This quantitative research investigated the integration of mobile learning in teaching English as a foreign language (EFL) within Indonesian higher education. This research adopts a two-phase data collection approach, using a structured questionnaire distributed to 134 lecturers from 86 universities and follow-up interviews with 11 selected lecturers. In analyzing this research, Statistical Package for Social Sciences (SPSS) version 26.0 used to provide comprehensive insights into lecturers’ experiences, availability, effectiveness of mobile learning, and adequacy of facilities and content design. The results reveal a general positive attitude towards mobile learning integration (mean score 4.29 out of 5), with particular challenges identified, such as minimal classroom facilities and difficulties in content design. The implications show the importance of combining technology with teaching and support, while the conclusion points out readiness, benefits, and challenges in EFL instruction. At the same time, the conclusion highlights readiness, benefits, and challenges, serving as a guide for further exploration and development in EFL instruction. The importance of this research is intended in delivering and analyzing the development of technology used, readiness of lecturers and facilities challenging, and aligning technology with teaching practice. The study’s limitations encompass potential over-reliance on self-reported data and limited geographical and institutional scope, with recommendations for future mixed-method research, expansion, collaboration, and continuous training and investment in classroom infrastructure.

Impact of the Diagnostic and Therapeutic Assignment Model (MADiT) on the quality of care in institutionalized older adults: A quasi-experimental study

Exercise training alleviates myocardial injury in mice with heart failure with preserved ejection fraction via the TLR4-mediated necroptosis pathway.

Vaccination is vital to public health, yet community pharmacists (CPs) face many challenges in its delivery. As highly accessible healthcare professionals, pharmacists play an essential role in promoting vaccination through education, counselling, and administration, thereby improving immunization coverage and preventing disease. This study aimed to identify and categorize the barriers faced by CPs in Greece when providing vaccination services, focusing on challenges related to patients, governmental policies, pharmacists, and interprofessional collaboration. A quantitative cross-sectional study was conducted using a 24-item questionnaire developed after an extensive literature review. The survey was distributed to CPs in Athens between October and December 2024, with 234 responses collected. The instrument assessed difficulties concerning vaccine administration, patient interactions, regulatory barriers, and professional collaboration. Qualitative insights were also gathered through informal discussions. Ethical approval was granted by the Pharmaceutical Association of Attica, which also endorsed the study. Four major barriers were identified: patient-related issues (e.g. hesitancy, misinformation), government-related obstacles (e.g. regulatory gaps, inadequate remuneration), pharmacist-specific challenges (e.g. limited training, workload), and weak interprofessional collaboration. Younger pharmacists (≤50years) and those with ≤10years of experience were more likely to report vaccine hesitancy (P = .008) and to have received additional training (P = .006). Early-career pharmacists also frequently cited understaffing as a major issue (P = .015). Despite significant barriers, CPs in Greece remain highly motivated to promote vaccination. Strengthening regulation, interprofessional cooperation, and continuous pharmacist training could enhance vaccine uptake and consolidate pharmacists' contribution to public health.

This study aimed to identify the role of training strategies in promoting the implementation of Total Quality Management (TQM) in Jordanian business organizations, as well as to determine the attitudes of employees in Jordanian telecommunications companies towards training strategies and TQM. The study employed a descriptive-analytical approach and used a questionnaire as the data collection tool. (450) questionnaires were distributed to the study sample, and (400) were returned. The data were analyzed using the Statistical Package for the Social Sciences (SPSS, Version 25) and descriptive statistics, including frequencies, percentages, Cronbach's alpha coefficient, and simple regression. The study reached a number of conclusions, most notably: Employees in Jordanian telecommunications companies held highly positive attitudes towards all variables and dimensions of training strategies, with an overall mean of 3.61 and a standard deviation of 0.537. Regarding the availability of training strategy dimensions, E-training ranked first, followed by continuous training. The study sample also held highly positive attitudes towards all variables and dimensions of Total Quality Management (TQM), with a mean of 3.93 and a standard deviation of 0.206. Furthermore, the study revealed a role for training strategies in promoting the application of TQM principles in Jordanian telecommunications companies, along with a positive correlation between them (R = 0.471). E-training and continuous training also played a role in promoting TQM implementation in Jordanian telecommunications companies, demonstrating a positive correlation between them. The study offered several recommendations, the most important of which are: developing training strategies within the training programs of Jordanian telecommunications companies by activating e-training and focusing on the continuity of training, and working to establish a culture of quality dissemination within these companies.

