Remote monitoring in peritoneal dialysis and its practical implementation is an important technology to leverage in optimizing automated peritoneal dialysis delivery. The more advanced our remote monitoring capabilities become, the greater the urgency to implement protocols to appropriately utilize and leverage the technology for the betterment of patient care. Debates about its utility tend to center around two main issues: responsibility and skepticism around the findings of studies that examined its utility, owing to a combination of hyperbolic claims and methodology variations. This review discusses the theory behind remote monitoring, the available data and capabilities, and a path forward towards adopting remote monitoring in peritoneal dialysis. Numerous clinical studies have demonstrated the association of remote monitoring protocol implementation with reduced hospitalization rates, shorter hospital stays, decreased automated peritoneal dialysis technique failure, and longer time on peritoneal dialysis. There is a need for standardized remote monitoring in peritoneal dialysis protocols. Fewer reported hospitalization rates, shorter hospital stays, and lower automated peritoneal dialysis (APD) technique rates are some of the findings demonstrated in remote monitoring studies. While it is more costly to implement than traditional automated peritoneal dialysis, the reported benefits of remote monitoring outweigh the cost burden. Patients have an overall positive perception and experiences with remote monitoring-APD. Remote patient monitoring provides an additional invaluable resource to enhance the quality of care delivered to.

EPAs Have Entered the Room: An Analysis of Residents' and Faculty Members' Perceptions.

This study aims to understand the dynamics of interpersonal communication between fathers and daughters regarding reproductive health issues. This issue is important given the limited involvement of fathers in reproductive health education. The study employs a descriptive qualitative approach using a case study method, involving nine pairs of fathers and daughters (aged 14–18) who live in the same household. Data were collected through in-depth interviews to explore the experiences, strategies, and communication barriers that arise. The results indicate that interpersonal communication between fathers and daughters about reproductive health is often hindered by gender differences, societal taboos, and the dominant role of mothers. However, the use of open and empathy-based communication strategies proves effective in fostering openness. Daughters’ positive perceptions of their fathers’ involvement are influenced by the fathers’ supportive and nonjudgmental attitudes. These findings highlight the important role of fathers in reproductive health communication in shaping daughters’ comprehensive understanding and preparedness for puberty.

The Flipped Classroom is an innovative instructional approach increasingly adopted in higher education for promoting higher-order thinking and problem-solving. It combines individualized pre-class learning through online lecture videos with in-class collaborative activities guided by instructors. Despite its global adoption, this model remains underexplored in Nepalese higher education institutions (NHEIs). This case study examined the learning outcomes and student perceptions of the flipped approach over four weeks in a Business Mathematics class of 40 students at a Far Western University Campus. Data were collected through a test, a student survey, and a focus group discussion with six purposively selected students. Descriptive and qualitative analysis indicated improved student performance and positive perceptions. Students reported enhanced understanding, problem-solving skills, and development of digital and social competencies. They also considered the approach suitable for digital-era learners and expressed interest in applying it to other courses. Key factors identified for successful implementation included adequate digital infrastructure, skilled educators, motivated students, and clear, high-quality lecture videos. The study highlights the potential of the flipped model to improve teaching and learning in NHEIs and encourages university administrators and educators to adopt it for quality education. It also calls on scholars to explore the model further, addressing existing research gaps and ensuring broader, more generalizable findings through extended studies.

This study aims to evaluate the marketing communication strategy of Grand Istana Rama Hotel (GIR) in Kuta, Bali, and to address the research gap regarding local wisdom as a core strategic asset rather than mere ornamentation in sustainable tourism. Employing a qualitative single case study method and in-depth interviews with key management, this research analyzes how GIR radically integrates the Tri Hita Karana (THK) philosophy into its brand equity through the strategic transformation of cultural capital. The process involves examining three strategic pillars: Palemahan (environment), transformed into a 1.7-hectare "Green Oasis" USP defying high-density economic logic; Parhyangan (spirituality), leveraged for brand trust through ritual transparency and ethical boundaries; and Pawongan (social), fostering strong emotional bonds through a humanist service culture amidst industry automation. Netnographic data from guest reviews validates that the human-centric service and the tranquil atmosphere are the primary drivers of customer loyalty and positive perception. The results show that this fundamental THK integration functions as a counterintuitive competitive defense mechanism, effective against market saturation and the impending 2025 hotel moratorium. The conclusion is that fundamentally integrated local wisdom offers a resilient and authentic model, positioning THK as a strategic communication framework that generates superior functional, psychological, and ethical value for sustainable tourism development.

