Search Results (2,107)

This study examines the relationship between institutional embeddedness, community factors, and the outcomes of labor market integration programs in contexts characterized by high social vulnerability and unemployment. The aim is to analyze how the local embeddedness of organizations and the mobilization of community resources influence the effectiveness of interventions designed to enhance employability. A mixed-methods approach was employed, combining qualitative and quantitative techniques. Data were collected from 100 participants in a labor market integration program in a southern Spanish city, using standardized scales that measured the sense of community, perceptions of community assets, employability, and perceived impact of the program. Additionally, the program’s implementation team was interviewed, a documentary analysis was conducted, and direct observations of training and job-placement activities were carried out. The findings highlight that the institutional and community embeddedness of organizations facilitates access, sustained participation, and the contextual adaptation of interventions. Connection with local dynamics is crucial for enhancing the impact of labor market integration programs, allowing for more personalized interventions that are sensitive to sociocultural barriers and focused on improving employability and the overall well-being of individuals at risk of exclusion. Full article

Online cybersecurity education increasingly serves diverse cohorts, including students with non-technical backgrounds and those balancing their studies with work or family responsibilities. Yet, research on sustaining educational quality while scaling fully online enrolments remains limited, particularly in foundational technical subjects where learning requires both conceptual understanding and professional judgement. This study aims to examine how teaching presence can be operationalised in fully online foundational cybersecurity subjects through inspectable artefacts and routines that remain workable for large cohorts and distributed teaching teams. This paper reports a Scholarship of Teaching and Learning (SoTL) design and transfer case grounded in the Community of Inquiry (CoI) framework. This study examines the redesign of CSE1ICB (Introduction to Cybersecurity) and the transfer of the same design logic to CSE1CPR (Cybersecurity in Practice). The findings identify a coherent four-component design model comprising (1) real-world incident integration, (2) scenario-based learning and interactive checks, (3) structured, layered support, and (4) a predictable communication rhythm across the learning management system (LMS) and email. Across these two subjects, these elements are presented as an integrated system intended to make learning objectives salient, increase opportunities for guided practice in professional reasoning, reduce avoidable friction in practical work, and create consistent instructor visibility through routine communication and support structures. This paper synthesises the approach into nine transferable design principles, mapped to CoI teaching presence dimensions and illustrated through concrete design choices, including incident-framing templates, scenario prompt patterns, layered support resources, formative feedback patterns, and communication routines. Overall, this study shows that teaching presence can be operationalised as a coordinated design system rather than as a set of isolated tactics. This paper contributes a reusable and theory-informed model for educators coordinating foundational cybersecurity subjects delivered online at scale. Full article

Background: Parental practices that support autonomy, provide structure, and foster warm relationships are associated with greater satisfaction of students’ basic psychological needs for autonomy, competence, and relatedness. In minority educational contexts, however, students’ psychological need satisfaction is also shaped by broader sociocultural conditions that may create additional pressures and sources of chronic stress. Within such environments, parental support may function as a protective factor that helps students cope with educational and cultural demands. Objective: The aim of this study was to explore how parental support contributes to the satisfaction of students’ basic psychological needs within a minority educational context where students from the Greek minority attend a bilingual school operating within a Turkish educational framework. Methods: A qualitative design was employed using three focus groups conducted in a minority school located in Gökçeada, Türkiye: one with parents (N = 5), one with lower secondary school students (N = 6), and one with upper secondary school students (N = 6). Interview questions were developed on the basis of Basic Psychological Needs Theory. Data were analyzed thematically by five members of the research team. Results: Findings indicated that parental support influenced students’ need satisfaction through practices related to autonomy (e.g., trust, space for mistakes), competence (e.g., encouragement, comparison), and relatedness (e.g., emotional presence, empathy). However, these practices were not experienced in a uniform way. Rather, their meaning and impact were shaped by contextual conditions associated with minority status, including bilingual educational demands, limited resources, and close-knit community dynamics. Conclusions: The study suggests that in minority school settings, parental support operates not simply as a general interpersonal resource but as a contextually mediated protective process. By showing how sociocultural and institutional conditions shape the enactment and experience of autonomy, competence, and relatedness, the findings extend existing BPNT research beyond majority settings and offer a more context-sensitive understanding of students’ psychological need satisfaction. Full article

