Search Results (504)

Background: Family caregivers are a vital yet often under-recognized part of the healthcare system. They provide essential emotional, physical, and logistical support to individuals with illness, disability, or frailty, and their contributions improve continuity of care and reduce system strain. However, many healthcare and social service providers are not equipped to meaningfully engage caregivers as partners. In Alberta, stakeholders validated the Caregiver-Centered Care Competency Framework and identified the need for a three-tiered education model—Foundational, Advanced, and Champion—to help providers recognize, include, and support family caregivers across care settings. This paper focuses on the development and early evaluation of the Advanced Caregiver-Centered Care Education modules, designed to enhance the knowledge and skills of providers with more experience working with family caregivers. The modules emphasize how partnering with caregivers benefits not only the person receiving care but also improves provider effectiveness and supports better system outcomes. Methods: The modules were co-designed with a 154-member interdisciplinary team and grounded in the competency framework. Evaluation used the first three levels of the Kirkpatrick–Barr health workforce education model. We analyzed pre- and post-surveys from the first 50 learners in each module using paired t-tests and examined qualitative feedback and SMART goals through inductive content analysis. Results: Learners reported a high level of satisfaction with the education delivery and the knowledge and skill acquisition. Statistically significant improvements were observed in 53 of 54 pre-post items. SMART goals reflected intended practice changes across all six competency domains, indicating learners saw value in engaging caregivers as partners. Conclusions: The Advanced Caregiver-Centered Care education improved providers’ confidence, knowledge, and skills to work in partnership with family caregivers. Future research will explore whether these improvements translate into real-world practice changes and better caregiver experiences in care planning, communication, and navigation. Full article

Introduction/Objective: Post-bariatric surgery patients require long-term, coordinated care to address complex nutritional, physiological, and behavioral challenges. Personalized smart nutrition, combining individualized dietary strategies with targeted monitoring, has emerged as a valuable direction for optimizing recovery and long-term outcomes. This article examines how traditional medical protocols can be enhanced by digital solutions in a multidisciplinary framework. Methods: The study analyzes current clinical practices, including personalized meal planning, physical rehabilitation, biochemical marker monitoring, and psychological counseling, as applied in post-bariatric care. These established approaches are then analyzed in relation to the NutriMonitCare system, a digital health system developed and tested in a laboratory environment. Used here as an illustrative example, the NutriMonitCare system demonstrates the potential of digital tools to support clinicians through real-time monitoring of dietary intake, activity levels, and physiological parameters. Results: Findings emphasize that medical protocols remain the cornerstone of post-surgical management, while digital tools may provide added value by enhancing data availability, supporting individualized decision making, and reinforcing patient adherence. Systems like the NutriMonitCare system could be integrated into interdisciplinary care models to refine nutrition-focused interventions and improve communication across care teams. However, their clinical utility remains theoretical at this stage and requires further validation. Conclusions: In conclusion, the integration of digital health tools with conventional post-operative care has the potential to advance personalized smart nutrition. Future research should focus on clinical evaluation, real-world testing, and ethical implementation of such technologies into established medical workflows to ensure both efficacy and patient safety. Full article

Over the last decade, the scientific community has increasingly focused on forest-based practices for human well-being (FBPW), a term that includes all forest activities (e.g., forest bathing, forest therapy, social outdoor initiatives) important for improving people’s health and emotional status. This paper aims to develop a quantitative literature review on FBPW based on big data analysis (text mining on Scopus title and abstract) and PRISMA evaluation. The two techniques facilitate investigations across different geographic areas (major areas and geographical regions) and allow a focus on various topics. The results of text mining highlight the prominence of publications on FBPW for the improvement of human health in East Asia (e.g., Japan and South Korea). Furthermore, some specific themes developed by the literature for each geographical area emerge: urban green areas, cities, and parks in Africa; sustainable forest management and planning in the Americas; empirical studies on physiological and psychological effects of FBPW in Asia; and forest management and FBPW in Europe. PRISMA indicates a gap in studies focused on the reciprocal influences of forest variables and well-being responses. An investigation of the main physiological indicators applied in the scientific literature for the theme is also developed. The main strengths and weaknesses of the method are discussed, with suggestions for potential future lines of research. Full article

