagement and tangible outcomes in waste sorting and recycling behaviors. The program’s reach has extended beyond schools through collaborations with national recycling consortia, NGOs, municipalities, and media (TV programs, social media, TEDx talks). Numerous awards and recognitions (2017–2025) have highlighted its impact. A comparative analysis shows that Greenopoli’s use of peer-led learning, gamification, and creative communication aligns with global best practices while offering a unique blend of tools. Greenopoli is a novel best-practice model in environmental education, bridging theory and practice and contributing to the goals of Education for Sustainable Development and a circular economy. It demonstrates the effectiveness of engaging youth as change-makers through interactive and creative learning, and it can inspire similar initiatives globally. Full article

This exploratory study examines how discursive design—using provocative, speculative artifacts to spark reflection and discussion—might expand public health experts’ problematization of approaches to tailoring and targeting interventions. Cultural tailoring and targeting (CTT) refers to adapting interventions for specific sociocultural populations. Because LGBTQ+ communities experience disproportionately high rates of tobacco use, this study applies discursive intervention concepts within this context to explore how they might help experts critically engage with CTT strategies for reaching LGBTQ+ populations more effectively. To investigate this, two pairs of discursive intervention concepts were designed and presented to three focus groups of public health experts. Each pair juxtaposed a conventional intervention approach with a more provocative, unfamiliar one—for example, deepfake-driven behavior disruption. The goal was to document the type of conversation discursive design could stimulate around CTT considerations and generate insights relevant to the value of design methodologies to foster new ways to problematize public health matters. Findings indicate that the concepts prompted critical conversations about CTT, although the depth and focus of engagement varied. Those with greater expertise in LGBTQ+ issues engaged more with CTT mechanisms and implications, while others focused on implementation and feasibility concerns—essential to intervention development but outside the study’s focus. These patterns highlight who should be included in such efforts and how they should be engaged from a facilitation perspective, raising important considerations for methodological refinements and future research. Overall, this initial exploration aims to uncover the potential of discursive design to deepen understanding of CTT interventions and inform more responsive, innovative approaches to addressing tobacco use among priority populations. Full article

Objective: This study aimed to investigate the effects of dual-task stroboscopic visual training (DTSVT) on balance, functional mobility, and gait in children who are hard-of-hearing. Methods: This randomized controlled study included 31 children (17 girls, 14 boys) with congenital sensorineural hearing loss. Participants were assigned to one of three groups: control group, conventional balance training (CBT) group, and DTSVT group. The CBT and DTSVT groups participated in an exercise program for 16 weeks, twice weekly, for 40 min (a total of 24 sessions). Static balance was assessed using the Tandem Romberg test and Single-Leg Stance (SLS) test, while dynamic balance was evaluated using the Functional Reach Test (FRT), balance disc test, and the Four Square Step Test (FSST). The Pediatric Balance Scale (PBS) was used as a subjective balance assessment. Functional mobility was assessed using the Timed Up and Go (TUG) Test, Step Test, 10 m Walk Test (10 MWT), and Functional Gait Assessment (FGA). Postural sway parameters were recorded using the GyKo device, including Sway Area (EA, cm²), Distance Length (DL, cm), Length (anterior–posterior (AP)) (cm), Length (medial–lateral (ML)) (cm), Mean Distance (D) (cm), Mean Distance (AP) (cm), and Mean Distance (ML) (cm). Results: Significant between-group differences were primarily observed in favor of the DTSVT group post-treatment, particularly in PBS scores, GyKoDL values during the eyes-open SLS test, and TUG test completion times (p < 0.05). Some baseline differences were noted among groups in functional reach distance, FSST completion time, and eyes-closed duration on the Balance Disc test (p < 0.05). Within-group comparisons revealed significant improvements in FSST times in both intervention groups, reduced postural sway parameters during the FRT in the DTSVT and control groups, and increased eyes-closed Tandem Romberg duration in the CBT group (p < 0.05). Most other outcome measures did not demonstrate statistically significant changes either within or between groups (p > 0.05). Conclusions: Dual-task stroboscopic visual training was more effective than conventional balance training in improving specific aspects of balance and functional mobility in children who are hard-of-hearing. These findings highlight the potential of adding cognitively demanding and visually engaging balance tasks to rehabilitation programs for this population. Larger and more diverse samples in future studies are needed to enhance the generalizability of these results. Studies that assess balance and gait using standardized clinical or laboratory tests may be particularly valuable. Given the small sample size and multiple comparisons, the results should be considered preliminary and exploratory. Full article

