Search Results (1,271)

Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by inattention, hyperactivity, and impulsivity, frequently observed in juvenile offenders. This systematic review explores the interplay between ADHD and juvenile delinquency, focusing on behavioural, psychological, and social dimensions. Following the PRISMA guidelines, a systematic literature review was conducted using EBSCO Discovery Service, Science Direct, PubMed, and snowballing techniques. Studies meeting specific inclusion criteria, including juvenile offenders diagnosed with ADHD and comparisons to non-offender or non-ADHD control groups, were analysed. The methodological quality of studies was assessed using the Joanna Briggs Institute appraisal tools. A total of 21 studies were included, highlighting significant associations between ADHD and juvenile delinquency. ADHD symptoms, especially impulsivity and emotional dysregulation, were linked to an earlier onset of offending and higher rates of property crimes. Comorbidities such as conduct disorder, substance use disorder, and depression exacerbated these behaviours. Sociodemographic factors like low education levels and adverse family environments were also critical modifiers. Early intervention and tailored treatment approaches were emphasised to address these challenges. The findings underscore the need for early diagnosis, individualised treatment, and integrative rehabilitation programmes within the juvenile justice system to mitigate long-term risks and promote social inclusion. Full article

The rubber industry is facing major socio-economic and environmental constraints. Rubber-based agroforestry systems represent a more sustainable solution through the diversification of income and the provision of greater ecosystem services than monoculture plantations. Participative approaches are known for their ability to co-construct solutions with stakeholders and to promote a positive impact on smallholders. This study therefore implemented a participatory research process with stakeholders in the natural rubber sector for the purpose of improving inclusion, relevance and impact. Facilitation training sessions were first organised with academic actors to prepare participatory workshops. A working group of stakeholder representatives was set up and participated in these workshops to share a common representation of the value chain and to identify problems and solutions for the sector in Indonesia. By fostering collective intelligence and systems thinking, the process is aimed at enabling the development of adaptive technical solutions and building capacity across the sector for future government replanting programmes. The resulting adaptive technical packages were then detailed and objectified by the academic consortium and are part of a participatory plant breeding approach adapted to the natural rubber industry. On-station and on-farm experimental plans have been set up to facilitate the drafting of projects for setting up field trials based on these outcomes. Research played a dual role as both knowledge provider and facilitator, guiding a co-learning process rooted in social inclusion, equity and ecological resilience. The initiative highlighted the potential of rubber cultivation to contribute to climate change mitigation and food sovereignty, provided that it can adapt through sustainable practices like agroforestry. Continued political and financial support is essential to sustain and scale these innovations. Full article

Demand for mental health support has exerted unprecedented pressure on statutory services. Innovative solutions such as Green or Nature-Based Social Prescribing (NBSP) programmes may help address unmet need, improve access to personalised treatment, and support the sustainable delivery of primary services within a prevention model of population health. We piloted an innovative health economics-informed Social Return on Investment (SROI) analysis and forecast of a ‘Making Well’ therapeutic craft and horticulture programme for mental health between October 2021 and March 2022. Quantitative and qualitative outcome data were collected from participants with mild-to-moderate mental health conditions at baseline and nine-weeks follow-up using a range of validated measures, including the Short Warwick–Edinburgh Mental Well-being Scale, ICEpop CAPability measure for Adults (ICECAP-A), General Self-Efficacy Scale (GSES), and a bespoke Client Service Receipt Inventory (CSRI). The acceptability and feasibility of these measures were explored. Results indicate that the Making Well programme generated well-being-related social value in the range of British Pound Sterling (GBP) GBP 3.30 to GBP 4.70 for every GBP 1 invested. Our initial pilot forecast suggests that the programme has the potential to generate GBP 5.40 to GBP 7.70 for every GBP 1 invested as the programme is developed and delivered over a 12-month period. Despite the small sample size and lack of a control group, our results contribute to the evidence-base for the effectiveness and social return on investment of NBSP as a therapeutic intervention for improving health and well-being and provides an example of the use of health economic well-being outcome measures such as ICECAP-A and CSRIs in social value analysis. Combining SROI evaluation and forecast methodologies with validated quantitative outcome measures used in the field of health economics can provide valuable social cost–benefit evidence to decision-makers. Full article

