Search Results (1,227)

Soil testing has long been used to optimize fertilization and crop production. More recently, soil health testing has emerged to reflect the growing interest in soil multifunctionality and ecosystem services. Soil health encompasses physical, chemical, and biological properties that support ecosystem functions and sustainable agriculture. Despite its relevance to several United Nations Sustainable Development Goals (SDGs 1, 2, 3, 6, 12, 13, and 15), comprehensive soil health testing is not widely practiced due to complexity and cost. The aim of the study presented here was to contribute to the further development, implementation, and testing of an integrated procedure for soil health assessment in practice. We developed and tested a rapid, standardized soil health assessment tool that combines near-infrared spectroscopy (NIRS) and multi-nutrient 0.01 M CaCl₂ extraction with Inductive Coupled Plasma Mass Spectroscopy analysis. The tool evaluates a wide range of soil characteristics with high accuracy (R² ≥ 0.88 for most parameters) and has been evaluated across more than 15 countries, including those in Europe, China, New Zealand, and Vietnam. The results are compiled into a soil health indicator report with tailored management advice and a five-level ABCDE score. In a Dutch test set, 6% of soils scored A (optimal), while 2% scored E (degraded). This scalable tool supports land users, agrifood industries, and policymakers in advancing sustainable soil management and evidence-based environmental policy. Full article

Background/Objective: The most effective strategy for addressing users’ prosthetic needs is a comprehensive clinical assessment that provides a holistic understanding of the individual’s symptoms, health, function, and environmental barriers and facilitators. A standardized evaluation form would provide guidance for a structured approach to comprehensive clinical assessments of people with LLA. The objective of this study was to determine a list of relevant elements to be included in prosthetic evaluation for adults with lower limb amputation. Methods: Three independent focus group discussions were conducted with prosthetists (n = 15), prosthesis users (n = 11), and decision makers (n = 4) to identify all relevant elements that should be included in the clinical assessment of prosthetic services. The final content was then determined using the Delphi technique, with 35 panelists (18 prosthetists and decision makers, and 17 prosthesis users) voting in each round. Results: A total of 91 elements were identified through the focus group, of which 78 were included through the Delphi process. The identified elements are mostly related to the physical health of the prosthesis user (e.g., mobility, pain, and medical information), while others address personal or psychosocial aspects (e.g., activities of daily living, goals, and motivation) or technical aspects (prosthesis-related). Conclusions: Through a Delphi consensus, a list of relevant elements to be included in a prosthetic evaluation was generated. These results will inform the development of a standardized clinical prosthetic assessment form. This form has the potential to improve the quality of clinical evaluations, guide interventions, and enhance the well-being of prosthetic users. Full article

Background/Objectives: Sudden cardiac arrest (SCA) is a major global health concern with high mortality despite advances in resuscitation techniques. Achieving return of spontaneous circulation (ROSC) represents merely the initial step in the extensive rehabilitation journey. This review highlights the critical role of structured, multidisciplinary rehabilitation following ROSC, emphasizing the necessity of integrated physiotherapy, neurocognitive therapy, and psychosocial support to enhance quality of life and societal reintegration in survivors. Methods: This narrative review analyzed peer-reviewed literature from 2020–2025, sourced from databases such as PubMed, Scopus, Web of Science, and Google Scholar. Emphasis was on clinical trials, expert guidelines (e.g., European Resuscitation Council 2021, American Heart Association 2020), and high-impact journals, with systematic thematic analysis across rehabilitation phases. Results: The review confirms rehabilitation as essential in addressing Intensive Care Unit–acquired weakness, cognitive impairment, and post-intensive care syndrome. Early rehabilitation (0–7 days post-ROSC), focusing on parameter-guided mobilization and cognitive stimulation, significantly improves functional outcomes. Structured interdisciplinary interventions encompassing cardiopulmonary, neuromuscular, and cognitive domains effectively mitigate long-term disability, facilitating return to daily activities and employment. However, access disparities and insufficient randomized controlled trials limit evidence-based standardization. Discussion: Optimal recovery after SCA necessitates early and continuous interdisciplinary engagement, tailored to individual physiological and cognitive profiles. Persistent cognitive fatigue, executive dysfunction, and emotional instability remain significant barriers, underscoring the need for holistic and sustained rehabilitative approaches. Conclusions: Comprehensive, individualized rehabilitation following cardiac arrest is not supplementary but fundamental to meaningful recovery. Emphasizing early mobilization, neurocognitive therapy, family involvement, and structured social reintegration pathways is crucial. Addressing healthcare disparities and investing in rigorous randomized trials are imperative to achieving standardized, equitable, and outcome-oriented rehabilitation services globally. Full article

