Search Results (1,107)

Hospital in the Home (HITH) programs are emerging as a key pillar of smart city healthcare infrastructure, leveraging technology to extend care beyond traditional hospital walls. The global healthcare sector has been conceptualizing the notion of a care without walls hospital, also called HITH, where virtual care takes precedence to address the multifaceted needs of an increasingly aging population grappling with a substantial burden of chronic disease. HITH programs have the potential to significantly reduce hospital bed occupancy, enabling hospitals to better manage the ever-increasing demand for inpatient care. Although many health providers and hospitals have established their own HITH programs, there is a lack of research that provides healthcare executives and HITH program managers with management models and frameworks for such initiatives. There is also a lack of research that provides strategies for improving HITH management in the health sector. To fill this gap, the current study ran a systematic literature review to explore state-of-the-art with regard to this topic. Out of 2631 articles in the pool of this systematic review, 20 articles were deemed to meet the eligibility criteria for the study. After analyzing these studies, nine management models were extracted, which were then categorized into three categories, namely, governance models, general models, and virtual models. Moreover, this study found 23 strategies and categorized them into five groups, namely, referral support, external support, care model support, technical support, and clinical team support. Finally, implications of findings for practitioners are carefully provided. These findings provide healthcare executives and HITH managers with practical frameworks for selecting appropriate management models and implementing evidence-based strategies to optimize program effectiveness, reduce costs, and improve patient outcomes while addressing the growing demand for home-based care. Full article

Millions of puppies are welcomed into the homes of families around the world each year. However, understanding the ways in which puppies are bred and raised by their breeders, as well as the perspectives and perceptions underpinning these practices, is still in its infancy. The current study administered an online survey to 200 Australian dog breeders to investigate their breeding program characteristics, breeding dog selection, understanding of the importance of early experiences in puppyhood, and the extent and diversity of their puppy rearing and socialisation practices. Results indicated that breeders were motivated by breed improvement and producing dogs for themselves rather than providing companion dogs, despite most of their puppies being placed in companionship roles. The participating breeders also acknowledged the important role they play in shaping puppies’ behaviour and temperament, which was reflected in both their breeding dog selection and in their rearing and socialisation practices. The majority of breeders housed their litters within their residence for the initial weeks of life but the socialisation experiences they provided were variable in type and frequency. Longer-term breeders and those with larger, more intensive programs reported providing human-focused socialisation experiences less frequently, though the correlational nature of these findings require cautious interpretation. Whilst future research should endeavor to explore these results more comprehensively among a more diverse sample, these findings provide valuable insight into the breeding, rearing, and socialisation process undertaken by dog breeders in Australia. Full article

This report presents the first complete natal dispersal trajectory of a female Montagu’s Harrier Circus pygargus, tracked in real time from fledging to first breeding using high-resolution continuous Global Positioning System (GPS) telemetry. The bird’s first flight occurred on 26 July 2024, initiating a 31-day post-fledging dependence phase (PFDP), followed by a 23-day pre-migratory phase (PMP), during which it explored areas up to 280.8 km from the nest and eventually settled ca. 190 km away in the Sirente-Velino Regional Park. From there, autumn migration began on 18 September 2024. The bird reached its first wintering site in Mali by 15 October. It used four wintering areas over 178 days, with a winter home range of 37,615.02 km². Spring migration started on 11 April 2025 and lasted 21 days, ending with arrival in the Gran Sasso e Monti della Laga National Park (Central Italy) on 2 May. The bird used two main sites during the pre-breeding phase (PRBP) before laying eggs on 2 June 2025. The natal dispersal distance, from birthplace to nest site, was 151.28 km. Over 311 days, it covered a total of 14,522.23 km. These findings highlight the value of advanced telemetry in revealing early-life movement ecology and are useful for understanding species-specific patterns of survival, reproduction, and space use and can inform conservation actions. Full article

This paper presents a case study of the Local Care Ecosystems developed by the provincial government of Gipuzkoa (Basque Country, Spain) to strengthen coordination between social services, health services, and community-based initiatives at the municipal level. The initiative seeks to personalize care, enhance service integration, and support community-based care with the overarching goal of improving the quality of life for older adults living at home. These ecosystems incorporate social, institutional, and technological innovations aimed at supporting individuals who are frail or vulnerable throughout the care cycle. At present, 18 Local Care Ecosystems are active, providing services to 1202 people over the age of 65 and 167 families. The model addresses a growing global challenge linked to population aging, which has led to increasing demand for care and support services that are often fragmented, under-resourced, and constrained by outdated regulatory frameworks. These structural issues can compromise both the quality and efficiency of care for dependent individuals. Based on the findings, the paper offers policy recommendations to support the transfer and adaptation of this model, with the aim of improving the well-being of older adults who wish to remain in their own homes. 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

