Search Results (24)

The 3-30-300 rule, proposed by Cecil Konijnendijk, is oriented towards the design of greener cities. However, subsequent literature has revealed some application limits due to overly simple definitions (visibility of 3 trees), fixed thresholds (30% tree cover) and theoretical distances (300 m to the park) that do not consider ecological quality, real green area proximity and possible socio-demographic differences. The present research attempts to overcome these limitations through the elaboration of a scalable composite index that, starting from the original rule, integrates ecological, infrastructural and population variables to give a more robust measure of the availability and usability of urban green. The index was tested in the study area of the urban centre of Ferrara (Italy). Three sub-indices were calculated for each building: Indicator 3—Visibility (I3), Indicator 30—Tree cover (I30), and Indicator 300—Green area proximity (I300). Once normalized and weighted, the three indicators were aggregated into a composite index conceived as a scalable and replicable framework adaptable to diverse urban settings. By spatially integrating population data, the methodology explicitly embeds the distributional dimension of climate justice, supporting evidence-based adaptation strategies and equitable urban regeneration policies. Moving beyond the binary logic of the original 3-30-300 rule, the approach provides an operational decision-support tool to detect intra-urban inequalities, to address just green transitions and to monitor urban greening interventions over time. Full article

Background: Physical inactivity and sedentary behaviour are major public health concerns associated with an increased risk of non-communicable diseases, reduced quality of life, and substantial healthcare burden. In recent years, technology-based interventions, including wearable devices, mobile health applications, artificial intelligence-driven systems, and adaptive digital platforms, have been increasingly adopted to promote physical activity and reduce sedentary time in adult populations. However, the evidence remains fragmented across intervention types, behavioural targets, and population groups. The aim of this scoping review was to map the recent literature on digital interventions designed to promote active lifestyles in adults, with a specific focus on their reported impact on physical activity promotion and sedentary behaviour reduction. Methods: This scoping review was conducted in accordance with the PRISMA-ScR guidelines. A literature search was performed in PubMed and Scopus using a predefined search strategy combining terms related to digital technologies, physical activity, sedentary behaviour, and adult populations. Studies published in English between 2022 and 2026 were considered. After removal of duplicates and screening of titles and abstracts, full texts were assessed according to predefined eligibility criteria. Data were charted descriptively and synthesised narratively to identify the main intervention models and emerging research trends. Results: The search identified 887 records, of which 35 studies were included in the final synthesis. The literature included was grouped into four broad categories: wearable devices and mHealth tools for monitoring and goal-setting; adaptive interventions based on Just-In-Time Adaptive Interventions, artificial intelligence, and gamification; advanced technologies such as Internet of Things systems and exoskeleton-based approaches; and hybrid interventions combining digital tools with human support or environmental modifications. Overall, technology-based interventions were generally associated with increases in step count, moderate-to-vigorous physical activity, and adherence to movement-related behaviours. In contrast, their effectiveness in reducing sedentary behaviour was less consistent and appeared to depend more strongly on context-sensitive prompting, posture-focused strategies, and multicomponent or hybrid intervention models. Conclusions: Digital health interventions represent a promising strategy for promoting physical activity in adults, but their impact on sedentary behaviour reduction remains more limited and heterogeneous. The findings suggest that simply increasing exercise is not sufficient to address prolonged sitting and that more tailored, adaptive, and context-aware approaches are needed. Future research should prioritise methodological standardisation, longer follow-up periods, and interventions specifically designed to interrupt sedentary time across different adult populations. Full article

Background/Objectives: Excess consumption of energy-dense foods (EDF; ultra-processed snacks, sweets, and sugar-sweetened beverages) among preschool-aged children is a public health concern, particularly in low-income families. Caregiver parenting style, psychological stress, and food-parenting practices (FPP) may shape children’s EDF consumption, yet little is known about how these factors operate in real time. This exploratory pilot study examined (1) associations between baseline characteristics and EDF feeding episodes across 1 week and (2) whether caregivers’ momentary stress during EDF episodes related to FPP used. Methods: In total, 22 caregivers of Head Start children (ages 3–5) completed baseline measures and 7 days of ecological momentary assessment (up to seven prompts/day). At each prompt, caregivers reported child EDF consumption in the past hour; if confirmed, they reported FPP used and rated momentary stress. Aim 1 used Poisson regression to model caregiver-level EDF episode counts. Aim 2 tested momentary stress–practice associations during EDF episodes using GEE, with within-person and between-person stress modeled separately. Results: Authoritarian parenting was associated with a higher weekly rate of EDF episodes (RR = 1.43, 95% CI 1.23–1.66, p < 0.001); authoritative parenting trended lower (RR = 0.90, p = 0.065). Higher baseline stress was associated with more EDF episodes (RR = 1.25, p = 0.001). Momentarily, elevated stress above a caregiver’s own average increased odds of using food as a reward (OR = 1.08 per +10 points, p = 0.011), while higher average momentary stress was associated with co-eating (OR = 1.59, p = 0.042). Domain-level FPP composites showed no association with momentary stress. Conclusions: Authoritarian parenting and higher caregiver stress were associated with increased EDF feeding, and momentary stress was linked to reward-based feeding during those episodes. These hypothesis-generating findings suggest potential behavioral targets for just-in-time adaptive intervention, pending replication in adequately powered studies. Full article

