Search Results (1,821)

Background/Objectives: The aging global population has led to a rising prevalence of type 2 diabetes mellitus (T2DM), in which biomedical outcomes alone fail to capture patients’ lived experiences. Patient-Reported Outcome Measures (PROMs) can provide insights into psychological, psychosocial, and quality-of-life (QoL) dimensions, yet their use—particularly among older adults—remains inconsistent. This AI-assisted rapid review aimed to map how PROMs are currently applied in adults with T2DM, with specific attention to studies involving older populations, focusing on their role in assessing well-being, distress, depression, and treatment satisfaction, as well as their implementation in clinical and organizational practice. Methods: A rapid review was conducted using Elicit, an AI tool designed to support systematic evidence synthesis. Studies published between 2015 and 2025 were identified from Semantic Scholar, complemented by manual searches for recent or unindexed papers. Eligibility criteria required inclusion of adults with T2DM and use of validated PROMs in real-world settings. Studies explicitly describing older or elderly subgroups were highlighted separately. After screening 504 records, 167 studies were included. Data extraction covered study design, instruments used, populations, outcomes, and implementation details. Results: The most frequently assessed outcomes were diabetes distress, depression, QoL, treatment satisfaction, and self-efficacy. Common instruments included PAID, DDS, PHQ-9, WHO-5, EQ-5D, SF-36, DTSQ, and GDS. Evidence showed PROMs effectively identified high-risk patients and informed tailored interventions, but integration into routine care remained limited. Barriers included workflow disruption, lack of provider training, heterogeneity of tools, and insufficient cultural validation. Facilitators included brief instruments, digital administration, and linkage with care planning. Conclusions: PROMs are valuable in capturing psychosocial and psychological burdens in adults with T2DM, including but not limited to older populations, but routine implementation is inconsistent. Broader adoption will require digital infrastructure, clinician training, and organizational integration, as well as the development of PROMs that capture experiences with emerging diabetes technologies. Methodologically, this study illustrates the feasibility of AI-assisted rapid reviews to generate timely, evidence-informed syntheses. Full article

This paper investigates how higher education institutions (HEIs) in tourism, hospitality, and events in the United Kingdom (UK) are embedding decarbonisation and sustainability competencies within their curricula. Drawing on a 28-item survey distributed to 67 universities, this study explores the relationship between explicit decarbonisation learning outcomes, Sustainable Development Goal (SDG) alignment, and the breadth of decarbonisation practices taught. Twenty-one institutions responded (31%). Results show that only 19% of programmes explicitly reference decarbonisation in their learning outcomes, yet these programmes deliver substantially broader practice coverage. While SDG-aligned programmes were more liable to include such outcomes, this association was not statistically significant. Findings here highlight the gap between representative SDG alignment and operational curriculum reform. This study recommends embedding assessment-focused decarbonisation outcomes and strengthening training supported by targeted continuing professional development. Limitations include the small, self-reported sample and cross-sectional design. Future research could adopt longitudinal and comparative approaches to help examine how specific curriculum commitments translate into applied competencies over time. Full article

Novice therapists often experience a complex interplay of self-doubt, emotional strain, and professional uncertainty as they transition from training to independent clinical practice. This study explored the lived experiences of novice cognitive behavioral therapy (CBT) therapists, focusing on the challenges of early practice and the strategies employed to support regulation and growth. Seven early-career CBT therapists participated in semi-structured interviews, and data were analyzed using Interpretative Phenomenological Analysis (IPA). Two overarching themes were identified: professional identity challenges and self-beliefs, and strategies for emotional regulation and continuous development. Participants reported difficulties managing anxiety, boundary-setting, and integrating their professional and personal selves, particularly when working with complex presentations such as grief, self-harm, and personality disorders. At the same time, supervision, personal therapy, peer and family support, and ongoing professional development were seen as crucial in building resilience and sustaining competence. The findings suggest that training and professional structures should place greater emphasis on reflective practice, boundary management, and preparation for emotionally charged cases, while framing supervision as both a clinical and emotional resource. By highlighting the perspectives of novice therapists, the study underscores the importance of supportive systems in fostering resilience and sustainable professional growth. Full article