Forests provide a variety of ecosystem services essential for human well-being, with recreation and ecotourism increasingly recognised as valuable non-market benefits. This study assesses the economic value of forest ecosystem services and visitors’ perceptions of recreational and conservation roles within two selected Eco Parks in Perak, Malaysia, namely Taman Eko-Rimba (TER) Lata Iskandar and TER Pasir Panjang. Using the Contingent Valuation Method (CVM), primary data were collected through structured surveys of 501 visitors (with a minimum of 250 respondents per site) to estimate their willingness to pay (WTP) for continued recreational access and enhanced conservation initiatives. The findings reveal that recreational and ecotourism services contribute significantly to the local economy through notable non-market values and individual WTP estimates. The OLS and Logistic regression models show mean WTP values of RM5.85 (OLS) and RM8.80 (Logit) for TER Lata Iskandar, and RM8.10 (OLS) and RM10.50 (Logit) for TER Pasir Panjang. Key significant determinants of WTP include income, education, visit frequency, visit duration, and repeat visitation, underscoring the influence of socio-economic capacity and behavioural factors on conservation support. Most visitors expressed strong support for conservation initiatives and recognised the importance of Eco Parks in providing environmental education, biodiversity protection, and community benefits. Positive visitor perceptions further reinforce the role of Eco Parks as essential assets for sustainable tourism and rural economic development. This study highlights the importance of integrating both economic valuation and public perception into forest management strategies to enhance conservation financing, improve visitor experiences, and support community livelihoods

Background Antenatal perineal massage (APM) is an established technique for preventing severe perineal trauma, but it is uncommonly practised in Hong Kong. This study aimed to investigate pregnant women’s knowledge, attitudes and interest in APM, and to identify factors that influence their interest in the technique. Methods A prospective cross-sectional study was conducted over 7 months at Princess Margaret Hospital. Pregnant women aged 18 years or above and under 37 weeks of gestation were invited to participate via a bilingual questionnaire distributed during antenatal clinic visits. Descriptive and regression analyses were used. Results Out of 385 respondents, only 31.4% were aware of APM with social media (61.2%) as their main source of knowledge. Only 44.8% of the questions were answered correctly, with a median knowledge score of 3.0 out of 7. A majority were unaware of the long-term impacts of severe perineal injury (57.7%) and potential benefits of perineal massage (54.5%), highlighting a deficiency of knowledge. Interest in APM was high (66.2%). Non-Chinese, higher education, planned vaginal delivery and knowledge of the technique’s benefit are positive predictors of expressed interest. However, concerns about discomfort (38.5%) and embarrassment (38.5%) were notable barriers to participation. Among those who practised APM, the median Likert score was 4 out of 5, indicating a generally positive perception of its benefits. Conclusions This study reveals important areas where knowledge regarding obstetric anal sphincter injuries (OASIS) and APM is lacking among some pregnant women in Hong Kong. There is a need to enhance education and resources regarding these topics in antenatal classes.

Purpose: This study examined the effects of dispatch work experience on job embeddedness, organizational commitment, and turnover intention among nurses. Methods: A cross-sectional survey was conducted among 130 nurses working at a tertiary hospital in Seoul. Data were analyzed using IBM SPSS version 28.0 with descriptive statistics, the independent t-test, one-way analysis of variance, Pearson correlation coefficients, and multiple linear regression. Results: Overall, 62.3% of participants reported improved competency following dispatch work experience, whereas 80.7% perceived pre-training as insufficient. Nurses with prior interaction with dispatch unit staff demonstrated significantly higher job embeddedness (F=10.37, p=.002) and organizational commitment (F=5.87, p=.017), along with significantly lower turnover intention (F=4.98, p=.027). Multiple regression analysis showed that job embeddedness was positively associated with prior interaction with dispatch unit staff (β=.170, p=.031) and perceiving dispatch operations as appropriate (β=.297, p<.001). Organizational commitment was significantly influenced by the perception of dispatch operations as appropriate (β=.209, p=.013). No dispatch-related factors were significantly associated with turnover intention. Conclusion: Positive perceptions of dispatch work and prior interaction with dispatch unit staff contribute to job embeddedness and organizational commitment. Improvements such as enhanced pre-interaction opportunities, practice-based training, and consideration of dispatch preferences are needed to optimize dispatch work experiences.

