Search Results (2,042)

Heme, an essential prosthetic group involved in mitochondrial respiration and transcriptional regulation, is synthesized via the rate-limiting enzyme 5-aminolevulinic acid synthase (ALAS). Utilizing heterozygous mouse models for ALAS1 and ALAS2, our studies have revealed diverse systemic consequences of chronic heme deficiency. ALAS1-heterozygous (ALAS1+/−) mice develop metabolic dysfunction characterized by insulin resistance, glucose intolerance, and abnormal glycogen accumulation, linked mechanistically to reduced AMP-activated protein kinase (AMPK) signaling. These mice also exhibit pronounced mitochondrial dysfunction, impaired autophagy, and accelerated aging phenotypes, including sarcopenia and metabolic decline, highlighting heme’s role as a critical metabolic regulator. Additionally, ALAS2 heterozygosity (ALAS2+/−) leads to impaired erythropoiesis, resulting in anemia and ineffective iron utilization. Importantly, supplementation with the heme precursor 5-aminolevulinic acid (5-ALA) significantly mitigates ALAS1+/− phenotypes, restoring metabolic function, mitochondrial health, autophagy, and immune competence. This review encapsulates key findings from our group’s research together with advances made by multiple research groups over the past decade, collectively establishing heme homeostasis as a central regulator of systemic physiology and highlighting the therapeutic potential of 5-ALA in treating heme-deficient pathologies. Full article

This study aims to understand the meaning nursing professionals attribute to their lived experiences of providing humanized care within a public hospital setting. Grounded in Jean Watson’s theory of human caring, the research adopts a qualitative, descriptive phenomenological design to capture the perceptions and emotions of nurses regarding humanized care. Data were collected through semi-structured interviews with nine experienced nurses, selected through purposive sampling. The interviews, conducted virtually between July and December 2024, were analyzed using Colaizzi’s method and supported by Atlas.ti software. Four main thematic categories emerged: institutional health policies, professional image and identity, strengths and challenges in care, and essential competencies for humanized care. The findings highlight the critical role of empathy, cultural sensitivity, ethical commitment, and emotional presence in delivering compassionate care. Participants emphasized that, beyond clinical procedures, humanized care requires relational and contextual sensitivity, often hindered by institutional limitations and excessive administrative burdens. The study concludes that nursing professionals are key agents in promoting ethical, empathetic, and culturally respectful practices that humanize health services. These insights offer valuable contributions for designing policies and training strategies aimed at strengthening humanized care as a cornerstone of quality healthcare systems. Full article

Improving construction site safety remains a critical challenge in Saudi Arabia’s rapidly growing construction sector, where high accident rates and diverse labor forces demand evidence-based managerial interventions. This study investigated the influence of Managers’ Safety Perceptions and Practices (MSP) on Workers’ Safety Behaviors (WSB) in the Saudi construction industry, emphasizing the mediating roles of Workers’ Safety Awareness (WSA), Safety Competency (WSC), and Safety Actions (SA). The conceptual framework integrates these three mediators to explain how managerial attitudes and practices translate into frontline safety outcomes. A quantitative, cross-sectional design was adopted using a structured questionnaire distributed among construction workers, supervisors, and project managers. A total of 352 from 384 valid responses were collected, and the data were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM) via SmartPLS 4. The findings revealed that MSP does not directly influence WSB but has significant indirect effects through WSA, WSC, and SA. Among these, WSC emerged as the most powerful mediator, followed by WSA and SA, indicating that competency is the most critical driver of safe worker behavior. These results provide robust empirical support for a multidimensional mediation model, highlighting the need for managers to enhance safety behaviors not merely through supervision but through fostering awareness and competency, providing technical training, and implementing proactive safety measures. Theoretically, this study contributes a novel and integrative framework to the occupational safety literature, particularly within underexplored Middle Eastern construction contexts. Practically, it offers actionable insights for safety managers, industry practitioners, and policymakers seeking to improve construction safety performance in alignment with Saudi Vision 2030. Full article

Sexual health constitutes a fundamental aspect of overall well-being, with direct implications for individual development and the broader social and economic progress of communities. Promoting environments that ensure sexual experiences free from coercion, discrimination, and violence is a key public health priority. Sexuality, in this regard, should be understood as an inherent dimension of human experience, shaped by biological, cultural, cognitive, and ideological factors. Accordingly, sexual health education requires a holistic and multidimensional approach that integrates sociocultural, biographical, and professional perspectives. This study aims to examine the level of knowledge and training in sexual health among nursing students and healthcare professionals, as well as to assess the extent to which sexual health content is incorporated into nursing curricula at Spanish universities. A scoping review was conducted using the Dialectical Structural Model of Care (DSMC) as the theoretical framework. The findings indicate a significant lack of knowledge regarding sexual health among both nursing students and healthcare professionals, largely due to educational and structural limitations. Furthermore, sexual health education remains underrepresented in nursing curricula and is frequently addressed from a narrow, fragmented biomedical perspective. These results highlight the urgent need for the comprehensive integration of sexual health content into nursing education. Strengthening curricular inclusion is essential to ensure the preparation of competent professionals capable of delivering holistic, inclusive, and empowering care in this critical area of health. Full article