Background: The COVID-19 pandemic uniquely challenged non-formal education (NFE), a sector reliant on interpersonal engagement, by forcing a rapid shift to remote work. This study examines how managerial leadership styles, technological self-efficacy (TSE), and attitudes toward remote work intersect among NFE coordinators in Israel’s Arab society, a minority community facing distinct cultural and systemic challenges. Aim: Focusing on school-based social-community education coordinators (SCECs) and community-based non-formal education coordinators (NFECs), the study investigates how leadership and organizational context shaped their adaptation to crisis. Method: The study employed a cross-sectional survey design, with data collected from 132 coordinators and 47 youth department directors between June and October 2021 using validated questionnaires. Pearson correlations, moderated mediation analysis, and ANOVA were used to analyze the data. Findings: The results revealed positive correlations between transformational leadership style (TLS), TSE, job satisfaction, and positive attitudes toward remote work. Critically, the analysis uncovered a context-dependent mechanism: TSE fully mediated the relationship between TLS and attitudes toward remote work, but this effect was significant only for community-based NFECs, not for school-based SCECs. Additionally, SCECs reported higher satisfaction and TSE than NFECs, who perceived more laissez-faire leadership. Contributions: Drawing on Bronfenbrenner’s ecological systems theory, the findings underscore that leadership’s effectiveness in crises is not one-size-fits-all; its impact is channeled through different mechanisms depending on the organizational ecosystem. The study highlights the pivotal roles of adaptive leadership and TSE in sustaining resilient NFE in minority communities. Theoretical and practical implications point to the need for culturally responsive, context-sensitive leadership development and targeted technology training to foster equitable learning environments. 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

Remote, self-managed neuroempowerment protocols are emerging as promising tools for promoting psychophysical well-being in healthy individuals through scalable, home-based interventions. Rooted in positive psychology, applied psychophysiology, and embodied awareness practices, these protocols increasingly leverage wearable technologies and digital platforms to support self-regulated training in cognitive, emotional, and physical domains. This scoping review explores the current literature on such interventions, guided by a triadic model of subjective well-being encompassing neurocognitive efficiency, psychological balance, and physical fitness. A systematic search across major scientific databases identified 28 studies meeting inclusion criteria, with a focus on home-based interventions targeting healthy adult populations using embodied awareness practices, applied psychophysiology techniques, and empowerment-based strategies. Findings indicate that these interventions yield improvements in attention regulation, stress reduction, and subjective well-being, particularly when combining digital feedback systems with embodied practices. However, significant methodological limitations persist, including the overreliance on self-report measures, lack of longitudinal follow-up, and insufficient integration of objective, multimodal assessment tools. Moreover, few studies explicitly address the role of participant engagement and agency—key elements in neuroempowerment frameworks that conceptualize the individual not as a passive recipient of treatment, but as an active agent in the training process. This review highlights the need for more rigorous and theoretically grounded research, advocating for integrative, adaptive intervention models supported by wearable neurotechnologies. Such approaches hold the potential to enhance motivation, personalize feedback, and promote sustainable well-being in ecologically valid, participant-centred ways. Full article

Background: Physiotherapy plays a crucial role in managing women’s health conditions, such as pelvic pain and postpartum recovery. However, its integration into standard care relies heavily on the awareness and referral practices of gynecologists and obstetricians, which may be suboptimal. Objective: To investigate the awareness, attitudes, and referral practices of gynecologists and obstetricians in Libya regarding the role of physiotherapy in women’s health. Methods: A cross-sectional study was conducted in public and private hospitals in Tripoli, Libya. A total of 100 practitioners were invited to participate. A self-administered questionnaire assessed demographics, awareness, attitudes, and practices. Results: The response rate was 67% (n = 67/100). The results revealed a key disparity: while the vast majority of respondents (94.1%) acknowledged the importance of physiotherapy in women’s health and 76.1% reported a willingness to refer patients, only 67.1% perceived physiotherapists as competent to manage these conditions. This indicates a significant gap in understanding specific physiotherapy techniques. Awareness percentage was significantly influenced by factors such as the type of hospital and prior exposure to physiotherapy education. Conclusions: A striking disparity was found between high general awareness (94.1%) and significantly lower perceived competence (67.1%) and knowledge of its role in specific conditions. This gap between general approval and specific understanding directly creates the critical barrier to referral. To improve interdisciplinary collaboration and patient access to care, enhanced educational initiatives for physicians, the development of clear clinical guidelines, and the establishment of dedicated women’s health physiotherapy clinics are strongly recommended. Full article

