Search Results (5,119)

Obesity is a complex public health issue requiring a holistic, interdisciplinary approach. The aim of this narrative review is to present motivational interviewing as a communication-based intervention that supports non-stigmatizing, patient-centered care for individuals with excess body weight, with particular emphasis on fostering intrinsic motivation and sustainable lifestyle change. This narrative review examines motivational interviewing (MI) as a tool to support non-stigmatizing, patient-centered communication and promote behavior change in adults, children, and adolescents with overweight or obesity. Evidence from original studies, systematic reviews, and randomized controlled trials suggests that MI can help improve healthy eating, increase physical activity, and strengthen confidence in maintaining lifestyle changes. Its effectiveness is linked to communication based on empathy, partnership, acceptance, and support, free from stigma, which enhances patient autonomy, and encourages active engagement. Despite promising results, research gaps remain regarding the long-term effectiveness of MI and its integration into routine clinical practice. Full article

In this article, a compact wideband three-slot filtering antenna is proposed. The antenna consists of a U-shaped driven slot, a folded resonant slot, and a linear resonant slot. A microstrip feedline with a shorting via is employed to excite the antenna. Mixed electric and magnetic couplings enable the driven slot to couple to the two resonant slots. Three resonant frequencies lie within the passband, resulting in wideband operation. The lowest resonant frequency is determined by the folded resonant slot, while the highest resonant frequency is determined by the linear resonant slot. The center resonant frequency is influenced by the combined effects of the U-shaped driven slot, the folded resonant slot, and the linear resonant slot. A low-frequency radiation null at 1.68 GHz and a high-frequency radiation null at 3.19 GHz are generated. These two radiation nulls enable the proposed antenna to achieve excellent filtering performance. A prototype was fabricated and measured. The measured results are in good agreement with the simulated ones. The measurements show that the proposed three-slot filtering antenna exhibits a relative impedance bandwidth of 39.1%. The out-of-band suppression levels reach 12.5 dB and 14.8 dB in the lower and upper sidebands, respectively. The proposed three-slot filtering antenna is suitable for applications in wireless communication systems. Full article

Background: Childhood obesity is a major public health concern associated with adverse metabolic outcomes later in life. Despite increased awareness, unhealthy lifestyle behaviors—including suboptimal diet quality, physical inactivity, insufficient sleep, and unfavorable body composition—remain prevalent in pediatric populations. Effective, child-centered educational tools for early prevention are still limited. Methods: We developed the Lifestyle Tridimensional Pyramid, an educational model integrating nutrition, physical activity, and sleep within a single, three-dimensional framework. The model also addresses body composition by emphasizing the balance between skeletal muscle and adipose tissue and the interdependence of lifestyle behaviors. This narrative review is supported by an umbrella review of 17 systematic reviews and meta-analyses published between 2010 and 2025, synthesizing evidence on lifestyle behaviors of pediatric obesity. Results: High- to moderate-quality evidence indicates that adherence to Mediterranean-style dietary patterns, regular moderate-to-vigorous physical activity, adequate sleep duration, and a healthier body composition might prevent the development of obesity and improved cardiometabolic profiles in children and adolescents. The pyramid provides a structured, visually accessible tool to support lifestyle counseling in pediatric outpatient settings and is adaptable to school- and community-based health promotion. Conclusions: Although prospective validation studies are warranted, the Lifestyle Tridimensional Pyramid represents a practical, evidence-informed framework to support integrated lifestyle education and improve primary and secondary prevention of pediatric obesity. Full article