Information and Communication Technology (ICT) has become increasingly important in Technical and Vocational Education and Training (TVET) and in supporting English as a second official language in Tanzania. ICT tools such as computers, laptops, mobile phones, and internet services are now integral to vocational teaching and learning processes. Effective utilisation of these technologies requires vocational trainers to be adequately trained in order to enhance students’ information technology skills and meet the demands of the 21st-century workforce. This study aimed to examine vocational trainers’ perceptions of ICT use in training and learning, as well as the challenges they encounter in implementing ICT in TVET institutions. A quantitative research design was employed, involving fifty (50) vocational trainers from TVET institutions in the Coast Region of Tanzania. Data were collected using structured questionnaires and analysed using descriptive statistics. The findings revealed that 46% of the participants demonstrated positive perceptions toward the use of ICT tools such as computers, mobile phones, and the internet as effective teaching and learning resources, while 44% reported being comfortable using ICT in their instructional activities. However, the study also identified several challenges hindering effective ICT integration. These included lack of regular training to keep pace with emerging technologies and software (52%), insufficient time for lesson preparation due to additional assigned duties (54%), inadequate time to master new or updated ICT tools (54%), and limited support from top management (54%). The study concludes that while vocational trainers generally hold positive attitudes toward ICT integration, significant institutional and professional development challenges persist, which must be addressed to enhance effective ICT implementation in TVET institutions

The milk productivity of Ethiopian smallholder farmers is greatly influenced by the use of commercial feed. Despite its potential to increase milk production, commercial feed is still not widely used. The study examined the factors influencing the commercial feed purchasing behaviour of small-scale dairy farmers in the Sululta peri-urban area of Ethiopia. Using a quantitative, cross-sectional design, data were collected from 348 farmers and analysed using the PLS-SEM (Partial Least Squares Structural Model). The model examined the interaction of six latent variables: socio-economic factors (SEF), market factors (MF), perceptions (PER), Resource Management and Constraints (RMC), commercial feed purchasing behavior (CFB) and productivity and profitability (DPP). The results showed that, although socio-economic and market factors strongly supported positive perceptions of farmers (β = 0.112, β = 0.044 and p = 0.001, respectively), these attitudes were not translated into actual purchasing behaviour. Notably, the behaviour of the commercial buyers had a significant negative impact on profitability (β = −0.465, p < 0.001), indicating a serious imbalance between costs and benefits. To facilitate sustainable production, it is essential to move beyond perception-based interventions to structural economic reforms, including targeted micro-credit, stabilizing feed price volatility and reduce high transport costs.

ABSTRACT Forest restoration is essential for reversing biodiversity loss and enhancing ecosystem services. While its ecological dimensions are well recorded, the societal aspects, particularly public support, remain underexplored. This study examines the factors influencing public support for forest restoration in Sweden and Spain, two regions with distinct ecological and socio-cultural contexts. Drawing on a standardised survey (n = 241) and a generalised linear model (GLM), we analyse the influence of socio-demographic, behavioural, and perception-based factors. The findings reveal contrasting age-related patterns: older individuals in Sweden show greater support for restoration, while younger individuals are more supportive in Spain. Longer travel times to forests are associated with reduced support, especially in Sweden. Positive perceptions of forest benefits, including biodiversity, risk mitigation and recreation, enhance support, whereas perceptions of forest exploitation are linked to reduced support, particularly in Spain. These results underscore the need for context-sensitive communication and engagement strategies. Tailoring policy measures to local perceptions and values is vital for fostering public participation and ensuring the success of forest restoration initiatives.

