Search Results (17,601)

This article presents a case study from a Social and Health Care School in Denmark, where a rooftop garden was designed to promote student health and support nature-based teaching across subject areas. A novel aspect of the project is the formal integration of the garden into teaching, implying that its long-term impact may extend beyond the students to the end-users they will later encounter in nursing homes and hospitals nationwide. This study applies the Evidence-Based Health Design in Landscape Architecture (EBHDL) process model, encompassing evidence collection, programming, and concept design, with the University of Copenhagen acting in a consultancy role. A co-design process with students and teachers was included as a novel source of case-specific evidence. Methodologically, this is a participatory practice-based case study focusing on the full design and construction processes, combining continuous documentation with reflective analysis of ‘process insights,’ generating lessons learned from the application of the EBHDL process model. This study identifies two categories of lessons learned. First, general insights emerged concerning governance, stakeholder roles, and the critical importance of site selection, procurement, and continuity of design responsibility. Second, specific insights were gained regarding the application of the EBHDL model, including its alignment with Danish and international standardised construction phases. These insights are particularly relevant for project managers in nature-based initiatives. The results also show how the EBHDL model aligns with Danish and international standardised construction phases, offering a bridge between health design methods and established building practice. The case focuses on the EBHDL process rather than verified outcomes and demonstrates how evidence-based and participatory approaches can help structure complex design processes, facilitate stakeholder engagement, and support decision-making in institutional projects. Full article

Existing research highlights that Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ+) teachers are often exposed to additional stressors in schools which adversely affect their mental health. Some mitigate the effects of these stressors by separating their personal and professional identities while others choose to integrate their identities so that they can be authentic, advance social justice in school contexts or be visible and vocal role models. Less is known about the experiences of pre-service teachers who are undertaking teacher preparation programmes. This systematic literature review presents the results of 20 published papers which represent the global experiences of both pre-service teachers and serving teachers. The findings highlight identity management, experiences of discrimination, agency and lack of confidence of teacher educators. Two new frameworks are presented that lay the foundations for embedding LGBTQ+ inclusion and proposed mandatory elements of curricula for initial teacher training. This systematic literature review has been informed by the following research questions RQ1. What are the experiences of LGBTQ+ pre-service teachers? RQ2. How do LGBTQ+ pre-service teachers negotiate their identities? RQ3. How do LGBTQ+ pre-service teachers disrupt hetero/cis-normative cultures in schools? RQ4: How well does the teacher education programme prepare pre-service teachers for teaching LGBTQ+ inclusive education? Full article

Non-digital traditional games such as board and card formats are increasingly recognised as valuable tools for active learning in higher education. These analogue approaches promote engagement, collaboration, and conceptual understanding through embodied and social interaction. This scoping review mapped research on the use of traditional, non-digital games as active learning strategies in tertiary education and examined whether the rise in generative artificial intelligence (GenAI) since 2022 has influenced their pedagogical role. Following the PRISMA-ScR framework, a systematic search of Scopus (October 2025) identified 2480 records; after screening, 26 studies met all inclusion criteria (explicitly using card and/or board games). Whilst this was a scoping, not a systematic review, some bias due to using only one database and evidence could have missed some studies. Results analysed the use and impacts of the games and whether AI was a specific driver in its use. Studies spanned STEM, business, health, and social sciences, with board and card games most frequently employed to support engagement, understanding, and collaboration. Most reported positive learning outcomes. Post-2023 publications suggest renewed interest in analogue pedagogies as authentic, human-centred responses to AI-mediated education. While none directly investigated GenAI, its emergence appears to have acted as an indirect catalyst, highlighting the continuing importance of tactile, cooperative learning experiences. Analogue games therefore remain a resilient, adaptable form of active learning that complements technological innovation and sustains the human dimensions of higher-education practice. Full article