Occupational sedentary behavior presents a public health risk, yet current interventions often rely on subjective self-reports or context-blind prompts. This study validates a privacy-preserving, edge-computing time-of-flight (ToF) sensor that detects postural states and quantifies therapeutic exercise gestures in real time. The dual-sensor architecture distinguishes between sitting, standing, and absence, while capturing rapid sit-to-stand repetitions suitable for active-break interventions. In this paper, a laboratory study (N = 7) evaluated the system against ground truth comprising activPAL3 accelerometry and video analysis. Across 378 postural events, the sensor achieved high temporal fidelity (mean absolute error < 1.6 s) and 100% sensitivity in counting exercise repetitions. The system differentiated workstation occupancy from physical absence. These findings demonstrate that ToF sensing matches the accuracy of video analysis without privacy concerns while offering the contextual awareness required for just-in-time, adaptive workplace interventions. Full article

Background: This pilot study examined the feasibility, acceptability, usability, and preliminary outcomes of apt.mind, a mobile app-based mindfulness intervention with an exploratory smartwatch component, among healthcare worker families during the COVID-19 pandemic. Methods: Using a micro-randomized trial (MRT) design, 102 healthcare workers and co-parents of children aged 4–13 years were randomized once per day over 30 days to one of three conditions: (1) an audio-guided mindfulness exercise delivered via the apt.mind mobile app, (2) an in-app push notification prompting a brief mindfulness activity, or (3) no intervention. Feasibility was assessed through participant enrollment, retention, and daily engagement rates, while acceptability and usability were evaluated through qualitative and quantitative feedback. Exploratory multilevel analyses examined proximal effects of intervention conditions on momentary stress. Results: Retention was high, with all participants completing the 30-day protocol, and 80% of participants completed at least one daily survey. Participants reported moderate-to-high acceptability and usability. However, smartwatch battery life and sensor reliability limited the collection of usable physiological data. Multilevel analyses did not identify any significant main effects of intervention condition on momentary stress, but age moderated the association between the audio exercise condition and stress, benefiting older participants. Conclusions: Mobile-based mindfulness interventions appear feasible and acceptable for healthcare worker families in high-stress contexts. Although proximal stress effects were limited and exploratory, the findings inform future optimization of just-in-time adaptive interventions. Improvements in wearable technology and MRT implementation strategies are needed to enhance physiological data quality and reduce assessment-related anxiety. Full article

This study investigated the feasibility and preliminary effects of enhanced midwifery care in reducing subclinical depression symptoms among women in ethnically diverse areas of the South Western Sydney Local Health District (SWSLHD). A pilot randomised controlled trial was conducted among pregnant women attending the Fairfield and/or Liverpool antenatal clinic with an Edinburgh Depression Scale (EDS) score of 10–12 (i.e., just below the generally accepted clinical cut-off score of 13 to indicate subclinical depressive symptoms) during the first antenatal visit (i.e., before 26 weeks gestation). Participants were randomly allocated to either the intervention group which received continuous and coordinated support from a dedicated Registered Midwife (RM) trained in counselling and linked with a multidisciplinary team, or the usual care group, which received standard maternity care from various providers without continuity or additional coordinated support. Primary outcomes included feasibility of recruitment, randomisation, intervention delivery and fidelity, and retention and follow-up. The secondary outcomes were improvement in depressive symptom severity assessed via EDS, psychological distress (Kessler’s psychological distress scale—K10), and parenting confidence (Karitane Parenting Confidence Scale (KPCS). Descriptive analyses were used to assess the feasibility outcomes, whereas mixed-effects models were used to examine the effects of treatment on secondary outcomes. Thirty-seven mothers were recruited into the study, of which eighteen were randomised to the intervention group and nineteen to the usual care group. The intervention was delivered with good fidelity, and remote adaptations during COVID-19 ensured both continuity of care and high retention at 6-month follow-up. Findings of the mixed-effects models showed significant within-group reduction in EDS scores over time, with scores at 8 weeks postpartum (T2) significantly lower than at baseline (T0; β = −2.77, SE = 1.36, p < 0.05) but no significant differences between the groups (β = −0.02, SE = 1.63, p = 0.992) or time-by-group interactions at any timepoint for EDS, K10, and KPCS. These findings demonstrate the feasibility of enhanced midwifery care in a “hard to reach” population of SWSLHD and highlight the need for adequately powered trials to determine its effectiveness on maternal mental health and parenting outcomes. Full article