While artificial intelligence (AI)-generated feedback offers significant potential to overcome constraints on faculty time and resources associated with providing personalized feedback, its perceived usefulness can be undermined by algorithm aversion. In-context learning, particularly the few-shot approach, has emerged as a promising paradigm for enhancing AI performance. However, there is limited research investigating its usefulness, especially in health profession education. This study aimed to compare the quality of AI-generated formative feedback from 2 settings, feedback generated in a zero-shot setting (hereafter, "zero-shot feedback") and feedback generated in a few-shot setting (hereafter, "few-shot feedback"), using a mixed methods approach in Japanese physical therapy education. Additionally, we examined the effect of algorithm aversion on these 2 feedback types. A mixed methods study was conducted with 35 fourth-year physical therapy students (mean age 21.4, SD 0.7 years). Zero-shot feedback was created using Gemini 2.5 Pro with default settings, whereas few-shot feedback was generated by providing the same model with 9 teacher-created examples. The participants compared the quality of both feedback types using 3 methods: a direct preference question, the Feedback Perceptions Questionnaire (FPQ), and focus group interviews. Quantitative comparisons of FPQ scores were performed using the Wilcoxon signed rank test. To investigate algorithm aversion, the study examined how student perceptions changed before and after disclosure of the feedback's identity. Most students (26/35, 74%) preferred few-shot feedback over zero-shot feedback in terms of overall usefulness, although no significant difference was found between the 2 feedback types for the total FPQ score (P=.22). On the specific FPQ scales, few-shot feedback scored significantly higher than zero-shot feedback on fairness across all 3 items: "satisfied" (P=.02; r=0.407), "fair" (P=.04; r=0.341), and "justified" (P=.02; r=0.392). It also scored significantly higher on 1 item of the usefulness scale ("useful"; P=.02; r=0.401) and 1 item of the willingness scale ("invest a lot of effort"; P=.02; r=0.394). In contrast, zero-shot feedback scored significantly higher on the affect scale across 2 items: "successful" (P=.03; r=0.365) and "angry" (P=.008; r=0.443). Regarding algorithm aversion, evaluations for zero-shot feedback became more negative for 83% (15/18) of the items after identity disclosure, whereas positive perceptions of few-shot feedback were maintained or increased. Qualitative analysis revealed that students valued zero-shot feedback for its encouraging tone, whereas few-shot feedback was appreciated for its contextual understanding and concrete guidance for improvement. Japanese physical therapy students perceived few-shot feedback more favorably than zero-shot feedback on case reports. This few-shot AI model shows potential to resist algorithm aversion and serves as an effective educational tool to support autonomous writing, facilitate reflection on clinical reasoning, and cultivate advanced thinking skills.

This study examines the mastery of Arabic transitive and intransitive verbs among students at Universiti Teknologi MARA (UiTM) through the interrelated dimensions of knowledge, practice, and perception. Adopting a quantitative descriptive design, data were collected from 83 purposively selected final-year students enrolled in an Arabic grammar course. A structured questionnaire was administered, covering demographic information, knowledge of verb concepts, usage in communication, and learners’ attitudes toward grammar learning. Data were analysed using descriptive and inferential statistics with SPSS version 26. The results show that students demonstrated a high level of theoretical knowledge of transitive and intransitive verbs (M=3.79, SD=0.85). However, their ability to apply these rules in writing and speaking was relatively weaker (M=3.69, SD=0.84), revealing a gap between knowing and doing. Learners expressed highly positive perceptions of grammar learning (M=4.11, SD=0.78), valuing interactive methods and real-life examples. Correlation analysis revealed significant positive associations among knowledge, practice, and perception, while regression analysis confirmed that both knowledge (β=.39, p<.01) and perception (β=.34, p<.01) significantly predicted usage, accounting for 42% of the variance. These findings highlight the cognitive and affective dimensions of Arabic grammar acquisition, underscoring the importance of bridging theory and practice through communicative tasks, scaffolding of morphological complexity, and technology-enhanced feedback. The study contributes empirical insights for designing effective pedagogical interventions in Arabic grammar instruction at the university level.