Selective Mutism (SM) is a childhood anxiety disorder characterized by the persistent inability to speak in specific social settings while being able to speak freely in more comfortable environments, such as at home with family. This condition often leads to significant impairments in social, academic, and occupational functions. This article presents a novel treatment methodology that integrates the physiology of vocal production with pragmatic language instruction through teletherapy, administered to two adolescents diagnosed with selective mutism (SM). The frequency of speaking on the Selective Mutism Questionnaire increased from 35% to 86% and from 25% to 55% for the two children. Pragmatic language skills on the Social Communication Skills: Pragmatics Checklist improved from 47% to 96% and 13% to 40% after treatment. It is crucial to emphasize vocal control for speech initiation and pragmatic language for verbal expression. Detailed strategies, specific activities, and treatment outcomes are provided. Full article

(1) Background: Physical activity (PA) plays a crucial role in preserving and enhancing mental health, particularly in the aftermath of major health crises such as the COVID-19 pandemic. However, the specific levels and domains of physical activity that have the greatest impact on alleviating symptoms of anxiety, depression, and stress in the post-COVID-19 period remain unclear. The aim of this study was to examine the influence of different levels and domains of PA on mental health parameters, specifically symptoms of anxiety, depression, and stress, in individuals who had recovered from COVID-19. (2) Methods: The study included initial measurements (2–4 weeks post-recovery) and final measurements (14–16 weeks post-recovery). The sample comprised 288 participants aged 20 to 60 years (M = 47.06; SD = 12.41), with 95 men and 193 women. PA was assessed using the long version of the IPAQ questionnaire, while mental health was evaluated using the long version of the DASS scale. (3) Results: Stepwise regression analysis revealed that low- (p = 0.010) and moderate-intensity (p = 0.022) PA was significantly associated with reductions in anxiety symptoms as well as lower stress levels (low PA: p = 0.014; moderate PA: p = 0.042). Total PA (p < 0.001) and vigorous-intensity PA (p = 0.008) emerged as significant predictors of reduced depression levels. Among the domains of PA, home-based activities had a statistically significant impact on all three mental health components: anxiety (p = 0.005), depression (p = 0.002), and stress (p = 0.041). Transport-related PA was significantly associated with anxiety (p = 0.011) and stress (p = 0.022), but not with depression. (4) Conclusions: The results suggest that a combined model incorporating different levels and domains of PA may represent an effective approach to improving mental health in individuals recovering from COVID-19. Further longitudinal studies are needed to establish more precise causal relationships. Full article

Background/Objectives: Patients with stage IV gastric cancer who develop chronic intestinal failure require home parenteral nutrition (HPN). This study aimed to evaluate the prognostic relevance of nutritional and immune–inflammatory biomarkers and to construct an individualised survival prediction model using machine learning techniques. Methods: A secondary analysis was performed on a cohort of 410 patients with TNM stage IV gastric adenocarcinoma who initiated HPN between 2015 and 2023. Nutritional and inflammatory indices, including the Controlling Nutritional Status (CONUT) score and lymphocyte-to-monocyte ratio (LMR), were assessed. Independent prognostic factors were identified using Cox proportional hazards models. A Random Survival Forest (RSF) model was constructed to estimate survival probabilities and quantify variable importance. Results: Both the CONUT score and LMR were independently associated with overall survival. In multivariate analysis, higher CONUT scores were linked to increased mortality risk (HR = 1.656, 95% CI: 1.306–2.101, p < 0.001), whereas higher LMR values were protective (HR = 0.632, 95% CI: 0.514–0.777, p < 0.001). The RSF model demonstrated strong predictive accuracy (C-index: 0.985–0.986) and effectively stratified patients by survival risk. The CONUT score exerted the greatest prognostic influence, with the LMR providing additional discriminatory value. A gradual decline in survival probability was observed with an increasing CONUT score and a decreasing LMR. Conclusions: The application of machine learning to immune–nutritional data offers a robust tool for predicting survival in patients with advanced gastric cancer requiring HPN. This approach may enhance risk stratification, support individualised clinical decision-making regarding nutritional interventions, and inform treatment intensity adjustment. Full article