Since the start of the energy crisis in 2020, the Dutch government has introduced various programmes aimed at alleviating energy poverty among low-income households. This research examines the effects of three specific interventions—energy coaching, home renovations, and white goods schemes—on a range of energy poverty-related aspects, including living comfort, physical and mental health, energy costs, financial concerns, social connection, neighbourhood involvement, and sustainable behaviour. While previous studies have mostly investigated these interventions in isolation, this research offers a comparative analysis to explore how their impacts differ and how they may complement one another. This research, comparing an intervention group and control, shows that energy coaches, renovations, and white goods schemes each have positive effects on various aspects of energy poverty. However, the nature and magnitude of these effects differ by type of support measure. Renovations are the most effective overall, significantly improving living comfort, physical health, and reducing energy costs. White goods schemes primarily reduce moisture and mould in dwellings and have a notable positive impact on mental health. Energy coaches contribute to improved living comfort, lower energy costs, and uniquely enhance community involvement. The complementary nature of these interventions highlights the potential added value of integrated or combined approaches to tackling energy poverty. Full article

Background: The introduction of cystic fibrosis transmembrane conductance regulator modulators, especially the triple therapy elexacaftor, tezacaftor, ivacaftor (ETI), has improved outcomes in people with cystic fibrosis (pwCF), reducing underweight but increasing overweight rates. Objectives: This study investigates the effect of ETI on appetite control, body composition, and energy balance during a 3-week inpatient rehabilitation programme with regular exercise. Methods: In 54 pwCF (38 on ETI, 16 without ETI), changes in body composition (fat mass index, FMI; fat-free mass index, FFMI) and energy balance (calculated from body composition changes) were assessed. Appetite control was evaluated via plasma peptide YY (PYY) levels and post-exercise meal energy intake. Results: The programme significantly increased BMI (+0.3 ± 0.1 kg/m²; CI 0.1–0.4) and energy balance (+4317 ± 1976 kcal/3 weeks), primarily through FFMI gains (+0.3 ± 0.1 kg/m²; CI 0.1–0.4). Despite higher post-exercise meal energy intake and a tendency towards lower PYY levels in the ETI group, changes in body composition and energy balance did not differ between groups. This is explained by a higher prevalence of exocrine pancreatic insufficiency in the ETI group (92% vs. 50%, p < 0.001). Small sample sizes limit the interpretation of data on appetite control and energy intake. Conclusions: A 3-week inpatient rehabilitation programme improved body composition in pwCF, without resulting in a more positive energy balance with ETI therapy. This is due to a higher prevalence of pancreatic insufficiency in this group. Full article

Background/Objectives: Single-dose pre-operative antibiotic prophylaxis for cardiac-device implantation is recommended but extending antibiotic prophylaxis is common. Locally, 50–60% of patients had extended prophylaxis after pacemaker insertion or generator change. Our antimicrobial stewardship programme (ASP) incorporated behavioural change strategies in implementing a multi-pronged intervention bundle to address this and evaluated its effectiveness and safety. Methods: This single-centre, retrospective cohort study included patients aged 21 years old or older, undergoing uncomplicated pacemaker insertion or generator change at Singapore General Hospital (SGH) from October 2022 to March 2025. To improve antibiotic use, ASP interventions incorporating behaviour change strategies were implemented, namely (1) data-driven feedback, (2) targeted education, (3) identification and engagement of ASP champion, and (4) clinical pathway revision. Results: There were 779 patients evaluated; 380 (48.8%) received standard prophylaxis while 399 (51.2%) received extended prophylaxis with oral antibiotics (mean duration, 3.3 ± 0.8 days). Following ASP interventions, the practice of extended prophylaxis declined significantly from 43.8% to 24.0% (p < 0.01). The incidence of surgical site infections was low and similar in both groups (0.8%, p = 1.000); all infections were superficial. There was also significant reduction in the proportion of patients on all antibiotics from 20.7% to 16.3% (p < 0.01). Identification and engagement of ASP champion proved pivotal in changing prescribing behaviour through peer influence and credibility. Conclusions: The bundled ASP interventions, incorporating behavioural change strategies, have effectively and safely reduced the use of extended prophylaxis post-cardiac device implantation. Behavioural change interventions are essential to achieve sustained stewardship success. Full article