Introduction: Work engagement among nurse case managers is central to safe, efficient, person-centred care, yet organisational and team-level factors that support engagement or mitigate burnout remain poorly synthesised. Aim: To map organisational and team-level strategies that enhance work engagement or reduce burnout among nurse case managers and aligned roles, as well as to consider their applicability to Gulf health systems. Method: We conducted a scoping review in accordance with the Arksey and O’Malley framework as refined by Levac et al. and reported it in line with PRISMA-ScR and PRISMA-S guidance. Six databases and targeted sources were searched for English-language records published between 2015 and 2025. Two reviewers independently screened titles/abstracts and full texts against predefined eligibility criteria, charted data using a piloted form, and synthesised findings thematically against Job Demands–Resources (JD-R) domains. Results: Of 303 records identified, 248 were screened after deduplication, and 11 studies were included. Across nine health systems, findings were mapped to three JD-R domains: job resources, job demands, and personal resources. The most recurrent resource-related strategies involved structural supports, staffing stability, coordination infrastructure, and supportive leadership or team practices. Key demands included role complexity, high caseloads, coordination workload, discharge pressures, and staffing instability. Personal-resource approaches were fewer and mainly involved stress management, communication, and reflective practice interventions. Engagement was infrequently measured directly, and only one empirical intervention study originated from a Gulf health system. Conclusions: This JD-R-informed scoping review suggests that strengthening structural, staffing, and coordination resources, alongside supportive leadership and team climates, may be important for sustaining engagement and limiting burnout among nurse case managers. However, these findings should be interpreted as exploratory signals that map the current evidence landscape rather than definitive evidence of effectiveness. Multi-component JD-R-informed bundles in Gulf region health systems should therefore be prioritised for context-sensitive co-design, piloting, and evaluation. Full article

Overweight and obesity during pregnancy are associated with increased maternal and neonatal risks, yet scalable interventions addressing the psychological processes underlying health behaviours remain limited. This study describes the development and formative evaluation of DEMETRA, a chatbot delivering an Acceptance and Commitment Therapy (ACT)-informed intervention to promote healthier lifestyles in pregnant women. In line with Phase 1 of the Obesity-Related Behavioral Intervention Trials framework, a multidisciplinary team developed a six-session digital program delivered via a rule-based virtual assistant. A mixed-methods design was employed to assess acceptability, usability, and perceived relevance among a heterogeneous stakeholder sample. Sixteen stakeholders (psychologists, communication experts, nutritionists, clinicians, and non-overweight, expectant women or those who had recently delivered) participated in iterative testing; 15 completed quantitative measures (Semantic Differential scales, uMARS, BUS-11) and 16 completed semi-structured interviews. Non-parametric analyses indicated significantly positive evaluations across most communication and content domains, particularly clarity and language appropriateness, whereas session duration and several engagement-related dimensions did not significantly differ from neutrality. Qualitative findings confirmed strengths in clarity, non-stigmatising tone, and multimedia support, while identifying limited personalisation and message pacing as key areas for refinement. Overall, findings provide formative evidence that ACT-informed principles can be translated into a chatbot-delivered antenatal program and highlight concrete priorities for optimisation (e.g., personalisation and message pacing). Because end-user testing did not include overweight/obese pregnant women and the sample was small and heterogeneous, conclusions regarding acceptability/feasibility in the intended clinical population remain preliminary; the results primarily support iterative refinement and subsequent proof-of-concept testing in the target group. Full article

