ABSTRACT Background Given the rising global prevalence of dementia from Alzheimer’s disease, early detection at the stage of Mild Cognitive Impairment (MCI) has become increasingly critical. In countries like the United States (U.S.), speech-language pathologists (SLPs) play an essential role in early risk identification and cognitive management of MCI. However, knowledge, attitude, and practice (KAP) patterns among Indian SLPs remain underexplored in this context. It would also be of great interest to examine whether the KAP patterns of Indian SLPs regarding MCI differ from those of their U.S. counterparts, given the influence of cultural and healthcare diversities. Investigating such differences could provide valuable insights into cross-national practices, which in turn could inform the development of international guidelines for cognitive communicative services by SLPs delivering clinical care to older adults at-risk for dementia. Aim The study aimed to investigate the KAP of SLPs in India regarding MCI diagnosis and treatment and compared these findings with trends among SLPs in the U.S. Methods & Procedures A cross-sectional study employing purposive sampling was conducted. The questionnaire, adapted from a U.S. based survey by Lanzi et al. (2022), assessed Indian SLPs’ KAP related to MCI across three sections: demographics; knowledge and attitude; and clinical practice. Qualitative and quantitative analyses explored KAP patterns among Indian SLPs and then compared the results with the original American survey to examine potential culture-specific differences. Outcomes & Results Results from 94 SLPs revealed a discrepancy between knowledge and practices concerning MCI, specifically in subtypes, diagnostic criteria, and the tools used for assessment and treatment. Notable differences were observed between Indian and American SLPs, especially in assessing activities of daily living and using compensatory strategies for assessment, intervention, and goal setting. Conclusions The findings shed light on the current KAP patterns of Indian SLPs regarding MCI, identifying areas for improvement through targeted education and training. Furthermore, the cross-national comparison underscores the need for culturally sensitive, contextually relevant cognitive-communication interventions to improve the MCI management through collaboratively developed, evidence-based, culturally informed tools.

Cognitive rehabilitation in contemporary neuropsychological practice: an exploratory survey of service delivery, reimbursement, and perceived barriers.

Background: Life Kinetics training, a multimodal intervention integrating coordinated motor tasks with cognitive challenges, has been proposed as a method to enhance neurocognitive and sport-specific performance. This study examined the effects of an 18-session Life Kinetics program on concentration, working memory, and service performance in junior and intermediate badminton athletes. Methods: Forty athletes (20 junior, 20 intermediate) were included in the final analysis following random allocation to Life Kinetics or control groups. The intervention group performed Life Kinetics training in addition to regular badminton practice for six weeks, while the control group maintained standard training. Outcomes included concentration (Concentration Grid Test), working memory (Digit Span Test), and short- and long-service performance. Data were analyzed using mixed-design ANOVA to assess Group × Time (pre–post) effects, with statistical significance set at p < 0.05. Results: Significant Group × Time interaction effects were observed for concentration (F(1, 38) = 152.40, p < 0.001, ηp2 = 0.80), working memory (F(1, 38) = 168.70, p < 0.001, ηp2 = 0.82), short-service performance (F(1, 38) = 181.20, p < 0.001, ηp2 = 0.83), and long-service performance (F(1, 38) = 210.50, p < 0.001, ηp2 = 0.85). The Life Kinetics group demonstrated substantial improvements across all outcomes, whereas the control group showed minimal changes. Improvements were observed in both junior and intermediate athletes, with variations across outcomes. Exploratory EEG observations suggested a shift toward higher-frequency spectral activity following the intervention. Conclusions: Life Kinetics training was associated with significant improvements in cognitive function and service performance in badminton athletes. These findings support the integration of cognitive–motor training into athlete development programs. However, EEG findings should be interpreted cautiously due to methodological limitations, and future research using larger samples and advanced neuroimaging techniques is warranted.

This retrospective cohort study aimed to evaluate whether integrating cognitive-executive dysfunction assessment enhances fall risk prediction beyond Morse Fall Scale in inpatient rehabilitation. Records at an inpatient rehabilitation hospital were reviewed to extract fall status data. Cognitive-executive dysfunction was characterized using non-verbal measures like the Clock Drawing Test, call light/button use, and need for speech-language services for cognitive goals. Of the 1033 patient-charts reviewed, 36 (3.48%) had experienced falls. Fallers had worse Morse Fall Scores (P=0.001) and were four times as likely to require speech-language cognitive services compared to non-fallers (Odd's Ratio = 4.368, P = 0.025) . Adding speech-language cognitive services to Morse Falls scale improved fall risk prediction, increasing model's discriminative performance (73% vs. 69%) and specificity (70.8% vs. 63.9%). In inpatient rehabilitation, incorporating speech-language therapy for cognitive-executive goals improves fall risk prediction beyond Morse Fall Scale alone. The enhanced specificity achieved by combining cognitive-executive screening and Morse Falls score helps better identify patients who are not at a high risk for falls, and thereby optimize resources. These findings underscore the value of integrating speech therapy with nursing, and physical therapy and occupational therapy to establish a comprehensive strategy for fall prevention in inpatient rehabilitation.