Dental caries remains a major global public health problem characterized by pronounced social inequalities. This study aimed to identify, critically appraise, and synthesize the most recent evidence on the relationship between socioeconomic indicators and dental caries among adults aged 19–60 years, providing an updated systematic review that builds upon our previous reviews from 2012 and 2018. Reported following the PRISMA 2020 guidelines, we conducted a systematic search of eight electronic databases for observational studies published between March 2017 and April 2024 (PROSPERO: CRD42017074434). Two independent reviewers performed study selection, data extraction, and risk of bias assessment using the Newcastle–Ottawa Scale. Due to substantial methodological heterogeneity across the 22 included studies, a narrative synthesis was undertaken. The findings demonstrated a strong inverse association between socioeconomic position and caries experience. Lower income, lower educational attainment, and unemployment or employment in manual/unskilled occupations were associated with a higher overall caries experience. Advanced analytical approaches in recent studies, including life-course, reinforced that education and income are key contributors of these oral health inequalities, with persistent social disadvantage conferring the greatest risk. In conclusion, dental caries in adults aged 19–60 years is a social condition reflecting the cumulative effects of socioeconomic inequality across the life course. Addressing adult dental caries requires integrated approaches that combine clinical prevention with social and public policies aimed at reducing structural inequalities. Full article

Background and Objectives: Bladder cancer (BC) represents a significant global health burden, ranking as the tenth most commonly diagnosed malignancy worldwide, with an incidence rate of 5.6 per 100,000 person-years annually. The research team aimed to summarize evidence on specialized nursing-led interventions for bladder cancer management across the disease continuum. Materials and Methods: This scoping review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) methodology to search four databases from January 2018 to November 2025. Results: This concise but informative scoping review of 20 studies revealed substantial clinical and patient-reported benefits from specialized nursing interventions. Enhanced recovery after surgery (ERAS) protocols incorporating structured nursing care demonstrated a 35% reduction in postoperative complications. Integrated nursing interventions during postoperative intravesical therapy significantly improved patient satisfaction, treatment compliance, and self-efficacy while reducing anxiety and depression. Digital health platforms, including internet-based and mobile applications, proved effective in reducing caregiver burden, enhancing disease knowledge, and improving coping strategies. Preoperative stoma education and postoperative ostomy care management significantly improved self-efficacy, stoma care knowledge, and overall health-related quality of life. Psychosocial interventions, including cognitive behavioral therapy and mindfulness-based approaches, demonstrated significant improvements in quality of life and reductions in fear of recurrence, depression, and anxiety. However, a critical evidence gap exists regarding bladder cancer-specific mental health interventions. Conclusions: Specialized nursing-led care plays a critical role in strengthening clinical and assistive practice in bladder cancer. Evidence from this scoping review shows that nursing-led interventions significantly improve clinical outcomes, patient satisfaction, symptom management, and quality of life across all phases of bladder cancer care while reducing caregiver burden and enhancing psychological well-being for both patients and families, reinforcing the value of integrating specialized nursing roles into routine bladder cancer management. Full article

Objective: Physician assistants (PAs) are frequently involved in managing acute bacterial infections in patients with documented penicillin (PCN) allergies. Inappropriate antibiotic choice in patients with existing allergies may place them at undue risk. This study aimed to assess the knowledge and confidence among PA students in managing patients with documented PCN allergies. Methods: An electronic survey was distributed to enrolled students in participating PA programs in North and South Carolina. The survey tool consisted of 20 questions with 13 focused on knowledge and confidence primarily scored on a 5-point Likert scale. Data were collected and protected via the REDCap^® database. Primary objectives were knowledge of penicillin allergies and confidence in management decisions. Sufficient knowledge was considered a score of 80% or greater; adequate knowledge was considered 70% or greater on relevant assessments. Results: Overall, 406 students from 10 unique programs completed the survey. They were predominantly female (76%) with 43% in the first year of their program. The mean student knowledge score was 25.9%, and 30% of respondents achieved adequate knowledge. Respondents reported an average cross reactivity between penicillin and beta-lactams of 29% (10–63%), cefazolin 50% (24–75), ceftriaxone 29% (11–60), and carbapenems 26% (8–50). The majority of respondents (66.5%) reported high levels of confidence in managing patients with penicillin allergies. Conclusions: The study found significant discordance between PA students’ high level of confidence in assessing patients with a PCN allergy and their comparative knowledge. PA students are likely to avoid beta-lactam antibiotics when there is a documented penicillin allergy, regardless of the documented reaction or low likelihood of cross-reactivity. Further training and education will help to encourage appropriate prescribing in these high-risk patients. Full article