While telemedicine has proliferated globally, its sustainable implementation in resource-constrained settings remains understudied. This study evaluates the efficacy, determinants of patient satisfaction, and systemic resilience of a “Home Ward” model at a rural Thai community hospital. Employing a convergent mixed-methods design, we surveyed 51 participants and conducted in-depth interviews with service users (n = 5) and a multidisciplinary team (n = 7). Multiple linear regression revealed high patient satisfaction ( = 3.70), explaining 67.3% of the variance (R² = 0.673). Notably, Perceived Usefulness (β = 0.589, p < 0.001) and the Effectiveness of Symptom Monitoring (β = 0.317, p < 0.05) significantly predicted satisfaction. Conversely, Overall System Quality was not a significant predictor (β = 0.142, p > 0.05), highlighting a ‘Low-Tech, High-Touch’ paradox. Qualitative analysis elucidated this through the “Human-in-the-Loop” mechanism, where Village Health Volunteers (VHVs) and healthcare providers bridge the digital divide. However, the study identifies an “invisible workload”—non-formalized discretionary effort—that sustains this resilience. Findings suggest that rural digital health governance should prioritize human intermediaries and pragmatic utility over purely technical upgrades. The study concludes that long-term sustainability requires institutionalizing human support networks while mitigating the exploitation of healthcare personnel’s goodwill. Full article

As population aging accelerates, the demand for high-quality end-of-life (EOL) care continues to rise. However, a substantial proportion of patients with terminal cancer still experience death in acute-care hospitals without adequate palliative care. Consultative palliative care (CPC) represents a feasible model for delivering palliative care without requiring dedicated inpatient units, yet evidence evaluating its clinical impact remains limited. In this study, we developed a structured hospital-based CPC model tailored to the Korean healthcare system, the Korea Holistic Optimized Palliative care for End-of-life (K-HOPE) model, and prospectively evaluated its clinical impact. K-HOPE was delivered by an interdisciplinary CPC team in a tertiary hospital. Unmet needs were assessed using the Integrated Palliative care Outcome Scale (IPOS), and longitudinal changes were analyzed using mixed-effects models for repeated measures. Among patients who died during hospitalization, quality of death was evaluated using the Good Death Scale (GDS). A total of 84 patients with terminal cancer received K-HOPE. The total IPOS score significantly decreased over time (β = −10.4, 95% CI −12.8 to −8.0; p < 0.001), indicating reduced overall burden and unmet needs. Significant improvements were observed in psychological distress (p = 0.010) and communication and information needs (p < 0.001), whereas changes in physical symptoms and practical concerns were not statistically significant. Among 22 patients who died during hospitalization, 59.1% achieved a good quality of death (GDS ≥ 12). Longer duration of CPC involvement was significantly associated with higher quality of death and remained an independent predictor in multivariable analysis. These findings suggest that the K-HOPE CPC model improves communication and overall EOL care experiences among hospitalized patients with terminal cancer, indicating that meaningful improvements in EOL care can occur even during short periods of CPC involvement. Structured CPC integrated into routine oncology practice represents a feasible strategy for improving EOL care in tertiary hospitals, and a standardized CPC framework may enhance the consistency and reproducibility of care delivery within the Korean healthcare system. Full article

Corporate reputation teams rely on media monitoring and qualitative research, both limited in speed and coverage when digital narratives form rapidly. This paper proposes SAPIENT (Sentinel-Augmented Population Intelligence for Emerging Narrative Tracking), a multi-agent system that links a sentinel layer over public text streams with a simulation layer that runs moderated, repeatable in silico focus-group sessions. The sentinel layer ingests social media, news, and forum text to produce a compact signal state (topics, sentiment, anomaly scores, risk labels), which conditions the simulation layer through an orchestrator. Persona agents and a moderator follow an Agentic Focus Group (AFG) protocol with repeated runs, variance reporting, and human review gates. We describe four sustainability communication scenarios: greenwashing backlash prediction, greenhushing risk assessment, campaign pre-testing, and crisis communication simulation. Nine experiments span 280 AFG runs across 20 conditions, three LLM backends (Claude Sonnet 4, GPT-4o, and Gemini 2.5 Flash), and a preregistered pilot human validation study with 54 participants. Signal conditioning improved simulation specificity ($p=0.012$). Cross-lingual sessions revealed a sentiment asymmetry between English and Turkish ($p=0.001$) with preserved persona rank ordering ($r=0.81$, $p=0.015$). Cross-model comparison showed consistent persona differentiation across all three backends (Pearson $r>0.92$, $p<0.002$ for all pairs). Sentiment was robust to prompt paraphrasing ($p=0.061$, n.s.), though credibility was sensitive to prompt wording ($p<0.001$). All significant results from Experiments 1–8 survived Benjamini–Hochberg correction. A preregistered pilot with 54 human participants on Prolific replicated the predicted credibility ranking across framing variants ($p=0.004$) but not the sentiment ranking, identifying a specific calibration target for future work. Full article