The increasing elderly population in Klaten Regency, reaching 17-18%, brings challenges in the form of an increased risk of cognitive decline and dementia. Posyandu (Integrated Health Post) Dahlia Mandiri in Tegal Malohan faces limitations in cognitive stimulation services due to a lack of media and the human resources capacity of its cadres. This community service activity aims to implement rollmate technology as a non-pharmacological intervention to improve the cognitive function of the elderly through the empowerment of Posyandu cadres. Training was conducted for six cadres using lecture and hands-on methods. The intervention was then applied to 55 elderly people over two cycles to measure the effectiveness of the tool's use on cognitive speed and scores. The cadre training showed a significant increase in knowledge, with an average pre-test score of 30.89 to 86.83 in the post-test. In the elderly group, the application of rollmate successfully increased the speed and duration of use by 1.5 minutes and increased scores by 100%. Qualitatively, elderly people reported feeling more "fresh" mentally and showed increased focus and stabilization of cognitive scores. The use of rollmate is effective as a means of stimulating eye-hand coordination and a recreational psychology for the elderly. Integrating this tool into routine posyandu activities is crucial for the sustainability of the intervention, with family support being a key factor in independent use at home. Keywords: Elderly, Cognitive Function, Rollmate, Posyandu Cadres

ABSTRACT Accessibility in cultural venues is critical along the different phases of the visitor journey: planning, arrival, visit, and departure. Against this framework, this article reports on the results of three focus groups in Catalonia in which two aspects were addressed: (a) the accessibility needs of persons with intellectual disabilities and the elderly when visiting cultural venues, and (b) the potential of a distinct cognitive accessibility service based on spoken Easy Language (easy audio explanations). Results highlight the importance of pre-visit information, staff training, and post-visit feedback mechanisms, while stressing the uneven presence of access services in cultural venues. Participants also show interest in the potential of the suggested cognitive accessibility service to enhance the comprehensibility of cultural experiences, while suggesting a universal design approach, the inclusion of AI-powered tools, clear user interfaces, and co-creation processes with users.

The article explores the scientific and technological foundations for the use of ontological platforms and semantic knowledge integration technologies in the context of STEM education development. A comprehensive analysis of modern ontology construction tools that ensure the formalization of knowledge, the establishment of semantic relationships between educational concepts, and the integration of educational resources from different disciplines is conducted. A conceptual model of transdisciplinary STEM ontology is substantiated, which includes the structure of entities, properties, relations, and logical rules and ensures the formation of interdisciplinary connections in the educational process. The architecture of an ontology-driven educational system is proposed, which provides for the integration of semantic knowledge models with analytical modules and cognitive educational services. The possibilities of using ontological platforms to create adaptive educational environments in which automated analysis of educational data, identification of knowledge gaps, and formation of personalized recommendations for students are carried out are considered. The prospects for integrating the developed models into digital educational ECO-systems are revealed, which contributes to the development of intelligent educational services and increases the effectiveness of STEM training.

Abstract Introduction In 2017, Medicare introducee Cognitive Assessment and Care Plan (CACP) billing code, which reimburses healthcare providers for comprehensive dementia visits. Uptake of CACP has been very low; drivers of use and underuse are not known. We sought to understand whether CACP spreads through practices after a champion provider adopts CACP. Methods We used 100% samples of Medicare Fee‐For‐Service claims and Medicare Advantage encounters from 2017 to 2022 to model the relationship between peer CACP adoption and individual CACP adoption. Results Our sample contained 607,164 providers, 8553 of whom billed for CACP from 2017 to 2022. Having a peer adopt CACP was associated with higher odds of adopting CACP individually (odds ratio [OR]: 17.1, confidence interval 95% CI: 16.1 to 18.2). The association was stronger if the peer shared the same specialty (OR: 23.5, 95% CI: 22.1 to 24.9). Conclusion Being exposed to a peer who adopted CACP was a strong predictor of providers’ own uptake of CACP.