Background and Objectives: Chronic low back pain (CLBP) is a prevalent condition that impairs quality of life, functionality, and work productivity. While most acute episodes of back pain resolve, 4–25% become chronic due to factors such as high pain intensity, psychological distress, and maladaptive behaviors. Nonspecific CLBP is best understood through the biopsychosocial model, encompassing biological, psychological, and social influences, including kinesiophobia. Management relies on physical activity, pain education, and psychological interventions, with therapist knowledge and attitudes affecting outcomes. This study aimed to assess the prevalence of CLBP among healthcare workers, examine their knowledge of pain neurophysiology, evaluate kinesiophobia, and explore how personal experience with CLBP influences their beliefs, attitudes, and interactions with patients. Materials and Methods: A cross-sectional observational study was conducted from January to May 2025 among healthcare professionals. A total of 50 participants completed an online questionnaire, of which 42 were valid and included in the analysis. The questionnaire collected demographic and professional data, determined the presence of CLBP, and included three standardized instruments: the Revised Neurophysiology of Pain Questionnaire (rNPQ) to assess knowledge of pain mechanisms, the Health Care Providers’ Pain and Impairment Relationship Scale (HC-PAIRS) to evaluate beliefs about pain and disability, and the Tampa Scale of Kinesiophobia (TSK-11) to measure fear of movement. Data were analyzed using SPSS and Microsoft Excel. Results: Among the 42 participants, 11 demonstrated low, 28 moderate, and 3 high knowledge of pain neurophysiology (rNPQ), with a mean score of 5.66. On the HC-PAIRS, the majority (30 participants) scored above 60, indicating beliefs that pain leads to disability, while 12 scored below 60, reflecting a biopsychosocial perspective; gender did not significantly affect HC-PAIRS scores (p = 0.213). As for kinesiophobia (TSK-11), 24 participants had low, 17 moderate, and 1 clinically significant fear of movement. Correlation analysis revealed that younger participants had higher rNPQ scores (r = −0.358, p = 0.020) and lower TSK-11 scores (r = −0.389, p = 0.011). TSK-11 scores increased with age (r = 0.432, p = 0.004), while HC-PAIRS scores showed no significant correlations. Conclusions: Healthcare professionals, particularly physiotherapists, show gaps in knowledge of pain neurophysiology and a tendency toward biomedical beliefs regarding chronic low back pain. This cross-sectional study indicates that a greater understanding of pain mechanisms is associated with lower kinesiophobia, emphasizing the importance of education. Integrating the biopsychosocial model into undergraduate and continuing professional training, through interdisciplinary and practical modules, may improve knowledge, reduce maladaptive fear-avoidance behaviors, and enhance patient care. Future studies should include larger, more diverse samples and assess the long-term impact of educational interventions on clinical practice. Full article

Foundational biomedical sciences are commonly taught without routine integration of local population health contexts, limiting students’ ability to connect mechanisms to community disease burden and practice responsibilities. In this method paper, we developed and piloted an AI-enabled “Sacramento County Public Health (SACPH)” AI workflow and app prototype, a structured, faculty-authored prompt sequence designed to guide population-to-practice reasoning using publicly available data. The workflow was implemented during a TBL session with first-year PharmD students in an immunology course. Using splenectomy and risk of overwhelming post-splenectomy infection (OPSI) as an illustrative use case, students executed a standardized prompt sequence addressing data source identification, coding logic (diagnosis vs. procedure codes), population-level estimation with uncertainty framing, and translation to pharmacist-relevant prevention and counseling implications. Feasibility was defined by conceptual convergence. The validated reasoning workflow was subsequently translated into a prototype, app-style interface using generative design prompts. Across student teams, outputs converged on similar categories, consistent recognition of coding frameworks and verification steps, and directionally similar interpretations of local burden and pharmacist responsibilities. The prototype demonstrated successful externalization of the reasoning workflow into a modular, reproducible artifact. SACPH demonstrates a feasible, reproducible method for using generative AI to integrate foundational science instruction with local population health context and pharmacist practice reasoning, while supporting AI literacy competencies. Full article