Healthy food service guidelines (HFSG) comprise food, nutrition, behavioral design, and other standards to guide the purchasing, preparation, and offering of foods and beverages in worksites and institutional food service. To date, there have been few attempts to synthesize evidence for HFSG effectiveness in non-K-12 or early childhood education sectors, particularly at worksites and institutional food services. We conducted a scoping review to achieve the following: (1) characterize the existing literature on the effectiveness of HFSG for improving the institution’s food environment, financial outcomes, and consumers’ diet quality and health, and (2) identify gaps in the literature. The initial search in PubMed and Web of Science retrieved 10,358 articles; after screening and snowball searching, 68 articles were included for analysis. Studies varied in terms of HFSG implementation settings, venues, and outcomes in both U.S. (n = 34) and non-U.S. (n = 34) contexts. The majority of HFSG interventions occurred in venues where food is sold (e.g., worksite cafeterias, vending machines). A diversity of HFSG terminology and measurement tools demonstrates the literature’s breadth. Literature gaps include quasi-experimental study designs, as well as interventions in settings that serve dependent populations (e.g., universities, elderly feeding programs, and prisons). Full article

Background: Pharmacy technicians are increasingly involved in immunization services, enhancing vaccine accessibility and reducing pharmacies’ workload. This scoping review aims to (1) provide a comprehensive overview of pharmacy technicians’ involvement in immunization services across various healthcare settings and countries, and (2) conduct a comparative analysis of training curricula for pharmacy technicians on immunization. Methods: A scoping review was conducted following the Arksey and O’Malley framework. A comprehensive search of the PubMed and Scopus databases was performed using keywords and MeSH terms such as “pharmacy technician(s)”, “immunization”, “vaccination”, “role”, and “involvement”. Studies included assessed pharmacy technicians’ roles in vaccine administration, training, and public health outcomes. Descriptive and thematic analyses were used to synthesize the findings. In addition, a supplementary analysis of immunization training curricula was conducted, reviewing programs from different countries to identify similarities, differences, and gaps in course structure, content, and delivery formats. Lastly, a comprehensive toolkit was developed, offering guidelines intended to facilitate the implementation of immunization training programs. Results: A total of 35 articles met the inclusion criteria, primarily from the United States of America (n = 30), Canada (n = 2), Ethiopia (n = 1), Denmark (n = 1) and United Kingdom (n = 1). The findings indicate that pharmacy technicians contribute significantly to vaccine administration, patient education, and workflow optimization, particularly in community pharmacies. The COVID-19 pandemic accelerated their involvement in immunization programs. Key challenges include regulatory barriers, a lack of standardized training, and resistance from other healthcare professionals. Facilitators include legislative support (e.g., the PREP Act), structured training programs, and collaborative pharmacist–technician models. Conclusions: Pharmacy technicians can play a vital role in expanding immunization services, improving vaccine uptake, and reducing pharmacist workload. Addressing regulatory inconsistencies, enhancing training, and fostering interprofessional collaboration are crucial for their effective integration of immunization programs. Since immunization by pharmacy technicians is not yet allowed in many EU countries, this review will provide a foundational basis to address their potential to support the healthcare workforce and improve access to immunization services. Full article

