Impact of multimodal training on nursing staff's competencies in dementia mealtime support: A mixed-methods pilot study.

Excess sodium intake is a leading modifiable risk for noncommunicable diseases. Despite some national sodium-reduction initiatives, no population-level updates to sodium-related knowledge, attitudes, behaviors (KAB) have been available since 2011. This study aimed to compare sodium-related KAB among Canadian adults in 2011 and 2024 and examine differences by sex and age, hypothesizing limited changes due to insufficient national sodium-reduction initiatives. Repeated cross-sectional national surveys were conducted in 2011 (n = 2603) and 2024 (n = 3267), readministering the same sodium KAB questions from the 2011 survey. Knowledge responses were coded as correct/incorrect, and 5-point Likert-scale items were recoded or dichotomized. Data were weighted to the Canadian census. Rao-Scott adjusted χ2, t-tests and regression models assessed changes over time, stratifying by sex and age. The proportion of adults actively limiting sodium intake declined from 57.4% in 2011 to 37.3% in 2024 (P < 0.001). Concurrently, engagement in nearly all sodium-reduction behaviors decreased in 2024, including avoiding processed foods (69.3%-52.3%), not adding salt at the table (69.2%-58.1%), avoiding salt during cooking (62.3%-43.4%) (all P < 0.001), and reading Nutrition Facts labels (54.2%-49.6%, P = 0.005). Paradoxically, overall population sodium concern remained high and unchanged (66.3%-65.9%, P = 0.812). Food label interpretation and awareness of recommended sodium intake improved (P < 0.001), but knowledge of health-related conditions linked to sodium such as blood pressure, heart disease, and stroke decreased (all P < 0.001). Reported barriers to sodium reduction included cost, taste, time constraints, and lack of social support. Many indices of sodium-related KAB deteriorated from 2011 to 2024 among Canadian adults, despite their continued concern about sodium intake. These findings highlight a widening knowledge-to-action gap and reinforce the need for comprehensive public health efforts to support population-wide dietary sodium reduction.

This paper explores how new pedagogic strategies (experiential learning, technology-enhanced learning, and interdisciplinary learning) can influence the sustainability and biodiversity education. The study will contribute to ecological literacy, student involvement, and pro-environmental behavioral improvement.The qualitative, exploratory research design was used in both the secondary and tertiary institutions using semi-structured interviews, focus groups, classroom observation, and instructional materials analysis. They involved educators, curriculum developers, and students involved in sustainability-oriented programs. Based on thematic analysis, it was found that six major pedagogical themes: experiential learning, technology-enhanced instruction, interdisciplinary curriculum integration, student engagement, ecological literacy, and pro-environmental behavior were strongly present in the results. The highest Ecological Literacy Index (ELI) scores were recorded in students who were exposed to high levels of experiential learning (mean = 4.7). On the cognitive (mean = 4.5) and behavioral engagement (mean = 4.6), cognitive and behavioral engagement improved substantially when technology-enhanced instruction was involved, especially using digital simulations. Interdisciplinary instruction led to moderate to high levels of engagement in cognitive, emotional, and behavioral aspects in the students. It was also established that high scores of experiential and interdisciplinary integrations were closely related to the strongest scores in the Pro-Environmental Behavior Index (PEBI) (mean = 4.4). The results indicate that an ecological literacy improvement, increased student engagement, and positive change in pro-environmental attitudes and behavior are the likely outcomes of ecological synergy and holistic and transformative pedagogies at once. The study concludes by recommending additional studies to examine the long-term behavior change.

The paper discusses how an English Medium Instruction (EMI) environment, which is based on a Content-Based Instruction (CBI) approach, affects the learning outcomes of English for Specific Purposes (ESP) students in Arab world universities. The study adopted a quasi-experimental mixed methods design, comparing the acquisition of listening comprehension skills, motivation, and attitudes towards learning among 125 students from Bahrain, Saudi Arabia, and Egypt. The findings revealed that the combined EMI/CBI strategy resulted in a significant improvement in the listening skills of all participant groups, with performance levels varying depending on the national environment. Additionally, the intervention led to significant positive changes in student motivation and attitudes, with the most notable attitude shifts observed among cohorts in Saudi Arabia and Egypt. The results emphasize the importance of teaching language and content simultaneously in ESP classrooms and highlight the substantial impact of local socio-educational factors on teaching effectiveness. This study provides evidence-based recommendations for educators and policymakers by presenting a model that supports the successful implementation of immersive, content-based language pedagogy tailored to the diverse educational contexts within the Arab region.