Background: Healthcare policy in the United Kingdom recognizes that teenagers and young adults (TYAs: 16–24 years at diagnosis) require specialist care. In England, Principal Treatment Centers (PTCs) exist, delivering enhanced care exclusively within the PTC or as ‘joint care’ with designated hospitals (DHs). Central to this is the TYA multidisciplinary team (MDT) and an outreach model coordinating care between hospitals. We previously reported similar outcomes regardless of care location. Aims: To compare TYA experiences of care with healthcare professionals’ perspectives of the service they deliver. Methods: Mixed methods across England and Wales were used. The TYA-MDT identified TYAs who then received a postal invite to a cross-sectional survey capturing experiences of places of care, treatment, healthcare professional support (HCP), mental health, sexuality/fertility, clinical trials and care coordination. Comparisons were made based on exposure to care in a specialist TYA environment within 6 months of diagnosis: all-TYA-PTC (all care in the TYA-PTC, n = 70, 28%), no-TYA-PTC (no care in the TYA-PTC (n = 87, 35%): care delivered in a children/adult unit only), and joint care (care in a TYA-PTC and in a children’s/adult unit, n = 91, 36%). HCP perspectives were captured by rapid ethnography. Results: A total of 250/1056 (24%) TYAs participated. Overall, 200 (80%) rated their teams as excellent/good for helping them prepare for treatment. No evidence of significant differences existed between categories of care for proportions receiving support from key TYA-related professionals: TYA cancer nurse specialists (all-TYA-PTC n = 58, 91%; joint care n = 71, 88%; no-TYA-PTC n = 64, 82%) and social workers (all-TYA-PTC n = 30, 55%; joint care n = 36, 48%; no-TYA-PTC n = 28, 38%). A trend of diminishing support from youth support co-coordinators existed (all-TYA-PTC 63%; joint care 49%; no-TYA-PTC 40%, p = 0.069). This may explain why few differences in patient experiences existed across categories of care. Forty-nine HCPs participated. They were more critical in their interpretation of care, highlighting inequity in resources and challenges in some pathways and coordination. Conclusions: Similar access to age-appropriate support across care settings is likely to reflect recruitment methods. When TYAs are known to the MDT, age-appropriate care can be mobilized beyond TYA units, which could explain the equitable outcomes observed across different care locations in young people who responded to the survey. Nevertheless, gaps persist in communication and coordination, particularly within joint care models, and in the involvement of allied health professionals such as dieticians and physiotherapists, whose input is essential for rehabilitation and return to normal life. Strengthening these areas will require continued investment in workforce capacity and digital infrastructure to support genuinely coordinated, developmentally appropriate TYA cancer care. Full article

Recent advancements in artificial intelligence (AI) have strengthened the interaction between sports and digital technologies. However, unlike widely studied sports such as football and basketball, handball has received limited attention from the scientific community, despite its fast-paced nature and strategic importance. This study focuses on object detection in handball and targets key entities, such as players, referees, goalkeepers, and the ball. A comprehensive dataset was created through a collaborative annotation process, consisting of annotated images extracted from real handball games. The YOLOv8 model was then trained and evaluated on this dataset to assess its effectiveness in entity recognition. The proposed approach achieved an object detection accuracy of 86.8% on a relatively small held-out test set, providing an indicative first benchmark for the application of state-of-the-art machine learning models to handball. To the best of our knowledge, the dataset generated in this study is the first comprehensive collection of annotated handball images, providing a valuable resource for further research. By bridging sports analytics and computer vision, this study contributes to the advancement of performance assessment in handball. These exploratory results suggest potential directions for future real-time systems and practical applications, such as improved understanding of player performance, team dynamics, and strategic decision-making. Full article