Pharmacists deliver high-value cognitive services in the ambulatory care setting; however, lack of provider recognition under the Social Security Act restricts their ability to independently deliver billable clinical services and access reimbursement through national payers such as Medicare Part B. This often raises the question of whether the collaborative efforts of a pharmacist and a billing provider (eg, physician) during a patient encounter can be combined as a "shared visit" to bill for a higher level of service (LOS). However, a distinction must be made between shared visits and "incident-to" billing. In an incident-to model, in which a pharmacist sees the patient alone under billing provider supervision, the service can only be billed at the lowest level, 99211, according to Medicare as of 2026. Even when both a pharmacist and billing provider see the patient and contribute to the visit, the pharmacist's documentation cannot be used to determine the LOS because they are not a recognized billing provider; only the billing provider's documented work counts for billing purposes. However, this should not deter collaboration between pharmacists and other health care providers given the clinical benefits of team-based care. With evolving billing requirements tied to documentation of the billing provider, opportunities remain to establish sustainable collaborative care models despite limitations in leveraging combined pharmacist-billing provider documentation to increase LOS through a shared visit model.

In recent years there have been exciting developments in the diagnosis and treatment of mild cognitive impairment and dementia due to Alzheimer's disease. Robust biomarkers and potentially disease modifying therapies are now available, with multiple other agents in clinical trials alongside on-going validation studies of blood-based biomarkers. Recent and probable future developments in the diagnosis and care of people with Alzheimer's disease pathology warrants serious re-evaluation of the structure and function of cognitive clinical services. Here we report recommendations from the November 2024 Brain Health Scotland roundtable discussion of opportunities and challenges for modern memory services.

Paired Associates Learning Performance in Rats Requires the Nucleus Reuniens

ABSTRACT Healthcare is widely recognized as one of the most critical services individual encounter throughout their lives, with growing expectations for higher quality and patient centered care. The purpose of this research is to systematically identify and examine the key constructs influencing outpatients’ satisfaction in private hospital settings. A six-dimension service quality model comprising technical quality of care, patient-provider communication, perceived cost, perceived waiting time, accessibility, and physical characteristics was developed and empirically tested on outpatients in private Lebanese hospitals. The findings provide empirical evidence of the effects of perceived service quality, patient trust, and patients’ emotions on patient satisfaction informing the development of the final model. Overall, the study contributes to both theory and practice by advancing empirical understanding of outpatient satisfaction and service quality in private healthcare settings. From a healthcare management perspective, managers of private hospitals would benefit from this framework as a practical diagnostic tool to assess patient satisfaction guide service quality improvement initiatives. Future research needs to examine the tensions between cognitive service quality and affective responses, perceived costs with patient demographics, and a comparison between SERVQUAL with HEALTHQUAL frameworks on outpatient care.

Purpose This research aims to address gaps in understanding the interplay between cognitive (COG) service evaluations and holistic experiential values in dark tourism. Specifically, given the focus on the Gen Z tourist segment, it explores the relationships between the five dimensions of service quality, their experience quality and loyalty. Design/methodology/approach This study applies the stimulus-organism-response model to examine the drivers and behavioural outcomes of tourist experience quality in dark tourism. It combines in-depth interviews with 24 Gen Z participants (aged 18–27) and a structural model tested on survey data from 477 Gen Z visitors, linking 5 service quality dimensions (stimuli), tourist experience quality (organism) and word-of-mouth and revisit intention (response). Findings The study identifies key drivers of customer experience at dark tourism sites. Specifically, COG experience is shaped by communication (COM), authenticity (AUT) and pluralistic values. Emotional and social experiences are influenced by responsiveness and AUT. Sensory experiences play a particularly impactful role in fostering word-of-mouth (WOM) and revisiting intentions. Tourists' experiential values, in turn, strengthen visitor loyalty and encourage positive WOM. Practical implications Research findings underscore the need for preserving physical AUT, designing sensitive multisensory environments, strengthening interpretive COM and fostering empathetic service delivery, while leveraging cost-effective digital and community-based strategies to enhance engagement and sustainable advocacy among Gen Z travellers. Originality/value This study is the first to examine how service quality evaluations and experiential values jointly shape tourist loyalty in Vietnamese dark tourism, while offering validated measurement scales for dark tourism service quality and experience quality for future research.