This study aims to comprehensively analyze the nature of learning and instruction in elementary schools through a literature study approach. The review was conducted by examining various classical and modern learning theories, concepts of 21st-century learning, and the practical implications that emerge within the context of basic education. The data were obtained from academic books, national and international scientific journals, research reports, and various digital publications relevant to the topic. Based on the literature review, learning is understood as a complex process that results in changes in behavior, knowledge, skills, values, and attitudes through direct experience or social interaction. Effective instruction requires a paradigm shift from teacher-centered learning to student-centered learning, where teachers are no longer merely transmitters of information but act as facilitators, motivators, and guides in the learning process. The study also shows that the implementation of 21st-century learning in elementary schools demands the application of instructional strategies that stimulate critical thinking, creativity, collaboration, and digital literacy. Learning must be designed to accommodate the developmental needs of children, particularly because elementary students are at the concrete operational stage, requiring real and contextual learning experiences. This study emphasizes that instructional quality will improve when planning, implementation, and evaluation are developed based on a deep understanding of children’s learning characteristics. Thus, this literature study provides a comprehensive overview of the importance of understanding the nature of learning and instruction as the foundation for developing effective, relevant, and sustainable educational practices in elementary

Attitudes change gradually and spontaneously in daily life, yet the neural mechanisms supporting such dynamic shifts remain poorly understood. Leveraging naturalistic fMRI paradigms across two studies, we investigated how neural dynamics track and implement attitude change during exposure to persuasive arguments. Our findings highlight the dorsal anterior cingulate cortex (dACC) as a central hub in this process. Individuals with more similar trajectories of attitude change exhibited greater similarity in the temporal dynamics of dACC activity and its functional connectivity with other brain regions, particularly the default mode network (DMN). These neural dynamics further predicted whether an individual changed their attitude over time, and at the precise moment of change, dACC-centered connectivity predicted the direction of that change. Additionally, individuals with higher intolerance of uncertainty (IU) showed stronger coupling between neural and behavioral similarity, suggesting that IU may serve as a trait-level modulator of this neural process. Together, our findings provide a dACC-centered, process-level account of the neural mechanisms underlying dynamic attitude change, bridging the gap between controlled laboratory research and real-time, naturalistic attitude change in daily life.

Youth violence remains a leading cause of morbidity and mortality. Social network-based interventions offer opportunities to strategically leverage relationships to reduce youth violence. This study evaluates feasibility and acceptability of a social network-based intervention aimed at strengthening adolescent-adult relationships. We conducted a parallel arm cluster-randomized trial evaluating a 12-session adolescent-adult social network-based intervention (Strengthening Connections for Change [SCC]) compared to a control condition (job skills training) across 4 neighborhood sites. Participants included youth aged 13-17 years and adults identified by youth as key supports. Our primary outcomes were feasibility (measured with session attendance) and acceptability (measured with satisfaction ratings). Exploratory outcomes included changes in social network characteristics and violence-related attitudes and behaviors from baseline to end-of-program (EOP). We used descriptive statistics for primary outcomes. Generalized linear mixed models assessed intervention effects on secondary outcomes using an intention-to-treat approach. A total of 63 youth (SCC: n = 34; control: n = 29) participated across 4 sites. Youth attendance was similar across study arms; adult engagement was variable. Satisfaction was high for both conditions. Youth in both study arms had increases in relationship strength, decreases in past-month violence victimization, and decreases in violence-related attitudes from baseline to EOP. Compared to control, SCC showed greater increases in network density and decreases in violence perpetration from baseline to EOP. SCC is feasible and acceptable for youth and their adult supports and may have potential to reduce violence. Future large-scale evaluations of SCC can guide strategies to cultivate meaningful adolescent-adult relationships in violence prevention programs.