Shift work can have an adverse impact on sleep and wellbeing, as well as negative consequences for workplace safety and productivity. SleepShifters is a co-developed sleep management programme that aims to equip shift workers and employers with the skills needed to manage sleep from the onset of employment, thus preventing sleep problems and their associated consequences from arising. This paper describes the co-development process and resulting programme protocol of SleepShifters, designed in line with the Medical Research Council’s framework for the development and evaluation of complex interventions. Programme components were co-produced in partnership with stakeholders from four organisations across the United Kingdom, following an iterative, four-stage process based on focus groups and interviews. As well as a handbook containing guidance on shift scheduling, workplace lighting, and controlled rest periods, SleepShifters consists of five key components: (1) an annual sleep awareness event; (2) a digital sleep training induction module for new starters; (3) a monthly-themed sleep awareness campaign; (4) a website, hosting a digital Cognitive Behavioural Therapy for insomnia platform and supportive video case studies from shift-working peers; (5) a sleep scheduling app for employees. Future work will implement and assess the effectiveness of delivering SleepShifters in organisational settings. Full article

Information and Communication Technologies (ICTs) are increasingly necessary in the educational context. Digital resources could support socio-educational practices to intervene with vulnerable groups, such as people with disabilities, and improve their accessibility and inclusion. This study aims to analyse educators’ perceptions of ICT resources for socio-educational intervention with people with disabilities, as well as to determine their training needs and the possibilities and risks derived from their use. A qualitative methodology has been used to analyse the content of 12 semi-structured interviews with social educators. All of them work with students with disabilities in the extracurricular field. Based on the results, the educators habitually use popular digital devices, such as computers. They regularly search for content on the internet to obtain and disseminate ideas, perceiving an adequate domain. However, there is a need for training on specific digital resources to intervene with students with disabilities. The study highlights the need to investigate the causes that may limit some ICT uses by educators and foster the design of specific training programmes to harness the potential of ICT in socio-educational intervention. Full article

This paper evaluates the effectiveness of driver training programmes aimed at the proper use of Advanced Driver Assistance Systems (ADASs). Participants (N = 49) were divided into the following three groups based on the type of training received: practical training, e-learning, and brief manual instruction. The effectiveness of the training methods was assessed using selected parameters obtained from driving simulator studies, including reaction times and system activation attempts. Given the large volume and nonlinear nature of the input data, a heuristic, expert-based approach was used to identify key evaluation criteria, structure the decision-making process, and define fuzzy rule sets and membership functions. This phase served as the foundation for the development of a fuzzy logic model in the MATLAB environment. The model processes inputs to generate a quantitative performance score. The results indicate that practical training (mean score = 4.0) demonstrates superior effectiveness compared to e-learning (3.09) and manual instruction (mean score = 3.01). The primary contribution of this work is a transparent, data-driven evaluation tool that overcomes the inherent subjectivity and bias of traditional trainer-based assessments. This model provides a standardised and reproducible approach for assessing driver competence, offering a significant advancement over purely qualitative, trainer-based assessments and supporting the development of more reliable certification processes. Full article