Introduction: The COVID-19 pandemic had significant effects on mental health and lifestyle behaviours, especially among university students who experienced academic disruptions, social isolation, and fewer social interactions. Alcohol consumption has long been part of student culture. Still, the influence of post-pandemic academic reintegration on drinking patterns and psychological distress remains relatively unexplored, particularly in countries like Portugal, where student traditions heavily shape consumption habits. This study aimed to describe the prevalence of alcohol consumption, depression, anxiety, and stress in a sample of Portuguese university students during the post-pandemic academic period, and to explore associations with sociodemographic variables. Methods: A cross-sectional study was conducted in November 2021 with 90 students from a private higher education institution in northern Portugal. Data were collected via an online questionnaire including sociodemographic information, the Alcohol Use Disorders Identification Test (AUDIT), and the Depression, Anxiety and Stress Scale (DASS-21). Result: The majority of the participants were not at risk of alcohol addiction (95.3%). In total, 15.1% of students reported anxiety symptoms ranging from severe to extremely severe. A binomial logistic regression was performed to ascertain the effects of being away from home and psychological distress (DASS-42 score), on the likelihood that participants were at risk of alcohol addiction (Level 3 and 4 in the AUDIT scale). The logistic regression model was statistically significant, χ²(2) = 9.20, p = 0.010. Living away from home was associated with a substantially lower likelihood of high-risk status (B = −2.79, p = 0.034), corresponding to an odds ratio of 0.06, indicating a strong protective effect. DASS-42 total score was positively associated with high-risk status (B = 0.04, p = 0.039), such that higher psychological distress increased the odds of being classified as high risk. Conclusions: The findings reveal a low prevalence of alcohol risk but heightened symptoms of anxiety, depression, and stress. Psychological distress notably increases the likelihood of hazardous alcohol use, emphasising the importance of targeted mental health and alcohol-use interventions among university students. Full article

Sexual violence against women is a global issue with profound health consequences, including elevated HIV risk due to genital tract inflammation and injury. However, limited research has examined the influence of mental health on HIV-related immunity after violence. We analyzed longitudinal data from female survivors of past-month rape (N = 25) to explore associations between mental health (perceived stress, depression, post-traumatic stress disorder [PTSD], and resilience) and HIV-associated immune biomarkers in the female genital tract. In bivariate analyses, mental health improved over the three-month follow-up period. Immune biomarker levels remained largely stable, except for TNF-α and SLPI. At baseline, depression was significantly correlated with TNF-α, IL-6, and IL-1β. In regression analyses, depression was associated with TNF-α (β = −0.133 to −0.152) and IL-6 (β = −0.171 to −0.207). PTSD was significantly associated with IL-1α (β = 0.576 to 1.681). Depression and resilience were negatively associated with percent HIV inhibition in adjusted models. These findings suggest that depression and PTSD are associated with genital tract inflammation following sexual violence, which may compromise mucosal immunity and enhance HIV risk. This highlights the importance of integrated mental health and immunological care for survivors and the need for further research into psychoneuroimmune pathways influencing HIV risk after trauma. Full article

Climate change and land-use intensification are speeding up the loss of ecosystem services that support human health, food security, and environmental stability. Vegetative interventions—such as urban forests in cities and cover crops in farming systems—are increasingly seen as nature-based solutions for climate adaptation. However, their benefits are often viewed separately. This review combines 20 years of research to explore how these strategies, together, improve provisioning, regulating, supporting, and cultural ecosystem services across various landscapes. Urban forests help reduce urban heat islands, improve air quality, manage stormwater, and offer cultural and health benefits. Cover crops increase soil fertility, regulate water, support nutrient cycling, and enhance crop yields, with potential for carbon sequestration and biofuel production. We identify opportunities and challenges, highlight barriers to adopting these strategies, and suggest integrated frameworks—including spatial decision-support tools, incentive programs, and education—to encourage broader use. By connecting urban and rural systems, this review underscores vegetation as a versatile tool for resilience, essential for reaching global sustainability goals. Full article

Occupational Health and Safety (OHS) in educational settings is a vital responsibility that is often inconsistently implemented. There is a need for research to bridge the gap between policy and practice. This study employed a cross-sectional mixed-methods design in six schools in the capital city of Indonesia to identify key implementation barriers, strategies, and compliance levels in OHS. Data were collected from 217 teachers using a structured KPAP (Knowledge, Attitudes, Perceptions, Practices) survey and from an additional 38 teachers via Focus Group Discussions (FGDs). Quantitatively, teachers showed highly positive attitudes (99.4% viewing OHS as a professional duty) and generally positive perceptions but implementation practices were sub-optimal (e.g., low participation in drills and PPE usage), showing a gap between awareness and action. Qualitatively, the main barriers identified were a lack of specific OHS regulation or guidance for schools, limited resources/infrastructure, and the perception of OHS as a low priority. Management strategies focused on external collaboration and ongoing in-school initiatives. In conclusion, a significant gap exists between OHS awareness and its integration into school management, highlighting the urgent need for strengthened governance, comprehensive policies, and sustained capacity-building to ensure a proactive, safe, and sustainable school environment for staff and students. Full article