Reconsidering the microwave: A historical analysis of changing attitudes to modernist kitchen technology

This study conducted a survey of 243 learners who had taken a blended learning-based certification course at a beauty academy. The collected data were analyzed using SPSS 25.0 and AMOS 25.0 programs to perform frequency analysis, exploratory and confirmatory factor analysis, reliability analysis, and correlation analysis. Structural Equation Modeling (SEM) analysis was conducted to verify the structural relationships among the variables. The results of the study showed that the model fit was acceptable (CFI=.966, RMSEA=.069), and the main findings are as follows. First, the learning content of blended learning had a statistically significant positive (+) effect on learners’ knowledge (β=.651), attitude (β=.637), and cognitive engagement (β=.218). This suggests that a systematic curriculum and easy-to-understand learning content are key antecedents that induce not only the acquisition of major knowledge but also positive learning attitudes and engagement. Second, both knowledge (β=.312) and attitude (β=.453) had a significant positive (+) effect on cognitive engagement. In particular, the influence of attitude on cognitive engagement was relatively greater, indicating that learners’ emotional motivation and proactive attitude are key mechanisms that enhance engagement during practical performance processes. This study demonstrated the structural path in which the qualitative enhancement of learning content in a blended learning environment promotes cognitive engagement through the mediation of knowledge and attitude. These results suggest the necessity of a systematic learning design that combines online and offline elements to maximize the effectiveness of beauty practice education and provide empirical foundational data for establishing teaching and learning strategies that can lead to active learner participation and attitude change.

This qualitative phenomenological study explored the experiences of students and educators in the implementation of project-based learning (PBL) in environmental education, focusing on how PBL influenced environmental awareness, values formation, skills development, and sustainable behaviors. The study was conducted among selected college students and instructors’ participants involved in PBL-based environmental projects and utilized in-depth interviews and thematic analysis to examine their lived experiences. Findings revealed that project-based learning promoted transformative and values-driven learning by moving students beyond rote memorization toward meaningful, real-world engagement. Key themes that emerged included real-world and community-based learning, experiential and hands-on activities, collaboration and teamwork, development of critical thinking and leadership skills, positive changes in environmental attitudes and behaviors, and the development of personal responsibility toward sustainability. Results also identified challenges related to student motivation, mindset, collaboration, time management, and limited resources; however, these were addressed through structured planning, scaffolding of complex concepts, effective communication strategies, and continuous guidance from educators. Collaboration with peers, teachers, families, and community members further enhanced project relevance and learning impact. Overall, the findings indicate that project-based learning is an effective pedagogical approach for environmental education when supported by contextualized instruction, strong collaboration, and appropriate instructional support. The study provides insights that may guide educators and school stakeholders in strengthening environmental education practices through learner-centered, experiential, and community-engaged instructional approaches.

ABSTRACT To assess the effects of participation in the Community Action Poverty Simulation (CAPS) on empathy and attitudes about poverty in undergraduate nursing, public health, and healthcare administration students and personnel attending a mid-sized southern regional university. Design: A quasi-experimental pretest – posttest evaluation of changes in empathy and attitudes about poverty after an experiential learning intervention. Participants (N = 447) completed pre- and post- validated surveys, including the Kiersma-Chen Empathy Scale and the Attitudes Toward Poverty Short Form, and data were subjected to descriptive and paired analyses (paired t tests and Wilcoxon signed-rank tests) to identify significant within-subject changes. Thematic analysis was performed on open-ended responses. Post simulation empathy scores increased significantly (p < .001). Changes in overall attitudes about poverty reached statistical significance in the first simulation. Qualitative themes included enhanced empathy, increased awareness of barriers, and critical reflection about personal biases. Simulation-based experiential learning activities can effectively and efficiently increase empathy and critically reflect on poverty in future health care providers. The study’s findings highlight the value of incorporating structured and facilitated CAPS into nursing and health sciences curricula. Simulation-based learning focused on empathy and social determinants of health can prepare community health nurses and other health professionals to interact with economically marginalized patients with increased sensitivity to structural limitations, decreased focus on deficiencies, and enhanced respectful, patient-centered dialogue.