Maternal Mortality Rate (MMR) is still a serious global and national health problem, including in Tanah Bumbu Regency, South Kalimantan, with bleeding and hypertension as the main causes. Effective postpartum services are very important, but the coverage of postpartum and KBPP visits at the Satui Care Health Center shows a decrease or fluctuation. Although the Minister of Health Regulation No. 21 of 2021 requires the use of integrated management charts during the postpartum period, the socialization of this chart/algorithm is not evenly distributed among midwives, has the potential to hinder early detection and management of complications, and contribute to AKI. This study aims to describe midwives' knowledge about the integrated management chart of postpartum services in the working area of the Satui Care Health Center, Tanah Bumbu Regency. This quantitative descriptive study involved 26 midwives as respondents from a population of 34 midwives who provided childbirth care, using the Purposive sampling method. Knowledge was measured by validated and reliable questionnaires (Cronbach's Alpha 0.933 for 15 valid items). The data was analyzed in univariate. The majority of midwives (57.69%) had "Sufficient", 23.08% "Good" and 19.23% "Less" knowledge regarding the integrated management chart of postpartum services. The knowledge of midwives in the work area of the Satui Care Health Center still needs to be improved, especially those with "lacking" knowledge. It emphasizes the importance of socialization and continuous training to optimize postpartum services and reduce AKI.

ABSTRACT The quick development of digital technologies has drastically changed how businesses handle their workforce. This study examines how contemporary technologies like artificial intelligence (AI), data analytics, cloud computing, and digital platforms are changing conventional HR procedures. It focuses on the digital transformation of talent management. The study demonstrates how businesses are using digital tools to improve learning and development, performance management, employee engagement, recruitment, and retention tactics. This study's main goal is to examine how digital transformation affects talent management procedures and determine how well it can enhance organizational effectiveness and employee satisfaction. The report also looks at the difficulties that businesses face, such as the demand for digital skills among HR workers, resistance to change, and worries about data privacy. The research adopts a descriptive methodology and is based on both primary and secondary data sources. The findings indicate that digital transformation leads to faster decision-making, improved talent acquisition, personalized employee development, and enhanced workforce productivity. However, successful implementation requires proper planning, technological infrastructure, and continuous training. digital transformation is no longer optional but essential for organizations to remain competitive in the modern business environment. Effective integration of digital technologies in talent management can create a more agile, innovative, and future-ready workforce. Keywords: Digital Transformation, Talent Management, Artificial Intelligence, HR Analytics, Employee Engagement, Recruitment, Workforce Productivity, Cloud Computing

The study is framed within the need to strengthen teacher performance in primary education, considering that educational quality largely depends on teachers’ preparation, reflection, and continuous professional development; in this regard, teacher professional development is analyzed from a situated and collaborative perspective, as an alternative to traditional decontextualized training models. The general objective was to generate teacher professional development strategies aimed at the comprehensive strengthening of the performance of teachers at the “Andrés Eloy Blanco” National Primary School, located in Punto Fijo, Falcón state. Methodologically, the research was developed under a qualitative approach, with an exploratory-descriptive type of study and a non-experimental design, supported by the action research modality; the population consisted of teachers, school administrators, and key informants from the institution, selected through purposive sampling; in-depth interviews, participant observation, and focus groups were used as techniques, employing interview guides and field diaries as instruments. The results revealed that teachers demonstrate a strong vocation and professional commitment, but face limitations in their continuous training, particularly in areas such as mathematics and languages, as well as economic and access barriers; likewise, a pedagogical practice marked by empirical experience and the need to strengthen collaborative reflection was identified. It is concluded that the implementation of situated and collaborative professional development strategies enhances teacher performance, promotes the collective construction of knowledge, and contributes to institutional educational quality.