Children with Autism Spectrum Disorder (ASD) frequently exhibit marked impairments in nonverbal communication, particularly in eye contact, which serves as a foundational element for social interaction and relational development. This study evaluated the effectiveness of an early intervention program utilizing interactive games supported by Augmented Reality (AR) technology to enhance eye contact behaviors, specifically initiation and maintenance, in children with autism. Using a multiple baseline across participants single-case experimental design, four boys (aged 5–7 years) diagnosed with ASD participated in an 8-week intervention at a specialized center in Saudi Arabia. The intervention featured tablet-based, gamified AR tasks incorporating real-time visual feedback, graduated difficulty levels, and reinforcement mechanisms designed to elicit social gaze and sustained eye contact. Eye contact duration and frequency were measured during structured social interactions via systematic direct observation. The results demonstrated significant improvements across all participants, with the mean duration of eye contact increasing from a baseline of 2.0 s to 5.8 s post-intervention. Visual analysis revealed robust treatment effects, further supported by substantial Tau-U effect sizes (range = 0.89–0.96; M = 0.93). Follow-up data collected three weeks post-intervention confirmed the maintenance of gains for three of the four participants. These findings suggest that AR-based interventions provide an effective and culturally responsive approach for enhancing specific nonverbal communication behaviors among children with autism in Middle Eastern contexts. Implications for clinical practice and directions for future research are discussed. Full article

Background/Objectives: Critical limits define quantitative thresholds for life-threatening diagnostic test results that require immediate clinician notification and may prompt urgent intervention to prevent adverse outcomes. This study aims to (1) characterize point-of-care (POC) critical limits for adults and newborns using a comprehensive U.S. national database, (2) identify POC instruments associated with these limits, and (3) support harmonization of point-of-care testing (POCT) practices. Methods: We gathered critical limit notification lists from 417 hospitals across all 50 states and Washington D.C., comprising university hospitals, trauma and heart centers, centers of excellence, community hospitals, and network hospitals. We extracted POC and central laboratory critical limits (at hospitals with POC), adult international normalized ratio (INR) data, and instrument usage. Results: Low and high glucose critical limits were the most frequently listed POC thresholds, with median values of 50 and 450 mg/dL, respectively, reported by 73 hospitals (17.5%). Troponin was listed by ten hospitals, specified as troponin (n = 4), troponin I (n = 5), or “troponin TnI” (n = 1). A few hospitals assigned instrument-specific critical limits for the same analyte, and 55 hospitals did not specify instrument usage for any measurand. Median differences in matched pairs of laboratory versus POC critical limits differed significantly (Wilcoxon signed-rank, p < 0.05) for low and high ionized calcium (n = 21), low hemoglobin (n = 23) and high INR critical limits for adults (n = 27) and newborns (n = 10). In some cases, matched pair analytes demonstrated identical critical limits. Conclusions: Harmonizing critical limit notification thresholds across point-of-care testing and different devices may improve consistency in clinical decision-making and patient outcomes. Despite the potential of POCT to shorten time to urgent intervention, relatively few hospitals currently include POCT critical limits on notification lists. Establishing standards, annual updating, and enforcing risk mitigation could enhance adoption and reliability. Broader inclusion and transparent sharing of POCT critical values could harmonize practices across institutions, facilitate inter-institutional collaboration, and promote more timely and reliable responses to life-threatening diagnostic results. Full article

Granary systems formed a core institutional foundation of state governance, famine relief, and social stabilization in premodern China. Using the complete corpus of the Twenty-Six Dynastic Histories, this study employs digital humanities methods—including text preprocessing, word-frequency analysis, collocation analysis, time-series comparison, and geographic co-occurrence analysis—to examine the long-term evolution and institutional structure of three major granary types: ever-normal granaries (ChangpingCang), charitable granaries (Yicang), and community granaries (Shecang). The results reveal significant temporal and spatial variation closely associated with dynastic stability, fiscal capacity, and disaster conditions. Ever-normal granaries evolved from early formation in the Western Han to institutional consolidation in the Tang, peak expansion in the Song, and functional diversification thereafter, operating as a centralized mechanism integrating price regulation, fiscal management, and famine relief. Charitable and community granaries, by contrast, display increasingly differentiated roles, reflecting a shift toward localized and socially embedded relief in later periods. Spatial analysis further demonstrates a hierarchical deployment pattern centered on political and agrarian cores and extended through transport corridors and frontier zones. Overall, the study highlights a multilayered relief system combining state authority and social participation, offering a data-driven reinterpretation of Chinese charity and governance. Full article

