Search Results (275)

Background/Objectives: Reducing inappropriate use of antimicrobial agents in healthcare settings is a critical strategy to mitigate the growing threat of antimicrobial resistance. Globally, the highest consumption of antimicrobials in human healthcare originates from antibiotic prescriptions made in General Practice settings. Small group learning has long held a key role in General Practice education, characterized by active participation, common learning goals, and opportunities for reflection. This mode of delivery has been explored as a potential approach to increase appropriate antibiotic prescribing, supported by research indicating that more didactic educational interventions are unlikely to effectively improve physician prescribing behaviours. This systematic review specifically sought to synthesise the evidence on the effectiveness of small group-based, interventions in improving appropriate antibiotic prescribing behaviours in general practice. Methods: A mixed methods systematic review was employed. Studies were eligible if they reported on in-person, small group-based educational interventions to improve antibiotic prescribing among GPs. Full-text screening resulted in 19 eligible studies. Key characteristics, such as study design, intervention content, and outcomes, were extracted. Results: The 19 included studies used single and multi-modal interventions, with 68% focusing on respiratory tract infections. Common topics were patient communication (n = 11) and adherence to prescribing guidelines (n = 8). Most (n = 11) reported positive outcomes like reduced prescribing and were acceptable to GPs. Conclusions: These types of interventions can be effective in increasing the appropriate use of antibiotics in General Practice and are well received by GP participants. However, further research is required on the optimal content delivered in interventions and their associated long-term impact. Full article

This review aimed to evaluate the effectiveness and feasibility of non-pharmacological interventions to reduce anxiety and agitation and improve observable wellbeing and patient engagement for people with dementia in acute hospital environments. The global increase in dementia has resulted in a substantial number of acute hospital beds occupied by people with dementia. Hospitalisation can exacerbate behavioural and psychosocial symptoms of dementia (BPSD) including anxiety and agitation, which negatively affects patient experience, safety and care. Clinical guidance recommends non-pharmacological interventions as a first-line tactic to manage BPSD. However, evidence for the effectiveness and feasibility of these interventions remains fragmented in such pressured environments. A systematic search of seven databases was conducted for studies published in the last ten years (2015–25), following the PRISMA guidelines. Fourteen studies met the eligibility criteria and included a total of 749 people with dementia. Studies used mixed interventions; music, music therapy and person-centred care highly featured and most studies reported reductions in observable BPSD during or immediately after interventions. Secondary benefits included wellbeing, reduced psychotropic medicine use, length of hospitalisation and high staff and patient acceptability. There was limited evidence for sustained effects beyond intervention. This review supports the feasibility and effectiveness of non-pharmacological interventions in acute hospitals to support dementia-inclusive, person-centred care. Full article

The scope of actual pro-environmental initiatives, programs, interventions, and campaigns is limited. Therefore, spillover effects from these activities to other domains of economy, the private sphere, and society are crucial to achieve a transformation of society towards sustainability. Starting from the known literature and using Google Scholar as a platform for searching additional studies, this explorative, traditional narrative review analyses behavioural spillover effects, where either one behaviour influences the likelihood of another behaviour, or an intervention shows an impact on an environmentally significant behaviour, which it did not primarily address. In the scientific literature, spillover is classified by direction (environmentally positive versus negative), involved behaviours (similar or cross-behavioural), timing (short or long term), context (e.g., work to private life), and social scope (personal, interpersonal, intra- and inter-organisational, intergroup, or international). Positive spillover can result from cognitive dissonance reduction, consistent self-perception, pro-environmental values, norms, self-identity, action-based learning, and habit formation. Negative spillover emerges through rebound effects, moral licensing, and psychological reactance. Stronger spillover is observed between similar behaviours, while cross-domain spillover is generally weaker. According to previous research, a facilitated participatory approach with strong pro-environmental orientation appears recommendable for practitioners to foster the value change required for effective and sustained positive spillover. Full article