Background: This paper aims to conduct an umbrella review of the effects of physical activity programmes for older adults (aged 70 and above). Methods: Comprehensive literature searches were conducted in MEDLINE, PubMed, EMBASE, PsychINFO, and Cochrane Library databases for English SRs 2024. Inclusion criteria were systematic reviews that included randomised controlled trials examining physical activity interventions in older adults. The data extracted were participant characteristics, physical activity interventions, and outcomes examined. A synthesis of results was conducted using the PRISMA guidelines, and the quality of the studies was assessed using the Assessment of Multiple Systematic Reviews-2 (AMSTAR-2). Results: Ten systematic reviews on 186 research articles were included. The AMSTAR-2 revealed that 4 out of 10 reviews were of high quality and 1 out of 10 were of moderate quality. The study samples in each systematic review ranged from 6 to 1254 participants. The total overall sample size for the 10 included studies was 22,652 participants. Across the included reviews, there was mixed evidence on whether physical activity interventions could improve outcomes in older adults across various settings. Conclusions: Sample sizes and findings in each included systematic review varied. The findings of this review emphasise the importance of physical activity as a vital component in maintaining and enhancing health, as well as combating poor health as we age. It also highlights the need for a deeper understanding of the specific physical activity requirements for those aged 70 and above. Future systematic reviews may focus on streamlined reporting of dosing of physical activity and specific intervention types, such as group versus single. Full article

The economic impact of health promotion and disease prevention interventions in ageing populations remains debated, as theories of morbidity compression and expansion offer contrasting views on the relationship between life expectancy and duration of morbidity. A MEDLINE search was conducted to identify studies evaluating the economic impact of health promotion or primary or secondary prevention interventions in OECD countries, over a lifetime time horizon. Among the 29 studies included, 16 reported cost-saving interventions (reducing costs while improving health outcomes), 11 reported cost-effective interventions (health gains at an acceptable additional cost based on an established threshold), and two presented cost-ineffective interventions (costs exceeding the threshold for the health benefits achieved). Interventions targeting diabetes and obesity prevention were cost-saving; cancer screening and fall prevention strategies were cost-effective; whereas interventions targeting rare diseases were cost-ineffective. Regulatory interventions were also cost-saving, while most programme-based interventions were cost-effective. Cost-saving or cost-effective interventions generally adopted broader analytical perspectives, while cost-ineffective ones employed narrower perspectives. The four studies that incorporated competing risks—despite using a narrower healthcare sector perspective—still found the interventions to be cost-saving or cost-effective interventions. None of the included studies assessed whether interventions led to morbidity compression or expansion. Only a few studies considered equity impact; those that did reported improved outcomes for disadvantaged groups, in regulatory and community-based interventions. Further research is needed to quantify morbidity outcomes and enhance methodological consistency, particularly with respect to analytical perspectives, the integration of competing risks, and the inclusion of equity analyses. Full article

Addressing climate change requires not only knowledge but also psychological resilience. This study examined whether integrating Mental Mode Management (MMM) self-regulation training with climate education improves pro-environmental outcomes and emotional responses to climate change. In a randomised 2 × 2 design, 44 participants were assigned to either a control group (CG; n = 21), which received a six-week climate education programme, or an experimental group (MMM; n = 23), which received the same education plus MMM training. Pro-environmental attitudes, behaviours, carbon emissions, climate change anxiety, mindfulness, and executive functions were assessed at baseline and post-intervention. A follow-up was also conducted six months later. Both groups showed increased pro-environmental attitudes post-intervention (η² = 0.3) and reduced food-related emissions (η² = 0.107). No changes were observed in pro-environmental behaviour scores or global carbon footprint. While neither intervention affected overall climate anxiety or cognitive impairment, functional impairment increased in the CG and decreased in the MMM group (η² = 0.177), with mindfulness facet acting with awareness moderating this effect. These findings contribute to sustainability research by showing that integrating climate education with psychological training enhances environmental awareness and fosters emotionally resilient engagement with climate challenges, supporting individual-level contributions to broader sustainability goals. Full article

