Search Results (632)

In parallel with technical training on knowledge and skills of task-specific medical or surgical procedures, wide arrays of soft skills training would contribute to obstetric safety in the contemporary healthcare setting. This article, as a service evaluation, explored the effect of a specialty-based Crew Resource Management (CRM) training series that transforms the concept of human factors into sustainable measures in fostering clinical safety culture of the Department of Obstetrics and Gynaecology (O&G) in the Queen Elizabeth Hospital. Within the last decade, a tri-phasic programme has been implemented by an inter-professional workgroup which consists of a consultant anaesthesiologist, medical specialists and departmental operations manager from O&G, a nurse simulation specialist, hospital administrators, and a research psychologist. (1) Phase I identified different patterns of attitudinal changes (in assertiveness, communication, leadership, and situational awareness, also known as “ACLS”) between doctors and nurses and between generic and specialty-based sessions for curriculum planning. (2) Phase II evaluated how these specific behaviours changed over 3 months following CRM training tailored for frontline professionals in O&G. (3) Phase III examined the coping style in conflict management and the level of sustainability in self-efficacy over 3 months following specialty-based CRM training. The findings showed the positive impacts of O&G CRM training on healthcare professionals’ increased attitude and behaviour in “ACLS” by 22.7% at a p < 0.05 level, character strengths in conflict management, and non-inferior or sustained level of self-efficacy under tough conditions in the clinical setting up to 3 months after training. As a way forward, incorporating a scenario-based O&G CRM programme into existing skills-based training is expected to change service framework with an innovative approach. In addition, exploring actual clinical outcomes representing a higher level of organisational impacts can be a strategic direction for further studies on the effect of this practical and educational approach on obstetric safety culture. Full article

Introduction: Tuberculosis (TB) remains a public health concern, and people at risk for TB are hesitant to seek care. The first South African National TB prevalence survey, conducted in 2017–2019, found that most participants with TB symptoms did not seek care for TB. In 2022, an estimated 23% of people with TB in South Africa were undiagnosed, contributing to the country’s burden of “missing” TB cases. This study explores health-seeking behaviour among people with TB (PwTB) in South Africa, focussing on barriers and facilitators to care-seeking and the quantification of TB-related stigma from a patient and community perspective. Methods: We conducted a mixed-method study in the City of Johannesburg (COJ) Metropolitan Municipality from February to March 2022. PwTB aged 18 and older initiating TB treatment for microbiologically confirmed pulmonary TB were recruited from three primary healthcare facilities in the COJ. After providing written informed consent, they participated in a one-time, in-depth, face-to-face interview. The interviews were digitally recorded and conducted by trained facilitators. We used thematic analysis with deductive approaches to develop themes. We used the Van Rie TB stigma assessment scale to quantify perceived stigma. Results: We interviewed 23 PwTB with an overall median age of 39 years and 14 (61%) males. Patient-level barriers to accessing TB care included visiting traditional healers and pharmacists before their TB diagnosis; wrong or missed diagnosis by private doctors; work commitments; scarcity of resources to attend the clinic or walk long distances; perceived and experienced stigma; and a lack of TB knowledge. Facility-level barriers included long clinic queues and uncertainty about where to receive TB care in the clinic. Facilitators for TB care-seeking included being in contact with someone who had TB, receiving encouragement from family, or having knowledge about TB transmission and early diagnosis. The overall median total stigma score among 21 PwTB was 53 (IQR: 46–63), with median community and patient stigma scores of 25 (IQR: 22–30) and 31 (IQR: 21–36), respectively. Conclusions: We found important considerations for the TB programme to improve the uptake of services. Since PwTB consult elsewhere before visiting a facility for TB care, TB programmes could establish private–public partnerships. TB programmes could also increase TB awareness in the community, especially among males, and mobile clinics could be considered to assist with TB case detection and treatment provision. Applying behavioural design techniques and co-designing interventions with patients and providers could improve TB health-seeking behaviours. Full article