Introduction: The increasing cultural diversity of patients poses new challenges for nurses. Cultural competence, especially knowledge of the cultural determinants of health and illness, is an important element of professionalism in nursing care. The aim of this study was to analyse nurses’ self-assessment of cultural knowledge, with a focus on the six dimensions of the Giger and Davidhizar model, prior to formal training in this area. Methods: A triangulation method combining qualitative and quantitative analysis was used. The analysis included 353 statements from 36 master’s student nurses. Data were coded according to six cultural phenomena: biological factors, communication, space, time, social structure, and environmental control. Content analysis, ANOVA, Spearman’s rank correlation, and cluster analysis (k-means) were conducted. Results: The most frequently identified that categories were environmental control (34%), communication (20%), and social structure (16%). Significant knowledge gaps were identified in the areas of non-verbal communication, biological differences, and understanding space in a cultural context. Three cultural knowledge profiles of the female participants were distinguished: pragmatic, socio-reflective, and critical–experiential. Conclusions: The cultural knowledge of the participants was fragmented and simplified. The results indicate the need to personalise cultural learning and to take into account nurses’ level of readiness and experience profile. The study highlights the importance of the systematic development of reflective and contextual cultural knowledge as a foundation for competent care. Full article

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

The European Union Council’s zero vision aims to eliminate workplace fatalities, while Industry 4.0 presents new challenges for occupational safety. Despite HR professionals assessing managers’ and employees’ competencies, no system currently exists to evaluate the competencies of workers’ representatives in occupational safety and health (OSH). It is crucial to establish the necessary competencies for these representatives to avoid their selection based on personal bias, ambition, or coercion. The main objective of the study is to identify the competencies and their components required for workers’ representatives in the field of occupational safety and health by following the steps of the DACUM method with the assistance of OSH professionals. First, tasks were identified through semi-structured interviews conducted with eight occupational safety experts. In the second step, a focus group consisting of 34 OSH professionals (2 invited guests and 32 volunteers) determined the competencies and their components necessary to perform those tasks. Finally, the results were validated through an online questionnaire sent to the 32 volunteer participants of the focus group, from which 11 responses (34%) were received. The research categorized the competencies into the following three groups: core competencies (occupational safety and professional knowledge) and distinguishing competencies (personal attributes). Within occupational safety knowledge, 10 components were defined; for professional expertise, 7 components; and for personal attributes, 16 components. Based on the results, it was confirmed that all participants of the tripartite system have an important role in the training and development of workers’ representatives in the field of occupational safety and health. The results indicate that although OSH representation is not yet a priority in Hungary, there is a willingness to collaborate with competent, well-prepared representatives. The study emphasizes the importance of clearly defining and assessing the required competencies. Full article

Nipah virus (NiV) is a highly pathogenic bat-borne zoonotic pathogen that poses a significant threat to human and animal health, with fatality rates exceeding 70% in some outbreaks. Despite its significant public health impact, there are currently no licensed vaccines or specific therapeutics available. Various virological tools—such as reverse genetics systems, replicon particles, VSV-based pseudoviruses, and recombinant Cedar virus chimeras—have been widely used to study the molecular mechanisms of NiV and to support vaccine development. Building upon these platforms, we developed a replication-competent recombinant vesicular stomatitis virus (rVSVΔG-eGFP-NiV_BD F/G) expressing NiV attachment (G) and fusion (F) glycoproteins. This recombinant virus serves as a valuable tool for investigating NiV entry mechanisms, cellular tropism, and immunogenicity. The virus was generated by replacing the VSV G protein with NiV F/G through reverse genetics, and protein incorporation was confirmed via immunofluorescence and electron microscopy. In vitro, the virus exhibited robust replication, characteristic cell tropism, and high viral titers in multiple cell lines. Neutralization assays showed that monoclonal antibodies HENV-26 and HENV-32 effectively neutralized the recombinant virus. Furthermore, immunization of golden hamsters with inactivated rVSVΔG-eGFP-NiV_BD F/G induced potent neutralizing antibody responses, demonstrating its robust immunogenicity. These findings highlight rVSVΔG-eGFP-NiV_BD F/G as an effective platform for NiV research and vaccine development. Full article

