Search Results (4,538)

This study investigates the concept of landscape services (LS), which integrate environmental and sociocultural dimensions of sustainable development. Recognizing landscapes as essential to daily life and well-being, the research aims to support sustainable spatial planning by analyzing both their potential and their actual use. The study has three main objectives: (1) to assess the potential of 16 selected landscape types to provide six key LS through expert evaluation; (2) to determine actual LS usage patterns among the local community (residents); and (3) to identify agreements and discrepancies between expert assessments and resident use. The services analyzed include providing space for daily activities; regulating spatial structure through diversity and compositional richness; enhancing physical and mental health; enabling passive and active recreation; supporting personal fulfillment; and fostering social interaction. Expert-based surveys and participatory mapping with residents were used to assess the provision and use of LS. The results indicate consistent evaluations for forest and historical urban landscapes (high potential and use) and mining and transportation landscapes (low potential and use). However, significant differences emerged for mountain LS, rated highly by experts but used minimally by residents. These insights highlight the importance of aligning expert planning with community needs to promote sustainable land use policies and reduce spatial conflicts. Full article

Background and Objectives: Depression is a leading cause of disability globally, with treatment challenges including limited access, stigma, and poor adherence. Gamification, which applies game elements such as points, levels, and storytelling into non-game contexts, offers a promising strategy to enhance engagement and augment traditional treatments. Our research is the first study designed to explore the implementation of gamification within the Malaysian context. The objective was to explore the feasibility of implementation of gamification as an adjunctive treatment for adults with depression. Materials and Methods: Focus group discussions were held with five mental health professionals and ten patients diagnosed with moderate depression. The qualitative component assessed perceptions of gamified interventions, while quantitative measures evaluated participants’ depressive and anxiety symptomatology. Results: Three key themes were identified: (1) understanding of gamification as a treatment option, (2) factors influencing its acceptance, and (3) characteristics of a practical and feasible intervention. Clinicians saw potential in gamification to boost motivation, support psychoeducation, and encourage self-paced learning, but they expressed concerns about possible addiction, stigma, and the complexity of gameplay for some patients. Patients spoke of gaming as a source of comfort, escapism, and social connection. Acceptance was shaped by engaging storylines, intuitive design, balanced difficulty, therapist guidance, and clear safety measures. Both groups agreed that gamification should be used in conjunction with standard treatments, be culturally sensitive, and be presented as a meaningful therapeutic approach rather than merely as entertainment. Conclusions: Gamification emerges as an acceptable and feasible supplementary approach for managing depression in Malaysia. Its success depends on culturally sensitive design, robust clinical oversight, and seamless integration with existing care pathways. Future studies should investigate long-term outcomes and establish guidelines for the safe and effective implementation of this approach. We recommend targeted investment into culturally adapted gamified tools, including training, policy development, and collaboration with key stakeholders to realistically implement gamification as a mental health intervention in Malaysia. Full article

Improving occupational health and safety (OHS) in the construction industry can contribute to the advancement of the Sustainable Development Goals (SDGs), particularly Goals 3 (Good Health and Well-being) and 8 (Decent Work and Economic Growth). Yet, workers’ risk-taking behaviors (RTBs) remain a persistent challenge. Drawing on Social Cognitive Theory and Social Information Processing Theory, this study develops and tests a social influence model to examine how foremen’s safety attitudes (SAs) shape workers’ RTBs. Drawing on survey data from 301 construction workers in China, structural equation modeling reveals that foremen’s SAs significantly and negatively predict workers’ RTBs. However, the three dimensions of SAs—cognitive, affective, and behavioral—exert their influence through different pathways. Risk perception (RP) plays a key mediating role, particularly for the cognitive and behavioral dimensions. Furthermore, interpersonal trust (IPT) functions as a significant moderator in some of these relationships. By identifying the micro-social pathways that link foremen’s attitudes to workers’ safety behaviors, this study offers a testable theoretical framework for implementing the Sustainable Development Goals (particularly Goals 3 and 8) at the frontline workplace level. The findings provide empirical support for organizations to move beyond rule-based management and instead build more resilient OHS governance systems by systematically cultivating the multidimensional attitudes of frontline leaders. Full article