Retrofitting existing buildings is regarded as a main driver of decarbonization, yet retrofitting activities are lagging behind their ambitious goals. This study explores 86 German construction practitioners’ perceptions of organizational, policy, and social challenges to sustainable retrofitting and how those perceptions relate to age, attitude, and their interaction. The primary analyses used OLS moderation models with HC3-robust standard errors and ordered-logit models, which served as robustness checks. Across outcomes, more pro-environment attitudes were associated with fewer perceived challenges, and older practitioners (41–56+) reported higher barrier perception. The attitude × age interaction results indicate that the protective link of attitude was weaker among older respondents, which was significant for policy and social challenges but only marginal for organizational challenges. The model fit was reasonable, at an Adj. R² between ≈0.56 and 0.72 with acceptable diagnostics. Our results suggest that even motivated professionals can feel constrained, especially among older, senior staff. Practical implications include early tenant engagement to enhance acceptance and foster internal organizational sustainability capacities. Policy instruments such as adult education programmes need to be leveraged to enhance sustainable construction capabilities and reinforce attitudes and behaviours toward sustainable retrofitting. More salient policy communications and guidance can contribute to increasing sustainability orientation and reducing perceived trade-offs with economic goals. Full article

Timber structures and structural members have undergone rapid development in recent decades and are now fully competitive with traditional structures made of reinforced concrete or structural steel in many areas. Low self-weight, high durability, rapid construction assembly, and a favourable environmental footprint predispose timber structures for wider future use. A persisting drawback is the often-complicated joining of individual elements, especially when moment resistance is required. For CLT panels, this issue is more urgent due to their relatively small thickness and cross-laminated lay-up. This paper presents experimental research investigating parameters related to the actual behaviour of a moment-resisting embedded joint of CLT panels. The test programme consisted of four series (12 specimens) loaded in four-point bending to failure. The proposed and tested joint consists of high-strength steel rods glued into the two connected parts of the CLT panel. In addition to a detailed investigation of the resistance and stiffness of the joint, this research evaluates the effect of composite action with a reinforced-concrete slab on the performance of this type of joint. The experimental results and their detailed analysis are also extended to propose a framework concept for creating a theoretical (mechanical) model based on the component method. Full article

Meat consumption, a key factor in both environmental sustainability and public health, is strongly influenced by educational characteristics, with higher levels of education often associated with more sustainable dietary patterns. However, research examining the mechanisms through which education influences meat-related behaviours remains limited. This study investigates the mediating role of climate literacy in the relationship between educational characteristics and meat consumption patterns among adults and school-enrolled youth in Slovenia. We used survey data from a sample of 2990 individuals (aged 14–88) to examine how educational stage, track, and level impact meat consumption and reduction. Our focus was on climate literacy as a multidimensional construct, comprising climate knowledge, attitudes, and pro-environmental behaviour. The findings indicate that young people in the tertiary educational track tend to eat less meat, have already reduced their meat consumption in the past, and intend to further reduce it in the future, compared to secondary track students, with climate attitudes playing a mediating role in all three cases. For adults, a tertiary educational level, relative to a secondary level, was linked to lower meat consumption, an association largely explained by more positive climate attitudes. By contrast, adults with only primary education consume meat more often and are less inclined to cut back in the future. Among secondary school students, both vocational and general school groups reported greater past and intended meat reductions than their peers in professional schools. The findings underscore the importance of integrating climate literacy, especially fostering pro-climate attitudes, into educational programmes to promote sustainable dietary choices. Full article

Background: Physical activity is essential in the prevention and management of type 2 diabetes mellitus (T2D), yet adherence to recommended activity levels remains insufficient. Wearable electronic devices have emerged as tools to support physical activity through self-monitoring and enhanced user engagement. This review synthesizes current evidence on the effectiveness of wearable technologies in improving adherence to physical activity and promoting clinical and metabolic health in adults with T2D. Methods: The review was conducted using systematic search strategies in PubMed and Scopus. We included studies that involved the use of wearable devices to monitor physical activity for at least seven consecutive days. The reported outcomes were related to physical activity adherence or clinical–metabolic health. Thirty-two studies met the inclusion criteria and were analyzed in terms of study design, device type, intervention characteristics, and outcomes. Results: Wearable devices were used either for monitoring daily activity in free-living conditions or within structured, often supervised, interventions. Most studies reported increased physical activity, particularly in step count. Several studies showed improvements in blood pressure and lipid profile, while results for HbA1c and BMI were mixed. Structured interventions with behavioural support produced more consistent and clinically relevant outcomes than passive monitoring alone. Conclusions: Wearable technologies can support physical activity in adults with T2D, especially when integrated into structured behavioural programmes. From a clinical standpoint, they may serve as useful tools to enhance lifestyle adherence, particularly when combined with professional support. Their inclusion in care pathways could help personalize interventions and improve long-term self-management. Full article