As new technologies, such as electronic medical records (EMRs), are introduced into healthcare services, we need to consider how they may be incorporated into simulated environments, so as to maintain and enhance authenticity and learning opportunities. While EMRs have revolutionised clinical practice, many education settings continue to rely on paper-based documentation in simulation, creating a widening gap between educational environments and real-world clinical workflows. This disconnect limits learners’ ability to engage authentically with the tools and resources that underpin contemporary healthcare, impeding the transfer of knowledge to the clinical environment. This practice-based commentary draws on institutional experience from a large, multi-disciplinary simulation-based education facility that explored approaches to integrating EMRs into simulation-based education. It describes the decision points and efforts made to integrate an EMR into simulation-based education and concludes that while genuine EMR systems increase fidelity, their technical rigidity and data governance constraints reduce authenticity. To overcome this, Adelaide Health Simulation adopted an academic EMR (AEMR), a purpose-built digital platform designed for education. The AEMR maintains the functional realism of clinical systems while offering the pedagogical flexibility required to control data, timelines, and learner interactions. Drawing on this experience, this commentary highlights how authenticity in simulation-based education is best achieved not through technological replication alone, but through deliberate use of technologies that align with clinical realities while supporting flexible, learner-centred design. Purpose-built AEMRs exemplify how digital tools can enhance both fidelity and authenticity, fostering higher-order thinking, clinical reasoning, and digital fluency essential for safe and effective contemporary healthcare practice. Here, we argue that advancing simulation-based education in parallel with health service innovations is required if we want to adequately prepare learners for contemporary clinical practice. Full article

The Immersive Decentralized Digital space (IDDs), derived from blockchain technology and Massively Multiplayer Online Games (MMOGs), enables real-time multisensory interactions that support social connection under metaverse concepts. Although recognized as a technology with significant potential for educational innovation, IDDs remain underutilized in health professions education. Health profession students are often unaware of how IDDs’ features can be applied to their learning through in- or after-classroom activities. This study employs a quantitative research design to evaluate students’ perceptions of next-generation digital learning without any prior exposure to IDDs. An electronic survey was developed to examine four dimensions of learning facilitation: “Remote Learning” for capturing past experiences with digital competence during the COVID-19 era; “Digital Evolution,” reflecting preferences in utilizing digital spaces; “Interactive Communication” and “Knowledge Application” for applicability of IDDs in the health professions education. Statistical analyses revealed no significant differences in perceptions based on gender or major on all factors. Nevertheless, significant differences emerged based on nationality in “Digital Evolution”, “Interactive Communication”, and “Knowledge Application”, highlighting the influence of cultural and educational backgrounds on receptiveness to virtual learning environments. By recognizing the discrepancies and addressing barriers to digital inclusion, IDDs hold strong potential to enhance health professional learning experiences and educational outcomes. Full article

Background: Ostomy care consultations are essential for promoting patient autonomy and quality-of-life. The integration of innovative technologies may enhance health education and support effective self-care among ostomized patients. Objective: To evaluate the impact of a nursing-led health education intervention supported by smart-glasses on the quality of life of ostomized patients. Methods: A pre–post quasi-experimental design was employed with 14 patients who had undergone digestive surgery resulting in an ostomy. The intervention consisted of a single 60-min session comprising three phases: (1) assessment of baseline knowledge on ostomy management, (2) personalized feedback, and (3) a hands-on workshop using Vuzix© smart-glasses to demonstrate ostomy care techniques. Quality of life was assessed using the SF-36 questionnaire before and after the intervention. Results: The intervention significantly improved overall SF-36 scores, with notable advancements in emotional role (78.57 ± 36.06 to 97.44 ± 9.25, d = 10.54), mental health (79.14 ± 20.10 to 87.38 ± 13.94, d = 6.27), and vitality (69.29 ± 20.56 to 71.15 ± 16.98, d = 4.19). Social function remained high throughout the study, while bodily pain showed a slight decline. A strong correlation (ρ = 0.923, p = 0.001) was observed between pre- and post-intervention quality of life scores. Conclusions: The findings suggest that integrating smart-glasses into nursing-led health education may enhance the quality of life and self-care capabilities of ostomized patients. However, the small sample size, lack of a control group, and exploratory nature of the study limit the generalizability of the results. Further research is needed to validate these findings in larger, controlled trials. Full article