Autonomous vehicles (AVs) have emerged as a promising sustainable urban mobility solution, expected to lead to enhanced road safety, smoother traffic flows, less traffic congestion, improved accessibility, better energy utilization and environmental performance, as well as more efficient passenger and freight transportation, in terms of time and cost, due to better fleet management and platooning. However, challenges also arise, mostly related to data privacy, security and cyber-security, high acquisition and infrastructure costs, accident liability, even possible increased traffic congestion and air pollution due to induced travel demand. This paper presents the results of a survey conducted among 654 residents who experienced an autonomous bus (AB) service in the city of Trikala, Greece, in order to assess their willingness to use (WTU) and willingness to pay (WTP) for ABs, through testing a range of factors based on a literature review. Results useful to policy-makers were extracted, such as that the intention to use ABs was mostly shaped by psychological factors (e.g., users’ perceptions of usefulness and safety, and trust in the service provider), while WTU seemed to be positively affected by previous experience in using ABs. In contrast, sociodemographic factors were found to have very little effect on the intention to use ABs, while apart from personal utility, users’ perceptions of how autonomous driving will improve the overall life standards in the study area also mattered. Full article

There is little qualitative research on the support needed by workers with type 1 diabetes to effectively self-manage at work and maintain work ability. In this UK study, 21 workers with type 1 diabetes participated in semi-structured interviews. The interviews were transcribed and analysed using interpretive phenomenological analysis and then characterised under the Psychosocial Flags Framework. Findings highlighted several obstacles to maintaining self-management, including systemic workplace issues (black flags), individual attitudes and beliefs (yellow flags), and workplace issues (blue flags). Participants generally lacked confidence in voicing their needs, emphasising a requirement for a more supportive, inclusive workplace culture. This indicates a need for employers to foster an environment where workers with T1D feel comfortable seeking support without penalty. Addressing unhelpful perceptions of T1D seems key to this, making increased knowledge and awareness crucial for the harmonious integration of T1D with work. But delivering effective interventions may be challenging, since they must account for the complex biopsychosocial interplay of obstacles to work ability that this qualitative investigation emphasises. Full article

As a key enabling technology for energy transition, the smart grid is propelling the global power system to evolve toward greater efficiency, reliability, and sustainability. Based on the three-dimensional analysis framework of “technology–policy–application”, this study systematically sorts out the technical architecture, regional development mode, and typical application scenarios of the smart grid, revealing the multi-dimensional challenges that it faces. By using the methods of literature review, cross-national case comparison, and technology–policy collaborative analysis, the differentiated paths of China, the United States, and Europe in the development of smart grids are compared, aiming to promote the integration and development of smart grid technologies. From a technical perspective, this paper proposes a collaborative framework comprising the perception layer, network layer, and decision-making layer. Additionally, it analyzes the integration pathways of critical technologies, including sensors, communication protocols, and artificial intelligence. At the policy level, by comparing the differentiated characteristics in policy orientation and market mechanisms among China, the United States, and Europe, the complementarity between government-led and market-driven approaches is pointed out. At the application level, this study validates the practical value of smart grids in optimizing energy management, enhancing power supply reliability, and promoting renewable energy consumption through case analyses in urban smart energy systems, rural electrification, and industrial sectors. Further research indicates that insufficient technical standardization, data security risks, and the lack of policy coordination are the core bottlenecks restricting the large-scale development of smart grids. This paper proposes that a new type of intelligent and resilient power system needs to be constructed through technological innovation, policy coordination, and international cooperation, providing theoretical references and practical paths for energy transition. Full article