Urban Heat Islands (UHIs) are intensifying under climate change, exacerbating thermal exposure risks for socially vulnerable populations. While the role of urban environmental features in shaping UHI patterns is well recognized, their differential impacts on diverse social groups remain underexplored—limiting the development of equitable, context-sensitive mitigation strategies. To address this challenge, we employ an interpretable ensemble machine learning framework to quantify how vegetation, water proximity, and built form influence UHI exposure across social strata and simulate the outcomes of alternative urban interventions. Drawing on data from 1660Dissemination Areas in Vancouver, we model UHI across seasonal and diurnal contexts, integrating environmental variables with socio-demographic indicators to evaluate both thermal and equity outcomes. Our ensemble AutoML framework demonstrates strong predictive accuracy across these contexts (R² up to 0.79), providing reliable estimates of UHI dynamics. Results reveal that increasing vegetation cover consistently delivers the strongest cooling benefits (up to 2.95 °C) while advancing social equity, though fairness improvements become consistent only when vegetation intensity exceeds 1.3 times the baseline level. Water-related features yield additional cooling of approximately 1.15–1.5 °C, whereas built-form interventions yield trade-offs between cooling efficacy and fairness. Notably, modest reductions in building coverage or road density can meaningfully enhance distributional justice with limited thermal compromise. These findings underscore the importance of tailoring mitigation strategies not only for climatic impact but also for social equity. Our study offers a scalable analytical approach for designing just and effective urban climate adaptations, advancing both environmental sustainability and inclusive urban resilience in the face of intensifying heat risks. Full article

(1) Background: Physical activity (PA) is a key modifiable risk factor for chronic diseases, yet many adults do not meet PA guidelines. Just-in-time adaptive interventions (JITAIs), a type of mobile health (mHealth) intervention, offer tailored support based on an individual’s context to promote PA. Integrating behavior change techniques (BCTs) and theories is critical to the design of effective mHealth interventions. Understanding which BCTs and theories work best can inform future JITAI development. (2) Objective: The objective of this study is to examine how behavior change theories and BCTs are implemented in mHealth PA JITAIs and assess their relationship with PA-related outcomes. (3) Methods: This scoping review followed the PRISMA-ScR guidelines. A total of 29 studies were included. (4) Results: The most commonly used BCTs include prompts/cues (n = 29), goal-setting (behavior) (n = 15), and feedback on behavior (n = 14), while self-determination theory (n = 4) and social cognitive theory (n = 4) are the most commonly used theories. However, there is insufficient evidence as to which theories and BCTs are most effective in eliciting effective PA behavior change. (5) Conclusions: Clearer reporting and integration of BCTs and behavior change theories, along with optimized user interfaces, are needed to improve the intervention quality, replicability, and long-term effectiveness of PA JITAIs. Full article

Digital therapeutics (DTx, software as a medical device) provide personalized treatments for chronic diseases and expand precision medicine beyond pharmacogenomics-based pharmacotherapies. In this perspective article, we describe how DTx for chronic low back pain (CLBP) can be integrated with pharmaceutical drugs (e.g., NSAIDs, opioids), physical therapy (PT), cognitive behavioral therapy (CBT), and patient empowerment. An example of an FDA-authorized DTx for CLBP is RelieVRx, a prescription virtual reality (VR) app that reduces pain severity as an adjunct treatment for moderate to severe low back pain. RelieVRx is an immersive VR system that delivers at-home pain management modalities, including relaxation, self-awareness, pain distraction, guided breathing, and patient education. The mechanism of action of DTx is aligned with recommendations from the American College of Physicians to use non-pharmacological modalities as the first-line therapy for CLBP. Herein, we discuss how DTx can provide multimodal therapy options integrating conventional treatments with exposome-responsive, just-in-time adaptive interventions (JITAI). Given the flexibility of software-based therapies to accommodate diverse digital content, we also suggest that music-induced analgesia can increase the clinical effectiveness of digital interventions for chronic pain. DTx offers opportunities to simultaneously address the chronic pain crisis and opioid epidemic while supporting patients and healthcare providers to improve therapy outcomes. Full article