Background/Objectives: Violence is a significant occupational health issue for paramedics, yet underreporting limits efforts to identify and mitigate risk. Leveraging a novel, point-of-event violence reporting system, we aimed to identify characteristics of 9-1-1 calls associated with an increased risk of violence in a single paramedic service in Ontario, Canada. Methods: We retrospectively analyzed all electronic violence and patient care reports filed by paramedics in Peel Region and used logistic regression to identify call-level predictors of any violence and, more specifically, physical or sexual assault. Results: In total, 374 paramedics filed 974 violence reports, 40% of which documented an assault, corresponding to a rate of 4.18 violent encounters per 1000 9-1-1 calls. In adjusted models, the risk of violence was elevated for calls originating from non-residential locations (e.g., streets, hotels, bars), occurring during afternoon or overnight shifts, and involving young or working-age males. Presenting problems related to intoxication, mental health, or altered mental status were strongly associated with increased risk, with particularly high adjusted odds ratios for assault. Conclusions: These findings support the utility of near-miss and violence surveillance systems and highlight the need for multidisciplinary crisis response to high-risk calls, especially those involving mental health or substance use. Full article

Background/Objectives: Healthcare workers (HCW) have increased the risk of occupational stress injuries and adverse mental health outcomes, which were exacerbated during the COVID-19 pandemic. Understanding HCW psychological distress patterns and help-seeking behaviors can inform responsive resource development that may mitigate negative outcomes in future crises. This paper provides insights on monthly trends in HCW distress and support utilization at a large Canadian hospital over a 14-month period. Methods: As part of a hospital-wide wellness initiative during COVID-19, the STEADY program emailed monthly confidential wellness assessments to hospital staff from April 2020 to May 2021. The assessments included screens for burnout, anxiety, depression and posttraumatic stress, types of support accessed, and demographic information. Repeated cross-sectional data were summarized as monthly proportions and examined alongside longitudinal COVID-19 data. Results: A total of 2498 wellness assessments were submitted (M = ~168 monthly, range: 17–945). Overall, 67% of assessments had at least one positive screen for distress. Average positive screens were 44% for anxiety, 29% for depression, 31% for posttraumatic stress, and 53% for burnout. Despite high distress, most respondents used informal supports (e.g., family/friends), highlighting limited formal support use. Conclusions: HCWs experienced sustained high levels of psychological distress during the COVID-19 pandemic, with burnout remaining a predominant and persistent concern. The limited use of formal support services may indicate barriers to accessing these types of supports. Our findings underscore the need for accessible and acceptable mental health supports for HCW during prolonged crises. Full article

With the rapid digital transformation of healthcare services in India, this study investigates the factors influencing the behavioral shift from traditional hospital visits to e-health consultations. The primary objective was to analyze patient attitudes, satisfaction, and perceived barriers to adopting virtual healthcare, especially in urban and semi-urban settings. Methods: The methodology adopted in the study was descriptive, and a convenience sampling technique was used for data collection because the feasible times of the patients’ availabilities were taken into consideration for data collection. Both primary and secondary data were collected using questionnaires and literature. A sample size of 385 participants was used in this study. Various statistical tools, such as frequency, ANOVA, and Chi-square tests, were used to test the hypotheses. Results: It was observed from ANOVA and Chi-square tests that the factors for switching from traditional consultation to e-health services have a positive association. It was found that integrating data through influencing factors significantly (p < 0.001) improved decisions on e-health services. Conclusion: This study highlights the shift from in-person to e-health consultations driven by convenience, flexibility, and pandemic-related needs while acknowledging barriers such as digital literacy, infrastructure gaps, and trust issues. It recommends strategies, such as secure platforms, training, and integrated care models, for a more inclusive digital health future. Full article