Rapid expansion of electric vehicle adoption has led to increased dependence on a charging infrastructure that is tightly integrated with energy distribution systems and digital communication networks. As electric vehicle charging stations evolve into complex cyber–physical systems, cybersecurity risks pose a growing threat to grid reliability and user trust. This paper presents a hybrid decision-support framework for cybersecurity risk assessment in EV charging infrastructure that advances beyond prior multi-criteria decision-making approaches by combining interpretability with data-driven validation. Specifically, the framework integrates the Analytic Hierarchy Process (AHP) for expert-driven weighting of cybersecurity attributes with PROMETHEE for flexible threat prioritization, enabling transparent and auditable risk rankings. The framework categorizes cybersecurity criteria across four infrastructure layers—transmission, distribution, consumer, and electric vehicle charging stations—and assigns relative weights through expert-driven pairwise comparisons. PROMETHEE is then applied to rank potential cyber threats based on these weights, allowing for flexible prioritization of cybersecurity interventions. The methodology is validated using the real-world WUSTL-IIoT-2018 SCADA dataset, which includes simulated reconnaissance (network scanning), device identification, and exploitation attacks. While this dataset does not natively include OCPP 2.0 or ISO 15118 protocols, the experimental results demonstrate strong discrimination power (AUC = 0.99, recall = 95%) and provide a basis for extension to modern EVSE communication standards. The results identify critical metrics such as anomalous source packet behavior and encryption reliability as key vulnerability markers, aligning with documented EV charging attack scenarios. By bridging expert judgment with empirical traffic data, the proposed framework offers both technical robustness and explainability, supporting grid operators, SOC teams, and infrastructure planners in systematically assessing risks, allocating resources, and enhancing the resilience of EV charging ecosystems against evolving cyber threats. Full article

Background/Objectives: Wolfram syndrome type 1 (WS1) is a rare, progressive, multisystem neurodegenerative disorder characterized by diabetes mellitus, optic atrophy, diabetes insipidus, and sensorineural hearing loss. As survival has improved, an increasing number of affected women are reaching reproductive age. However, evidence on pregnancy and peripartum management in WS1 remains scarce, and practical guidance is limited. This case report describes the multidisciplinary management of pregnancy and delivery in a woman with genetically confirmed WS1 and highlights key considerations for peripartum care. Case Presentation: A woman with genetically confirmed WS1 and long-standing multisystem involvement, including diabetes mellitus, diabetes insipidus, neurogenic bladder requiring frequent self-catheterization, progressive neurologic manifestations, and severe sensory impairment, achieved pregnancy through assisted reproduction with oocyte donation and was closely monitored by a multidisciplinary team. Due to persistent breech presentation, a planned external cephalic version was performed at 37 + 5 weeks’ gestation with immediate availability for cesarean delivery. After unsuccessful attempts, cesarean delivery was performed under combined spinal–epidural anesthesia. Peripartum management focused on strict glycemic control, careful monitoring of fluid balance and urine output, neuraxial anesthesia with proactive hemodynamic management, precautions related to the cochlear implant, and tailored communication strategies. Postpartum recovery was favorable, although anemia on postoperative day 1 required transfusion of one unit of packed red blood cells and intravenous iron therapy. Discussion and Conclusions: Pregnancy in WS1 represents a high-risk clinical scenario because of the coexistence of endocrine, urologic, and neurologic comorbidities, while published evidence on peripartum management remains limited. This case supports an individualized, multidisciplinary approach to obstetric and anesthetic planning and the use of a practical framework to optimize peripartum management and enhance maternal–fetal safety in this rare condition. Full article

