Search Results (375)

Background/Objectives: Mentoring may support professional development in medicine, but experiences and perceived programme availability may differ across career stages. We aimed to describe previous mentoring participation, perceived availability, satisfaction, preferred topics and formats, and responses to a generic digital facilitation item among medical students and physicians responding to an open survey in Switzerland. Methods: An open cross-sectional Research Electronic Data Capture (REDCap) survey was conducted from November 2024 to March 2025. Of 672 submitted records, 548 (81.5%) were complete and used for principal analyses. Analyses were descriptive and exploratory using valid item-level denominators. Results: Respondents were predominantly German-speaking (473/546, 86.6%), and 263/375 physicians (70.1%) worked in Bern. Previous mentoring participation was reported by 177/545 respondents (32.5%); 91/163 (55.8%) rated prior mentoring positively. Programme availability was perceived as insufficient by 475/530 (89.6%), while 515/545 (94.5%) anticipated professional benefit. Career advice was the most frequently selected topic. Previous participation increased from 21.3% among medical students to 44.6% among senior physicians, whereas perceived insufficiency remained high across career stages (85.5–97.4%). Conclusions: Within this self-selected, predominantly German-speaking and Bern-based respondent sample, previous participation in medical mentoring programmes was relatively uncommon, while perceived insufficiency of programme availability was consistently high across professional stages. Career advice emerged as a shared priority across career groups. These findings describe respondent-level perceptions and should not be interpreted as estimates of mentoring availability or unmet need across Switzerland. Full article

In natural language understanding, intent recognition plays a central role in human–computer interaction. However, in elderly-care scenarios, acoustic signals are often affected by atypical speech patterns, slower speaking rates, and environmental noise, making audio information less reliable and reducing the effectiveness of conventional text–audio fusion methods. To address this problem, we propose a prompt-guided and quality-aware text–audio intent recognition framework. Specifically, a χ²-based intent prototype soft prompt is introduced to enhance the semantic representation of text. Then, a residual-free text-guided cross-attention module is designed to refine degraded acoustic features using textual semantics as reliable guidance. In addition, a dynamic fusion gate is developed to adjust the contributions of text and audio based on modality reliability and intent-related information. Experiments on the MIntRec dataset with simulated acoustic degradation show that the proposed model achieves 60.90% accuracy, 60.80% weighted F1, and 57.90% macro-F1, outperforming several competitive baselines. These results indicate that the proposed framework can improve the robustness of intent recognition under challenging acoustic conditions in elderly-oriented interaction scenarios. Full article

‘Wellness-at-sea’ is an integral part of the cruise holiday service bundle. Marketed within an image of experiential diversity within a safe, controlled environment, it features medical centers, spa facilities and restoration-focused itineraries. Nevertheless, epidemiologically speaking, cruise ships rank amongst the riskiest transmission environments in tourism. This perspective paper proposes a typology of wellness cruising along two axes (i.e., offer scope: themed voyages versus onboard amenities and promotion focus: borrowed credibility versus narrative ‘storyscaping’) and uses it to develop the ‘wellness-risk paradox’, a boundary case for health-tourism literature. Three testable propositions emerge: reputational risk exposure increases with the offer’s wellness centrality; narrative-based promotion is more susceptible than credibility-based promotion and a quadrant-adjusted health-assurance scheme is more effective than current inspection standards. The argument draws on the 2026 Andes hantavirus outbreak aboard the MV Hondius (three deaths among thirteen cases), the 2020 Diamond Princess outbreak, and a decade of official outbreak surveillance, reporting an increase in gastrointestinal outbreaks from 0.34 to 0.62 per million passengers between 2019 and 2025 (rate ratio 1.84, 95% CI 0.87–3.86), which reverses the pre-pandemic downward trend although annual counts remain too small for the change to reach conventional statistical significance. Sanitation-inspection compliance cannot reliably predict outbreaks, nor does it facilitate trust. Four domains of action are proposed: continuous air-quality monitoring, wastewater surveillance, behavioral risk modeling and jurisdictional coordination. Full article