This study examined the relationship between the appropriateness of accommodation strategies and the level of modification strategies used by Science teachers in inclusive classrooms for learners with autism. Inclusive education requires teachers to adjust instruction to address diverse learning needs, particularly for learners with autism who often require additional support to participate meaningfully in Science lessons. Understanding how these strategies are related provides insight into teachers’ implementation of inclusive practices. A modified convergent parallel mixed-methods design was employed. Thirteen elementary Science teachers from selected public schools in Bislig City were chosen through purposive sampling. Quantitative data were gathered using a survey questionnaire that measured the use of accommodation and modification strategies, while qualitative data were collected through a focus group discussion to explore teachers’ experiences and challenges. Quantitative data were analyzed using descriptive statistics and Pearson’s product–moment correlation coefficient at the 0.05 level of significance, and qualitative data were used to support and explain the quantitative findings. Results revealed a moderate positive and statistically significant relationship between the appropriateness of accommodation strategies and the level of modification strategies used (r = 0.392, p = 0.029). This suggests that teachers who effectively implement accommodations also tend to apply more instructional modifications. The study concludes that inclusive Science teaching is strengthened when accommodations and modifications are used together, highlighting the need for continuous teacher training and institutional support to improve learning outcomes for learners with autism.

the development of digital technology has changed the paradigm of health care, including in the practice of Telenurse, where nurses are required to have sufficient digital competence to provide remote services effectively. Purpose: This study purpose to determine the effect of digital technology training on the competence of nurses in Telenurse services. Methods: this study uses quasi-experimental quantitative design with pretest-posttest approach. The sample consisted of 20 purposively selected nurses at Hermina Hospital Pekanbaru. Data were collected using the nurse digital competency questionnaire and analyzed using the Wilcoxon test to determine significant differences in competency before and after training, because the sample size is relatively small and the data is not always normally distributed. Results: the results showed a significant increase in nurse competence after training, with an average pretest value of 60.5 increased to 82.3 on the posttest (p < 0.05). These improvements include aspects of mastering Telenurse applications, digital communication with patients, and technical troubleshooting. Conclusion: digital technology training effectively improves the competence of nurses in Telenurse services, thus enabling more efficient, accurate, and responsive services. The implications of this study emphasize the importance of continuous training programs for nurses to master digital technology, as well as hospital management support in the provision of adequate facilities and Telenourse systems to improve the quality of health services.

The objective of this article is to address the inclusion of children and adolescents in classrooms, emphasizing the need to implement a holistic perspective that considers political, cultural, social and pedagogical aspects. Thus, the article proposes to analyze how inclusive education can promote equity in schools, ensuring that all students receive a high-quality education, regardless of their specific conditions or needs. The research method used is qualitative, contemplating the examination of a variety of normative documents, ranging from international to national policies, in order to foster inclusion and diversity. In addition, the study addresses the difference between equality and equity; While the first refers to the equal treatment of all students, the second concerns the availability of resources and support according to the individual needs of each student. In addition, it is crucial to highlight that inclusion goes beyond the mere physical presence of students in a regular classroom, as it is essential that pedagogical practices and curricula are adapted to ensure effective and quality learning. In addition, the continuous training of teachers is highlighted at the end of the article as a priority to make this practice viable. In general, true inclusion requires a collective commitment, not only from educational institutions, but from society as a whole, through a series of public policies that ensure inclusion with adequate support.