Of all the fallen women on the Victorian stage, Nancy in adaptations of Dickens’ Oliver Twist is the lowest. Specifically deemed a ‘prostitute’ by the author, she is also the abused mistress of a thuggish burglar who murders her. In the innumerable dramatisations of the novel, Nancy might seem appealing as an opportunity for character acting, but presents a hurdle to actresses chary of risking their hard-won reputations. How could such a debased woman be made palatable to the admirers of respectable leading ladies? So an offstage marriage ceremony took place in which she became ‘Nancy Sykes’ (the name usually misspelt). This essay will examine how the interpretation of Nancy and her profession were ameliorated and bowdlerised to suit changes in social attitudes and how these alterations were accommodated in playwriting, staging, and publicity. It will place her within the dramatic conventions of melodrama's fallen woman, demonstrating where she fits on the scale of the courtesan and the ‘woman with a past’.

Robotic-assisted surgery is transforming surgical practice, necessitating early exposure for medical students. Its representation in undergraduate curriculum is limited. This study was conducted with the objective to assess if a structured simulation-based demonstrative workshop impacted any change in knowledge and attitude of medical undergraduates towards robot-assisted surgery. A cross-sectional study was conducted at a robotic training facility on undergraduates. Baseline and post-session questionnaire-based survey using a validated self-developed questionnaire was done for knowledge and attitude domains. The workshop included 15-min didactic lecture and live demonstration of simulation tasks. Statistical analysis was performed using STATA 18.0. Fifty undergraduates were enrolled. Median knowledge scores increased from 2 (interquartile range [IQR]: 1-4) to 7 (IQR: 4-9) (P < 0.0001). The majority believed robotic surgery should be integrated into medical curriculum. Median attitude score increased from 2 (IQR: 2-3) to 3 (IQR: 3-5) (P < 0.0001). Structured robotic simulation workshop significantly enhanced medical students' knowledge and attitudes towards robotic surgery.

Two studies investigated the roles of interconnectedness and critical reflection in reducing indifference and mobilizing collective action intentions for lesbian, gay, bisexual, and transgender (LGBT+) and other social minoritized groups. Study 1 used a cross-sectional design with 378 heterosexual cisgender participants recruited from Hong Kong. Findings indicated that critical reflection accounted for significant variance in indifference toward LGBT+ and minoritized groups (ΔR² = .07-.18, p < .001) and collective action intentions (ΔR² = .04-.20, p < .001). Interconnectedness also contributed to variance in these outcomes, but to a lesser extent (ΔR² = .02-.05, p < .01). Study 2 employed a 3 (interconnectedness, critical reflection, and control) by 2 (sample types: 111 heterosexual cisgender and 112 LGBT+) experimental design with participants recruited in Hong Kong. In other words, participants were randomly assigned to six experimental conditions to evaluate how different inductions worked on indifference and collective action intentions in sexual and gender diverse samples. Results showed that, among heterosexual cisgender participants, both inductions effectively lowered indifference toward LGBT+ and minoritized groups (p < .001) and enhanced LGBT+ collective action intentions (p = .001-.01). Among LGBT+ participants, while interconnectedness decreased indifferences, it did not significantly increase collective action intentions, suggesting different mechanisms of attitude change and behavioral intention across social groups. These findings highlight the potential of interconnectedness and critical reflection as strategies to mobilize heterosexual cisgender individuals and the LGBT+ community in addressing social injustices. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Microplastics have emerged as a growing environmental and public health concern, found in air, water, and food, with potential health impacts including respiratory, digestive, and endocrine disruption. Therefore, the preventive effort needs to be amplified. This study aimed to evaluate the effectiveness of three different microplastic education interventions, lecture-based education, peer group education, and infographic distribution, among high school students in DKI Jakarta. A quasi-experimental design was employed involving 334 students from six schools, with pre- and post-intervention assessments of knowledge and attitudes. Data were analyzed using the Wilcoxon Signed-Rank Test and Kruskal-Wallis Test, followed by Dunn's post hoctest. Findings revealed that peer group and infographic interventions significantly improved knowledge scores, with the peer group showing the most substantial gains. However, lecture-based education did not yield significant improvement in knowledge. Attitude changes across all interventions were not statistically significant, although numerical improvements were observed, especially in the peer group. The Kruskal-Wallis test indicated significant differences in knowledge improvement across groups (p=0.0041), and Dunn's test confirmed a statistically significant difference between peer group and lecture-based education. The results suggest that interactive and peer-driven educational approaches may be more effective in enhancing students' understanding of microplastic pollution compared to traditional lectures. However, attitude change may require more prolonged or multifaceted interventions that integrate psychosocial and behavioral elements. Given the formative nature of adolescence and their potential as agents of environmental change, incorporating targeted and participatory education into school curricula is essential. These findings underscore the importance of using context-specific, engaging methods for environmental health education, contributing to the achievement of Sustainable Development Goals (SDGs), particularly SDG 12 and SDG13.