Background: During imprisonment, inmates face many difficulties in adapting to life behind bars. The aim of the study was to find out (a) how challenging for inmates were the selected COVID-19 pandemic-related changes and stressors, (b) what moods and emotions are most commonly experienced by prisoners just after the difficult period of the COVID-19 pandemic, and (c) which of the selected factors determine the positive and negative mood of inmates. Methods: The research was conducted in July 2022 in six randomly selected Polish prisons. Prisoners (N = 250) were invited to participate. Comparative and regression analyses were carried out. Two scales measuring moods: the General Mood Scale and the Mood Scale (positive and negative), the Emotions Questionnaire by B. Wojciszke and W. Baryła, and a proprietary questionnaire were used. Results: Sanitary restrictions implemented in prisons resulted in a moderate experience of discomfort among prisoners, mainly in terms of not being able to have direct contact with family and friends, limitation in their personal freedoms to do their jobs, self-development, and deterioration of mental and physical health. A depressed mood predominated among the prisoners, making them feel unhappy, discouraged, tense, and uptight. They reported dominant feelings of alienation, distress, anxiety, and worry at the time of the survey. The mood of inmates was changing from more positive to more negative; on average, it was described as moderate. Based on the regression coefficients, the significant predictors of inmates’ positive mood were perceived happiness (for those who got sick with COVID-19 during their prison sentence) and joy, angst, and contentment (for the healthy ones). In the group of SARS-CoV-2-infected prisoners, unhappiness, age, concern, cheerfulness, and rage were found to be predictors of their negative mood. The feeling of joy appeared to be a significant predictor of negative mood for those inmates who had no personal experience with COVID-19. Conclusions: It is necessary to provide convicts with continuous psychological care and to monitor their mood. Such measures should be the foundation for restorative interventions. Full article

We assessed 3 years of post-release movements of a reintroduced plains bison (Bison bison bison) population for evidence of anchoring, settling, exploratory and adaptive behavior within a 1200 km² target reintroduction zone in Banff National Park. We first held them in a soft-release pasture for 18 months, then partially constrained their movements with drift fences and hazing trials to discourage excursions from a 1200 km² target reintroduction zone. Their post-release movements were within 13 km of the soft-release pasture for the first 3 months, but management interventions were needed to keep the animals within 29 km of the release site and inside the reintroduction zone for the remainder of the 3-year study period. Bison exploration was high in the first year but decreased thereafter, as did the size of their annual home range. Step lengths did not decrease but the frequency of “surge movements” (step lengths > 4 km in 2 h) did. Fence visits did not decrease over time but the need to herd/haze the bison from other, unfenced boundary areas did. The reintroduced bison seasonally selected for rugged, high-elevation habitat despite being translocated from a flat landscape. Our results suggest wild bison reintroductions to areas of just a few hundred square kilometres are possible without perimeter fencing, so long as good habitat and management interventions to discourage broad movements are in place. Trends suggest such interventions will need to continue in Banff until the bison range can be expanded and/or bison movements are constrained by other forces, such as regulated hunting outside the park. Full article

Breaking up prolonged sitting with short bouts of light physical activity including standing and walking has been shown to be beneficial for people with type 2 diabetes (T2D). This paper presents the development of an android mobile app to deliver a just-in-time adaptive intervention (JITAI) to reduce sedentary time in people with T2D. A total of six design workshops were conducted with seven experts to identify design requirements, a behavioural framework, and required contextual adaptations for the development of a bespoke mobile app (iMOVE). Moreover, a focus group was conducted among people with T2D as potential end-users (N = 10) to ascertain their perceptions of the app. Feedback from the focus group was used in subsequent iterations of the iMOVE app. Data were analysed using an inductive qualitative thematic analysis. Based on workshops, key features of iMOVE were developed, including simplicity (e.g., navigation, login), colours and font sizes, push notifications, messaging algorithms, and a triggering system for breaking up sitting time and moving more. Based on the user testing results, a goal-setting tab was added, font sizes were made larger, the brightness of colours was reduced, and a colour indicator was used to indicate device connectivity with an activity tracker. A user-centric app was developed to support people with T2D to transition from sedentary to active lifestyles. Full article