Background/Objectives: In late 2019, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) caused a pandemic called the ‘coronavirus disease 2019’ (COVID-19). After the acute SARS-CoV-2 infection, many individuals (up to 33%) complained of unexplained symptoms involving multiple organ systems and were diagnosed as having Long COVID-19 (LC-19). Currently, LC-19 is inadequately defined, requiring the formation of consistent diagnostic parameters to provide a foundation for ongoing and future studies of epidemiology, risk factors, clinical characteristics, and therapy. LC-19 represents a significant burden on multiple levels. The reduced ability of workers to return to work or compromised work efficiency has led to consequences at national, economic, and societal levels by increasing dependence on community services. On a personal scale, the isolation and helplessness caused by the disease and its subsequent impact on the patient’s mental health and quality of life are incalculable. Methods: In this paper, we used Walker and Avants’ eight-step approach to perform a concept analysis of the term “Long COVID-19” and define its impact across these parameters. Results: Using this methodology, we provide an improved definition of LC-19 by connecting the clinical symptomology with previously under-addressed factors, such as mental, psychological, economic, and social effects. This definition of LC-19 features can help improve diagnostic procedures and help plan relevant healthcare services. Conclusions: LC-19 represents a complex and pressing public health challenge with diverse symptomology, an unpredictable timeline, and complex pathophysiology. This concept analysis serves as a tool for improving LC-19 definition, but it remains a dynamic disease with evolving diagnostic and therapeutic approaches, requiring deeper investigation and understanding of its long-term effects. Full article

Geographic disparities threaten equitable access for children to health-promoting safe green spaces, and quality early education in the communities in which they live and grow. To address gaps in the field, we integrated the fields of developmental psychology, public health, and environmental science to examine, at the population level, associations between the environmental burden, socioeconomic vulnerability, and kindergarten readiness in a diverse urban county. Three administrative datasets were integrated through an early childhood data sharing research partnership in Miami-Dade County. The Bruner Child Raising Vulnerability Index, the five domains of the Environmental Burden module from the Environmental Justice Index, and public school kindergarten readiness scores were aggregated at the census tract level. Analysis of variance and multiple regression analyses found associations between socioeconomic vulnerability and race/ethnicity. The socioeconomic vulnerability levels were highest in census tracts with a higher percentage of Black residents, compared to all other races/ethnicities. Areas of greater social vulnerability had lower kindergarten readiness and a higher environmental burden. A higher environmental burden predicted lower kindergarten readiness scores above and beyond race/ethnicity and socioeconomic vulnerability. The findings advance our understanding of global challenges to sustainable healthy child development, such as the persistence of a disproportionate environmental burden and inequitable access to resources such as green spaces and early education programs. The present study results can inform community health improvement plans to reduce risk exposures and promote greater access to positive environmental and educational resources for all children. Full article

Earthen flood protection structures are planned and constructed with an expected service life of several decades while being exposed to environmental impacts that may lead to structural or hydraulic failure. Current maintenance procedures involve only repairing external damage, leaving internal processes contributing to structural damage often undetected. Through structural health monitoring (SHM), structural deficits can be detected before visible damage occurs. To improve maintenance workflows and support predictive maintenance of dikes, this paper reports on the integration of digital twin concepts with SHM strategies, referred to as “digital-twin-based SHM”. A digital twin concept, including a standard-compliant building information model, is proposed and implemented in terms of a digital twin environment. For integrating monitoring and sensor data into the digital twin environment, a customized webform is designed. A communication protocol links preprocessed sensor data stored on a server with the digital twin environment, enabling model-based visualization and contextualization of the sensor data. As will be shown in this paper, a digital twin environment is set up and managed in the context of SHM in compliance with technical standards and using well-established software tools. In conclusion, digital-twin-based SHM, as proposed in this paper, has proven to advance predictive maintenance of dikes, contributing to the resilience of critical infrastructure against environmental impacts. Full article

Background/Objectives: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide, with rural populations experiencing higher prevalence and worse outcomes. This paper explores the transformative potential of nurse-led palliative care models in addressing the unique challenges faced by rural patients with COPD and their informal caregivers and synthesizes current evidence on nurse-led palliative care interventions, highlighting their impact on symptom management, advance care planning, and psychosocial support. Methods: This is a comprehensive synthesis of nurse-led palliative care programs, focusing on home-based care, telehealth, community outreach, and primary care integration. Results: Nurse-led interventions significantly improve patient satisfaction, reduce symptom burden, and enhance the likelihood of advance care planning discussions. Home-based care models and telehealth are particularly effective in rural settings, offering accessible and continuous support. Conclusions: Nurses have a critical role in bridging the palliative care gap for rural patients with COPD and their informal caregivers. Expanding nurse-led palliative care services can improve quality of life, reduce healthcare utilization, and promote health equity. Future research should focus on long-term outcomes, cost-effectiveness, and strategies for scaling nurse-led palliative care programs in rural contexts. Full article