African swine fever (ASF) is a highly contagious and fatal disease of domestic pigs and wild boars, with severe economic and ecological consequences. Wild boar hunters play a critical role in the early detection and control of ASF due to their direct interaction with wild boar populations. This study examined the attitudes, knowledge, and behaviour of wild boar hunters in Croatia regarding ASF prevention and control, with a focus on the influence of sociodemographic factors, hunting experience, and participation in training programmes. An online survey of 276 wild boar hunters from an ASF-affected county in Croatia was conducted between October and December 2024. Results indicate that 93.5% of wild boar hunters are aware of ASF and its risks, relying primarily on internet sources for information. Experienced and higher-educated wild boar hunters demonstrated greater confidence in recognising ASF symptoms and stronger support for preventive measures, education, and institutional cooperation. Factor analysis revealed three main dimensions shaping attitudes: communication and awareness, institutional capacity, and regulatory policies. The results emphasise the importance of continuous education, transparent communication and participatory approaches to strengthen cooperation with hunters and improve ASF control. They also emphasise the need for targeted, evidence-based communication strategies that actively involve hunters in surveillance and reporting. Tailored educational materials and digital communication could increase carcass reporting, improve early detection and increase the overall effectiveness of ASF control programmes. Full article

Background/Objectives: Based on years of work from high-income countries, the Parenting for Lifelong Health programme for parents of Young Children (PLH-YC) was developed by the first and last authors, as a freely available low-cost programme for low-income families in low- and middle-income countries (LMICs). The initial group-based 12-session programme has since been delivered, adapted, and evaluated across many LMICs and now has a significant body of evidence. Over the last 10 years, early intervention services in the UK have been considerably reduced whilst, exacerbated by the impact of COVID-19, service demands have grown. This paper describes a feasibility trial of the 12-session PLH-YC programme in Wales to explore whether it could recruit and retain parents, and demonstrate improvements in parenting skills and reductions in child behaviour problems. Methods: Two small pre–post trials were conducted in socially disadvantaged communities in Wales, and they were delivered by local parenting practitioners. Of the 20 parents recruited across 3 groups, 17 provided pre- and post-course data and 10 completed qualitative interviews. Results: Retention was good (85%) with mean attendance of 8.7 sessions, and parental and facilitator feedback reported high levels of satisfaction with the programme, with the only recommendation being to make the programme longer and for facilitators to be given more time. Results showed significant benefits to parent-reported parenting practices, child behaviour, and parental mental wellbeing. Conclusions: These preliminary results justify work to develop a rigorous evaluation to establish whether PLH-YC could have a place among parenting-support programmes in the UK. Full article

The captive breeding and release of threatened small-bodied freshwater fish is a common conservation method, yet many of these fish lack the behavioural profile to survive in the wild. Soft-release sites that provide wild-like experiences with minimal threat to survival can improve post-release outcomes. Here, we investigated whether captive-bred first generation Southern pygmy perch (Nannoperca australis) exposed to six months of soft-release experience develop natural behaviour. In laboratory tests, we compared the behaviour of fish from a hatchery, a soft-release site, or the wild in emergence, exploration, habitat choice, predator response, and novel food tests. As predicted, we found that fish from the soft-release site showed similar behavioural responses to wild-caught fish. However, soft-release fish were significantly larger (14.6 mm, 1.6 g advantage) and made greater use of refuge structures (basket ledges). Also, while trends suggested altered anti-predator responses, statistical support was limited, warranting further investigation. We conclude that soft-release experience enhances growth and shelter-seeking behaviour in this species, though further tests in a more natural environment should be undertaken to confirm ecologically important experience-dependent changes in behaviour. We recommend prioritising soft-release programmes that maximise natural foraging opportunities, reduce competition, and provide complex structures to support shelter use. Finally, the overall similarity in behaviour of fish from different environments suggests that, in this species, behaviour appears mostly inherited. Full article