Fire regimes are changing in several regions of the world. In those regions, some exotic species may be better adapted to new regimes than the native species. This study focused on identifying the microsite characteristics associated with the occurrence of post-fire Eucalyptus globulus regeneration from seeds, outside the species native-range. This information is important in helping to assess the naturalization status of the species, to understand its invasion risk, and to manage wildlings in plantations. To characterize the establishment niche, pairs of microsites (sapling presence/absence) were sampled in four salvage-logged plantations of E. globulus two years after fire (20 pairs/plantation). Microsites of wildlings from three size classes and control microsites were established in one of these plantations (20 quartets) in order to characterize the recruitment niche and to assess ontogenic niche shifts. Two post-fire wildling cohorts were identified. The first emerged just after fire and was abundant. The second emerged after logging and was scarce, probably due to seed limitation. First-cohort wildlings were observed in microsites characterized by a high incidence of fire-related variables (charcoal, ash, increased soil pH and K). The aggregated distribution of these wildlings and their association with other species may indicate the existence of facilitative relationships and/or the exploitation of resource-rich patches. All these factors were relevant for first-cohort persistence and likely also for its establishment and recruitment. Second-cohort wildlings occurred in microsites where salvage-logging disturbance was evident, showing the importance of this disturbance for its emergence. Wildling size diversity was explained by the two recruitment events and by the asymmetrical competition between wildlings and adults. No niche shifts were detected. The high densities of E. globulus wildlings found established in burnt plantations indicated naturalization was in progress. The timing of major recruitment events and the phenology of the species should be considered for monitoring this regeneration and scheduling control interventions, if required. Full article

Since COVID-19 has become a pandemic, everyday life has seen dramatic changes affecting individuals, families, and children with and without autism. Among other things, these changes entail more time at home, digital forms of communication, school closures, and reduced support and intervention. Here, we assess the effects of the pandemic on quality of life for school-age autistic and neurotypical children and adolescents. First, we provide a comprehensive review of the current relevant literature. Next, we report original data from a survey conducted in several countries, assessing activities, well-being, and social life in families with autism, and their changes over time. We focus on differences between children with and without autism from within the same families, and on different outcomes for children with high- or low-functioning autism. While individuals with autism scored lower in emotional and social functioning than their neurotypical siblings, both groups of children showed comparable decreases in well-being and increases in anxiety, compared to before the pandemic. By contrast, decreases in adaptability were significantly more pronounced in autistic children and adolescents compared to neurotypical children and adolescents. Overall, although individual families reported some positive effects of pandemic restrictions, our data provide no evidence that these generalize across children and adolescents with autism, or even just to individuals with high-functioning autism. We discuss the increased challenges that need to be addressed to protect children and adolescents’ well-being under pandemic conditions, but also point out potentials in the present situation that could be used towards social participation and success in older children and young adults with autism. Full article

Fitness and exercise may counteract the detrimental metabolic and mood adaptations during prolonged sitting. This study distinguishes the immediate effects of a single bout vs. work-load and intensity-matched repeated exercise breaks on subjective well-being, blood glucose, and insulin response (analyzed as area under the curve) during sedentary time; and assesses the influence of fitness and caloric intake on metabolic alterations during sedentariness. Eighteen women underwent cardiopulmonary exercise testing and three 4 h sitting interventions: two exercise interventions (70% VO₂max, 30 min, cycle ergometer: (1) cycling prior to sitting; (2) sitting interrupted by 5 × 6 min cycling), and one control condition (sitting). Participants consumed one meal with ad libitum quantity (caloric intake), but standardized macronutrient proportion. Exercise breaks (4057 ± 2079 μU/mL·min) reduced insulin values compared to a single bout of exercise (5346 ± 5000 μU/mL·min) and the control condition (6037 ± 3571 μU/mL·min) (p ≤ 0.05). ANCOVA revealed moderating effects of caloric intake (519 ± 211 kilocalories) (p ≤ 0.01), but no effects of cardiorespiratory fitness (41.3 ± 4.2 mL/kg/min). Breaks also led to lower depression, but higher arousal compared to a no exercise control (p ≤ 0.05). Both exercise trials led to decreased agitation (p ≤ 0.05). Exercise prior to sitting led to greater peace of mind during sedentary behavior (p ≤ 0.05). Just being fit or exercising prior to sedentary behavior are not feasible to cope with acute detrimental metabolic changes during sedentary behavior. Exercise breaks reduce the insulin response to a meal. Despite their vigorous intensity, breaks are perceived as positive stimulus. Detrimental metabolic changes during sedentary time could also be minimized by limiting caloric intake. Full article