Background/Objectives: Chronic diseases pose a major challenge for healthcare systems, requiring integrated, patient-centered approaches that combine clinical management, prevention, and self-care. Lifestyle Medicine (LM) and lifestyle in general offers complementary frameworks to address these needs. However, the potential integration of LM within community nursing—particularly through the role of Family and Community Nurse (FCN)—has not been comprehensively synthesized. This narrative review aimed to synthesize international evidence on the role of community nursing—particularly FCN—in integrating chronic care management and LM view. Methods: For quality assessment, a narrative review was conducted in accordance with the SANRA criteria to enable the integration of heterogeneous evidence and a comprehensive synthesis of this complex topic. Literature searches were performed in the PubMed–Medline database, and the final screening of references from included studies was used to identify relevant manuscripts. Primary studies published in English over the past ten years were screened and analyzed using the PICOS framework. Sixteen eligible studies were included in the final synthesis. Results: The included studies indicated that nurse-led community interventions in LM view were associated with improvements in self-management, treatment adherence, and selected clinical outcomes, such as blood pressure, glycated hemoglobin, and physical activity levels. Empowerment-based approaches and the use of digital or telehealth tools supported patient engagement and health literacy. At the organizational level, multidisciplinary collaboration, shared protocols, and professional leadership emerged as key factors in sustaining continuity and quality of care, while organizational fragmentation and limited training in behavioral counseling were commonly reported barriers. Conclusions: Community nursing, particularly through FCNs, plays a relevant role in integrating chronic care management and LM approaches, contributing to improved self-management, treatment adherence, and selected clinical outcomes. The evidence highlights the importance of empowerment-based interventions, digital support tools, and multidisciplinary collaboration in enhancing care continuity and patient engagement. Addressing organizational barriers and strengthening behavioral counseling training remain essential to support effective implementation in community settings. Full article

Background: Healthcare policy in the United Kingdom recognizes that teenagers and young adults (TYAs: 16–24 years at diagnosis) require specialist care. In England, Principal Treatment Centers (PTCs) exist, delivering enhanced care exclusively within the PTC or as ‘joint care’ with designated hospitals (DHs). Central to this is the TYA multidisciplinary team (MDT) and an outreach model coordinating care between hospitals. We previously reported similar outcomes regardless of care location. Aims: To compare TYA experiences of care with healthcare professionals’ perspectives of the service they deliver. Methods: Mixed methods across England and Wales were used. The TYA-MDT identified TYAs who then received a postal invite to a cross-sectional survey capturing experiences of places of care, treatment, healthcare professional support (HCP), mental health, sexuality/fertility, clinical trials and care coordination. Comparisons were made based on exposure to care in a specialist TYA environment within 6 months of diagnosis: all-TYA-PTC (all care in the TYA-PTC, n = 70, 28%), no-TYA-PTC (no care in the TYA-PTC (n = 87, 35%): care delivered in a children/adult unit only), and joint care (care in a TYA-PTC and in a children’s/adult unit, n = 91, 36%). HCP perspectives were captured by rapid ethnography. Results: A total of 250/1056 (24%) TYAs participated. Overall, 200 (80%) rated their teams as excellent/good for helping them prepare for treatment. No evidence of significant differences existed between categories of care for proportions receiving support from key TYA-related professionals: TYA cancer nurse specialists (all-TYA-PTC n = 58, 91%; joint care n = 71, 88%; no-TYA-PTC n = 64, 82%) and social workers (all-TYA-PTC n = 30, 55%; joint care n = 36, 48%; no-TYA-PTC n = 28, 38%). A trend of diminishing support from youth support co-coordinators existed (all-TYA-PTC 63%; joint care 49%; no-TYA-PTC 40%, p = 0.069). This may explain why few differences in patient experiences existed across categories of care. Forty-nine HCPs participated. They were more critical in their interpretation of care, highlighting inequity in resources and challenges in some pathways and coordination. Conclusions: Similar access to age-appropriate support across care settings is likely to reflect recruitment methods. When TYAs are known to the MDT, age-appropriate care can be mobilized beyond TYA units, which could explain the equitable outcomes observed across different care locations in young people who responded to the survey. Nevertheless, gaps persist in communication and coordination, particularly within joint care models, and in the involvement of allied health professionals such as dieticians and physiotherapists, whose input is essential for rehabilitation and return to normal life. Strengthening these areas will require continued investment in workforce capacity and digital infrastructure to support genuinely coordinated, developmentally appropriate TYA cancer care. Full article