Background: Multiple sclerosis (MS) is the most prevalent neurological disorder in young adults, characterised by physical, psychological and cognitive dysfunction. Exercise training is a safe management strategy. Healthcare providers (HCPs) acknowledge deficiencies in awareness, counselling strategies, and resources that prevent them from promoting and prescribing this effective treatment. We implemented an online evidence-based educational programme and evaluated the effect, acceptability, appropriateness, and feasibility of the programme in improving HCP confidence, knowledge, and attitudes towards remote exercise prescription to persons with MS. Methods: Physiotherapists and exercise physiologists were recruited and received the educational programme (online theory and 16-week experience of prescribing to persons with MS). Participants’ confidence, knowledge and attitudes towards exercise prescription, as well as their professional quality of life, were our primary outcomes—baseline (T1), immediately post-online theoretical learning (T2), post-application with clients (T3; approximately 16 weeks after T2), and at 12-month follow-up (T4). We gathered participants’ acceptability, appropriateness, and feasibility evaluation at T2, T3 and T4. We analysed the effect on primary outcomes using generalised linear mixed models, with secondary and evaluative outcomes analysed as counts and qualitative themes. Results: Of 40 participants who provided baseline data, 24 completed the theoretical programme, and 16 completed the experiential programme. Self-confidence improved significantly (|βs| ≥ 1.27, SEs ≤ 0.31, |zs| ≥ 5.28, ps < 0.001), with large effect sizes (percentage change: 256.8–479.4%). Some theoretical domains framework-based domains have improved, such as beliefs about skills to prescribe evidence-based principles. Participants expressed high satisfaction with the programme and showed increased delivery of implementation behaviour change strategies. Conclusions: An online evidence-based education programme for MS care improved HCPs’ self-confidence, perceived skills and delivery of evidence-based exercise behaviour-based prescription. Full article

In modern organisations, ethical leadership has emerged as a key driver of sustainability, shaping both employee behaviour and long-term organisational performance. This study investigates the mechanisms through which ethical leadership fosters organisational sustainability, with a focus on the mediating role of organisational commitment. A quantitative, cross-sectional survey was conducted in mainland Portugal between January 2024 and January 2025 with a sample of 285 employees from medium and large companies (48% male, 52% female). Ethical leadership was measured with the 10-item Ethical Leadership Scale (α = 0.94), organisational commitment with a 7-item validated scale (α = 0.91), and organisational sustainability with a 12-item scale capturing ethical climate and voluntary pro-environmental behaviours (α = 0.93). Data were analysed using structural equation modelling with maximum likelihood estimation and bootstrapping. Results support the hypothesised model, showing that ethical leadership positively predicts organisational commitment (β = 0.62, SE = 0.07, p < 0.001, 95% CI [0.48, 0.75]) and organisational sustainability indirectly through commitment (indirect effect β = 0.31, SE = 0.06, p < 0.001, 95% CI [0.20, 0.43]). Direct effects of ethical leadership on sustainability were weaker and non-significant once the mediator was included, confirming the centrality of commitment. Model fit indices indicated strong adequacy (CFI = 0.962, TLI = 0.954, RMSEA = 0.048, SRMR = 0.041). Theoretically, the findings reinforce the integration of ethical leadership theory with sustainability research, clarifying the role of commitment as a mediating mechanism. Practically, the study suggests that fostering ethical leadership behaviours—fair decision-making, role modelling, and integrity—can strengthen employee commitment, which in turn drives sustainable organisational practices. This highlights the importance of leadership development programmes centred on ethics as a strategic lever for long-term sustainability. Full article

