Search Results (1,901)

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

Family empowerment is a key component of effective family-centered practices in healthcare, mental health, and educational services. The Family Empowerment Scale (FES) is the most commonly used instrument to evaluate empowerment in families raising children with emotional, behavioral, or developmental disorders. Despite its importance, the FES for diverse populations, especially Latinx parents, has rarely been evaluated using innovative psychometric approaches. In this study, we evaluated key dimensions and psychometric evidence of the Family Empowerment Scale (FES) for 96 Latinx parents of children with intellectual and developmental disabilities (IDD) in the United States using an exploratory graph analysis (EGA). The EGA identified a five-dimensional structure, and EGA models outperformed the original CFA 3-factor models for both parents of children with autism and other disabilities. This study identified distinct, meaningful dimensions of empowerment that reflect both shared and unique empowerment experiences across two Latinx parent groups. These insights can inform the design of culturally responsive interventions, instruments, and policies that more precisely capture and boost empowerment in Latinx families. This study contributes to closing a gap in the literature by elevating the voices and experiences of Latinx families by laying the groundwork for more equitable support systems in special education and disability services. 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 quality of water in households can be affected by plumbing design and materials, water usage patterns, and source water quality characteristics. These factors influence stagnation duration, disinfection residuals, metal release, and microbial activity. In particular, stagnation can degrade water quality and increase lead release from lead service lines. This study employs numerical modeling to assess how combined corrosion control and flushing strategies affect lead levels in household taps with lead service lines under reduced water use. To estimate potential health risks, the U.S. EPA model is used to predict the percentage of children likely to exceed safe blood lead levels. Lead exceedances are assessed based on various regulatory requirements. Results show that exceedances at the kitchen tap range from 3 to 74% of usage time for the 5 µg/L standard, and from 0 to 49% for the 10 µg/L threshold, across different scenarios. Implementing corrosion control treatment in combination with periodic flushing proves effective in lowering lead levels under the studied low-consumption scenarios. Under these conditions, the combined strategy limits lead exceedances above 5 µg/L to only 3% of usage time, with none above 10 µg/L. This demonstrates its value as a practical short-term strategy for households awaiting full pipe replacement. Targeted flushing before peak water use reduces the median time that water remains stagnant in household pipes from 8 to 3 h at the kitchen tap under low-demand conditions. Finally, the risk model indicates that the combined approach can reduce the predicted percentage of children with blood lead levels exceeding 5 μg/dL from 61 to 6% under low water demand. Full article

This article describes the design, methods, and baseline characteristics of the social needs assessment (SNA) of participants enrolled in an ongoing randomized clinical trial implementing a comprehensive approach to improving diabetes self-management and providing an intensive Diabetes Self-Management Education and Support (iDSMES) Program at St. Vincent’s House Clinic, a primary care practice serving resource-challenged diverse populations in Galveston, Texas. Standardized SNA was conducted to collect information on financial needs, psychosocial well-being, and other chronic health conditions. Based on their identified needs, participants were referred to non-medical existing community resources. A series of in-depth interviews were conducted with a subset of participants. A team member independently categorized these SNA narratives and aggregated them into two overarching groups: medical and social needs. Fifty-nine participants (with a mean age of 53 years and equal representation of men and women) completed an SNA. Most (71%) did not have health insurance. Among 12 potential social needs surveyed, the most frequently requested resources were occupational therapy (78%), utility assistance (73%), and food pantry services (71%). SNA provided data with the potential to address barriers that may hinder participation, retention, and outcomes in diabetes self-management. SNA findings may serve as tertiary prevention to mitigate diabetes-related complications and disparities. Full article

Background/Objectives: Quality of life (QOL) is a multifaceted concept involving a variety of factors which define the overall well-being of individuals. Food security, which implies a resilient food system, is one factor that is central to the calculus of the QOL status of a community considering that food is a staple of life. Advancing food security as a strategy for attaining sustained improvement in community QOL hinges on recognizing that food security is embedded in a matrix of other factors that work with it to generate the QOL the community experiences. The lived experience of the community defines the community’s QOL value matrix and the relative position of food security in that value matrix. Our thesis is that the role of food security in the lived experience of low-income communities depends on the position food security is accorded relative to other factors in the QOL value matrix of the community. Methods: This study employed a multimethod approach to define the QOL value matrix of low-income Guilford County residents, identifying the relative position of the value components and demographic segments based on priority ranking. First, an in-depth interview was conducted and then a telephone survey (280 sample) was used for collecting data. The ISAC Analysis Procedure and Best–Worst Scaling methods were used to identify and rank components of the QOL value matrix in terms of their relative impact on QOL. Results: The analysis revealed that spiritual well-being is the most important contributor to QOL, with a weight of 0.23, followed by access to health services (0.21) and economic opportunities (0.16), while food security has a moderate impact with 0.07. Conclusions: These findings emphasize the need for targeted policy interventions that consider the specific needs of different demographic segments to effectively improve QOL and inform the design of resilient food systems that reflect the lived experiences of low-income communities. Food security policies must be integrated with broader quality of life interventions, particularly for unemployed, low-educated, and single individuals, to ensure that a resilient food system effectively reduces inequities and address community-specific vulnerabilities. Full article

