Search Results (9,539)

Background: Malnutrition is common among older adults aged 65 years and over and is associated with physical and mental health risks. Malnutrition is a complex condition; supporting older adults in achieving healthy, sustainable dietary behaviors remains a challenge for care professionals. Assistive technologies to support malnutrition care, such as monitoring tools, social robots, or smart spoons, are often poorly adapted to real-world contexts and fail to sustain long-term engagement. Method: A design research approach was used to understand care practices better and explore design opportunities for assistive technologies. Eight in-depth, qualitative interviews were conducted with dietitians treating older adults with malnutrition. Interviews were transcribed and analyzed through thematic analysis. A five-phase patient journey was created as a visual tool to identify where assistive technologies could improve the care process and define design requirements. Results: Dietitians face challenges due to the dynamic nature of patient journeys, limited time for personalized care, difficulty in monitoring progress, and unclear collaboration with other care providers. Conclusions: This study contributed by reframing malnutrition as a dynamic, multi-actor patient journey in which assistive technology can play a supportive role at different phases, supporting collaboration, facilitating relationship-building, and involving the larger care network. Full article

This study investigates digital leadership as a networked social process by analyzing how influential actors operating across professional and institutional domains construct leadership discourse and draw on transformational leadership (TFL) principles within Twitter (X) networks, with particular attention to the skill-transfer gaps that persist between formal academic preparation and workforce demands. Social Network Analysis (SNA) using the NodeXL program was used to examine the relational structure of that discourse across a dataset of 1186 Twitter accounts and 1362 relational ties. The analysis identified 27 prominent actors operating within a distinct community cluster whose discourse spanned politics, health, technology, media, and education, with thematically diverse but uneven engagement with leadership topics. Combining semantic cluster analyses, inductive thematic mapping, and a supplementary exploratory factor analysis (EFA), the study finds that the four TFL principles (individualized consideration, intellectual stimulation, inspirational motivation, and idealized influence) are unevenly represented in this discourse. The EFA condensed the co-occurrence structure into three platform-shaped factors, with the strongest support for individualized consideration and no coherent factor for idealized influence, indicating partial rather than comprehensive alignment with the four-dimensional TFL model. The findings position digital leadership as a relational and iterative social process, sustained through repeated interactions, endorsements, and positional recognition within platform-based publics that extend across academic, industry, and socio-political boundaries. The study highlights social media as a networked yet uneven environment for leadership development and the broader social negotiation of skill-transfer challenges across digital professional contexts. Full article

Background/Objectives: Telemedicine offers significant potential to improve the quality and accessibility of geriatric care, particularly in resource-constrained settings. However, its effective implementation depends largely on healthcare professionals’ acceptance and willingness to use such systems. Drawing on an extended Technology Acceptance Model (TAM), this study examines the determinants of doctors’ and nurses’ intentions to adopt telemedicine for elderly care in Algeria, with particular emphasis on self-efficacy and institutional support. Methods: This cross-sectional study employed a structured questionnaire administered to 130 healthcare professionals, including physicians and nurses, in Algeria. Hierarchical multiple regression analysis was conducted to test the proposed hypotheses and assess the incremental explanatory power of the extended model. Results: The extended TAM accounted for 48.7% of the variance in intention to use telemedicine. Institutional support (β = 0.432, p < 0.001) and self-efficacy (β = 0.264, p = 0.001) emerged as the strongest predictors. Perceived ease of use (β = 0.178, p = 0.038) and perceived usefulness (β = 0.139, p = 0.021) also had significant positive effects. The inclusion of self-efficacy and institutional support increased the model’s explanatory power by 23.5%. Conclusions: The findings highlight the critical role of organizational support mechanisms, digital competencies, and system usability in fostering telemedicine adoption among healthcare professionals. The study provides practical implications for policymakers and healthcare institutions, emphasizing the need for targeted training programs, supportive infrastructure, and institutional policies that enhance confidence and facilitate the integration of telemedicine into clinical workflows. Full article