Background/Objectives: International nurse recruitment is increasingly important, but early integration depends on language, professional adaptation, organizational welcome, and retention support. Evidence from non-English-speaking healthcare systems and multi-stakeholder implementation evaluations remains limited. This study aimed to evaluate a structured onboarding pathway as an exploratory, response-level pilot and a feasibility platform. Methods: Anonymous five-point Likert questionnaires were administered to clinical coaches, ward teams, and newly hired international nurses at conceptual time points T0, T1, and T2. T0 was partly retrospective because the first survey wave, administered at approximately 3 months, asked respondents to rate both arrival status and current status. Analyses were response-level; T0–T1 ratings were summarized with a paired within-row sensitivity analysis when both ratings were available, whereas T2 could not be linked to the earlier wave. Results: The primary dataset contained 410 anonymous response-level observations, mostly from ward-team proxy ratings. Median language proficiency ratings were 3 (IQR 2–3) at T0, 3 (IQR 3–4) at T1, and 3 (IQR 3–4) at T2; the proportion of ratings at or above the pragmatic adequacy threshold (≥3) rose from 53.5% to 76.4% and 91.0%, respectively. For professional training/competence, median ratings were 3 (IQR 2–4), 3 (IQR 3–4), and 3 (IQR 3–4), with corresponding adequacy-threshold proportions of 53.5%, 78.0%, and 89.7%. However, stakeholder-specific patterns differed, and international nurses’ self-rated language proficiency followed a non-monotonic pattern. In the nurse-specific analytic subset (14 anonymous response rows), overall welcome was associated with intention to stay (Spearman rho = 0.73, FDR-adjusted p = 0.016) and willingness to recommend the experience (rho = 0.86, FDR-adjusted p = 0.002). Conclusions: The pilot generated hypotheses and, more importantly, mapped feasibility requirements for a future confirmatory study. Although the findings should not be interpreted causally or as paired longitudinal evidence, they provide an initial overview of issues related to the integration of international nurses in non-English-speaking healthcare settings. A future study should prospectively collect pseudonymized identifiers, objective and validated measures, and a pre-specified longitudinal analytic model. Full article

How does the Federal Reserve sound when it speaks? We measure the delivery of the Chair across 84 FOMC press conferences from 2011 to 2026, using Google’s Gemini 2.5 Flash to annotate 11,156 sixty-second segments spanning the Bernanke, Yellen, and Powell eras. The model returns ten paralinguistic variables, among them emotion, firmness, speech rate, and hesitation counts. Rather than trust these labels, we test them. Checked against regex-based transcript counts of disfluencies and against Praat, hesitations and speech rate prove reliable (Pearson r up to 0.92); firmness and emotion do not, showing little acoustic grounding and shifting when the prompt changes, so they are better read as sentiment drawn from the words than from the voice. Using the measures that survive this test, we find that calm delivery dominates, as one would expect of a Fed Chair, yet the three Chairs differ in ways that hold up under a hierarchical model, with the sharpest gaps in the unscripted question-and-answer session. Measured disfluency rises around episodes such as the 2022 Ukraine war, but not across the pandemic as a whole. The wider lesson is that multimodal models must be validated feature by feature before they are trusted as instruments. Full article

Background/Objective: The Patient-Specific Functional Scale (PSFS) is a patient-centered outcome measure that captures limitations in activities that are personally meaningful to patients. Although the Arabic PSFS has demonstrated acceptable validity and reliability, its responsiveness in individuals with lower extremity musculoskeletal disorders has not been established. This study aimed to examine the responsiveness of the Arabic PSFS in detecting changes in lower extremity function over time. Methods: A prospective cohort study was conducted in three outpatient physical therapy clinics in Riyadh, Saudi Arabia. Seventy-two adults with lower extremity musculoskeletal disorders receiving physical therapy care completed the Arabic PSFS, RAND-36, and Numeric Pain Rating Scale (NPRS) at baseline and follow-up. At the follow-up, participants also completed the Global Rating of Change (GRC). Responsiveness was evaluated using eight a priori hypotheses following COSMIN recommendations. Change scores were analyzed using correlation coefficients, paired t-tests, effect size (ES), and standardized response mean (SRM). Results: Sixty participants (83.3%) reported improvement in the GRC. PSFS scores improved significantly (mean difference = 1.66; p < 0.001), demonstrating a large magnitude of improvement (ES = 0.80; SRM = 0.92). PSFS change scores correlated moderately with RAND-36 physical functioning (r = 0.51) and GRC (r = 0.55) and weakly with emotional well-being (r = 0.26) and showed smaller-than-expected associations with pain measures. Six out of eight (75%) predefined hypotheses were confirmed. Conclusions: The Arabic PSFS demonstrates sufficient responsiveness in detecting improvement in lower extremity function and is suitable for monitoring rehabilitation outcomes in Arabic-speaking adults with lower extremity musculoskeletal disorders receiving outpatient physical therapy. Full article