This paper investigates the features of self-attitude and perceptions of ideal beauty among young women with negative and positive perceptions of their own appearance. The problem of body and appearance dissatisfaction deserves close attention due to its high prevalence and profound destructive effects. It directly undermines the psychological well-being of young women, being a cause of not only low self-esteem and negative self-perception but also maladaptive behavioral strategies. The empirical study involved 50 young women aged 20–34. The method of projective storytelling was used as the primary research technique. The processing of respondents’ narratives was conducted using content analysis and Fisher’s angular transformation. A comparative analysis of perceptions of ideal beauty revealed that for the group of young women dissatisfied with their appearance, a focus on external attributes (such as attractive facial features and a perfect body) is characteristic, as well as heightened sensitivity to issues of gender discrimination based on appearance. At the same time, young women with a positive perception of their appearance were significantly more likely to associate the concept of beauty with the development of spiritual potential. This indicates that acceptance of one’s own appearance provides freedom from stereotypical beauty standards, opening the way for a deeper and more meaningful self-perception. The results of the study demonstrate that a negative body image acts not as an isolated problem but as a complex factor deforming the holistic system of self-attitude in young women.

Simulation-based learning (SBL) in oral radiology offers a safe, structured environment that supports students' transition to clinical practice. However, limited research has captured students' perceptions of SBL for intraoral radiography training. This study aimed to explore the perceptions of dental students about SBL in intraoral radiography using a mixed-methods approach across two dental institutions. Third-year undergraduate dental students from two institutions were recruited. All students were trained on both periapical (paralleling technique in Institution A and bisecting angle technique in Institution B) and bitewing radiographs using a mannequin. Data were collected through a 9-item Likert-scale survey and three open-ended questions. Quantitative data were analyzed using descriptive statistics and Mann-Whitney U test, while qualitative data underwent thematic analysis. A total of 44 students expressed overall positive perceptions of SBL, with a mean score of 4.27. The highest-rated item was "Readiness for clinical transition" (mean=4.53), and the lowest was "Realism" (mean=3.81). Institution A students showed significantly more positive responses than those from Institution B in items: develop self-confidence, skill development, and skill mastery through repetition. Thematic analysis supported quantitative findings and revealed four key themes. Students valued the role of SBL in skill development, providing a psychologically safe learning environment, and bridging theory and practice. Students noted barriers about mannequin realism, technical challenges, and access issues. They also provided suggestions for improving the SBL experience. The findings indicate that students value SBL as an effective approach for teaching core oral radiology skills and preparing students for clinical training. Enhancing mannequin design and practice opportunities may further improve undergraduate learning experiences in simulated settings.

This study examines teachers’ perceptions of Artificial Intelligence (AI) integration in education, with a particular focus on its impact on cultural literacy and its contributions to the Sustainable Development Goals (SDGs). The study employs a quantitative descriptive design, involving 25 teachers from SD Islam Prihaswari in East Lombok, Indonesia, who were selected through purposive sampling. Data were collected between July and August 2025 using a Likert-scale questionnaire consisting of 20 items distributed across four dimensions: AI utilization, cultural awareness, contribution to SDGs, and readiness and challenges. Data analysis employed descriptive statistics, including mean scores, standard deviations, percentage indices, 95% confidence intervals, and categorical interpretations. The results indicate an overall positive perception of AI integration in education. The highest mean score was observed in the SDGs dimension (M = 4.90, SD = 0.30, CI95% = 4.78–5.02), while the utilization dimension received the lowest score (M = 4.20, SD = 0.65, CI95% = 4.03–4.37). These findings suggest that teachers recognize AI’s potential to strengthen cultural literacy and support sustainable education, although practical implementation remains constrained by infrastructural and pedagogical limitations. The study highlights the need for improved digital infrastructure, systematic teacher training, and culturally responsive AI-based learning models to ensure meaningful and sustainable integration of AI in education