Design and use of wearable technology have grown exponentially, particularly in consumer products and service sectors, e.g., healthcare. However, there is a lack of a comprehensive understanding of wearable technology in consumer acceptance. This systematic review utilized a PRISMA on peer-reviewed articles published between 2014 and 2024 and collected on WoS, Scopus, and ScienceDirect. A total of 38 full-text articles were systematically reviewed and analyzed using bibliometric, thematic, and descriptive analysis to understand the technical functions of digital wearable products (DWPs) in consumer acceptance. The findings revealed four key functions: (i) wearable technology, (ii) appearance and design, (iii) biomimetic innovation, and (iv) security and privacy, found in eight types of DWPs, among them smartwatches, medical robotics, fitness devices, and wearable fashions, significantly predicted the customers’ acceptance moderated by the behavioral factors. The review also identified five key outcomes: health and fitness, enjoyment, social value, biomimicry, and market growth. The review proposed a comprehensive acceptance model that combines biomimetic principles and AI-driven features into the technical functions of the technical function model (TAM) while addressing security and privacy concerns. This approach contributes to the extended definition of TAM in wearable technology, offering new pathways for biomimetic research in smart devices and robotics. Full article

Background: Psychological problems post-stroke can negatively impact stroke survivors. Although general psychological services exist (e.g., NHS Talking Therapies), access remains limited, particularly for individuals with post-stroke communication and cognitive impairments. Stroke service staff report low confidence in managing psychological distress. This study is the first to explore the barriers and facilitators to implementing a novel intervention package comprising a cross-service care pathway and staff training to enhance post-stroke psychological provision. Methods: Staff from stroke and mental health services in four UK regions, recruited through purposive sampling to ensure diversity of services and professional roles, participated in semi-structured interviews or focus groups, guided by the Theoretical Domains Framework (TDF), before and after implementation of the intervention package. Pre-implementation interviews/groups identified anticipated barriers and facilitators to implementation and training needs, informing the development of site-specific intervention packages; post-implementation interviews/groups explored experienced barriers, facilitators and perceptions of the intervention. Interviews underwent thematic analysis using the TDF. Results: Fifty-five staff participated pre-implementation and seventeen post-implementation, representing stroke (e.g., nurse, physiotherapist, consultant) and psychology (e.g., counsellor, psychological therapist) roles across acute, rehabilitation, community, and voluntary services. Challenges anticipated pre-implementation included: limited specialist post-stroke psychological support; low staff confidence; and fragmented service pathways. Post-implementation findings indicated increased staff knowledge and confidence, enhanced screening and referral processes, and stronger inter-service collaboration. Implementation success varied across sites (with some sites showing greater ownership and sustainability of the intervention) and across staff roles (with therapy staff more likely than nursing staff to have received training). Conclusions: Effective implementation of an intervention package to increase psychological provision post-stroke requires staff engagement at all levels across all services. Staff investment influenced ownership of the intervention package, beliefs about priorities and overall enhancement of service capability. Full article

Assessing a city’s level of smartness according to global indices is a relatively new area of investigation. It is useful in encouraging a rethinking of urban digital strategies, although the different approaches to global smart city rankings have been subject to criticism. This paper highlights the methodological features of constructing the Smart City Index (SCI) from the IMD (International Institute for Management Development) based on residents’ assessments, their satisfaction with electronic services, and their perception of the priority of urban infrastructure areas. The Central European cities of the Visegrad region (Prague/Czech Republic, Budapest/Hungary, Bratislava/Slovakia, Warsaw and Krakow/Poland) were chosen as the basis for an in-depth analysis. The architectonics, i.e., the internal system of constructing and calculating city rankings by SCI, is analyzed. A comparative analysis of the technology indicators (e-services) in five cities of the Visegrad region, presented in the SCI, showed the smart features of each city. The progressive and regressive trends in the dynamics of smartness in the cities in the Visegrad region were identified in five urban spheres indicated in the Index: Government, Activity, Health and Safety, Mobility, and Opportunities. This also made it possible to identify certain methodological gaps in the SCI in establishing interdependencies between the data on the residents’ perception of the priority of areas of life in a particular city and the residents’ level of satisfaction with electronic services. In particular, the structural indicators “Affordable housing” and “Green spaces” are not supported by e-services. This research aims to bridge this methodological gap by proposing a model for evaluating the e-service according to the degree of coverage of different spheres of life in the city. The application of the project, as well as cross-sectoral and systemic approaches, made it possible to develop basic models for assessing the value of e-services. These models can be implemented by municipalities to assess and monitor e-services, as well as to select IT projects and elaborate strategies for smart sustainable city development. Full article