Background/Objectives: Older patients with cancer are predisposed to malnutrition, contributing to adverse postoperative outcomes, high complication rates, and poor prognosis, warranting dietary support from nurses. Practices and factors related to such support remain unexplored. We examined factors associated with discharge-oriented dietary support for older patients with cancer. Methods: This cross-sectional study involved registered nurses working in wards and was conducted using a self-report questionnaire between September 2024 and February 2025 at two regional core cancer Japanese hospitals. The survey included the Ward Nurses’ Discharge-Oriented Dietary Support Scale for Older Adult Patients (NDODSS), items assessing nurses’ perceived difficulty with cancer care, patient assessment, interprofessional collaboration, and their interest in, perceived importance of, and difficulty with dietary support. Data were analyzed using t-test, Pearson correlation, and multiple regression analysis. Results: Overall, 134 nurses, with an average of 6.8 years of cancer nursing experience, were included. The total mean scores for NDODSS, assessment of healthy eating behavior, adjustment of the living environment, and continual frailty assessment were 68.6 (11.8), 28.4 (4.9), 18.2 (4.7), and 22.0 (4.2), respectively. Multiple regression analysis showed that NDODSS was significantly associated with difficulty providing dietary support (β = −0.127, p = 0.043), physical assessment of cancer patients (β = 0.282, p < 0.001), social assessment (β = 0.207, p = 0.003), and consultation with other professionals (β = 0.205, p = 0.010). Conclusions: Dietary support for older patients with cancer requires a multidisciplinary approach, including cancer symptom assessment, social factor evaluation and sharing dietary support-related challenges. Full article

Major depressive disorder (MDD) affects approximately $4.4\%$ of the global population. Its prevalence is increasing among adolescents and has led to the psychosocial condition known as hikikomori. MDD is typically assessed by self-report questionnaires, which, although informative, are subject to evaluator bias and subjectivity. To address these limitations, recent studies have explored machine learning (ML) for automated MDD detection. Among the input data used, speech signals stand out due to their low cost and minimal intrusiveness. However, many speech-based approaches lack integration with cognitive behavioral therapy (CBT) and adherence to evidence-based, patient-centered care—often aiming to replace rather than support clinical monitoring. In this context, we propose ML models to assess MDD in hikikomori patients using speech data from a real-world clinical trial. The trial is conducted in Italy, supervised by physicians, and comprises an eight-session CBT plan that is clinical evidence-based and follows patient-centered practices. Patients’ speech is recorded during therapy, and the Mel-Frequency Cepstral Coefficients (MFCCs) and wav2vec 2.0 embedding are extracted to train the models. The results show that the Multi-Layer Perceptron (MLP) predicted depression outcomes with a Root Mean Squared Error (RMSE) of $0.064$ using only MFCCs from the first session, suggesting that early-session speech may be valuable for outcome prediction. When considering the entire CBT treatment (i.e., all sessions), the MLP achieved an RMSE of $0.063$ using MFCCs and a lower RMSE of $0.057$ with wav2vec 2.0, indicating approximately a $9.5\%$ performance improvement. To aid the interpretability of the treatment outcomes, a binary task was conducted, where Logistic Regression (LR) achieved $70\%$ recall in predicting depression improvement among young adults using wav2vec 2.0. These findings position speech as a valuable predictive tool in clinical informatics, potentially supporting clinicians in anticipating treatment response. Full article