The rapid diffusion of industry 4.0 technologies has substantially transformed the maritime transportation sectors by enabling data-driven operations, enhanced connectivity, and more intelligent decision-making processes. Digital technologies such as the Internet of Things (IoT), simulation systems, and advanced data analytics are increasingly reshaping operational structures in maritime logistics, positioning technological transformation as a strategic priority for firms. However, the weighting and prioritization of components emerging with industry 4.0 technologies remain an underexplored area in the literature. The primary motivation of this study is to determine the weights of these industry 4.0 components using the Bayesian Best Worst Method (BWM) and to reveal their corresponding credal ranking levels. In this context, the present study aims to evaluate and prioritize the critical industry 4.0 components influencing technological transformation processes using the Bayesian BWM. Bayesian BWM is preferred over alternative Multi Criteria Decision Making (MCDM) approaches due to its ability to explicitly model uncertainty within a probabilistic framework, generate more consistent weighting results, and flexibly incorporate decision-makers’ judgments. The findings reveal that safety and security (0.2945) constitute the most influential main component, underscoring the necessity of robust digital infrastructures and reliable systems within highly digitalized operational environments. Among the sub-components, data privacy (0.1301) demonstrates the highest global weight, highlighting the growing importance of safeguarding sensitive information in data-intensive digital systems. The results further indicate that autonomous operation and coordination play significant roles in facilitating efficient digital operations, particularly through real-time equipment monitoring and IoT-based operational visibility. Moreover, sustainability (0.1968) emerges as the second most important component, suggesting that organizations increasingly assess technological investments not only in terms of operational efficiency but also with respect to long-term resilience. Within this dimension, continuous training (0.0614) is identified as the most influential component, indicating that the success of digital transformation depends not only on technological infrastructure but also on the development of human capabilities. With the increasing digitalization of the maritime industry, protection against cyber threats has become essential for ensuring operational continuity and safeguarding data integrity. In this regard, adopting proactive cybersecurity strategies and continuously monitoring and updating systems are of critical importance. In the digital transformation of maritime transportation, integrating sustainability considerations is essential to ensure long-term operational efficiency and environmental responsibility. These practical implications are particularly relevant for policymakers, port authorities, and shipping companies seeking to enhance both digital capabilities and sustainable performance.

Background: Circular economy encourages environment protection and social prosperity while giving the green light to economic growth with sustainable development in a country. The apparel industry both globally and Sri Lanka faces considerable environmental challenges and it is recognized as a major consumer of water. Aim: This study seeks to identify the challenges and opportunities of adopting circular economy practices to enhance resource efficiency in the apparel manufacturing industry of Sri Lanka, under social, environmental, and economic aspects. Methods: Within the apparel industry, circular design, product life extension, textile recycling, and resource efficiency were identified as key circular economy practices. Qualitative research approach was adopted to identify the social, environmental, and economic aspects of circular economy adoption. Target population consisted of key stakeholders in Sri Lanka’s apparel manufacturing sector, including lean managers, sustainability officers, supply chain professionals, and employees involved in circular economy-related practices. Given the qualitative nature of this study, a purposive sampling strategy was adopted to select 4 respondents. A semi-structured interview used as the primary method of data collection and content analysis used to identify key factors through participants’ responses. Results: The results revealed that circular economy is understood among Sri Lankan apparel manufacturers as a strategic shift from linear “take-make-dispose” model to a closed-loop system that keeps materials in use for as long as possible. Despite facing notable challenges such as high initial costs, limited infrastructure, and low awareness, companies are making steady progress through innovation, collaboration, and commitment to sustainability goals. The social findings revealed the need for awareness and training to drive behavioral change, while environmental results confirmed significant achievements in waste reduction, water reuse, and carbon footprint minimization. Economically, although initial investments are high, long-term cost savings, market differentiation, and stronger buyer relationships make circular adoption a viable and strategic direction for the industry. Implications: Apparel manufacturers in Sri Lanka need to implement circular economy principles as port of their core business strategy rather than as isolated sustainability projects. Capacity building in employees and suppliers through continuous awareness and training program; collaborating across the supply chain actors, leveraging circularity for brand differentiation; developing the supportive policy frameworks; expanding recycling and waste management infrastructure and establishing regulatory and certification system would encourage to take part in circular transformation. Further Study: This study focused on the manufacturing perspective; future research could explore consumer behavior, buyer expectations, and government policy roles in enabling circular transformation.