Background: Immigrant working women’s well-being is shaped not only by formal health and settlement services but also by everyday opportunities for rest, social connection, cultural expression, and participation in community life. This study examined how three community-based leisure activities were experienced by Farsi-speaking Iranian immigrant women aged 30 to 55 living in Ottawa, Canada. Methods: Organized in partnership with PAND Settlement Services, the activities included a group walk along the Rideau Canal, a Classical Persian dance workshop, and a group visit to the National Gallery of Canada. Data were drawn from 32 post-activity evaluation surveys, researcher field notes, and two follow-up semi-structured feedback sessions. Structured items were analyzed descriptively; open-ended responses and feedback sessions notes were analyzed thematically following Braun and Clarke’s six-phase approach. Results: Participants rated all three activities positively across enjoyment, accessibility, and social contact. Leisure was experienced as a meaningful break from routine, a source of emotional relief, an opportunity to meet other women, and a setting in which shared language and migration experience made participation easier and more comfortable. Sustained participation remained shaped by time pressure, caregiving demands, weather, transportation, cost, and access to clear and trusted information. Conclusions: Leisure activities contributed to the well-being and sense of belonging for the women who participated in the study. Full article

Background/Objectives: People with severe mental illness experience high rates of malnutrition and cardiometabolic disease, and hospital food is increasingly regarded as part of clinical care rather than mere catering. Although nutrition is increasingly recognised as a therapeutic component of psychiatric care, little is known about how the professionals closest to nutritional care would design an inpatient meal concept. Methods: We conducted a cross-sectional, anonymous online survey of 26 nutrition professionals working in psychiatric settings in the German-speaking D-A-CH region (Germany, Austria, and Switzerland), who rated the goals, patient needs, dietary forms, meal characteristics, organisational aspects, and barriers relevant to an inpatient meal concept on five-point Likert scales. Free-text responses were analysed thematically. Results: Respondents prioritised eating enjoyment (mean [M] = 4.65) and psychological stability over economic goals, and rated both appetite loss and hyperphagia, together with medication-related metabolic change, as key patient needs. A Mediterranean dietary pattern was clearly the preferred model (M = 4.62), whereas low-carbohydrate options were the least endorsed form (M = 2.65). Interprofessional communication between nursing, kitchen, and dietetics was the highest-rated item overall (M = 4.75), while budget restrictions were seen as the principal barrier. Conclusions: In this small, self-selected expert sample, experts largely converged on a patient-centred, Mediterranean, flexible and choice-based meal concept delivered through strong interprofessional processes, supporting a shift from catering toward nutrition as a therapeutic component of inpatient psychiatry. Full article

In this study, we examine positive-unlabeled (PU) learning for classifying Polish texts intended for large language model training. We evaluate six PU methods, Naive, Clust, Strict-LassClust, Non-Strict-LassClust, LassoJoint, and Spy, under both classic and MVC non-SCAR labeling schemes. Across the benchmark, the best F1 reaches 0.906 on an open subtitles corpus under classic labeling and 0.900 under MVC labeling; the largest absolute gain over the Naive baseline is 0.811 F1 points on ulotki medyczne and 0.758 on plwiki in the classic setting. The experimental workflow supports multiple labeling rates, c calc, and repeated random seeds, and evaluates models with AUC, PR-AUC, and F1 as the main metrics. Our study focuses on six SpeakLeash datasets spanning different domains: plwiki, open subtitles corpus, job offers corpus, ISAP corpus, ulotki medyczne, and wolne lektury corpus. For each dataset, we construct a binary PU setup from the quality field, where HIGH is treated as positive and LOW is negative, while other values are removed. The resulting preprocessed tables retain only the selected linguistic and structural features, rescale numeric variables to the [0, 1] range, and remove the raw text column. Full article