Comprehensive data are presented for corrosion losses of mild steel exposed for up to 5 years, all obtained from exposing steel coupons at one specific severe marine exposure site on the Pacific Ocean coast. The test programme considered the effects of duration of exposure, inclination, orientation, height, shielding, and coupon variability, using multiple, nominally identical mild steel coupons, all under a single local climatic regime. Such a controlled, consistent, natural environment permits unique, valid comparison of the various influences, both for short-term and longer-term exposures, unlike previous tests of some parameters conducted in the short term at disparate sites. In contrast to coupons exposed only on one side, boldly exposed double-sided coupons corroded severely within 3 years. The effects on corrosion behaviour between individual coupons exposed at different heights and vertical continuous single strips of steel are described. Also reported are corrosion losses for continuous strips and for a series of coupons oriented in different directions. Observations of variability in corrosion losses for nominally identically exposed steel coupons are reported. The effect on corrosion losses with continued exposure to 5 years is reported and compared with information available in the literature. Full article

This article proposes a comparative framework for interpreting architectural and armorial artefacts through morphological and symbolic analysis. Focusing on the Romanesque, Gothic, and Renaissance periods, the study explores how buildings and body armour—though differing in scale and function—encode similar cultural values related to protection, identity, and representation. Rather than seeking direct historical transmission, the research reveals convergent design logics shaped by shared symbolic imperatives. Methodologically, the article combines typological comparison with embodied heritage practices. These include experimental reconstruction, traditional stone carving, and field-based conservation conducted through the Ambulance for Monuments (Ambulanța pentru Monumente) programme. Such experiences support a situated understanding of proportion, articulation, and material behaviour in both architecture and armour. By repositioning historical armour as a culturally meaningful artefact rooted in craft knowledge and symbolic logic, the study contributes to current debates in heritage science. It argues for the inclusion of martial objects within broader frameworks of heritage interpretation. The findings highlight how architecture and armour function as co-expressive elements of a shared design culture, offering new insights for research, conservation, and the communication of historical meaning. Full article

Internationally, introduced invasive species inflict incalculable damage on native species and primary production. In New Zealand, wallabies, which were introduced from Australia, are damaging the native and agricultural environments, and their range is spreading. As a first step towards the long-term goal of eradicating wallabies from New Zealand, the Tipu Mātoro National Wallaby Eradication Programme has the immediate goal of restricting wallabies to containment areas designated in regional pest management plans and to eliminate outlier populations by 2025. The success of this strategy is put at risk if people catch wallabies and release them outside the containment areas. We sought to characterise the motivations, beliefs, and attitudes of members of the public who might engage in this illegal behaviour by surveying members of the New Zealand public. We discovered that a very small proportion of the public supported the illegal catch-and-release of wallabies. Respondents, including hunters, that supported catch-and-release believed that wallabies create economic benefits and do not severely damage the environment. They also believed that hunting helps control wallaby numbers. These results yielded a variety of specific policy implications required to reduce catch-and-release behaviour. Full article

Encapsulation of fish oil within oleogels can potentially prevent oxidation and enable its use in food with programmable release within the gastrointestinal tract. Here, we report on the formation of oleogels from two different fish oils—salmon oil (SO) and cod liver oil (CLO)—using different concentrations of either rice bran wax (RBW) or myristic acid (MA) as gelators. The gels were assessed with respect to their structural, thermal, viscosity, digestive, and oxidative properties. Polarized light microscopy (POM) revealed that RBW consistently produced dense, interconnected crystalline networks across both oils, while MA formed larger, spherulitic crystals that were more sensitive to the oil type. This was further supported by time-lapse imaging, showing faster crystal growth of MA in cod liver oil. Viscosity studies indicate that the molecular weight and concentration of gelator, as well as the type of fish oil (SO vs. CLO), significantly impact the shear stability of the oleogels. Thermal and viscosity analyses confirmed that RBW-based oleogels exhibited higher crystallization temperatures and stronger viscoelastic behaviour. Based on oxidative stability measurements—as measured by peroxide value (PV) analysis—encapsulation within oleogels does not lead to significant oxidation of the fish oils and also attenuates further oxidation upon storage. The fish oil oleogels were stable when exposed to either simulated gastric or intestinal fluids (SGF and SIF, respectively), but decomposed after sequential exposure first to SGF and then to SIF. These findings could broaden the range of food products which can be fortified with fish oils. Full article