This article examines the theoretical and practical foundations for fostering giftedness and supporting scientific research activities among students within STEM education. It analyzes factors influencing learning effectiveness, emphasizing the integration of cognitive, technological, and pedagogical components that develop systematic thinking, problem-solving, and interdisciplinary competencies. Special attention is given to semantic networks as tools for structured knowledge representation, enabling students to organize information, enhance analytical and critical thinking, and evaluate research data effectively. A STEM-oriented model for supporting gifted students’ research activities is proposed, including personalized learning trajectories, task adaptation to individual cognitive and motivational characteristics, and integration of modern digital services. The model also emphasizes independent research, collaborative problem-solving, and project-based learning to stimulate creativity and deepen understanding of complex concepts. The research highlights technological approaches and digital tools that engage students with educational objects and research processes, including robotics kits, virtual and augmented laboratories, cloud platforms, IoT sensors, cognitive services, and knowledge graphs. These tools provide handson interaction, support data collection and analysis, and foster autonomous learning and interdisciplinary thinking. Research support tools are designed using semantic networks to model knowledge and research processes, combined with digital technologies promoting self-directed exploration and analytical reasoning. The proposed approaches enhance students’ scientific competence, develop innovative potential, and build transferable skills necessary for addressing complex real-world problems. Overall, the study offers a practical framework for implementing STEMbased strategies that nurture giftedness and research skills, preparing students for academic and professional success in a knowledge-driven society.

With the rapid growth of the Internet of Things, service explosion has become a serious challenge, hindering efficient collaboration in the Cyber-Physical-Social-Thinking (CPST) space. In response, the Internet of X (IoX) under the CPST framework is examined through an in-depth analysis from three dimensions: Internet of Things (IoT), Internet of People (IoP), and Internet of Thinking (IoTk). The rapid growth of IoT devices and data, the significant increase in the frequency of personalized interactions in IoP, and the explosive growth in the demand for IoTk cognitive services have caused existing communication, computing, and storage systems to face problems such as response delays and resource bottlenecks. To address the above challenges, a new AGI-based paradigm is proposed to address the problem of service explosion. The main mitigation approaches include interoperability, data/network efficiency, and security in IoT; scalable user management, personalization, and privacy in IoP; and brain-computer interaction, neural data processing, and brain information privacy in IoTk. Subsequently, the case of smart homes is employed to elaborate on how AGI alleviates the service explosion phenomenon in IoT, IoP, and IoTk scenarios. Finally, the development of artificial super intelligence is anticipated, and potential directions for future research are outlined.

Objective: Examine whether self-reported cognitive symptoms, an indicator of need, were associated with the likelihood that Veterans with moderate-severe traumatic brain injury (msTBI) received a cognitive rehabilitation referral. We also explored whether non-clinical factors modified the relationship between cognitive symptoms and receipt of a referral. Setting: Veterans Health Administration (VHA). Participants: Veterans with msTBI, determined using Comprehensive Traumatic Brain Injury Evaluation data from 2013–2023 ( n = 10 790). Design: Cross-sectional study of VHA medical record data. Modified Poisson regression modelled the likelihood of cognitive rehabilitation referral based on cognitive symptom severity and non-clinical predisposing (eg, race/ethnicity) and enabling (eg, drive time) factors. Models were specified to explain referral to occupational therapy (OT), speech-language pathology (SLP), and neuropsychology. Statistical interactions determined whether non-clinical factors modified the relationship between cognitive symptoms and referral. Main Measures: Cognitive rehabilitation referrals, identified using a validated algorithm detecting key phrases in unstructured consult data. Self-reported cognitive symptom severity measuring using the Neurobehavioral Symptom Inventory. Results: Only 35% received a cognitive rehabilitation referral, with SLP services being the most common discipline (25%). Veterans with more severe self-reported cognitive symptoms were more likely to receive a referral (relative risk [RR], 1.06; 99% confidence interval [CI], 1.05-1.08), and this relationship was stable in discipline-specific models. However, many Veterans without a referral reported disabling cognitive challenges, indicating unmet need. Non-clinical factors—including drive time (RR, 0.86; 95% CI, 0.77-0.97) and rurality (RR, 0.92; 95% CI, 0.85-0.99)—were associated with receipt of a referral, though these relationships varied across discipline-specific models. Interactions did not provide support for non-clinical factors modifying the relationship between cognitive symptoms and receipt of a referral. Conclusions: While cognitive rehabilitation services tend to be allocated to those in need, results revealed gaps in access. Findings can guide development of strategies expanding access to cognitive rehabilitation among Veterans with msTBI, enhancing clinical outcomes.