Introduction: Low medication adherence and low hypertension control are a public health challenge, particularly in low- and middle-income countries (LMICs). Healthcare system- and patient-related barriers hinder the successful management of hypertension. This study aimed to identify the perceptions of barriers and facilitators to hypertension management among health system stakeholders in Santander, Colombia. Materials and Methods: We conducted a qualitative, phenomenological, and interpretative study, comprising five focus groups, to explore the barriers and facilitators to managing people with hypertension. Each focus group was formed by stakeholders from territorial entities, healthcare insurers, or healthcare providers. Meetings were held between December 2022 and February 2023. The sessions were recorded and transcribed using NVivo Transcription and analyzed using NVivo version 1.6.1. Results: Seven categories of barriers and facilitators were identified: strategies, resources, access, risk assessment, cross-sector collaboration, articulation, and stewardship. Of these categories, articulation and stewardship emerged as the main barriers, as revealed through axial coding and cluster analysis, which highlighted deficiencies in stewardship practices, a lack of clear objectives, and misalignment with public policy frameworks. Conclusions: Multisectoral actions extending beyond healthcare providers and aimed at improving coordination and intersectoral collaboration are essential for enhancing hypertension control in LMICs, such as Colombia. Addressing social determinants and strengthening primary healthcare through community-based strategies are critical, making stewardship and improved access key priorities. Full article

Due to globalization, companies are exposed to a culturally diversified workforce; therefore, great emphasis is placed on identifying the most effective leadership style that would be able to manage such a workforce. Although numerous studies have attempted to identify successful leadership styles in different cultural settings, none have focused on the perceptions of top managers who work in multinational corporations (MNCs) in culturally diversified surroundings. Thus, our research attempts to identify the most preferred leadership style and characteristics from the perspective of top managers in MNCs in the United Arab Emirates (UAE). The 13 leadership characteristics analyzed in this study were generated from the 21 characteristics found by Global Leadership and Organizational Behavior Effectiveness (GLOBE) research. The participants, top managers in MNCs, needed to evaluate leadership styles by considering leadership characteristics. To ensure the objectiveness of the study, we analyzed their answers by applying the Fuzzy Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method. The results indicated that the most preferred leadership characteristics were visionary, inspirational, collaborative team-oriented, and performance-oriented. Moreover, the transformational leadership style emerged as the most preferred leadership style. The study’s findings show that top managers believe that employees in MNCs in the UAE seek a leader with a vision who will inspire, motivate, and help them fulfill their true potential. Full article

The integration of digital twin technology with robotic automation holds significant promise for advancing sustainable horticulture in controlled environment agriculture. This article presents DigiHortiRobot, a novel AI-driven digital twin architecture tailored for hydroponic greenhouse systems. The proposed framework integrates real-time sensing, predictive modeling, task planning, and dual-arm robotic execution within a modular, IoT-enabled infrastructure. DigiHortiRobot is structured into three progressive implementation phases: (i) monitoring and data acquisition through a multimodal perception system; (ii) decision support and virtual simulation for scenario analysis and intervention planning; and (iii) autonomous execution with feedback-based model refinement. The Physical Layer encompasses crops, infrastructure, and a mobile dual-arm robot; the virtual layer incorporates semantic modeling and simulation environments; and the synchronization layer enables continuous bi-directional communication via a nine-tier IoT architecture inspired by FIWARE standards. A robot task assignment algorithm is introduced to support operational autonomy while maintaining human oversight. The system is designed to optimize horticultural workflows such as seeding and harvesting while allowing farmers to interact remotely through cloud-based interfaces. Compared to previous digital agriculture approaches, DigiHortiRobot enables closed-loop coordination among perception, simulation, and action, supporting real-time task adaptation in dynamic environments. Experimental validation in a hydroponic greenhouse confirmed robust performance in both seeding and harvesting operations, achieving over 90% accuracy in localizing target elements and successfully executing planned tasks. The platform thus provides a strong foundation for future research in predictive control, semantic environment modeling, and scalable deployment of autonomous systems for high-value crop production. Full article