With the widespread application of artificial intelligence (AI) technology in the sports industry, the spectator’s experience is increasingly shaped by AI-driven features. To explore the mechanism through which the perceived AI-enabled spectating experience affects viewing behavior, and to validate the mediating role of viewing motivation (SDT Needs Satisfaction) in the relationship between AI and viewing behavior as well as the moderating role of player identification in this mediating pathway, we adopted literature review, survey, and empirical analysis methods. A sample of 272 Chinese tennis enthusiasts was surveyed, and both the measurement model and the structural model were evaluated. The results indicate that the measurement model has good internal consistency, reliability, convergent validity, and discriminant validity. The perceived AI-enabled spectating experience has a significant positive effect on viewing motivation, viewing intention, and recommendation intention. The data show that the indirect effect of the perceived AI-enabled spectating experience on the viewing intention through the viewing motivation is 0.0479, and the indirect effect of the perceived AI-enabled spectating experience on the recommendation intention through the viewing motivation is 0.0548. Both reached a significant level, and the direct effect of the perceived AI-enabled spectating experience has also reached statistical significance. Therefore, viewing motivation plays a partial mediating role between AI and viewing intention and between AI and recommendation intention. Player identification plays a significant positive moderating role (β = 0.2809 on viewing intention, β = 0.1621 on recommendation intention) in the relationship between viewing motivation and viewing behavior; however, it does not moderate the relationship between AI and viewing motivation. In other words, for spectators with higher player identification, viewing motivation drives more strongly both their viewing intention and recommendation intention. We suggest that sports event organizers and media use AI technologies to design differentiated marketing to enhance user engagement and optimize spectators’ experience. For spectators with lower player identification, improving service quality can enhance their satisfaction; for those with higher player identification, efforts should focus on strengthening their connection with the players. Full article

Background: Humanitarian surgical missions play a critical role in addressing health disparities, particularly in low-resource settings where conditions such as cleft lip and palate (CL/P) are prevalent. The success of these missions relies heavily on the commitment of volunteers, including healthcare professionals and logistical personnel. While their contributions are widely acknowledged, the psychological and emotional impact of participating in such missions remains underexplored. Objective: This study protocol aims to explore the lived experience of volunteers involved in humanitarian surgical missions. Materials and Methods: A qualitative study, using Interpretative Phenomenological Analysis (IPA), will be conducted. Semi-structured interviews will be carried out with volunteers who have participated in at least one humanitarian surgical mission. Interviews will be audio-recorded, transcribed verbatim, and analyzed to identify emerging themes. Data collection will continue until saturation is reached. The reporting of this study will follow the COREQ guidelines. Expected Results: This study is expected to provide a deeper understanding of the emotional and professional experiences of volunteers in surgical missions. Expected results include identifying key themes related to motivation and preparation, on-site engagement, field experience, interpersonal relationships and group dynamics, and personal reflections. These results will inform strategies to enhance the effectiveness of missions, improve volunteer support, and ensure the sustainability of humanitarian interventions. Additionally, these findings will contribute to the broader field of international health volunteering and support future program development. Conclusions: This protocol outlines a rigorous qualitative approach to investigating the lived experience of volunteers in humanitarian surgical missions. The anticipated findings are expected to inform targeted training, psychological support, and organizational strategies, ultimately improving the effectiveness and sustainability of future missions and the well-being of volunteers. Full article

This study examines hydrogen-based and alternative strategies for decarbonising residential heating in the North of Tyne (NoT) region, UK, focusing on energy efficiency and conservation. A multi-system-perspective framework integrating scenario analysis and quantitative energy-system modelling is applied to assess socio-technical interventions, technology pathways (heat pumps and hydrogen boilers), and hydrogen-blending levels up to 2050. Monte Carlo simulations and a game-theoretic investment model are used to evaluate energy demand, CO₂ emissions, and system costs. The results show that socio-technical interventions substantially reduce energy demand but are insufficient alone to reach net zero. Hydrogen blending provides modest emission reductions, while full electrification via heat pumps is most cost-effective in the long term, particularly with carbon capture and storage (CCS). A hybrid 50/50 heat pump–hydrogen-boiler pathway with CCS post-2040 presents a practical transition option. The findings highlight the importance of coordinated infrastructure planning and societal engagement for achieving deep heating decarbonisation. Full article

Foster carers are a hard-to-reach population who carry a vast bureaucratic and emotional load. They need tailored and specialised training, support, and advice regarding the digital lives of the children and young people (CYP) they care for. Looked-after CYP are vulnerable in multiple ways and are particularly at risk in the digital age. Their susceptibility to online risks raises complex challenges. The training programme Fostering in a Digital Age was designed to support foster carers’ understanding of and responses to the digital lives of looked-after CYP, including both positive and negative aspects. It is research-informed and provides relevant knowledge, resources, tools, and skills. This exploratory study sought the opinions of foster carers and social workers regarding the strengths and limitations of the programme and recommendations for improving it. Semi-structured interviews were conducted with ten foster carers who had completed the programme and ten social workers who accessed the programme for evaluation purposes. Participants’ experiences and reflections were analysed using thematic analysis. Resulting themes highlighted the relevance of the training programme, with participants recognising the importance of digital lives for looked-after CYP and the need for tailored guidance. The programme was viewed as flexible, accessible, and user-friendly, with comprehensive coverage of key concepts and reflective activities that enhanced carers’ understanding and confidence. Its child-centred and sustainable design enabled carers to apply learning “as and when” needed and to collaborate with CYP to promote safer digital engagement. However, some participants found the volume of resources overwhelming and reported navigation challenges or digital anxiety. Social workers emphasised professional and structural improvements, while carers focused on the programme’s relational benefits and practical relevance. Both groups recommended wider promotion through local authorities and fostering agencies and adaptations to make the programme suitable for social workers and carers with differing digital skills. Overall, fostering in a digital age effectively provided foster carers with tailored knowledge to support CYP online, prevent harm, and respond to adverse digital experiences, aligning with Self-Determination Theory by supporting carers’ autonomy, competence, and relatedness. This evaluation also revealed gaps in online safety knowledge among both foster carers and social workers, highlighting opportunities for the development of future training programmes. Full article