Compassion is a critical competence for university students in the healthcare field when dealing with the suffering of patients and relatives. However, there are no tools that measure compassionate capacity during students’ training. Recently, the Compassion Capacity Scale (CCS) was developed for health professionals, exhibiting good psychometric properties. The aim of this study was to translate, culturally adapt, and validate the CCS for Portuguese university students in the healthcare field. The study was divided into two phases: (1) translation and adaptation of the CCS for Portuguese university students in the healthcare field; (2) validation and analysis of psychometric properties. The CCS-PHS showed good internal consistency (Cronbach’s α = 0.886), temporal stability (rho = 0.703), and content validity (CVI-i = 1). Criterion validity analysis showed strong correlations between all of the CCS-PHS’s dimensions and the chosen reference criteria scale. Construct validity analysis revealed that the CCS-PHS is composed of 17 items, classified into four factors. The differences found in the exploratory factor analysis in relation to the original scale may be due to the differences in the life experiences of healthcare professionals when compared to those of students. Our psychometric analysis suggests that the CCS-PHS is a reliable and valid tool to assess compassionate capacity in healthcare students. Knowing the compassionate competence of students is vital for guiding educational strategies, implementing compassion training programs and evaluating their effectiveness, as well as reinforcing key attitudes and behaviors for humanized and ethical healthcare. Full article

Background: It is well-established that, for adolescents to adopt sustainable healthy lifestyle behaviors, not only access to information but also the skills required to translate that information into action are critical. In this field, research that examines the relationship between e-health literacy and sustainable healthy lifestyle behaviors within the context of physical literacy is notably scarce. In this context, the aim of this study is to examine the effect of e-health literacy on a sustainable healthy lifestyle and to evaluate the mediating role of physical literacy in this relationship. Methods: A total of 835 adolescents from high schools across Türkiye voluntarily participated in this study. During the data collection process, the e-Health Literacy Scale, the Perceived Physical Literacy Scale, and the Healthy and Sustainable Lifestyle Scale were utilized. Data were analyzed using the JASP (version 0.18.3.0) software. Correlation analysis and structural equation modeling were conducted, and the bootstrap method (n = 5000) was employed for mediation analysis. Results: The effect of e-health literacy on a sustainable healthy lifestyle was found to be positive and statistically significant (β = 0.452, p < 0.001). Similarly, e-health literacy significantly predicted physical literacy (β = 0.755, p < 0.001), and physical literacy significantly predicted a sustainable healthy lifestyle (β = 0.310, p < 0.001). The mediating effect was also statistically significant (β = 0.234, p < 0.001). The model explained 32% of the variance in healthy lifestyle behaviors. Conclusions: The findings indicate that evaluating e-health literacy and physical literacy together provides a holistic approach to fostering sustainable healthy lifestyle habits among adolescents. It is recommended that intervention programs be structured to encompass both areas of competence. Full article

Equine-Assisted Services (EAS), which incorporate horses in a variety of ways in an effort to improve human wellbeing, have grown in popularity in recent years. Although much research has been conducted regarding the benefits that horses may provide for human health and wellbeing, little attention has been paid to practitioners’ experiences and perspectives of the field, despite the fact they are uniquely positioned to advance our understanding of this area. This study aimed to explore practitioners’ lived experiences of EAS, focusing on the benefits they observed, possible underlying mechanisms for any health benefits witnessed, and challenges faced in the area. Fifteen EAS practitioners from the UK/Ireland took part in qualitative semi-structured interviews, analysed using reflexive thematic analysis. Five themes were identified, three of which related to the horse’s influence on building connections, relationships, and enriching the process, whilst the remainder explored challenges within the field of EAS. These themes were explored through the practitioners’ lens, where possible linking them to our current understanding of human–animal interactions and related fields in the literature. Findings showed that horses, through EAS, were considered invaluable for building relationships, relational skills, and motivation to engage in whichever service was being provided. However, EAS was also viewed as complex. Concerns regarding competencies to practice, training, and lack of governance were expressed. These areas need further exploration and progress if EAS is to grow in efficacy and attain professional status. Full article