When emergency incidents, such as bridge damage, abruptly occur on highways and lead to traffic disruptions, the multidimensionality and complexity of driver behaviors present significant challenges to the design of effective emergency response mechanisms. This study introduces a multi-level collaborative emergency mechanism grounded in driver behavior characteristics, aiming to enhance both traffic safety and emergency response efficiency through hierarchical collaboration and dynamic optimization strategies. By capitalizing on human drivers’ perception and decision-making attributes, a driver behavior classification model is developed to quantitatively assess the risk response capabilities of distinct behavioral patterns (conservative, risk-taking, and conformist) under emergency scenarios. A multi-tiered collaborative framework, comprising an early warning layer, a guidance layer, and an interception layer, is devised to implement tailored emergency strategies. Additionally, a rear-end collision risk propagation model is constructed by integrating the risk field model with probabilistic risk assessment, enabling dynamic adjustments to interception range thresholds for precise and real-time emergency management. The efficacy of this mechanism is substantiated through empirical case studies, which underscore its capacity to substantially reduce the occurrence of secondary accidents and furnish scientific evidence and technical underpinnings for emergency management pertaining to highway bridge damage. Full article

Background: Chronic stress in childhood and adolescence leads to excessive cortisol secretion, adipokines production and obesity with all the negative mental and physical effects on the health of individuals and adulthood. Objectives: The aim of the present non-randomized controlled trial was to investigate the effect of a stress management protocol with diaphragmatic breathing (DB) and physiotherapy exercise on stress, body composition, cardiorespiratory and metabolic markers of children and adolescents with morbid obesity. Methods: The study included 31 children and adolescents (5–18 years old) with morbid obesity (22 in the intervention arm and 9 controls). All participants completed anxiety questionnaires and a self-perception scale. Forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), blood pressure (BP) and SpO₂ were measured. Fasting glucose, uric acid, triglycerides, HbA1c, (AST/SGOT), (ALT/SGPT), HDL, LDL, insulin, ACTH, cortisol, HOMA-IR, 17-OH, S-DHEA, SHBG were assessed, and anthropometric measurements were also performed. Results: In the intervention group, 4 months after the treatment, an improvement was noted in the BMI, BMI z-score, waist-to-height ratio, FEV1, SpO₂, pulse and systolic BP. HDL increased, ALT/SGPT and insulin resistance improved. Positive changes were observed in temporary and permanent stress and self-esteem of children in the intervention group, including anxiety, self-perception, physical appearance, etc. Conclusions: A combined exercise and DB protocol has a positive effect on stress, by improving body composition, reducing insulin resistance, and ameliorating physical and mental health and quality of life of pediatric patients with morbid obesity. Full article

Background: Postoperative pain management after a cesarean section remains a significant challenge, as inadequate control can delay maternal recovery and hinder early bonding and breastfeeding. While multimodal analgesia is the standard approach, non–pharmacological strategies like immediate skin–to–skin contact (SSC) are often underused despite their potential benefits in reducing pain, improving uterine contractions, and increasing maternal satisfaction. Objective: To evaluate the effects of immediate SSC on postoperative pain perception, uterine contraction quality, and maternal satisfaction, and to explore ways to incorporate SSC into routine post–cesarean care to promote recovery and humanized care. Method: A randomized clinical trial was conducted with 80 women undergoing elective cesarean sections, divided into two groups: SSC (40 women) and control (40 women). Postoperative pain was measured using the Visual Analog Scale (VAS) at various intervals, while uterine contraction quality and maternal satisfaction were assessed through clinical observation and a Likert scale, respectively. Results: We found that women in the SSC group experienced significantly lower pain scores (VAS2 and VAS3, p < 0.001), stronger infraumbilical uterine contractions (92.5%, p < 0.001), and higher satisfaction levels (average 9.98 vs. 6.50, p < 0.001). An inverse correlation was observed between pain intensity and satisfaction, indicating that SSC enhances both physiological and psychological recovery. Conclusions: Immediate SSC after cesarean is an effective, humanizing intervention that reduces pain, supports uterine contractions, and boosts maternal satisfaction. These findings advocate for integrating SSC into standard postoperative care, aligning with ethical principles of beneficence and autonomy. Further research with larger samples is necessary to confirm these benefits and facilitate widespread adoption in maternity protocols. Full article