The present study aimed to examine the role of character virtues in the quality of romantic relationships and friendships during emerging adulthood. The sample included 505 individuals, comprising 269 single and 236 partnered emerging adults. Participants completed three self-report instruments: the Values in Action-114GR (VIA-114GR), Sternberg’s Triangular Love Scale (STLS), and the Friendship Network Satisfaction scale (FNS). Latent Profile Analysis (LPA) applying ipsatization identified three distinct virtue profiles, which were not significantly associated with participants’ relationship status. Concerning friendships, analyses of variance revealed that emerging adults characterized by a balanced virtue profile reported significantly greater perceived closeness than those classified within profiles defined by lower levels of restraint and transcendence virtues. However, no significant differences were observed in the frequency of socializing. Regarding romantic relationships, it was found that different virtue profiles support different love dynamics. Specifically, the results showed that profiles differing in endorsing the knowledge virtue were overrepresented in love profiles characterized by low passion or low commitment. These findings offer significant theoretical contributions and practical implications for strengths-based interventions designed to enhance emerging adults’ social and emotional well-being. Full article

Industrial Robots (IRs) are typically employed as flexible machines to perform many types of repetitive and intensive tasks within fenced safe areas, ensuring high productivity and cost efficiency. However, their rigid programming approaches often pose challenges during cell commissioning and reset, hindering the implementation of self-reconfigurable systems. In addition, several production lines still need the presence of skilled operators to conduct assisted assembly operations and inspections. This motivates the growing interest in the development of innovative solutions for supporting safe and efficient human–robot collaborative applications. The manual guidance of the IR end-effector is a representative functionality of such collaboration, as it simplifies heavy-part manipulation and allows intuitive robot teaching and programming. The present study reports a sensor-based approach for enabling manual guidance operations with high-payload IRs and discusses its practical implementation on a production cell with an extended workspace. The setup features a KUKA robot mounted on a custom linear track actuated via Beckhoff technology to enable flexible assembly and machining operations. The developed logic and its software configuration, split into multiple control units to allow the manual guiding of both the 6-axis IR and the linear track unit, are described in detail. Finally, an experimental demonstration involving two users with different levels of expertise was conducted to evaluate the approach during target teaching on a physical cell. The results showed that the proposed manual guidance method significantly reduced task completion time by more than 55% compared with the conventional teach pendant, demonstrating the effectiveness and practical advantages of the developed framework. Full article

This study examines the role of psychological factors on Greek K-12 teachers’ perceptions of the European Union (EU) and their readiness to integrate EU-related content into class-room practice. Grounded in self-determination theory and burnout literature, it focuses on the role of personality traits, psychological needs, self-efficacy, and mental health. A sample of 171 teachers (M_age = 47.67, SD = 8.61) completed validated instruments assessing EU perceptions, Big Five traits, psychological need satisfaction and frustration, well-being, self-efficacy, and symptoms of depression, anxiety, stress, and burnout. Confirmatory factor analysis supported the factorial validity of the instruments, along with proper indices for assessing their internal consistency. Cluster analysis identified three distinct teacher profiles: Skeptically Exhausted, Realistically Cautious, and Optimistically Engaged. These groups differed significantly in burnout, self-efficacy, and openness to EU programs. Teachers with high well-being and self-efficacy demonstrated stronger readiness to adopt EU-related pedagogy, while those experiencing elevated burnout reported low institutional trust and limited involvement. These findings highlight the psychological heterogeneity of the teaching workforce and suggest that differentiated, context-sensitive policy interventions are essential for fostering inclusive readiness for European initiatives. Enhancing teacher well-being and strengthening professional development pathways may serve as strategic entry points for promoting meaningful and sustainable EU integration in school curricula. Full article