Objectives: The COVID-19 pandemic significantly disrupted healthcare delivery, including the highly effective treatment of electroconvulsive therapy (ECT). This study aims to explore the perspectives of ECT service providers at Western Health, a metropolitan hospital in Melbourne, Australia during the COVID-19 pandemic. Materials and Methods: Surveys were distributed to Western Health staff involved in ECT delivery during the pandemic, gathering insights on changes in demand, protocols, patient attitudes, support received, and challenges faced. ECT delivery data from 2017 to 2022 was also analysed. Results: Nineteen out of 38 responses were complete for analysis from 100 people surveyed. The median respondent age was 38, with 5 years of ECT experience and a median of 25 sessions delivered in the past year. Key challenges reported by clinicians included the use of personal protective equipment (PPE), screening procedures, and managing infection risks, with 79% reporting significant protocol changes. In addition, 21% noted patient hesitance due to cumbersome procedures, though 89% felt adequately supported by health services. Conclusion: While disruptions occurred, ECT was deemed essential, and protocols were developed to ensure continued delivery. Concerns about delays for urgent cases and patient reluctance highlight areas for improvement. Reflecting on provider feedback and revising guidelines may enhance future pandemic preparedness.

INTRODUCTION. The branch of dentistry known as preventive dentistry focuses on treatments and lifestyle choices that assist individuals in preventing the onset or progression of oral disease. It involves both patient-performed dental care at home and professional dental staff-performed dental care and education in an office or clinic. Fluoride is frequently used to avoid and eradicate dental cavities, new unfavorable media coverage and worries regarding careless fluoride usage contributed to a change in parental attitudes. The benefit of fluoride and possible natural or herbal substitutes, this study investigates parental knowledge, preferences, and attitudes toward preventive interventions. MATERIALS AND METHODS. A survey study was the design of our investigation. Parents of children ages 6 to 14 whom brought their children to the Dijlah University Department of Pediatric Dentistry for examination or treatment were given a 9-questions survey form as part of the study, 300 parents participated in the study. Numbers and percentages were used to record the data. RESULTS. 155 (51.6%) of the parents said they would prefer natural alternatives to fluorinated varnish if they were given a choice to use natural herbal components instead. There was a statistically significant correlation found between the parents’ educational level and their observations on the effects of fluoride ( p &lt; 0.05). Just 19 parents (6.3%) who were university graduates believed fluoride had negative consequences, in contrast to 59 (19.6%) of parents who were primary graduates believed fluoride had negative consequences. CONCLUSIONS. some parents continue to avoid using fluoride products, and parents lack adequate attitudes and thoughtful regarding oral and dental health prevention measures. Therefore, parents need to be aware of fluoride consumption and its impact on children’s health.