Background: Engaging diverse populations, including Muslims, in research activities is important to support patient-centered research and improve health equity. Objectives: The research aimed to describe the community engagement steps that informed conducting research with five distinctively diverse U.S. Muslim communities. Methods: This work provides methodological reflections on engaging diverse Muslim communities in the U.S. Researchers built trust-based partnerships with community healthcare organizations and engaged with administrative leaders, advisory members, and people from five diverse communities. Strategies to support sampling, recruitment, multi-language interpretation methods, and how to engage communities and address their concerns are discussed. Results: A total of 22 participants were included in the original study. The research team successfully engaged five of the six planned communities, utilizing multiple interpretation methods and participating in community events to support recruitment and relationship-building. Direct-to-participant recruitment efforts were strengthened by personal connections with trusted community members. Conclusions: Flexibility and adaptability are integral in recruitment and data collection, as diverse communities may respond differently to methods successfully used elsewhere. Attention to gender-related cultural norms, the inclusion of language-concordant researchers, and respect for communities’ autonomy in deciding whether and how to participate collectively contributed to more effective and culturally grounded engagement with Muslim communities. Full article

The construction industry in South Africa faces challenges with the current payment system used to manage progress payments. Contractors often experience delays in progress payments for completed works. These late payments stem from the improper management of progress payment procedures, namely, information, communication, and collaboration, as well as corruption. This study proposes the integration of common data environment (CDE) as it has emerged central in managing information, improving communication and collaboration in a transparent manner. However, the implementation of CDE is facing challenges in the industry. Therefore, the study aimed at developing a model based on the implementation of CDE to uphold efficiency in the management of payment systems for progress payments. A systematic review was conducted to examine the enabling factors, characteristics of CDE in managing progress payment challenges, and benefits of integrating a payment system in a CDE platform. Furthermore, the study utilised questionnaire surveys to purposively collect data from construction professionals who implemented CDE in their projects. From 201 valid questionnaire responses, a structural equation model was developed; testing for the reliability, validity, model fit, and hypotheses was conducted using AMOS and ADANCO. The findings revealed that enabling factors such as quality technology and quality assurance team are the strongest enablers, followed by training and policy. The findings further predict that CDE integration will improve the management of the payment system by 0.589. The study provides theoretical and practical guidance for researchers, policy makers, and construction professionals seeking to strengthen CDE-based payment system frameworks in South Africa. Furthermore, it is recommended to adopt the method of questionnaire surveys and SEM to validate variables and establish their influence on one another to improve generalisation. Full article

The conservation of geosites is essential for geoconservation. It requires systematic management, particularly for severely degraded and threatened geosites, along with consistent monitoring to ensure the long-term preservation of geoheritage. This study reviews the main concepts, principles, and frameworks for geosite monitoring and proposes a systematized model applicable across diverse geological frameworks. Management is the planned and sustainable use, conservation, restoration, and protection of geosites to maintain their value (scientific, educative, cultural and touristic) and the benefits they provide to society. Monitoring is highlighted as a critical tool for evaluating conservation status, guiding decision-making, and establishing cause–effect relationships between processes and degradation of the most threatened sites. Although international initiatives have advanced geoheritage sites recognition, the lack of standardized monitoring indicators for geoconservation remains a significant challenge. To address this gap, we propose a framework comprising two phases and twelve stages, integrating geoconservation strategies and monitoring phases: threat identification, indicator selection, parameter definition, and measurement techniques. The model emphasizes the interdependence of conservation status, potential use, and conservation needs in prioritizing actions. Future challenges include adapting the methodology to varied legal and administrative contexts, developing multidisciplinary management teams, and applying the framework in other study cases. By systematizing monitoring procedures, this study contributes to establishing clearer cause–effect relationships in geoconservation threats, enhancing scientific communication, and supporting sustainable site use. The proposed framework provides a flexible yet robust tool to strengthen geoconservation through monitoring and promote the long-term safeguarding of geoheritage. Full article