Disruption of circadian rhythms by abnormal light exposure and reduced melatonin secretion has been linked to heightened pain sensitivity and opioid tolerance. This study evaluated how environmental light manipulation and exogenous melatonin supplementation influence pain perception and morphine tolerance in a rat model of neuropathic pain induced by partial sciatic nerve transection (PSNT). Rats were exposed to constant darkness, constant light, or a 12 h/12 h light–dark cycle for one week before PSNT surgery. Behavioral assays and continuous intrathecal (i.t.) infusion of morphine, melatonin, or their combination were conducted over a 7-day period beginning immediately after PSNT. On Day 7, after discontinued drugs infusion, an acute intrathecal morphine challenge (15 µg, i.t.) was administered to assess tolerance expression. Constant light suppressed melatonin levels, exacerbated pain behaviors, and accelerated morphine tolerance. In contrast, circadian-aligned lighting preserved melatonin rhythms and mitigated these effects. Melatonin co-infusion attenuated morphine tolerance and enhanced morphine analgesia. Reduced pro-inflammatory cytokine expression and increase anti-inflammatory cytokine IL-10 level and suppressed astrocyte activation were also observed by melatonin co-infusion during morphine tolerance induction. These findings highlight the potential of melatonin and circadian regulation in improving opioid efficacy and reduced morphine tolerance in managing neuropathic pain. Full article

Background/Objectives: Effective teamwork is crucial for minimizing human error in healthcare settings. Medical teams, typically composed of physicians and nurses, supported by auxiliary professionals, achieve better outcomes when they possess strong collaborative competencies. High-quality teamwork is associated with fewer adverse events and complications and lower mortality rates. Based on this background, the objective of this study is to analyze the perception of non-technical skills and immediate learning outcomes in interprofessional simulation settings based on E-CRM items. Methods: A cross-sectional observational study was conducted involving participants from the official postgraduate Medicine and Nursing programs at the Catholic University of Murcia (UCAM) during the 2024–2025 academic year. Four interprofessional E-CRM simulation sessions were planned, involving randomly assigned groups with proportional representation of medical and nursing students. Teams worked consistently throughout the training and participated in clinical scenarios observed via video transmission by their peers. Post-scenario debriefings followed INACSL guidelines and employed the PEARLS method. Results: Findings indicate that 48.3% of participants had no difficulty identifying the team leader, while 51.7% reported minor difficulty. Role assignment posed moderate-to-high difficulty for 24.1% of respondents. Communication, situation awareness, and early help-seeking were generally managed with ease, though mobilizing resources remained a challenge for 27.5% of participants. Conclusions: This study supports the value of interprofessional education in developing essential competencies for handling urgent, emergency, and high-complexity clinical situations. Strengthening interdisciplinary collaboration contributes to safer, more effective patient care. Full article

The growing integration of technology in education has heightened awareness of global risks, such as the spread of disinformation. This awareness is vital for fostering the well-being of individuals, especially teenagers, by promoting critical thinking and responsible digital practices. By cultivating these skills, sustainable education empowers individuals to identify potential threats, protect themselves, and advocate for informed, positive change. As part of a European project, this study aims to analyze the current level of awareness among secondary school students (12 to 17) and their teachers. Differences between both are analyzed in how they deal with disinformation in terms of (1) perceptions, (2) feelings and practices, and (3) knowledge and management. A quantitative approach was adopted for this study, which surveyed 1186 minors and 166 teachers. The analysis was based on non-parametric statistics; the Mann–Whitney U statistic was applied as the appropriate measure for comparing independent samples (teachers and students) with a non-normal distribution (p < 0.05). The results were surprising in that they highlighted that minors were more expert than expected in their use of technology and their awareness of the risks of disinformation. These conclusions make it clear that technological tools have the potential to raise awareness of the dangers of disinformation and improve the sustainability of education. Full article