Misuse of over-the-counter (OTC) and prescription-only medicines (POMs) is increasingly recognised as a public health and medicine-safety concern. Although specialist substance misuse services (SMS) increasingly support people affected by OTC/POM misuse, little is known about how SMS staff perceive the characteristics, challenges, and treatment needs of this population. This study explored the experiences of SMS staff to address this evidence gap and inform pharmacy practice and service development. Confidential semi-structured interviews were conducted with staff across five community adult English SMS. Audio recordings were transcribed verbatim and analysed thematically using NVivo^®. Twenty interviews with varied professionals achieved data saturation. Three overarching themes emerged: (1) characteristics of OTC/POM misuse; (2) staff-perceived patterns among people who misuse OTC/POM; and (3) negative experiences and concerns. Dependence on orally administered opioids (particularly codeine-containing products), benzodiazepines and gabapentinoids predominated. Polypharmacy including illicit substance use was also reported. Withdrawal symptoms frequently perpetuated misuse, and abrupt supply cessation created additional risks. Routine enquiry about OTC/POM misuse and provision of tailored harm-reduction interventions are essential. The findings suggest that pharmacists may have an important role in early identification of problematic OTC/POM use, harm-reduction interventions, medicine review and facilitating referral into appropriate treatment pathways. Further research should examine whether dedicated OTC/POM pathways are required and explore differences in demographic and treatment needs across medicine types. Full article

Background: Since 2014, all Australian jurisdictions have progressively amended legislation to authorise pharmacists to administer vaccines, evolving from restricted pilots to an essential public health pillar. Objective: This review analyses the longitudinal evolution of pharmacist-administered vaccinations (PAVs), documenting changes in authorised vaccines, age eligibility, and regulatory frameworks across all Australian jurisdictions. Methods: A retrospective review of Australian jurisdictional legislation, regulations, and policy documents was undertaken. Searches included official legislative registers, Government Gazettes, Health Department protocols, and professional guidance published by Pharmaceutical Society of Australia (PSA) and The Pharmacy Guild of Australia between 2014 to 2026. Documents were independently reviewed by five authors, followed by secondary verification and consensus-based adjudication to resolve discrepancies and confirm findings. Results: PAVs scope was expanded from a single influenza pilot in 2014 to include over 21 vaccine-preventable diseases by 2026. The COVID-19 pandemic catalysed rapid reform, leading to the standardisation of age eligibility (largely ≥5 years). A landmark milestone occurred in 2025 when South Australia enabled pharmacists to administer any vaccine within their professional scope. Conclusion: Legislative reforms have significantly enhanced vaccine accessibility. However, jurisdictional fragmentation persists. National harmonisation, using a competency-based model similar to South Australia, is recommended to streamline delivery and optimise public health outcomes. Full article

Background: Seasonal influenza remains a major public health challenge worldwide, causing significant morbidity each year and imposing substantial burdens on individuals, healthcare systems, and national economies. Vaccination is considered the most effective available strategy for prevention; however, uptake rates vary considerably across countries, with many failing to achieve the recommended coverage levels. The aim of this umbrella review is to systematically synthesize and critically appraise the existing evidence on healthcare professionals’ beliefs, attitudes, and behaviors regarding seasonal influenza vaccination. Methods: This umbrella review was conducted in accordance with the PRISMA 2020 statement. A literature search was conducted in PubMed, the Cochrane Library, and Google Scholar. The following search terms were used: beliefs, attitudes, behaviors, influenza vaccination, flu vaccine, healthcare professionals and primary healthcare. The inclusion criteria were as follows: (1) Reviews, (2) Published after 1 January 2000, (3) English language, (4) Healthcare professionals as the target-population. Results: Twenty-five studies met the selection criteria and were included in this review. Twelve out of 25 studies were systematic reviews. Globally, vaccination uptake remains below recommended levels, with reported coverage ranging from approximately 2% to 44% in several settings, while rates can exceed 90% in countries with mandatory vaccination policies. North America demonstrates the highest vaccination coverage, while the lowest coverage is reported in Africa and South America. Overall, low- and middle-income countries show significantly lower vaccination behavior compared with high-income countries. Attitudes and beliefs appear to shape vaccination behavior in high-income countries. The main driver of acceptance is perceived protection of oneself and family, whereas hesitancy is mainly driven by concerns about side effects and vaccine safety. Across studies, non-physician healthcare professionals consistently demonstrated lower influenza vaccine acceptance compared with physicians, while pediatricians and general practitioners were found to receive the influenza vaccine more frequently. In addition, younger physicians and those with fewer years of professional experience showed higher vaccination coverage and a greater likelihood of recommending influenza vaccination to patients. Conclusions: Vaccination coverage, worldwide, is lower than what is recommended by the World Health Organization. Healthcare professionals working in hospital settings tend to be vaccinated at a higher rate compared with those working in primary care or community-based healthcare settings. The recommendations that healthcare professionals give are influenced by whether they accept influenza vaccines themselves. Beliefs and attitudes seem to influence behavior in countries where structural barriers, such as limited access to primary healthcare and socio-economic status are absent. Full article