In the Philippines, most children speak regional languages like Ilokano, Cebuano, and Hiligaynon as their first language (L1), but they have historically been schooled in English and Tagalog (i.e., Filipino). In 2012, the Department of Education (DepEd) institutionalized Mother Tongue-Based Multilingual Education (MTBMLE), designating regional/local languages as the primary medium of instruction in the early grades. Despite this major policy shift, data on how it affected children of different linguistic and ethnic backgrounds remain scarce. This study addresses that gap by examining the effects of language-of-instruction (LOI) policy, child L1, and parental ethnicity on Grade 1 academic achievement in San Fernando, La Union—a multilingual city where Ilokano is the predominant language of the community and Ilocos Region. This quasi-experimental pre–post cohort comparison leverages an exogenous policy change to analyze data from 3002 Grade 1 students across 10 urban public schools in two consecutive school years: the last year of the old English–Filipino bilingual policy (SY 2011–2012) and the first year of MTBMLE (SY 2012–2013). Ordinary least squares and mixed-effects linear regression models estimate the effects of LOI policy, child L1, parental ethnicity, and their interactions on achievement scores. Under the old L2-oriented bilingual policy, L1 Ilokano children (the demographic majority) achieved significantly lower academic ratings than their L1 Tagalog peers, with an estimated gap of approximately 1.17–2.13 points (up to 0.5 standard deviations). Within one year of MTBMLE implementation, this gap decreased to just 0.10–0.18 points (less than 0.1 SD), driven primarily by an increase in Ilokano-speaking children’s achievement across all subjects. Parental ethnicity moderates these effects: children with at least one Ilokano parent showed greater achievement gains under MTBMLE than children with no Ilokano parents, but having one Ilokano parent was more advantageous than two. This suggests that multilingual home environments influence outcomes in complex ways. Overall, the findings provide empirical support for MTBMLE’s positive impact on educational outcomes and equity, observable even within the first year of implementation. They carry urgent implications as the Philippine government has suspended the policy under Republic Act 12027 of 2024. Policymakers are urged to disaggregate educational achievement data by children’s home languages, and incorporate L1s in instruction, assessment, and program evaluation. Full article

Developmental Language Disorder (DLD) is characterized by persistent difficulties in language acquisition and use and is frequently accompanied by variability in cognitive performance. This study compared auditory psycholinguistic abilities and selected cognitive outcomes in children with DLD and typically developing (TD) peers and examined whether associations between these domains were robust within each group. Eighty Spanish-speaking children aged 7–9 years participated (40 DLD, 40 TD). Four auditory subtests of the Illinois Test of Psycholinguistic Abilities assessed auditory comprehension, auditory association, auditory integration, and auditory sequential memory. Age-scaled scores from selected WISC-V subtests represented verbal comprehension, working memory, fluid reasoning, and processing speed. Between-group differences were examined with independent-samples t tests and sensitivity analyses controlling for paternal education. Pearson correlations were supplemented by Spearman correlations and false-discovery-rate corrections. Children with DLD scored lower than TD peers on all auditory psycholinguistic and cognitive measures (Cohen’s d = 1.35–2.55). The between-group differences remained significant after accounting for paternal education; for auditory integration, significant differences were observed at both levels of paternal education despite a significant interaction. Three Pearson correlations reached nominal significance before correction, but none was replicated as statistically significant by Spearman analysis or survived correction for multiple testing. The findings therefore indicate broad between-group differences but limited evidence for stable within-group coupling between the auditory psycholinguistic and cognitive measures assessed. Comprehensive assessment should consider language-related and cognitive domains separately rather than assuming a single explanatory mechanism. Full article

Research has examined the negative consequences of internalized weight bias on mental health (e.g., disordered eating, depression, anxiety). In South Korea’s patriarchal society, appearance rather than ability or talent is considered the principal determinant of a woman’s success, as evidenced by high rates of cosmetic surgery and anti-fat bias. Given strict appearance norms and pervasive weight stigma, we developed a Korean version of the Modified Weight Bias Internalization Scale (K-WBIS), examined its psychometric properties, and explored its associations with other established measures. Confirmatory factor analysis was used to assess the factor structure. An item was removed, and a revised 10-item one-factor model was estimated. The final model demonstrated an acceptable incremental model fit indices (CFI = 0.934, TLI = 0.909, SRMR = 0.047), although RMSEA remained elevated (RMSEA = 0.163). The 10-item K-WBIS demonstrated promising psychometric properties in a sample of South Korean adult women. Findings provide preliminary support for the K-WBIS and warrant further evaluation in larger and more diverse Korean-speaking populations. Full article