Youth mental health-related problems and disorders have garnered increased attention due to global prevalence estimates that have, in some cases, increased following the COVID-19 pandemic. Various methodologies have been proposed to leverage artificial intelligence (AI) for detecting mental health problems in the general population; however, research specifically focused on AI methods for youth remains limited. Shortcomings in modern AI include limited training data modalities (i.e., types of input data used for model training), reliance on offline training, and the use of static models. This scoping review provides an overview of evidence that uses AI methods applied to youth mental health (YMH) and provides an assessment of the current state of research that integrates multimodal AI (i.e., models that incorporate multiple data modalities) and/or online learning (i.e., incremental or continual model training from streaming data) for the diagnosis, monitoring, and treatment of YMH-related problems. The findings indicate that research in AI applied to YMH is limited in the areas of multimodal AI and online learning. The number of studies in this field is steadily growing. Studies incorporating online learning demonstrate that this approach enhances model performance and adaptability, which is crucial for developing translational models capable of addressing real-world challenges effectively. Despite these advances, key challenges remain, including the availability and long-term validity of multimodal data, the lack of participant-related information in certain databases and studies, the ethical and logistical difficulties of collecting data from minors, and the computational costs of training robust AI models.

Palliative care (PC) in Morocco is still developing, with limited integration of standardised assessment and diagnostic tools in clinical practice. This study aimed to explore healthcare professionals' knowledge, perceptions, and use of early diagnostic tools in PC at Ibn Sina University Hospital Centre, Rabat, and to identify contextually appropriate tools and barriers to their implementation within the Moroccan healthcare context. A qualitative, descriptive study was conducted at Ibn Sina University Hospital Centre between March and September 2025. Semi-structured, face-to-face interviews were held with 56 healthcare professionals involved in palliative and end-of-life care across multiple departments. Participants were recruited through purposive sampling. Data were transcribed verbatim and analysed thematically following Braun and Clarke's framework. Fifty-six healthcare professionals (43 nurses, 13 physicians) participated. Six major themes emerged. Most interviewers reported limited knowledge and irregular use of early diagnostic tools such as Pallia 10 and PICT, mainly due to insufficient training, lack of standardised protocols, heavy workload, and cultural factors. While Pallia 10 was preferred for its simplicity and compatibility with clinical routines, PICT was valued for its psychosocial and multidimensional perspective. Participants highlighted the need for cultural and linguistic adaptation, multidisciplinary collaboration, and institutional support. Integrating early diagnostic tools into Moroccan PC could enhance early identification, care coordination, and quality of life for patients. However, successful implementation requires national strategies, continuous professional training, and culturally sensitive adaptation to bridge the gap between theoretical recognition and practical use.

Efficacy of different high-intensity interval training versus moderate-intensity continuous training for body composition and cardiorespiratory fitness in obese/overweight patients: a systematic review and network meta-analysis.