This article presents the results of an empirical study aimed at identifying key factors in the development and functioning of the educational environment at a modern pedagogical university. The theoretical and methodological framework for the study is based on the principles of the personal-activity, axiological, and system-activity approaches. The study is based on a survey of 1,308 students at pedagogical universities in five regions of Russia (Vologda, Orenburg, Perm, Pskov, and Yaroslavl). Using factor analysis, a two-factor structure of the environment was identified that determines student interactions with it: «student orientation» and «conditions for active participation». Based on these factors, a new typology of students was constructed using cluster analysis. It identifies three types: «engaged» (positive perceptions of both the environment and opportunities), «unfulfilled» (positive attitudes toward the environment despite a lack of attractive opportunities), and «alienated» (negative perceptions of the environment despite acknowledging the presence of opportunities). Statistically significant differences were found between the student types in terms of value-semantic values, academic motivation, and spiritual well-being. A negative trend in student engagement in the educational environment at the university was identified from their junior to senior years, with a critical decline in their fourth year. Based on the results, systemic patterns of educational environment development were formulated, offering a scientific basis for a differentiated approach to designing an educational environment that purposefully shapes the value-oriented position of future teachers.

The development of social media has significantly transformed Public Relations practices from one-way communication into audience centered engagement. Instagram, as a highly visual and interactive platform, is widely utilized by organizations to implement digital Public Relations campaigns through collaborative strategies. This study aims to examine the influence of the #PastiAdaJalan Public Relations campaign, a collaboration between Gojek and Band Perunggu, on audience interaction on Instagram. This research employs a quantitative approach using a survey method. Data were collected through an online questionnaire distributed to 100 respondents who follow the @gojekindonesia Instagram account and have viewed the #PastiAdaJalan campaign content. Data analysis was conducted using simple linear regression with the assistance of IBM SPSS software. The results indicate that the #PastiAdaJalan campaign has a significant effect on audience interaction. The regression equation Y = 6.054 + 0.318X demonstrates a positive relationship between the Public Relations campaign and audience interaction. Furthermore, the coefficient of determination (R²) value of 0.606 indicates that 60.6% of the variation in audience interaction can be explained by the campaign. These findings suggest that collaborative Public Relations campaigns on social media are effective in building attention and positive brand perception, although they do not fully encourage active audience participation. This study is expected to contribute to the development of digital Public Relations campaign strategies on social media platforms.

The public perception and performance of youth leadership of Kathmandu Metro City is a mirror of youth leadership in the view of people. The main objective of the study is to find out the relationship between public perception and the performance of youth leadership. To probe the consequences, mixed method approach has been applied. Five-point Likert survey and qualitative interviews have been applied. In conclusion majority of people have perfectly positive perception and similar to the action or the performance of youth leadership. The correlation between perception and performance is 0.98, means the level of public perception and performance in Kathmandu is significant or satisfactory. Improving public perception of youth leadership can play a crucial role in enhancing the performance of youth leaders. Efforts to boost public perception should focus on transparency, community engagement, and addressing local concerns. This approach not only enhances the effectiveness of youth leadership but also fosters a positive feedback loop that benefits both the leaders and the communities they serve.

ObjectivesThe primary objective of the study was to analyze the extent of ChatGPT usage and students’ attitudes about ChatGPT. The secondary objective is to examine the potential underlying structure of students’ perceptions about this AI tool in academic settings. Additionally, the focus on students studying in Serbian and English may shed light on the cultural and linguistic influence of technology implementation in educational settings.MethodsThis descriptive study investigated how medical students perceive the application of ChatGPT in educational settings using a 3-part questionnaire: a demographic section collecting participants’ overall experience and perceptions of ChatGPT, and a section collecting students’ attitudes toward artificial intelligence who did not use ChatGPT.ResultsIn the survey, there were 1212 students (1037 students in the Serbian and 175 students in the English language). Almost four-fifths of students have heard of ChatGPT (79.4%), but less than half of students have used ChatGPT (42.2%). Principal component analysis revealed 4 components: Positive Perception and Usefulness, Negative Impacts and Risks, ChatGPT Usability and Improvement, and Interaction and Communication Challenges items.DiscussionA positive attitude was prevalent in our population; however, students were also aware of the limitations of ChatGPT, which were recognized as potential academic dishonesty and a risk of job loss. There were significant differences in students’ agreement with various statements across 3 components among students studying Serbian and English, implying a possible role of linguistic barriers in AI responses. Therefore, using ChatGPT to promote education and healthcare should be done ethically and responsibly, considering the possible improvements in AI tools and the risks and issues they raise.