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

Background/Objectives: Pharmacists are highly accessible healthcare providers who have frequent, repeated contact with diverse patient populations. They are poised to offer expanded and comprehensive healthcare, including mental health services. One potential barrier to this is a lack of knowledge, confidence, or training in mental health, which may be overcome with a program like Mental Health First Aid (MHFA) training. The aim of this systematic review and meta-analysis is to fill this gap in knowledge by critically evaluating all studies of MHFA training for pharmacists or pharmacy students that report on knowledge, attitudes, or self-efficacy outcomes. Methods: A systematic review was performed to identify all relevant studies. Data was extracted and a random-effects meta-analysis was performed for knowledge and attitudes/self-efficacy outcomes, respectively. Subgroup analyses were performed based on survey question type, geographic location, and population studied. Results: Overall, MHFA training significantly increased pharmacists’ and pharmacy students’ knowledge (Hedges’ g = 0.228) and combined attitudinal/self-efficacy measures (Hedges’ g = 0.376). Subgroup analyses based on question type, study quality, design, population studied, and location showed similar, significant effects. Conclusions: MHFA training appears to have significant effects on pharmacist and pharmacy student knowledge, attitudes, and self-efficacy. Future work should establish the durability of these effects. Full article

Composite laminates are widely used in aerospace, automotive, construction, and luxury industries, owing to their superior mechanical properties and design flexibility. However, detecting manufacturing defects and in-service damage remains a vital challenge for structural safety. While traditional unsupervised machine learning methods have been used in structural health monitoring (SHM), their high false positive rates limit their reliability in real-world applications. This issue is mostly inherited from their limited ability to capture small temporal variations in Lamb wave signals and their dependence on shallow architectures that suffer with complex signal distributions, causing the misclassification of damaged signals as healthy data. To address this, we suggested an unsupervised anomaly detection framework that integrates a self-attention autoencoder with a Gaussian mixture model (SAE-GMM). The model is solely trained on healthy Lamb wave signals, including high-quality synthetic data generated via a generative adversarial network (GAN). Damages are detected through reconstruction errors and probabilistic clustering in the latent space. The self-attention mechanism enhances feature representation by capturing subtle temporal dependencies, while the GMM enables a solid separation among signals. Experimental results demonstrated that the proposed model (SAE-GMM) achieves high detection accuracy, a low false positive rate, and strong generalization under varying noise conditions, outperforming traditional and deep learning baselines. Full article

The global rise in urban-related health issues poses significant challenges to public health, particularly in cities facing socio-economic crises. In Lebanon, 70% of the population is experiencing financial hardship, and healthcare costs have surged by 172%, exacerbating the strain on medical services. Given these conditions, improving the quality and accessibility of green spaces offers a promising avenue for alleviating mental health issues in urban areas. This study investigates the psychological impact of nine urban public spaces in Beirut through a comprehensive survey methodology, involving 297 participants (locals and tourists) who rated these spaces using Likert-scale measures. The findings reveal location-specific barriers, with Saanayeh Park rated highest in quality and Martyr’s Square rated lowest. The analysis identifies facility quality as the most significant factor influencing space quality, contributing 73.6% to the overall assessment, while activity factors have a lesser impact. The study further highlights a moderate positive association (Spearman’s rho = 0.30) between public space quality and mental well-being in Beirut. This study employs a hybrid methodology combining Research for Design (RfD) and Research Through Designing (RTD). Empirical data informed spatial strategies, while iterative design served as a tool for generating context-specific knowledge. Design enhancements—such as sensory plantings, shading systems, and social nodes—aim to improve well-being through better public space quality. The proposed interventions support mental health, life satisfaction, climate resilience, and urban inclusivity. The findings offer actionable insights for cities facing public health and spatial equity challenges in crisis contexts. Full article

The Emporia State University (ESU) /Kansas Arts Commission (KAC) Arts in Medicine Partnership exemplifies interdisciplinary collaboration and the capacity of art therapy to impact mental health and well-being. Through the partnership, art therapy services were offered to medical agencies across the state of Kansas. Participants included medical patients, families, caregivers, staff, and professionals. The article introduces (1) the profession of art therapy and the subspecialty of medical art therapy, (2) the ESU/KAC Arts in Medicine Partnership, (3) examples of positive psychology-informed arts-based experiences, and (4) a pilot study designed to explore the impact of group art therapy sessions with medical teaching faculty. Full article