Young- to middle-aged patients with breast cancer face significant psychosocial challenges. Existing interventions often lack comprehensiveness, timely initiation, and tailoring specific to this population's unique needs. This study aimed to evaluate the impact of a peer-led, nurse-involved, blended online and offline peer support intervention program (PNO2PSP) on psychosocial adjustment in young- to middle-aged patients with breast cancer. The effectiveness of PNO2PSP was evaluated through a single-center cluster randomized controlled trial involving 70 newly diagnosed young- to middle-aged patients with breast cancer (35 in each group). The intervention group received an 8-week PNO2PSP in addition to routine care. Psychosocial adjustment, self-efficacy, social support, and coping modes were assessed presurgery and at 4, 8, and 12 weeks post surgery. Generalized estimating equations were used for intention-to-treat analyses. In-depth interviews with 9 participants explored their experiences. Compared to the control group, the intervention group demonstrated significantly lower psychosocial adjustment scores at 8 weeks (T2; Wald χ²1=14.96; P<.001) and 12 weeks (T3; Wald χ²1=7.49; P=.006); social support was higher at 8 weeks (T2; Wald χ²1=7.65; P=.006). Confrontation coping scores were higher at T2 (Wald χ²1=5.46; P=.02), T3 (Wald χ²1=10.04; P=.002), while avoidance coping scores were lower at T1 (Wald χ²1=8.24; P=.004), T2 (Wald χ²1=7.45; P=.006), and T3 (Wald χ²1=5.70; P=.02). Qualitative findings supported these quantitative results, highlighting the program's role in facilitating psychosocial adjustment, providing vital support, boosting treatment confidence, and fostering positive coping. The PNO2PSP effectively improved psychosocial adjustment, social support, and positive coping in young- to middle-aged patients with breast cancer. Its scientifically validated, feasible, and patient-centered design supports its recommendation for wider clinical implementation, with continued training for peer supporters and sustained delivery of peer support.

Background: Focused Antenatal Care (FANC) aims to improve maternal and neonatal outcomes through targeted, high-quality interventions. Despite global recommendations, its effective implementation remains limited in many low resource settings. This study assessed the coverage, quality, and determinants of FANC at the CSCOMU of Banconi, Mali. Methods: A cross-sectional analytical study was conducted from January to June 2023 among 515 postpartum women and antenatal care providers. Data were collected through structured interviews and review of antenatal care records. Quality was evaluated using predefined performance thresholds for coverage and essential interventions. Results: Only 40.78% of women completed at least four antenatal visits. Initiation of care was predominantly late, with 86.41% attending their first visit after the first trimester. Knowledge gaps were substantial: 70.68% of women did not know the recommended number of visits, significantly reducing the likelihood of completing adequate care. Implementation of essential interventions was suboptimal, including incomplete tetanus vaccination, iron supplementation, intermittent preventive treatment for malaria, and HIV screening. Financial barriers led to missed laboratory tests in 96.05% of cases. Documentation quality was poor, with 93.20% of antenatal records inadequately completed. Factors associated with low-quality FANC included low education level, multiparity, poverty, late initiation of care, long waiting times, poor provider–patient interactions, and inadequate service organization. Providers reported needs for training, equipment, and improved patient education tools. Conclusion: FANC coverage and quality at CSCOMU Banconi remain insufficient, with major gaps in timely attendance, preventive interventions, and documentation. Improving FANC requires integrated strategies addressing financial accessibility, health literacy, service organization, and continuous provider training.

High-intensity interval training and moderate-intensity continuous training improve hippocampal synaptic plasticity in Alzheimer's disease via differential lactylation.

This study aims to examine the role of compensation, training, and competency development in influencing employee work effectiveness at a Regional Disaster Management Agency in Indonesia. A quantitative approach was employed using survey data collected from 43 employees. The independent variables consist of compensation, training, and competency development, while employee work effectiveness serves as the dependent variable. Data were analyzed using multiple linear regression, supported by instrument testing, classical assumption tests, coefficient of determination, and hypothesis testing. The findings reveal that compensation, training, and competency development simultaneously have a significant effect on employee work effectiveness. Partially, each variable also demonstrates a positive and significant influence. Compensation contributes to enhancing employee motivation and performance outcomes, training improves employees’ skills and job-related capabilities, while competency development strengthens employees’ adaptability and overall effectiveness in performing their tasks. These results indicate that integrating fair compensation systems, continuous training programs, and structured competency development initiatives can significantly improve employee work effectiveness in public sector organizations. This study contributes to the human resource management literature by providing empirical evidence on key determinants of employee effectiveness, particularly within disaster management institutions.