Background: Sexuality education is essential for adolescent health and well-being, yet in Italy it is not included in a mandatory national curriculum, resulting in heterogeneous implementation across regions. Within the ESPRIT project, a multidisciplinary training-of-trainers (ToT) model was developed to prepare professionals to support school-based peer-education pathways. This study aimed to describe the training model and perform a pilot evaluation of short-term knowledge outcomes among trained participants. Methods: A pilot non-randomized controlled comparative study was conducted within the ESPRIT project framework. A multidisciplinary Training Team developed a structured ToT pathway based on WHO guidance, national recommendations, and peer-education models. Ten advanced public health residents in Hygiene and Preventive Medicine attended a three-day residential training course. One month later, a 10-item knowledge questionnaire was administered to trained participants (n = 10) and untrained advanced public health residents (n = 10). Results: Trained participants achieved higher questionnaire scores than the comparator group (median score 8 [IQR 2] vs. 3.5 [IQR 2]; p < 0.0005). Conclusions: Structured ToT programmes may represent a promising approach for strengthening professional preparation in sexuality education. Larger studies with longer follow-up are needed to evaluate sustainability and real-world implementation. Full article

Challenging work conditions and a predominantly male workforce have intensified concerns about worker well-being in the U.S. construction industry. Although these issues are increasingly acknowledged, empirical evidence on how management perceives and addresses employees’ psychological needs remains limited. This study seeks to fill that gap by examining managerial awareness and responsiveness to workplace mental health challenges, as well as the implementation of targeted well-being interventions across construction organizations. A mixed-methods approach was employed, integrating quantitative data from a nationwide survey of construction professionals with qualitative insights from open-ended responses. Results indicate that workers experience moderate levels of psychological strain, with notable differences across demographic and occupational groups. Women, non-white professionals, and site supervisors reported higher stress and lower overall well-being, emphasizing the need for more inclusive and tailored interventions. While both senior leaders and frontline supervisors demonstrated moderate awareness of these challenges, supervisors were perceived as less consistent in taking action to address them. Among existing workplace practices, transparent compensation structures and opportunities for skill diversification were identified as the most established supports for well-being. In contrast, mentoring programs, employee recognition, and open feedback mechanisms emerged as promising yet underutilized strategies. Overall, the study contributes by shifting attention from documenting construction-related mental health stressors to understanding how leadership recognition is translated into organizational response. Therefore, the findings provide practical guidance for construction leaders seeking to strengthen workers’ well-being and build a more resilient work environment. Full article

Implicit bias, automatic attitudes or stereotypes outside conscious awareness, may influence clinicians’ communication, diagnosis, and treatment decisions, contributing to inequities in care. We conducted a scoping review to map measurement strategies used to assess implicit bias among health professionals and students in healthcare and training settings. Using Joanna Briggs Institute guidance and PRISMA-ScR, we searched PubMed, Embase, BVS, Google Scholar, and institutional repositories for studies to November 2025; two reviewers independently screened and charted data (protocol was developed a priori but submitted internal in organization, and then uploaded in OSF. Of 1864 records, 93 studies from 28 countries were included. We identified 57 bias domains, most often race/ethnicity, weight, and sexual orientation. Across studies, 42 unique instruments were reported; the Implicit Association Test was most common, while psychometric validation and administration details were frequently limited, constraining comparability and interpretation. Evidence gap mapping showed concentration in academic and hospital settings, with fewer studies in primary care or community contexts and limited attention to age, disability, and intersectionality-related biases. The evidence base is growing but fragmented; future work should prioritize standardized administration and reporting, stronger validation, and tools that better capture automatic responding across diverse identities and care settings to support education and equity-oriented interventions. Full article