Background/Objectives: The demand for accessible and reliable digital health services has increased significantly in recent years, particularly in regions facing physician shortages. HomeDOCtor, a conversational AI platform developed in Slovenia, addresses this need with a nationally adapted architecture that combines retrieval-augmented generation (RAG) and a Redis-based vector database of curated medical guidelines. The objective of this study was to assess the performance and impact of HomeDOCtor in providing AI-powered healthcare assistance. Methods: HomeDOCtor is designed for human-centered communication and clinical relevance, supporting multilingual and multimedia citizen inputs while being available 24/7. It was tested using a set of 100 international clinical vignettes and 150 internal medicine exam questions from the University of Ljubljana to validate its clinical performance. Results: During its six-month nationwide deployment, HomeDOCtor received overwhelmingly positive user feedback with minimal criticism, and exceeded initial expectations, especially in light of widespread media narratives warning about the risks of AI. HomeDOCtor autonomously delivered localized, evidence-based guidance, including self-care instructions and referral suggestions, with average response times under three seconds. On international benchmarks, the system achieved ≥95% Top-1 diagnostic accuracy, comparable to leading medical AI platforms, and significantly outperformed stand-alone ChatGPT-4o in the national context (90.7% vs. 80.7%, p = 0.0135). Conclusions: Practically, HomeDOCtor eases the burden on healthcare professionals by providing citizens with 24/7 autonomous, personalized triage and self-care guidance for less complex medical issues, ensuring that these cases are self-managed efficiently. The system also identifies more serious cases that might otherwise be neglected, directing them to professionals for appropriate care. Theoretically, HomeDOCtor demonstrates that domain-specific, nationally adapted large language models can outperform general-purpose models. Methodologically, it offers a framework for integrating GDPR-compliant AI solutions in healthcare. These findings emphasize the value of localization in conversational AI and telemedicine solutions across diverse national contexts. Full article

Anxiety is a significant mental health concern in universities worldwide. This study examines the structure of anxiety symptoms and their relationship with contextual stressors among pre-service English teachers. The sample included 269 students enrolled in a Teaching English as a Foreign Language program at a public university in Manabí, Ecuador. Data were collected using the Zung Self-Rating Anxiety Scale and a custom-designed questionnaire identifying anxiety triggers. Results showed that while most students reported normal or mild anxiety levels, a considerable portion exhibited moderate to severe symptoms. Cluster analysis revealed three emotional profiles, with the high-anxiety group strongly associated with stressors such as economic hardship and job insecurity. Academic pressure and financial instability emerged as the strongest predictors of anxiety. These findings highlight the urgent need to develop and evaluate targeted psycho-educational strategies to prevent and reduce anxiety within teacher training programs in higher education. Full article

Private 5G networks offer exclusive, secure wireless communication with full control deployments for many clients, such as enterprises and campuses. In these networks, edge computing plays a critical role by hosting both application services and the User Plane Functions (UPFs) as containerized workloads close to end devices, reducing latency and ensuring stringent Quality of Service (QoS). However, edge environments often face resource constraints and unpredictable failures such as network disruptions or hardware malfunctions, which can severely affect the reliability of the network. In addition, existing redundancy-based UPF resilience strategies, which maintain standby instances, incur substantial overheads and degrade resource efficiency and scalability for the applications. To address this issue, this study introduces a novel design that enables quick detection of UPF failures and two failover mechanisms to restore failed UPF instances either within the cluster hosting the failed UPF or across multiple clusters, depending on that cluster’s resource availability and health. We implemented and evaluated our proposed approach on a Kubernetes-based testbed, and the results demonstrate that our approach reduces UPF redeployment time by up to 37% compared to baseline methods and lowers system cost by up to 50% under high-reliability requirements compared to traditional redundancy-based failover methods. These findings demonstrate that our design can serve as a complementary solution alongside traditional resilience strategies, offering a particularly cost-effective and resource-efficient alternative for edge computing and other constrained environments. Full article

Modern software solutions have a multiplicative effect on enhancing quality of life across various urban sectors, including the environment, education, public health, security, transportation, time efficiency, employment, and other key aspects of city living. This article addresses a specific issue concerning the organisation of leisure activities for both local residents and tourists, using the Chechen Republic as a case study. In response, the study aimed to develop a digital solution to address this challenge, with potential for integration into the Republic’s unified digital ecosystem. By employing system analysis methods, the authors identified the key objects and stakeholders involved in the problem domain. They also defined the software product’s functionality and classified user categories. Using Unified Modelling Language methods, a use case diagram was developed to illustrate the conceptual operation of the system. Furthermore, object-oriented design methods were applied to create a user interface prototype for the software product. As a result, a digital service was developed that enables users to create personalised leisure routes, taking into account individual goals, time constraints, traffic conditions, and the real-time status of urban infrastructure. The resulting software solution is both customisable and scalable. The article also presents selected examples of project development. Full article