The incorporation of digital health into the medical curricula is becoming more important to better prepare doctors in the future. Digital health comprises a wide range of tools such as electronic health records, health information technology, telemedicine, telehealth, mobile health applications, wearable devices, artificial intelligence, and virtual reality. The present study aimed to explore the medical and biomedical students’ perspectives on the integration of digital health in medical curricula. A cross-sectional study was conducted on the medical and biomedical undergraduate students at the College of Medicine and Health Sciences at Sultan Qaboos University. Data was collected using a self-administered questionnaire. The response rate was 37%. The majority of respondents were in the MD (Doctor of Medicine) program (84.4%), while 29 students (15.6%) were from the BMS (Biomedical Sciences) program. A total of 55.38% agreed that they were familiar with the term ‘e-Health’. Additionally, 143 individuals (76.88%) reported being aware of the definition of e-Health. Specifically, 69 individuals (37.10%) utilize e-Health technologies every other week, 20 individuals (10.75%) reported using them daily, while 44 individuals (23.66%) indicated that they never used such technologies. Despite having several benefits, challenges exist in integrating digital health into the medical curriculum. There is a need to overcome the lack of infrastructure, existing educational materials, and digital health topics. In conclusion, embedding digital health into medical curricula is certainly beneficial for creating a digitally competent healthcare workforce that could help in better data storage, help in diagnosis, aid in patient consultation from a distance, and advise on medications, thereby leading to improved patient care which is a key public health priority. Full article

Background/Objectives: Emotional intelligence has emerged as a key factor in shaping nursing performance and care quality, yet its specific mechanisms and impact within the Greek public healthcare context remain underexplored. This study aimed to investigate the role of emotional intelligence in ethical behavior, crisis management, and the perceived quality of care among nurses working in Greek public hospitals. Methods: A cross-sectional survey was conducted among practicing nurses using validated instruments to assess emotional intelligence, ethical compliance, crisis management skills, and care quality. Data were analyzed using covariance-based structural equation modeling (CB SEM) to examine both direct and indirect relationships among variables. Results: The results indicated that emotional intelligence training had a strong and significant effect on nurses’ ethical behavior and their ability to manage critical situations. However, the direct effect of emotional intelligence on the perceived quality of care was not significant; instead, its influence was mediated through improvements in ethics and crisis management. Conclusions: These findings suggest that the benefits of emotional intelligence in nursing are most evident when integrated with supportive organizational practices and ongoing professional development. Overall, this study highlights the need for comprehensive emotional intelligence training and a supportive workplace culture to enhance ethical standards, resilience, and patient care quality in Greek healthcare settings. Full article

This concept paper outlines an implementation strategy for a mandatory training programme using the ADDIE instructional design model for delivery to nurses and other health professionals in an interprofessional education (IPE) environment). Background: Competence in Basic Life Support (BLS) is a lifesaving requirement for health professionals in clinical settings to ensure patient safety and accreditation outcomes. It is essential that health professionals are supported in attending mandatory training, including BLS. To inform learning and teaching strategies, it is useful to apply theoretical perspectives to the development of mandatory staff training methods. However, various training models exist, and few are grounded in instructional design theory to the unique environment for BLS in IPE. Method: A theory-based implementation strategy is outlined for a mandatory interprofessional training programme including BLS, using the ADDIE model to enhance patient outcomes. ADDIE is an instructional design framework comprising five elements: Assess, Design, Develop, Implement and Evaluate; describing a learning methodology that can be readily applied to mandatory training in IPE. Results: Through its iterative capability, the ADDIE model promotes learner needs and rapid acquisition of clinical skills that improve training accessibility. The strategy can equip educators with teaching skills based on a robust theoretical model, with potential to promote nursing and health professional attendance for mandatory training. Conclusions: Mandatory health professional training that addresses a theory informed strategy framed by the ADDIE model can support interprofessional collaboration and consistent competency across healthcare teams. This strategy has potential to contribute by demonstrating how instructional design can be operationalised to improve the effectiveness and engaging approach to BLS training and education to the unique dynamics of an interprofessional environment. Full article

Background/Objectives: Despite the health benefit of regular physical activity, many adults often discontinue it within 3–6 months due to various obstacles. The purpose of this study was to investigate factors affecting physical activity adherence of male office workers based on self-determination theory by constructing a structural equation model. Methods: In total, 257 full-time male office workers who engage in regular physical activity participated. The participants from 15 companies completed a survey asking about perceived physical activity barriers, autonomy support, psychological need satisfaction in physical activity, autonomous motivation, and physical activity adherence. Data analysis was performed using the SPSS 28.0 and the AMOS 26.0 programs to verify the fit of the hypothetical model and identify the direct and indirect effects of variables on physical activity adherence for male office workers. Results: As a result, the path significance test results for the hypothetical model showed that five of the nine paths were significant. The results show that psychological need satisfaction in physical activity and autonomous motivation were significant variables that had a direct effect on physical activity adherence, while autonomy support from significant others and perceived physical activity barriers had a significant indirect effect through psychological need satisfaction and autonomous motivation, explaining 62.0%. Conclusions: Based on these findings, it is recommended to implement customized workplace-specific physical activity interventions to enhance autonomous motivation and the autonomy, competence, and relatedness aspects of psychological need satisfaction in physical activity. Full article