Ongoing urbanization continuously reshapes water quality, habitat structure, and biological communities in river ecosystems; however, its impacts on host-associated microbial communities remain poorly documented. The fish gut microbiota, a critical interface between the aquatic environment and host physiology, is widely recognized as an integrative indicator of both environmental change and host ecological traits. This study established a continuous urbanization gradient along Shanghai’s Suzhou River, spanning from suburban areas through the outer and inner ring roads to the city center. Five common wild fish species (Coilia nasus, Hemiculter bleekeri, Culter alburnus, Acheilognathus macropterus, and Pseudorasbora parva) were collected, and their gut microbiota were characterized via high-throughput 16S rRNA gene sequencing. Significant variation in OTU richness, alpha diversity, and community structure was observed across urbanization gradients and among fish species. Principal coordinate analysis revealed that samples from suburban areas were structurally distinct from those collected in other zones, whereas inner-ring and urban-core areas exhibited substantial compositional overlap. Taxonomic analysis revealed that Firmicutes and Pseudomonadota dominated all samples; however, their relative abundances and genus-level composition varied considerably among fish species and across the urbanization gradient. PICRUSt-based functional prediction indicated that metabolic pathways predominated, particularly those involved in global and overview maps, carbohydrate metabolism, amino acid metabolism, energy metabolism, and metabolism of cofactors and vitamins. Collectively, these findings demonstrate that fish gut microbial communities exhibit spatial structuring along the urbanization gradient, with species-specific responses linked to ecological traits. This study provides valuable data on host-associated microbial communities in urban rivers and offers a reference for incorporating microbial indicators into urban water ecological assessments. Full article

New quality productive forces are increasingly recognized as important drivers of coordinated regional development, with urban agglomerations acting as key vehicles for their spatial implementation. Based on the theory of new quality productive forces, this study takes the 13 cities in the Beijing–Tianjin–Hebei (BTH) urban agglomeration as its research subjects, spanning the period from 2005 to 2023, and constructs a four-dimensional evaluation index system for new quality productive forces covering economic, social, ecological, and technological dimensions. It employs the entropy method to determine indicator weights and calculate development indices for each dimension and utilizes a coupling coordination model to measure the overall and subsystem-level coordination by analyzing their spatiotemporal evolution characteristics. The results indicate a steady upward trend in the overall coordination level, progressing from a low level to an intermediate level, with the state of coordination continuously improving; spatial differentiation is significant, forming a gradient development pattern centered on Beijing, with marked disparities in coordination levels among cities. Subsystem analysis reveals an imbalanced synergy structure: while economic and ecological synergy levels are relatively high, the coupling and synergy between science and technology and the economy and society remain prominent weaknesses. Most cities in Hebei Province lack sufficient scientific and technological innovation capabilities, resulting in a weak supportive role for economic and social development. Based on these findings, this study proposes policy recommendations such as establishing a regional innovation community, promoting the integration of factor markets, and strengthening collaborative governance of the ecological environment, with the aim of leveraging new quality productive forces to drive a qualitative leap in the coordinated development of the BTH urban agglomeration. Full article

Background/Objectives: Spinal cord injury (SCI) leads to long-term changes in mobility, bodily function, and everyday participation, extending beyond physical impairment to affect autonomy, identity, and social inclusion. In Greece, limited community-based rehabilitation services, environmental inaccessibility, and fragmented follow-up care further shape the lived experience of individuals with SCI. This study aimed to explore the lived experiences and perceived rehabilitation needs of people with paraplegia living in the community, adopting a phenomenological approach to understand rehabilitation as an ongoing process of reclaiming autonomy, dignity, and participation. Methods: A qualitative phenomenological design was employed. In-depth semi-structured interviews were conducted with fourteen individuals with paraplegia following SCI. Data were analyzed using Braun and Clarke’s reflexive thematic analysis, supported by ATLAS.ti software. Results: Participants described living with SCI as a ‘Socially lived disability: a daily confrontation with an inadequate system and the ongoing struggle for accessibility, autonomy, and dignity’ (Overarching Theme). Participants’ experiences were organized into six themes: (A) facing the new reality, (B) barriers and facilitators of independent living, (C) role and importance of rehabilitation, (D) me and others around me, my difference, (E) the need for adequately trained and informed health professionals and caregivers, (F) ageing as an additional challenge. Conclusions: Living with SCI is experienced as an ongoing process of embodied and social reorientation, in which autonomy, participation, and dignity are continuously negotiated rather than restored once and for all. Rehabilitation emerges as a lifelong, person-centered process that extends beyond functional recovery to support bodily confidence, accessibility, social inclusion, and quality of life across the life course. These findings highlight the need for coordinated, community-based rehabilitation systems, accessible environments, and adequately trained health professionals capable of addressing the evolving functional, social, and existential realities of individuals living with SCI. Full article