Background and Objectives: As Romanian health systems deploy artificial intelligence (AI), uptake depends on navigating the EU AI Act, GDPR, the Medical Device Regulation (MDR), and national rules. We measured AI legislation literacy, governance readiness, and adoption intentions among Romanian healthcare professionals, identified implementation phenotypes, and tested whether confidence mediates the literacy–adoption link. Materials and Methods: In a multicenter cross-sectional survey (N = 109), participants completed a 20-item AI Legislation Literacy Index (0–20) plus scales rated form one to five measuring legislative confidence, adoption intention, readiness, trust, and perceived compliance burden. We used PCA and k-means clustering, multivariable logistic regression for high adoption intention (≥4), and covariate-adjusted mediation (5000 bootstrap resamples). Results: Mean age was 38.7 ± 9.8 years, and 60.6% of participants were female. Literacy was moderate (11.2 ± 4.1/20) and familiarity favored GDPR (69.7%) over the EU AI Act (25.7%). Literacy correlated with confidence (=0.52), whereas confidence correlated with adoption intention (=0.41); trust correlated positively (=0.44) and burden correlated negatively (=−0.29) with adoption. High adoption intention was noted in 50.5% of participants and was independently associated with higher literacy (aOR 1.85 per +1 SD; 95% CI 1.20–2.85), higher trust (aOR 1.72; 1.13–2.63), lower burden (aOR 0.64; 0.43–0.95), and prior AI training (aOR 2.10; 1.03–4.29). Three phenotypes emerged (Confident Adopters n = 44; Cautious Compliers n = 36; Skeptical Low Literacy n = 29), with adoption scores of 4.2 ± 0.5 vs. 3.1 ± 0.7 in the highest and lowest groups. Mediation showed a partial indirect effect via confidence (0.13; 95% CI 0.05–0.24). Conclusions: AI legislation literacy, confidence, trust, and perceived burden are key, modifiable determinants of AI adoption intentions; phenotype-guided strategies can target training, governance support, and post-deployment monitoring readiness. The revised framing explicitly situates these determinants within recent AI-specific regulatory and technical developments, including high-risk AI obligations, AI-enabled medical device change control, generative/large multimodal model risks, and lifecycle monitoring. Full article

Introduction: Traditional instruments for measuring lifelong learning of health professionals fail to capture digital-age learning, creating a critical measurement disconnect. To address this gap, we developed a 16-item Self-Pursuits, Aspirations, and Knowledge Endeavors in the Digital Era (SPArKED) instrument. Methods: To gather validity evidence for SPArKED, a cross-sectional survey was deployed to health professional students (n = 558). The survey questionnaire included: SPArKED, Jefferson scale of lifelong learning for students in health professions, basic psychological needs satisfaction scale, and human–computer trust scale assessing students’ trust in generative technology to support lifelong learning. Exploratory factor analysis (EFA) and correlation analysis were performed. Results: The EFA of the SPArKED revealed a three-component structure: networked learning, i-learning (individual mastery), and AI-powered learning, together explaining 55% of the total variance. The SPArKED demonstrated good internal consistency (α = 0.86) and convergent validity with the Jefferson scale of lifelong learning (r = 0.75). The correlations between SPArKED and psychological needs satisfaction scores were moderately high: autonomy (r = 0.50), competence (r = 0.48), and relatedness (r = 0.51). SPArKED had a higher correlation with students’ trust in generative technology to support lifelong learning than the Jefferson scale (r = 0.52 and r = 0.32, respectively). Conclusions: Compared to the Jefferson scale, the SPArKED instrument appears to better capture digital-age learning behaviors among students in health professions. By assessing these evolving behaviors in learners, education programs can better guide future health practitioners in developing desired lifelong learning competencies and digital literacies. Future research should gather validity evidence for SPArKED across diverse learner samples and educational stages, informing a critical re-assessment of established instruments in the rapidly evolving learning landscape. Full article

Background/Objectives: We examined whether guidance on dietary habits or nutrition-related problems from healthcare professionals during cancer treatment was associated with quality of life, after treatment. Methods: Cross-sectional data were drawn from the Icelandic Compass study, conducted in 2020–2021 among adults diagnosed with cancer in 2015–2019. The analysis included participants who had completed treatment for breast cancer (n = 341), prostate cancer (n = 137), or colorectal cancer (n = 132), for a total sample of 610 participants. Quality of life (QL) was assessed using the EORTC QLQ-C30 global health status/quality of life scale. Associations were examined using regression models adjusted for age, marital status, education, number of cancer treatments, stage at diagnosis, body mass index, tobacco and alcohol use, and comorbidities. Results: Overall, 26% of participants reported receiving sufficient guidance on general dietary habits during treatment and 19% on nutrition-related problems. On average, three years had passed since diagnosis. Among all participants, guidance on general dietary habits was associated with higher QL scores (β = 5.6; 95% CI: 0.8 to 10.5), as was guidance on nutrition-related problems (β = 5.7; 95% CI: 0.3 to 11.1). In subgroup analyses, statistically significant associations were observed among prostate cancer survivors for both dietary guidance (β = 12.4) and guidance on nutrition-related problems (β = 14.0), and among breast cancer survivors for guidance on nutrition-related problems (β = 8.4). Conclusions: Patient-reported sufficient discussions about dietary habits or nutrition-related problems during treatment were associated with slightly higher post-treatment QL scores. Full article