The increasing use of Global Positioning System (GPS) tools reshapes nature-based recreational practices. While previous research has examined the role of GPS technologies in outdoor recreation, limited attention has been given to the specific factors driving GPS use in nature-based settings such as natural parks. This case study examines the sociodemographic, behavioural, motivational and experiential factors influencing GPS use among visitors to the Capçaleres del Ter i del Freser Natural Park (Catalonia, Spain). A structured visitor survey (n = 999) was conducted over a one-year period and a hierarchical binary logistic regression model was applied to evaluate the explanatory contribution of four sequential variable blocks. The results showed that the behavioural factors (i.e., physical activity intensity) emerged as the strongest predictor of GPS use. Additionally, the final model demonstrated that visitors who were younger, engaged in higher-intensity physical activities, motivated by health-related goals, undertook longer routes, and reported more positive experiences were significantly more likely to use GPS tools during their visit. These findings highlight the need to adapt communication strategies to diverse visitor profiles and leverage volunteered geographic information (VGI) for improved visitor monitoring, flow management, and adaptive conservation planning. Full article

Improving community walkability can encourage older adults to walk, which is beneficial for enhancing their physical activity level (PAL) and keeping healthy. The first purpose of this study was to formulate an optimized community Walk Score measurement system from the perspective of Chinese seniors. It will be optimized from the aspects such as community service facility selection, weight determination, and distance decay function calculation. The second purpose was to verify its validity by exploring the correlation between Walk Score and subjective/objective community environment variables based on Spearman correlation analysis and the ANOVA method. The third purpose was to examine the relationship between Walk Score and Chinese seniors’ PAL and health outcomes by means of ordered/binary logistic regression. The results show the following: (1) Walk Scores are significantly correlated with partial objective environmental variables. (2) Walk Score was related to older adults’ physical activity level. (3) There was no significant relationship between Walk Score and two health outcomes. Walk Score can provide a supporting basis for urban renewal, older-community renovation, age-friendly community planning and design, and public health practitioners or policymakers. Full article

Maternal mortality and morbidity are critical health challenges in the U.S., and building the perinatal workforce is a key to providing high-quality maternal medical care and services. Texas Southern University (TSU), home to a Doctor of Pharmacy program, launched the first Maternal Health Education and Research Training (MHERT) program to educate a cohort of high school, pharmacy, and health sciences students. Aiming to raise awareness of maternal health issues, build research skills, and promote action-based solutions. MHERT integrated online self-paced interactive lessons with hands-on research or community projects. Topics included maternal health epidemiology, causes of morbidity and mortality, research methods, literature reviews, and the development of action plans addressing maternal health challenges. Assessment tools included quizzes, open-ended reflection responses, training surveys, and course evaluations. Running from 3 June to 26 July 2024, the program enrolled 22 students. All participants completed both course components. Course evaluations showed strong and consistent satisfaction with the program, with teaching effectiveness rated at 95% and 96% for mid-program and final evaluations, respectively. MHERT enhanced participants’ understanding of maternal health, improved research skills, and encouraged community engagement and interdisciplinary collaboration. It offers a scalable model to strengthen public health education among high school, pharmacy, and health sciences students. Full article

Ageing is a global demographic trend that has increased the total prevalence of multimorbidity, disability and frailty, posing ever greater challenges for public health systems. For older people, ageing is often associated with a loss of quality of life, independence and well-being. This study analyses the role of urban gardens as spaces that promote active ageing and contribute to the physical, psychological and social well-being of older adults. Focusing on the urban areaof Valencia, this research adopts a qualitative approach based on in-depth semi-structured interviews with 15 older adults who regularly participate in urban gardens. The findings indicate that urban gardens contribute significantly to active ageing by providing opportunities for regular physical activity, emotional well-being, social engagement, and improved nutrition through the cultivation of food by the participants themselves. These spaces also enhance autonomy, stimulate cognitive functions, elevate mood, and offer a renewed sense of purpose following retirement. Moreover, urban gardens serve as inclusive environments that promote intergenerational interaction and reinforce community bonds. As multifunctional spaces, they hold considerable potential for enhancing the quality of life among older adults and addressing key public health challenges associated with population ageing. Consequently, their integration into urban planning frameworks should be prioritised. Full article

Introduction: Racial and ethnic disparities in end-of-life (EOL) cancer care persist, leading to lower rates of advance care planning (ACP), reduced access to palliative care, and poorer patient outcomes for minority populations. While previous research has documented these inequities, less is known about the specific interventions developed to address them, necessitating a comprehensive review of existing strategies aimed at improving EOL care for racial and ethnic populations. The objective of this scoping review is to examine the extent and characteristics of interventions and their outcomes designed to address racial and ethnic disparities in EOL cancer care in the United States. Methods: A comprehensive search of EOL cancer care interventions for minority populations was conducted in Ovid MEDLINE, CINAHL with Full Text (EBSCOhost), and Scopus (Elsevier) in September 2024. Two independent reviewers screened titles, abstracts, and full texts following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, with inclusion limited to studies conducted in the US and published in English. Results: Of 3104 screened studies, 10 met the inclusion criteria. Participants enrolled were only from Latino (n = 6 studies) or Black (n = 4 studies) populations. We identified four types of interventions, including communication skills for patients, caregivers, researchers, and clinicians (n = 2), education programs for patients (n = 1), navigation and support programs for patients and caregivers (n = 3), and training programs for health workers and community leaders (n = 4). The most effective interventions were those that addressed linguistic barriers, integrated cultural values, and involved trusted community figures. Faith-based models were particularly successful among African American patients, while bilingual navigation and family-centered ACP interventions had the greatest impact in Latino populations. Conclusions: This review highlights (1) the importance of culturally tailored interventions for specific minority populations and (2) the limited number of such interventions, which primarily target only the largest minority groups. Full article