This study investigated individuals’ emotional responses to bed bugs and how these were influenced by sex, proximity, and educational intervention. Using a pre-post experimental design, participants (n = 157) completed emotional assessments before and after viewing an educational video about bed bugs. Contrary to our initial hypothesis that only fear and disgust would be observed, participants also exhibited high levels of anxiety and anger. Following the educational intervention, disgust, fear, and anger toward bed bugs increased significantly. Participants experienced greater disgust and fear when imagining encounters with bed bugs in closer proximity, with home infestations giving stronger responses than workplace scenarios. The educational video reduced disgust toward bed bugs in the home but increased fear of them in public spaces, potentially promoting vigilance that could limit bed bug spread. Females reported higher levels of disgust and fear than males across all proximity conditions, supporting evolutionary theories regarding sex-specific disgust sensitivity. The educational video successfully increased participants’ knowledge about bed bugs while simultaneously shifting emotional responses from contamination-based disgust to threat-specific fear. These findings suggest that educational interventions can effectively modify emotional responses to bed bugs, potentially leading to more rational management behaviors by transforming vague anxiety into actionable awareness of specific threats. Full article

In the context of global demographic aging, falls among the elderly remain a major public health concern, often leading to injury, hospitalization, and loss of autonomy. This study proposes a real-time fall detection system that combines a modern computer vision model, YOLOv11 with integrated pose estimation, and an Artificial Intelligence (AI)-based voice assistant designed to reduce false alarms and improve intervention efficiency and reliability. The system continuously monitors human posture via video input, detects fall events based on body dynamics and keypoint analysis, and initiates a voice-based interaction to assess the user’s condition. Depending on the user’s verbal response or the absence thereof, the system determines whether to trigger an emergency alert to caregivers or family members. All processing, including speech recognition and response generation, is performed locally to preserve user privacy and ensure low-latency performance. The approach is designed to support independent living for older adults. Evaluation of 200 simulated video sequences acquired by the development team demonstrated high precision and recall, along with a decrease in false positives when incorporating voice-based confirmation. In addition, the system was also evaluated on an external dataset to assess its robustness. Our results highlight the system’s reliability and scalability for real-world in-home elderly monitoring applications. Full article

Background/Objectives: This study evaluates the effects of a personalized exercise program on symptoms (pain, fatigue, sleep, cognitive function, physical function), resilience, and health-related quality of life (HRQOL) and compares the effectiveness of in-person versus telehealth delivery. Methods: A secondary data analysis was conducted on two 12-week randomized control pilot studies for solid tumor cancer survivors. One study involved in-person home visits with telephone follow-ups. The second utilized weekly exercise recommendations via a smartphone app. Both studies had control participants who received the standard care. Symptoms, resilience, and HRQOL were measured at baseline and after 12 weeks. Paired t-tests were conducted for intervention effects and ANCOVA for group differences, adjusting for age and education. Results: The analysis included 75 program completers: 15 in-person (iHBE), 38 telehealth (TEHE), and 22 who received standard care. Those receiving exercise interventions reported improvements in physical (t = 3.0, p < 0.01) and mental fatigability (t = 3.1, p < 0.01) at program completion compared to baseline. Comparing the mean changes between participants receiving exercise interventions in-person and via telehealth, there were no significant differences between the two delivery methods except perceived visuo-perceptual cognitive difficulty (F = 3.55, p = 0.027), where telehealth showed a slight advantage. Conclusions: The study provides initial evidence of the effectiveness of a telehealth personalized exercise on fatigability and cognitive difficulty, suggesting it is a potential viable alternative to in-person intervention. Further research with a larger cohort is essential to ascertain the effects of these interventional modalities on cancer-related health outcomes. Full article