Purpose The purpose of this study is to hypothesize that a tailored, game-based intervention in higher education settings for communicating and advocating scientific facts about food sustainability-related topics would significantly improve students’ knowledge and attitudes immediately after the intervention, and these gains would be retained at follow-up, indicating potential for long-term behavior change. While the impact on game-based learning was widely positive, lack of longitudinal follow-up to measure sustained change has been a challenge. Drawing on the perspectives of Elaboration Likelihood Model and the Knowledge–Attitude–Behavior framework, this study evaluates both immediate and sustained cognitive and attitudinal effects. Design/methodology/approach A total of 134 university students volunteered to participate in this study. A validated questionnaire covering the food sustainability topics and related factors were created. A board game intervention covering the same topics was explicitly tailored for this study. In a quasi-experimental design, participants were administered the questionnaire both before and after and 15 days after participating in a tailored board game intervention. Findings The results of this study revealed three key patterns: immediate and persistent improvements across most targeted knowledge items; selective persistence of system-level concepts alongside decrease of some fact-based improvements; and a pronounced shift toward systems-focused attributions of responsibility. Moreover, this study strengthened participants’ attitudes toward the Ministry of Agriculture and Forestry as the primary actor in sustainability. Depletion of agricultural land is consistently perceived as the major factor associated with sustainability, with little change over time. Research limitations/implications Building on these findings, future research should include multi-session designs and include behavioral outcome measures to examine both long-term retention and the translation of attitudinal shifts into actual behavior. This study involved a relatively homogeneous sample of university students; future studies are recommended for implementing the intervention in diverse institutions to enhance generalizability. Practical implications This study provides educators simple and scalable tool to integrate sustainability topics into university teaching and campus outreach. For policymakers and institutional actors, the intervention can inform the development of policy-aligned sustainability communication strategies in higher education, increase awareness and shape attitudes toward food sustainability by engaging students beyond traditional classrooms. Additionally, this study adds to the growing literature on educational game interventions by combining Elaboration Likelihood Model and Knowledge–Attitude–Behavior frameworks with short-term retention assessments. Originality/value This research makes several novel contributions to sustainability education research. Specifically, this study introduces a scientifically informed and tailored board game that uniquely integrates topics on food sustainability with a structured, trivia-based design to engage both central and peripheral routes of cognitive processes, it includes a short-term follow-up at 15 days, enabling the evaluation of knowledge and attitude retention over time, and it applies a combined mixed method analytic strategy combining Linear Mixed Models for repeated-measures data with the best-worst scores, allowing for the examination of both knowledge and attitude change processes.

Abstract This study examines how national and cultural stereotypes, as depicted in audiovisual media, shape the identities of both the EU and the UK. Using excerpts from the multilingual TV series Parlement (2020), the research focuses on post-Brexit portrayals of stereotypes on screen. Over a period of four years, we surveyed 158 young Europeans to gauge their responses to cultural, historical, and political stereotypes presented in the series. The findings reveal changing attitudes toward EU identity amid ongoing socio-political fragmentation, highlighting the complex interaction between media representation and audience interpretation. Our research illuminates the challenges of fostering cross-cultural cohesion, providing insights into how stereotypes are negotiated in multilingual contexts and underscoring the influential role of audiovisual media in shaping collective identities.

Through socialization in friendship networks, individuals' levels of prejudice become more similar to their friends' levels of prejudice over time. However, the potential consequences of socialization for prejudice in a social environment remain unknown, as research has yet to explore the size of the socialization effect. Using longitudinal social network analysis and empirically informed network simulations, the present research investigated the extent to which socialization among low-, medium-, and high-prejudice individuals relates to changes in attitudes toward ethnic and religious outgroups in school friendship networks (N = 2,484 adolescents in 10 German schools). Results from the longitudinal social network model showed that individuals' levels of prejudice became more similar to their friends' levels of prejudice over time, providing evidence of socialization. Results from the empirically informed network simulations revealed that socialization produced at most a 3% change in prejudice over 9 months, reflecting a small effect size akin to the effects of prejudice-reduction interventions. Increases, decreases, and stability in prejudice were observed in the simulations, depending on the initial levels of prejudice among individuals and their friends. Socialization was strongest among friends who held initially opposing attitudes, which led both high- and low-prejudice individuals to become more neutral over time. The findings thus suggest that socialization has a neutralizing effect, rather than a polarizing effect, on prejudice in adolescent friendship networks. This research has methodological implications for the estimation of effect sizes in psychological studies and practical implications for network interventions that aim to utilize socialization to reduce societal prejudice. (PsycInfo Database Record (c) 2026 APA, all rights reserved).