This study explains how strategy–execution gaps become self-reinforcing during digital process transformation in layered manufacturing organizations. Drawing on an embedded qualitative process study of a large Chinese brewery’s transformation (2020–2024), we triangulate 10 semi-structured interviews across hierarchical levels with longitudinal public disclosures to reconstruct the initiative timeline and trace mechanisms across change phases. The analysis shows that platform-based process governance can scale faster than shared meaning and dialog, producing frontline sensemaking gaps and formalistic, top-down communication. These conditions thin employee voice and weaken feedback closure, which in turn erodes the legitimacy of organizational diagnosis and fragments implementation support. As interface problems are handled through local workarounds, management intensifies visibility-based monitoring, further suppressing voice and reinforcing the execution gap. We develop an organizational development process model that centers feedback closure and diagnosis legitimacy as bridging mechanisms linking soft change dynamics (meaning, trust, voice) with hard digital governance (process standards, data infrastructures, monitoring). The model offers actionable implications for leaders to build closure and legitimate diagnosis as operational capabilities throughout transformation. Full article

Blue-green infrastructure in high-density communities has been found to be vital to the well-being of urban residents, particularly in 15 min walkable communities. However, residents’ environmental preferences for blue-green infrastructure in high-density urban areas have received little attention. This study uses a walking interview method with 90 participants to explore residents’ motivations, activities and preferences in both community and riverside green spaces. The study area centers on the Licun River and surrounding communities within a 15 min walking distance of the river in Qingdao, China, a high-density city promoting 15 min walkable communities. The findings showed that relaxation was the main reason for visiting both types of spaces. Riverside green spaces supported a wider variety of activities but notable differences in preferences for particular spaces, particularly across gender and age groups. Within community green spaces, artificial elements had a stronger impact on preferences, whereas in riverside green spaces, natural elements were more influential. Blue-green infrastructure planning in high-density cities should then consider diverse user needs by accounting for demographic differences and adapting design elements to various spatial contexts. Since a 15 min walk is not feasible for all residents, enhancing the safety, walkability and inclusivity of blue-green infrastructure is essential for everyday use. Full article

The mobile industry has experienced long-run changes in its knowledge structure, including identifiable transition points observable through embedding-based semantic analysis. Using abstracts from 86,674 mobile industry publications published between 2005 and 2024, we embed documents with SPECTER2, build year-specific embedding distributions, and derive knowledge regimes by combining change-point detection with inter-year distribution distances. We then extract regime-specific topics via clustering and reconstruct topic lineages by aligning topic similarities to classify inheritance, differentiation, convergence, and disappearance. The analysis delineates three regimes spanning 2005 to 2012, 2013 to 2019, and 2020 to 2024, with pronounced transitions around 2012 to 2013 and 2019 to 2020. Regime 1 centers on foundational technologies such as wireless communication, power, sensors, and reliability. Regime 2 expands toward platforms, apps, and data analytics alongside cross-domain convergence. Regime 3 is characterized by strengthened 5G operations and data-driven services, together with the independent rise in policy, governance, and regulation topics. Transitions reflect recombination built on inherited knowledge rather than abrupt replacement, and post-transition topics display distinct growth typologies by network position and growth pattern. By integrating embedding-based changepoint detection with topic lineage reconstruction, we provide a reproducible account of regime transitions and quantitative evidence to inform the timing of corporate R&D, standard and platform strategies, and policy and regulatory design. Full article