Background/Objectives: Climate change is a major global health challenge with direct implications for public health. As frontline health professionals and agents of change, nurses must develop competencies to address climate-related health issues and implement sustainable practices. This study aimed to translate and culturally adapt the Climate, Health, and Nursing Tool (CHANT) into French and to assess its content validity using item-level and scale-level content validity indices (I-CVI and S-CVI, respectively). The CHANT evaluates nurses’ awareness, motivations, concerns and self-reported behaviours related to climate change. A secondary objective was to examine potential associations between experts’ sociodemographic and professional characteristics and their CVI ratings. Methods: A descriptive international study using a three-round modified e-Delphi approach was conducted between January and June 2025 in French-speaking regions of Switzerland, France and Belgium. A multidisciplinary panel of experts in nursing, planetary health and environmental sciences evaluated the relevance, clarity and comprehensiveness of each item and response option, enabling iterative refinement. Results: The original 12-item CHANT was evaluated by 17 experts in Round 1. Following expert recommendations, one additional item was incorporated, resulting in a 13-item version, which was subsequently evaluated by 15 experts in Round 2 and 25 experts in Round 3. Across the three Delphi rounds, 57 completed expert evaluations contributed to the iterative refinement of the instrument. Round 1 I-CVI ranged from 0.79 to 1.0, and S-CVI reached 0.935, with full consensus. Round 2 I-CVI ranged from 0.71 to 1.0, and S-CVI was 0.91 (92% consensus), with one item not meeting the predefined threshold. Round 3 I-CVI ranged from 0.82 to 1.0, and S-CVI returned to 0.935, confirming consensus. A final linguistic, semantic and cultural review conducted by the research team ensured the conceptual consistency and cultural appropriateness of the translated instrument. Conclusions: The French-language version of the CHANT demonstrated satisfactory content validity and provides a culturally adapted instrument to assess climate-related competencies and eco-literacy in nursing education and practice. Further psychometric evaluation is warranted. Full article

Genomic testing is a key component of precision oncology; however, Black patients receive genomic testing at lower rates. The purpose of this qualitative study was to identify individual and health system drivers of genomic testing disparities at a National Cancer Institute-designated comprehensive cancer center. We conducted interviews with 15 oncology providers and 11 Black cancer patients between September 2023 and October 2024. These patients were eligible for genomic testing based on National Comprehensive Cancer Network (NCCN) guidelines, being diagnosed within last 10 years (2014–2023), at least 18 years old, and English-speaking. Providers included oncologists and oncology patient navigators. Topics included motivators, barriers, and knowledge of genomic testing and factors influencing decision-making. The Penchansky and Thomas theoretical framework of healthcare access (e.g., availability, accessibility, accommodation, affordability, and acceptability) guided thematic analysis. Among patients eligible for genomic testing, most participants (n = 7) received genomic testing as part of their cancer treatment based on EMRs, however many patients (n = 7) could not recall discussing genomic testing with their oncologist. Most patients and all providers highlighted affordability as a challenge: patients were concerned about unexpected costs associated with testing, while providers were concerned about costs of matched molecular targeted therapy. Both patients and providers highlighted patient-centered communication to mitigate mistrust and promote patient engagement in care. Despite limited awareness, Black patients view genomic testing positively. Addressing multiple dimensions of access is key to improving system-level processes and ensuring that more patients benefit from lifesaving targeted therapy. Full article

Farmworkers experience disproportionate risks of pesticide exposure, yet only two U.S. states, California and Washington, currently mandate routine cholinesterase biomonitoring programs for agricultural workers. Although regulatory and resource limitations influence implementation of worker protection programs, operational barriers also complicate repeated biomonitoring among highly mobile and underserved farmworker populations. The objective of this preliminary study was to evaluate the operational feasibility of recruiting, retaining, and repeatedly monitoring farmworkers using a novel, rapid, portable cholinesterase analysis device under routine agricultural field conditions. Guided by an evidence-based feasibility framework, a multidisciplinary team administered surveys and collected blood samples from 25 farmworkers in rural North Carolina at three time points during a single agricultural season. Participation and visit completion rates were high, although worker mobility, changing job assignments, environmental conditions, and temperature-sensitive samples created logistical challenges. Experienced bilingual promotoras de salud played a critical role in coordination, communication, scheduling, and retention. Findings provide preliminary evidence that repeated field-based cholinesterase biomonitoring protocols are feasible and acceptable when supported by community-based outreach organizations with Spanish speaking health workers, structured logistics, and culturally responsive engagement strategies. Evaluation of the analytical performance is beyond the scope of this report, however, these results provide practical insights for strengthening occupational health surveillance and future implementation studies designed to protect agricultural workers. Full article