Mangroves form the dominant coastal plant community of low-energy tropical intertidal habitats and provide critical ecosystem services to humans and the environment. However, more frequent and increasingly powerful hurricanes and storm surges are creating additional pressure on the natural resilience of these threatened coastal ecosystems. Advances in remote sensing techniques and approaches are critical to providing robust quantitative monitoring of post-storm mangrove forest recovery to better prioritize the often-limited resources available for the restoration of these storm-damaged habitats. Here, we build on previously utilized spatial and temporal ranges of European Space Agency (ESA) Sentinel satellite imagery to monitor and map the recovery of the mangrove forests of the British Virgin Islands (BVI) since the occurrence of back-to-back category 5 hurricanes, Irma and Maria, on September 6 and 19 of 2017, respectively. Pre- to post-storm changes in coastal mangrove forest health were assessed annually using the normalized difference vegetation index (NDVI) and moisture stress index (MSI) from 2016 to 2023 using Google Earth Engine. Results reveal a steady trajectory towards forest health recovery on many of the Territory’s islands since the storms’ impacts in 2017. However, some mangrove patches are slower to recover, such as those on the islands of Virgin Gorda and Jost Van Dyke, and, in some cases, have shown a continued decline (e.g., Prickly Pear Island). Our work also uses a linear ANCOVA model to assess a variety of geospatial, environmental, and anthropogenic drivers for mangrove recovery as a function of NDVI pre-storm and post-storm conditions. The model suggests that roughly 58% of the variability in the 7-year difference (2016 to 2023) in NDVI may be related by a positive linear relationship with the variable of population within 0.5 km and a negative linear relationship with the variables of northwest aspect vs. southwest aspect, island size, temperature, and slope. Full article

Background/Objectives: Grief in cancer patients represents a multidimensional psychological response encompassing anticipatory, existential, and identity-related distress. While the recent literature has examined grief in caregivers, family members, and even healthcare professionals, the psychological grief experienced by patients themselves following a cancer diagnosis remains comparatively understudied and insufficiently characterized in empirical research. This systematic review aims to evaluate observational studies that used validated psychometric instruments to measure grief in adult cancer patients and to synthesize findings on the significance of grief in this population. Methods: Following PRISMA 2020 guidelines, a systematic search of PubMed, CINAHL, and PsycINFO was conducted to identify observational studies that employed validated tools to assess grief among adult cancer patients. The inclusion criteria required the use of psychometrically validated grief instruments and the collection of quantitative data. Fifteen studies met eligibility criteria and were included in the final analysis. Results: Grief symptoms were consistently present at moderate to high levels across diverse cancer types, care settings, and geographic regions. Preparatory Grief in Advanced Cancer (PGAC) scores often exceeded thresholds associated with clinical concern, with correlations observed between grief and psychological variables such as anxiety (r = 0.63), depression (r = 0.637), hopelessness (r = 0.63), and dignity (r = 0.654). Demographic factors (e.g., younger age, female gender) and illness perceptions (e.g., identity centrality, stigma) further intensified grief. Grief was a predominant psychological concern even when general distress measures failed to capture its presence. Conclusions: Future research is essential to identify an effective public health strategy for addressing grief through structured screening conducted in primary care and outpatient medical settings, coupled with accessible referral pathways to community-based support groups and coordinated follow-up services to facilitate grief management. Full article