Artificial intelligence (AI) is a field of computer science dedicated to solving cognitive problems typically associated with human intelligence, such as learning, creation, and image recognition. Amazon's cognitive services represent a key segment of innovation within Amazon Web Services (AWS), offering advanced tools based on artificial intelligence that enable machines to mimic human abilities of perception, understanding, and decision-making.

ABSTRACT Objective To provide a snapshot of the availability and accessibility of cognitive assessment in Australia to identify relative areas of strength, as well as opportunities for improvement in service delivery. Method An anonymous survey was completed by 241 clinicians who self-identified as conducting cognitive assessments in Australia between 6 June 2023 to 11 August 2023. These clinicians completed a 27-item online questionnaire asking about their clinical practice. Quantitative data were analysed descriptively, and qualitative data analysed through inductive content analysis. Results Most participants were registered psychologists (98%) with over 70% of the sample holding clinical endorsement or undertaking a registrar program. Clinicians were overwhelmingly “Caucasian”, despite providing services to a more multicultural client base, and were primarily conducting assessments in state capitals. The average cost of a cognitive assessment for those who paid was $1,634 with a 2–3-month modal wait period across both private and public settings. Conclusions Our survey is the first to document the relative availability and affordability of cognitive assessment in Australia. We call upon sector and government leaders to address the gaps identified to ensure high-quality cognitive assessment services are available across diverse populations in Australia

ABSTRACT Aim/Purpose This study investigates customer sentiment toward telecom Quality of Service Delivery (QoSD) in Ghana by integrating dual sentiment, that is, an expressed emotional sentiment from customer narratives and experienced service sentiment derived from SERVQUAL ratingsinto a unified service quality evaluation framework. Background Although SERVQUAL-based research consistently links service quality dimensions to customer satisfaction, far less is known about how emotional expressions interact with cognitive service evaluations in developing markets. This gap limits understanding of how users interpret service failures and form satisfaction judgments in resource-constrained telecom environments. Methodology A nationwide survey of 536 mobile users was analyzed using a hybrid analytical approach: (1) natural language processing (NLP) sentiment scoring of open-ended responses, and (2) construction of a Service Sentiment Index (SSI) based on standardized SERVQUAL dimension scores. Mediation analysis using Hayes’ PROCESS tested whether experienced sentiment serves as a psychological pathway linking reliability to overall satisfaction. Contribution The study introduces and empirically validates a dual-sentiment framework for telecom QoSD assessment, demonstrating significant divergence between customers’ expressed emotional sentiment and their experienced service sentiment. It extends the SERVQUAL model by incorporating affective evaluation processes and provides empirical evidence that sentiment partially mediates the reliability–satisfaction relationship. Findings Expressed sentiment was predominantly negative (56.5%), whereas SSI reflected more moderate evaluations. Reliability, assurance, and empathy emerged as key predictors of both sentiment and satisfaction. Mediation results confirmed that experienced sentiment explains a substantial portion of the total effect of reliability on satisfaction, supporting a dual cognitive–affective interpretation of QoSD. Recommendations for Practitioners Telecom providers should prioritize network reliability, transparent communication, and empathetic customer engagement to address emotional dissatisfaction. The presence of strong negative expressed sentimenteven among customers reporting moderate satisfactionsignals potential reputational and churn risks requiring proactive management. Recommendations for Researchers Researchers should integrate text analytics with psychometric models in service quality studies and further examine sentiment as a mediator across diverse service industries and cultural settings. Impact on Society Understanding sentiment divergence enhances the design of customer-centric QoS interventions, strengthens regulatory oversight, and supports the development of more responsive telecom service policies in emerging markets. Future Research Longitudinal studies should explore sentiment trajectories over time, while cross-market comparative research should validate the generalizability of the dual-sentiment framework across other developing and developed economies.

The children's book publishing industry is facing the dilemma of market downturn and fierce competition. Generative Artificial Intelligence (AIGC) provides a breakthrough path for the development and dissemination of children's storybook intellectual property (IP). This paper analyzes how AIGC reconstructs the IP value chain and promotes the transformation of the publishing industry from static books to dynamic interactive ecology. Opportunities include reducing development costs, improving efficiency, and amplifying the potential of IP derivatives, such as "millet economy" cross-border. However, its transformation faces challenges such as lack of content quality, security risks, insufficient cultural inclusion, copyright ethics and market integration. To this end, human-AI collaboration, multi-layer filtering, localized training, traceability mechanism and cross-border integration are proposed to help publishers transform IP into sustainable industrial vitality, and realize the upgrade from a single content output to a children's cognitive service provider.