Background: Electroencephalography (EEG) is a non-invasive technique that records millisecond-scale cortical electrical activity using scalp electrodes. In EEG-based neurofeedback (NFB), these signals are processed to provide real-time feedback that supports self-regulation of targeted brain rhythms; evidence suggests improvements in cognitive and neurophysiological performance in athletes and non-athletes. However, methodological inconsistencies—such as limited blinding, poor sham control, and outdated approaches to EEG spectral analysis—restrict reproducibility and hinder cumulative progress in the field. Methods: This scoping review aimed to identify and analyze the methodological characteristics, outcome measures, and reproducibility gaps in EEG-based NFB studies involving athletes and non-athletes. Following PRISMA-ScR guidelines, we systematically searched academic databases (PubMed, Embase, Scopus, Web of Science, PsycINFO, and Cochrane Library), as well as gray literature sources (ProQuest Dissertations, LILACS, Tripdatabase, and Google Scholar). Of 48 included studies, 44 were published in international peer-reviewed journals and 4 in regional journals. Data were extracted on study design, participant population, NFB protocols, targeted EEG rhythms, cognitive and neurophysiological outcomes, and methodological rigor. Results: The review revealed substantial heterogeneity in targeted rhythms, protocols, and reporting standards. None of the studies employed modern spectral parameterization methods (e.g., FOOOF), while only 29% used active sham protocols and 6% employed inert sham conditions. Reporting blinding procedures and follow-up assessments was limited or absent in most studies. Discussion: This review highlights critical methodological shortcomings that may bias interpretations of NFB effects in sport and cognitive domains. To strengthen future research, studies should rigorously implement sham and blinding procedures, ensure transparent reporting of EEG metrics, and adopt open-science practices, including modern approaches to spectral parameterization. Full article

Objective: To explore medical students’ perceptions towards the integration of basic science into virtual patient (VP) cases and to evaluate the impact on self-perceived clinical reasoning (CR) ability. Methods: We conducted a qualitative and explorative study involving 14 medical students during their clinical placement within rheumatology. Basic science elements were integrated into five VP scenarios using the virtual interactive case simulator. Students’ perceptions were explored through the analysis of semi-structured interviews with seven students, followed by Malterud’s systematic text condensation. Results: The analysis yielded five themes: (i) appreciation of basic science knowledge, (ii) ambiguity towards basic science as an obstacle for integration, (iii) the effect of integration on self-perceived clinical reasoning, (iv) engaging design of the basic science integration, and (v) low knowledge of clinical reasoning concepts. Despite positive perceptions, students demonstrated low motivation for independent engagement in practice. The students who completed the intervention reported enhanced self-perceived CR abilities, as evidenced by more comprehensive thinking processes. Conclusions: Basic science integration into VP cases was positively perceived and appeared to enhance self-perceived CR abilities. However, students’ reluctance to independently engage posed implementation challenges. Early introduction of CR learning objectives and CR as a conceptual framework may improve motivation and provide coherence for the integration of basic science in the clinical components of medical education. Full article

Owner-led self-medication for companion animals is a growing global practice; however, empirical data from Japan remain limited. Framing medication safety within a One Health perspective, this study aimed to characterize Japanese pet owners’ use of over-the-counter (OTC) drugs and identify possibilities for pharmacists to support rational self-medication. A cross-sectional 13-item online survey was administered to 500 owners in Japan between 30 May and 2 June 2025. Data on owner demographics, willingness to consult pharmacists, veterinary visit behavior, and OTC purchasing practices were summarized. Many owners were receptive to pharmacy support; 65% wished to consult a pharmacist, and 6.8% had already done so. Overall, 15.2% reported using OTCs drugs, primarily for treatment or prevention and prioritized perceived effectiveness and safety when selecting products. Some owners managed mild pet illnesses at home, citing perceived mildness and cost as reasons for not visiting a veterinary clinic. There is an unmet demand for accessible expert counseling at the point of purchase. Leveraging community pharmacies linked with pet specialty pharmacies as first-contact hubs could promote appropriate self-medication; doing so would require veterinary-specific training, establishing a formal credential for veterinary pharmacists, and defining pharmacist–veterinarian communication to ensure safe and effective use. Full article