This study investigates the cybersecurity landscape of Aotearoa-New Zealand through a culturally grounded lens, focusing on the integration of Indigenous Māori values into cybersecurity frameworks. In response to escalating cyber threats, the research adopts a mixed-methods and interdisciplinary approach—combining surveys, focus groups, and case studies—to explore how cultural principles such as whanaungatanga (collective responsibility) and manaakitanga (care and respect) influence digital safety practices. The findings demonstrate that culturally informed strategies enhance trust, resilience, and community engagement, particularly in rural and underserved Māori communities. Quantitative analysis revealed that 63% of urban participants correctly identified phishing attempts compared to 38% of rural participants, highlighting a significant urban–rural awareness gap. Additionally, over 72% of Māori respondents indicated that cybersecurity messaging was more effective when delivered through familiar cultural channels, such as marae networks or iwi-led training programmes. Focus groups reinforced this, with participants noting stronger retention and behavioural change when cyber risks were communicated using Māori metaphors, language, or values-based analogies. The study also confirms that culturally grounded interventions—such as incorporating Māori motifs (e.g., koru, poutama) into secure interface design and using iwi structures to disseminate best practices—can align with international standards like NIST CSF and ISO 27001. This compatibility enhances stakeholder buy-in and demonstrates universal applicability in multicultural contexts. Key challenges identified include a cybersecurity talent shortage in remote areas, difficulties integrating Indigenous perspectives into mainstream policy, and persistent barriers from the digital divide. The research advocates for cross-sector collaboration among government, private industry, and Indigenous communities to co-develop inclusive, resilient cybersecurity ecosystems. Based on the UTAUT and New Zealand’s cybersecurity vision “Secure Together—Tō Tātou Korowai Manaaki 2023–2028,” this study provides a model for small nations and multicultural societies to create robust, inclusive cybersecurity frameworks. Full article

There is a growing global interest in making existing buildings more energy-efficient. However, stakeholders seem to have differing views on the matter, especially in developing countries, thus raising the issue of awareness amongst key stakeholders at the operational stage of existing buildings. This study aimed to examine stakeholders’ awareness of the benefits of passive retrofit in residential buildings using a convergent mixed-methods approach. Quantitative data were collected from 118 property managers and 163 owners of residential buildings, and qualitative data were collected from six government officials in Lagos State, Nigeria. The quantitative data collected were analysed using fuzzy synthetic evaluation, which addresses the fuzziness in judgement-making on multi-criteria phenomena. The results revealed that property managers and owners had a moderately high level of awareness of the environmental, economic, and social benefits of the passive retrofitting of residential buildings. However, while property managers generally had a higher level of awareness than owners, a significant gap was found in their awareness of environmental benefits. Conversely, the qualitative analysis results showed that government officials demonstrated a strong awareness of environmental benefits (energy reduction, air quality, and natural lighting) and economic advantages (cost savings and lower implementation costs). In contrast, their awareness of social benefits was limited to health improvements. The findings have practical implications for policy development and awareness campaigns. Building agencies need to further reinforce their targeted awareness programmes for owners, who demonstrated fair awareness of environmental benefits while leveraging the intermediary role of property managers in promoting home retrofit practices. Economic benefits should also be an integral part of policy frameworks to drive wider adoption across all stakeholder groups. Full article

The “Baby Ubuntu” programme is a well-established, low-cost, community-based intervention to support caregivers of children with complex neurodisability, like cerebral palsy, in low- and middle-income country (LMIC) contexts. This process-focused paper describes our utilisation of the ADAPT guidance to adapt “Baby Ubuntu” for use in ethnically and linguistically diverse, and economically deprived urban boroughs in the United Kingdom (UK). The process was guided by an adaptation team, including parents with lived experience, who explored the rationale for the intervention from local perspectives and its fit for this UK community. Through qualitative interviews and co-creation strategies, the perspectives of caregivers and healthcare professionals substantially contributed to the “Encompass” programme theory, drafting the content, and planning the delivery. Ten modules were co-produced with various topics, based on the “Baby Ubuntu” modules, to be co-facilitated by a parent with lived experience and a healthcare professional. The programme is participatory, allowing caregivers to share information, problem solve, and form supportive peer networks. The “Encompass” programme is an example of a “decolonised healthcare innovation”, as it aims to transfer knowledge and solutions developed in low- and middle-income countries to a high-income context like the UK. Piloting of the new programme is underway. Full article