This study examines and evaluates key performance indicators (KPIs) that impact user engagement on social media platforms, with a primary focus on fashion retail within seasonal tourism contexts. The primary objective is to determine which engagement metrics most accurately predict user interaction levels and to enhance strategic decision-making in digital marketing. Using a dataset of 2500 Facebook photos and videos from a women’s retail store, collected between 2016 and 2024, the study employs descriptive analysis and predictive modeling. Three KPIs—such as 3 s video views, reach from organic posts, and other clicks—are examined for their impact on user engagement. The posts are categorized into engagement levels, and classification models, including Random Forests (RF), Extreme Gradient Boosting (XGBoost), K-Nearest Neighbors (KNN), and Naïve Bayes (NB), are evaluated. Results show that short video views and post reach are key predictors of user engagement. With XGBoost achieving a classification accuracy of 94.73%, the models perform effectively, and Cronbach’s alpha analysis confirms the consistency among the variables selected. The findings underscore the significance of KPI analysis in social media strategy and illustrate the value of data mining techniques in uncovering user behavior patterns that offer practical insights for optimizing digital marketing efforts. Full article

Background/Objectives: Anxiety and depression are prevalent global health concerns, especially prominent in vulnerable groups such as older adults, individuals with chronic health conditions (e.g., neurodegeneration and cancer), and those from low socioeconomic backgrounds. Digital interventions, including computerized cognitive training (CCT), show promise in addressing emotional dysfunctions in a more accessible and cost-effective manner. The CREATE platform aims to enhance Emotion Regulation (ER) through targeted Working Memory (WM) training, aesthetic engagement, and creativity, while accounting for dopamine activity via spontaneous Eye Blink Rate (sEBR). The purpose of the present study is to evaluate the platform’s feasibility and validity through a single pilot trial. Methods: The study enrolled twenty-seven healthy adults (aged 21–44) who completed standardized self-report questionnaires on sleep quality and ER. They were also enrolled in sEBR recordings and performed a CCT-adapted Corsi block-tapping task and an aesthetic art evaluation. Affective textual narratives and valence/arousal ratings were also collected. Participants were divided into “Good Sleepers” and “Poor Sleepers”. The platform evaluation enrolled a multi-modal pipeline including correlations and regression analysis of intervention metrics, sentiment analysis, and group comparisons. Results: WM task performance correlated positively with global ER and Cognitive Reappraisal scores. Post-training sEBR was significantly associated with ER, and lower sleep efficiency negatively impacted changes in dopamine activity (sEBR Diff). Dopamine activity of “Good Sleepers”, as indicated by sEBR, reached the high levels of the “Poor Sleepers” group after the training, suggesting a dopamine boost caused by the CREATE platform for those with quality sleep. Creativity and emotional expression, as indicated by sentiment analysis, were related to sleep quality. Conclusions: The CREATE platform shows promise in enhancing ER through multi-modal digital engagement, integrating cognitive training, art, and creativity. The findings support the inclusion of sleep and dopamine markers in intervention evaluation. Further studies with larger samples and clinical cohorts are warranted to establish efficacy and generalizability, as the present one was not powered to test the effectiveness of our training platform but was designed to assess its feasibility and validity instead. Full article

To quantify the communication effectiveness of automotive online videos, this study constructs a multimodal deep learning framework. Existing research often overlooks the intrinsic and interactive impact of textual and dynamic visual content. To bridge this gap, our framework conducts an integrated analysis of both the textual (titles) and visual (frames) dimensions of videos. For visual analysis, we introduce FER-MA-YOLO, a novel facial expression recognition model tailored to the demands of computational communication research. Enhanced with a Dense Growth Feature Fusion (DGF) module and a multiscale Dilated Attention Module (MDAM), it enables accurate quantification of on-screen emotional dynamics, which is essential for testing our hypotheses on user engagement. For textual analysis, we employ a BERT model to quantify the sentiment intensity of video titles. Applying this framework to 968 videos from the Bilibili platform, our regression analysis—which modeled four distinct engagement dimensions (reach, support, discussion, and interaction) separately, in addition to a composite effectiveness score—reveals several key insights: emotionally charged titles significantly boost user interaction; visually, the on-screen proportion of human elements positively predicts engagement, while excessively high visual information entropy weakens it. Furthermore, neutral expressions boost view counts, and happy expressions drive interaction. This study offers a multimodal computational framework that integrates textual and visual analysis and provides empirical, data-driven insights for optimizing automotive video content strategies, contributing to the growing application of computational methods in communication research. Full article