With the rapid development of science and technology, attackers have invented more and more ways to hide malicious information. Hidden malicious information often contains a large number of malicious codes and malicious scripts, which can be hidden in legitimate software and reconstructed to be executed as the software is executed. In recent years, phishing software has become popular at home and abroad, causing fraud to occur frequently. Among various carriers with high redundancy, images are often used by attackers to hide malicious information because they are often used as information transmission carriers and highly redundant storage. This paper aims to explore how attackers hide malicious information in images and use a convolutional neural network (CNN) framework with acceleration based on the analysis of the Edge of Stability (EOS) phenomenon to detect mobile phishing software. To design a machine learning approach to solve the problem, we summarize the characteristics of nine presented mainstream malicious information hiding methods and present a CNN framework that maintains a high initial learning rate while preventing the gradient from exploding in EOS. R-tree is used to speed up the search for nearby pixels that contain malicious information. The CNN model generated by training under this framework can reach an accuracy of $98.53\%$ and has been well implemented in mobile terminals. Full article

Indoor radon constitutes a public health issue in various regions across the United States as the second leading cause of lung cancer following tobacco smoke. The U.S. Environmental Protection Agency advises radon mitigation interventions for residential buildings with indoor radon concentrations exceeding the threshold level of 4 pCi/L. Despite considerable research assessing the technical effectiveness of radon mitigation systems, there remains a gap in understanding their broader influence on occupant behavior and preferences in residential design. This study aims to investigate the impact of residing in radon-mitigated homes within the Commonwealth of Kentucky—an area known for elevated radon concentrations—on occupants’ preferences regarding healthy home design attributes. The objectives of this research are twofold: firstly to determine if living in radon-mitigated homes enhances occupant awareness and consequently influences their preferences toward health-related home attributes and secondly to quantitatively evaluate and compare the relative significance homeowners assign to health-related attributes such as indoor air quality, thermal comfort, and water quality relative to conventional attributes including home size, architectural style, and neighborhood quality. The overarching purpose is to explore the potential role radon mitigation initiatives may play in motivating occupants towards healthier home construction and renovation practices. Using choice-based conjoint (CBC) analysis, this paper compares preferences reported by homeowners from radon-mitigated homes against those from non-mitigated homes. While the findings suggest a relationship between radon mitigation and increased preference for indoor air quality, the cross-sectional design limits causal interpretation, and the possibility of reverse causation—where health-conscious individuals are more likely to seek mitigation—must be considered. The results provide novel insights into how radon mitigation efforts might effectively influence occupant priorities towards integrating healthier design elements in residential environments. Full article

The temperate rainforests and their associated coastline in Scotland have long been home to dye-producing plants including lichens, some commercialised and patented by George and Cuthbert Gordon in 1758 as the dye Cudbear. Using merchant records and family correspondence, this paper will shed new light on the early trade and manufacture of Cudbear and also Cuthbert Gordon’s later investigations into other colour-producing plants undertaken as chemistry and botany emerged as fields of economic opportunity and study in the 18th century. It appears that Cudbear was used for longer and more widely than has previously been supposed and was integrated into known dye practices and used later with synthetic dyes. A rare pattern book of dyed wool flannel samples, held at the Royal Botanic Garden of Edinburgh, shows a re-evaluation of indigenous dye plants, especially lichens, in a time of national emergency in 1916. The result of a government initiative during WW1 and produced under laboratory conditions at the University of Glasgow, it is used here to identify some of the colours studied by Cuthbert Gordon of which we have little contemporary record. Full article

In 2022, the United Nations Global Biodiversity Framework set forth an ambitious target for “biodiversity-inclusive cities”, recognising the imperative to address biodiversity decline across all sectors, including the built environment. However, the application of this emerging concept remains limited, with few projects directly aligned with the framework’s objectives or timelines necessary for meaningful biodiversity outcomes. To address this limitation this research presents The Paddock, a 27-home regenerative development in southeastern Australia, designed to empower residents in ecological restoration and regeneration efforts. Engagement was initiated through citizen science surveys and a co-design workshop during 2015–2016. As a result, The Paddock seeks to support five focal species’ return via ecosystem-centred design principles. Utilising a mixed-methods approach, the paper documents the design process, ecological decision-making, and the evolving people–nature relationships within the community. Preliminary results indicate the anecdotal return of four targeted species alongside other local fauna. Feedback gathered from residents, combined with insights from the landowner and architect, illustrates that residing in a regenerative environment enhances ecological connections and stewardship tendencies. Ongoing long-term species monitoring will further evaluate the project’s ecological impact. This case study underscores the potential of biodiversity inclusive design (BID) in fostering biodiversity-positive and socially responsive housing developments. Full article