Background/Objectives: Mobile healthcare units (MHUs) comprise flexible, ambulatory healthcare teams that deliver community care services, particularly in underserved or remote areas. In Greece, MHUs were pivotal in epidemiological surveillance during the COVID-19 pandemic and are now evolving into a sustainable and integrated service for much-needed community-based healthcare. To support this expanded role, targeted, competency-based training is essential; however, this can pose challenges, especially in coordinating synchronous learning across geographically dispersed teams and in ensuring engagement using an online format. Methods: A nationwide, online training program was developed to improve the knowledge of the personnel members of the Hellenic National Public Health Organization’s MHUs. This program was structured focusing on four core themes: (i) prevention–health promotion; (ii) provision of care; (iii) social welfare and solidarity initiatives; and (iv) digital health skill enhancement. The program was implemented by the University of Crete’s Center for Training and Lifelong Learning from 16 January to 24 February 2025. A multidisciplinary team of 64 experts delivered 250 h of live and on-demand educational content, including health screenings, vaccination protocols, biomarker monitoring, chronic disease management, treatment adherence, organ donation awareness, counseling on social violence, and eHealth applications. Knowledge acquisition was assessed through a pre- and post-training multiple-choice test related to the core themes. Trainees’ and trainers’ qualitative feedback was evaluated using a 0–10 numerical rating scale (Likert-type). Results: A total of 873 MHU members participated in the study, including both healthcare professionals and administrative staff. The attendance rate was consistently above 90% on a daily basis. The average assessment score increased from 52.8% (pre-training) to 69.8% (post-training), indicating 17% knowledge acquisition. The paired t-test analysis demonstrated that this improvement was statistically significant (t = −8.52, p < 0.001), confirming the program’s effectiveness in enhancing knowledge. As part of the evaluation of qualitative feedback, the program was positively evaluated, with 75–80% of trainees rating key components such as content, structure, and trainer effectiveness as “Very Good” or “Excellent.” In addition, using a 0–10 scale, trainers rated the program relative to organization (9.4/10), content (8.8), and trainee engagement (8.9), confirming the program’s strength and scalability in primary care education. Conclusions: This initiative highlights the effectiveness of a structured, online training program in enhancing MHU knowledge, ensuring standardized, high-quality education that supports current primary healthcare needs. Future studies evaluating whether the increase in knowledge acquisition may also result in an improvement in the personnel’s competencies, and clinical practice will further contribute to assessing whether additional training programs may be helpful. Full article

Using the behavioral model of engagement in health services, the current study assessed client characteristics that may contribute to treatment duration in trauma-focused psychotherapy in a community clinic setting. Participants (n = 893) were adults ages 18–78 years old (M = 36.36, SD 12.37). Demographic data (e.g., age, income) and health profile questionnaires assessing trauma and depression symptoms were collected at intake and every three sessions thereafter to track health outcome progress. Logistic regression models assessed factors associated with treatment duration at three time points: treatment initiation (0–2 sessions), treatment engagement (3–5 sessions), and treatment sustainment (6–8 sessions). For this sample, 38.6% ended treatment at the treatment initiation phase. Lower education level and higher quality of social relationships was predictive of ending treatment. In the engagement phase, 29.2% of the remaining participants (n = 548) ended treatment before six sessions, but there were no predictors of ending. During the sustainment phase, 31.7% ended treatment. African American race was associated with ending at this phase. In total, 70.3% of participants ended treatment before nine sessions. Participants who remained in treatment through the sustainment phase showed significant improvement in trauma and depression symptoms at each of the previous treatment phases, providing evidence of a dose response effect. Lower education, higher quality of social relationships, and African American race were associated with leaving treatment early. Many participants ended treatment before nine sessions, but those that completed treatment experienced improvement in symptoms to sub-clinical levels. Full article