Objectives: Temporomandibular disorders (TMD) are common musculoskeletal conditions in adults. The repetitive neuromusculoskeletal demands of operatic singing, together with suboptimal technique, intensive training, and psychological strain, may be associated with TMD-related symptoms. Knowledge of TMD and awareness of warning signs may support appropriate health-seeking behaviours. This study aimed to assess self-reported TMD-related symptoms and selected aspects of TMD-related knowledge among Polish opera singers. Methods: An online cross-sectional survey was conducted in 2024 among 241 adult Polish classically trained singers, including professional opera singers and vocal students (90 men and 151 women; age range, 20–73 years). Data were collected using an author-developed questionnaire and the Fonseca Anamnestic Index (FAI), a self-report screening instrument for TMD-related symptoms and symptom severity. Results: FAI scores were within the lowest symptom category in 21.6% of participants, within the mild category in 50.6%, within the moderate category in 24.5%, and within the severe category in 3.3%. Overall, 87.1% rated their TMD-related knowledge as poor or sufficient, although 89.6% recognised that TMD may adversely affect vocal technique. Conclusions: Self-reported TMD-related symptoms were frequently observed in this study sample, and responses to individual questionnaire items indicated gaps in selected areas of TMD-related knowledge. A self-reported previous diagnosis of TMD was associated with greater FAI-assessed symptom severity, whereas self-assessed TMD knowledge was not. These findings may support further evaluation of targeted education and access to appropriate clinical assessment for classically trained singers. Full article

Background/Objectives: Retention of healthcare professionals in the workforce, their employment, and the improvement of working conditions largely depend on identifying the factors that influence their departure and their health. The study was conducted during the period from January to June 2021. This study aimed to examine the association between specific work-related stressors and work ability. The initial hypothesis was that general and specific occupational stressors negatively associate with work ability among healthcare professionals in emergency medical intervention teams. Methods: The study was designed as a cross-sectional comparative study. It was conducted among nurses and physicians in pre-hospital emergency medical services, employed full-time in intervention teams, while the control group consisted of employees from dispatch and call-receiving units. The study was conducted on the 840 participants, representing 43.3% of all healthcare professionals employed in pre-hospital emergency medical services in the Republic of Croatia. In addition to questions on participants’ personal characteristics, the following instruments were used: 1. a validated Questionnaire on Workplace Stressors among hospital healthcare professionals; and 2. the international standardized Work Ability Index (WAI) questionnaire for assessing work ability. Participants completed the questionnaires in paper form. Results: On average, the participants demonstrated lower levels of stress compared to reference values, both for overall stress and for individual stress factors, while their work ability, assessed using the Work Ability Index (WAI), ranged from very good to excellent. The control group showed higher levels of stress across all factors and lower work ability. However, the control group was older on average, generally had lower levels of education, and consisted more often of women—personal characteristics that may influence the examined variables. Lower stress levels and better work ability were associated with job satisfaction, ambition, and the fact that participants were working in their desired profession. Frequent sick leave (absenteeism) was highly correlating with both higher stress levels and poorer work ability. Conclusions: Greater job satisfaction and higher motivation have a positive impact on stress levels and employees’ work ability. The study results can serve as a starting point for institutional management in designing feasible decisions aimed at improving satisfaction, health, the work environment, and the work ability of emergency medical service personnel, as well as making these institutions more attractive for recruitment and retention of employees both in their positions and within the profession. Full article

Schools in Sweden support multilingual students’ language and knowledge development in various ways, including through pedagogical collaboration among multiple professionals. Despite the recognized benefits, however, little is known about how such pedagogical collaboration is understood and practiced by classroom teachers in Sweden. The purpose of the present study is to deepen the understanding of how teachers in the early years of schooling collaborate with heritage language teachers, Swedish as a second language teachers, and special educational needs teachers, in order to support language and knowledge development in second language learners. Individual semi-structured interviews were conducted with 15 Swedish teachers working in the early years of schooling, i.e., from reception year to Grade 3. The interviews were analyzed thematically. Results showed that teachers generally perceive collaboration with other professionals as beneficial. They conceptualized varying forms of pedagogical collaboration, encompassing frequent and flexible collaboration with close colleagues, interdependent collaboration with heritage language teachers (often complicated by structural constraints), and regular, structured collaboration within the student health team. Identified opportunities associated with pedagogical collaboration included the provision of holistic support for second language learners, as well as opportunities for professional development and collegial support. At the same time, several challenges were highlighted, including time-related and structural constraints that hinder collaboration, as well as language barriers and the influence of individual characteristics. Student health teams were highlighted as important for integrating expertise; however, limited teacher insight and the infrequent inclusion of Swedish as a second language teachers were reported to result in multilingual perspectives being overlooked. This study therefore recommends greater consideration of multilingual expertise in assessments of special educational needs and calls for further research on the role of student health teams in supporting second language learners. Full article