Urban green spaces (UGSs), including parks, forests, and community gardens, play a critical role in enhancing public health and well-being by providing essential ecosystem services such as improving air quality, reducing surface temperatures, and mitigating harmful substances. As urbanization accelerates, especially in rapidly growing cities like Jinan, China, the demand for UGSs is intensifying, necessitating careful urban planning to balance development and environmental protection. While previous studies have often focused on city-level green coverage, this study shifts the analytical focus from UGS as a whole to urban functional units (UFUs), allowing for a more detailed examination of how green space is distributed across different land use types. We investigate UGS changes in Jinan over the past two decades and assess the influence of socio-economic factors—such as housing prices, land use types, and building age—on UGS distribution within UFUs. Remote sensing technology was employed to analyze the spatiotemporal dynamics of UGS and its correlation with these variables. Our findings reveal a significant shift in UGS distribution, with parks and leisure areas becoming primary drivers of UGS expansion. This study also highlights the growing influence of economic factors, particularly housing prices, on UGS distribution in more affluent UFUs. Additionally, while UGS in Jinan has generally expanded, challenges remain in balancing green space with urban expansion, especially in commercial and residential UFUs. This paper contributes to a more nuanced understanding of UGS distribution by integrating the UFU framework and identifying socio-economic drivers—including housing prices, construction age, and land use type—that shape green space patterns in Jinan. Our findings demonstrate that the spatial pattern of UGS in Jinan mirrors socio-economic and land use disparities observed in other global cities, highlighting both the universality of these patterns and the need for targeted planning in rapidly urbanizing contexts. Full article

Hospitals require continuous access to water to sustain essential health services, especially when resources are taxed when drought conditions are compounded with other public health emergencies. In mid-2020, we conducted a rapid assessment of 71 hospitals in northern Thailand to evaluate water use and resilience during the concurrent 2019–2020 drought and the early phase of the COVID-19 pandemic in Thailand. While most hospitals reported adequate water availability, many depended on short-term measures such as shallow wells and improvised storage. Water use per bed often exceeded international benchmarks, reflecting broader usage patterns that extend beyond potable consumption. Community hospitals, in particular, reported more limited backup supply and planning capacity. Drawing on both our findings and international guidance, we propose the Hazard Management Model, involving a set of recommendations to strengthen hospital water resilience, including hazard-specific planning, protected infrastructure, emergency storage, and improved efficiency. These insights contribute to the growing body of work on climate-adaptive healthcare, particularly in resource-constrained settings facing intensifying multi-hazard risks. Full article

Background/Objectives: Despite high breastfeeding initiation rates nationwide, disparities in breastfeeding continuation among Black mothers remain a public health issue. The BreastFeed Iowa Black Immigrant Project aimed to improve breastfeeding rates among low-income Black immigrant mother-infant dyads in Johnson County, Iowa by exploring factors influencing breastfeeding retention and developing a framework for culturally sensitive breastfeeding interventions. Methods: Using a descriptive cross-sectional study design, we employed a convergent, parallel mixed-methods approach to explore factors that influence breastfeeding duration among Black immigrant mothers with children 0–2 years old. Nine focus group discussions (FGDs) were conducted on Zoom among 40 participants with a semi-structured guide on breastfeeding beliefs, experiences, and feeding practices. Additionally, a 22-item survey was administered to 33 participants. Results: Based on the survey, one out of five participants indicated that they were unable to breastfeed for as long as they had planned. The top five reasons why mothers stopped breastfeeding included having received formula from the Supplemental Nutrition Program for Women, Infants and Children; being sick and having to take medicine; the baby was hungry too often; the baby was sick and could not breastfeed; and not producing enough milk. The top five themes that emerged from FGDs as barriers to breastfeeding included lack of lactation support, knowledge gaps on breastfeeding benefits, perception of inadequate milk supply, lack of comfort with breast milk expression, and work-related barriers. Conclusions: The community needs assessment identified the elements needed to develop a culturally sensitive framework with targeted interventions to address breastfeeding barriers in the Black immigrant community. Full article