Background: Behavioural therapy (BT), including Comprehensive Behavioural Intervention for Tics (CBIT), is an evidence-based first-line treatment for patients with tic disorders. However, access remains limited due to a shortage of trained providers, geographical barriers, costs, and high treatment burden for patients and families. Rapid advances in digital health technologies including telemedicine, web-based treatment platforms, and mobile applications offer new opportunities to expand access to BT for individuals with tic disorders across the lifespan. Methods: For the purpose of this narrative review, we conducted a literature search in PubMed, Europe PMC, and the Cochrane Library to identify relevant studies investigating the effectiveness of digital health treatment approaches in tic disorders. Results: A total of 16 original studies were included. Although the available evidence remains limited and heterogeneous, existing studies suggest that emerging technologies for delivering behavioural interventions for tic disorders, including telehealth-based CBIT, digital therapy platforms, and app-supported habit reversal training (HRT), are feasible, cost-effective, user-friendly, flexible, and safe. These approaches also appear effective for symptom monitoring and personalized treatment support in both pediatric and adult populations. Conclusions: Recent technological advances have the potential to reduce the treatment gap in tic disorders, provided that these approaches are implemented within rigorous, evidence-based, and ethically grounded frameworks. Full article

This study examines workplace bullying within the middle-management tier of a large Gauteng-based retail organisation in South Africa, with a focus on structural organisational pressures and perceptual differences among managers. While traditional research often emphasises individual personality traits or victim demographics, this study explores how organisational conditions—particularly the “middle management squeeze” and performance-driven Key Performance Indicators (KPIs)—are reflected in workplace behaviours. Grounded in a positivist paradigm, a quantitative cross-sectional survey was conducted among a probability-based sample of 253 retail managers. Data were collected using the Negative Acts Questionnaire (NAQ-22) and analysed using Exploratory Factor Analysis (EFA) and nonparametric inferential tests. The findings indicate that task-related negative acts, such as micromanagement (M = 2.00) and persistent monitoring (M = 1.87), are frequently experienced. EFA identified two dimensions—General Harassment and Managerial Control—accounting for 62% of the total variance. Inferential results show that perceptions of General Harassment differ significantly across educational groups (p = 0.0268), whereas perceptions of Managerial Control remain consistent (p = 0.3378). These findings indicate that social forms of incivility are interpreted differently across educational cohorts, while task-related managerial practices are widely normalised. The study highlights the importance of understanding workplace bullying as both a structural and perceptual phenomenon and underscores the need for organisational interventions that address systemic pressures rather than relying solely on individual-level approaches. Full article

Disinformation, amplified by digital platforms and algorithmic distribution systems, represents a growing challenge for media trust, public health communication, and societal stability. This narrative literature review examines disinformation through an integrative psychosocial perspective, focusing on how patterns of exposure interact with individual vulnerability factors—including education, political beliefs, social identity, personality traits, and emotional responses to uncertainty—to influence the processing and acceptance of misleading information. The review synthesises interdisciplinary evidence on how algorithmic amplification and emotionally salient content increase susceptibility to disinformation and shape risk perception, health-related decision-making, and preventive behaviours. Findings indicate that repeated exposure to false or misleading information reinforces perceived credibility through familiarity effects, contributes to declining trust in institutional sources, and intensifies social and political polarisation. Disinformation is therefore conceptualised not only as an informational problem but also as a psychosocial process affecting emotional regulation, cognitive evaluation, and collective responses to crises, particularly in public health contexts. The analysis further highlights a recursive feedback loop in which reduced media trust increases vulnerability to subsequent disinformation, with broader implications for democratic participation and social cohesion. Mitigation strategies discussed include media literacy initiatives, critical thinking education, platform governance, regulatory approaches, and interventions targeting psychosocial drivers of susceptibility. Full article

Adolescence and youth are key stages for acquiring responsible sexual behaviour. Previous research has focused on measuring knowledge; however, in order to achieve the goal of developing safe sexual behaviour, it is necessary to complement this with measures of attitudes, for which there is currently a lack of valid and reliable measurement tools specifically focused on attitudes toward contraceptive use. The objective of this research is to develop and psychometrically validate the Attitudes Toward Contraceptive Use Scale (ACUS) in university students. A cross-sectional correlational validation study was designed using Item Response Theory. The sample consisted of 411 nursing students aged between 18 and 25 years. The final version of the scale, comprising 12 items, was evaluated using the Rasch Rating Scale Model (Andrich model), and its reliability was assessed in terms of internal consistency and temporal stability. The Rasch model showed an excellent overall fit, high item reliability (0.989), adequate person reliability (0.81), and good temporal stability (ICC = 0.796). The ACUS is a valid and reliable instrument for assessing attitudes toward contraception among university students. It can be used to identify less favourable attitudinal profiles toward contraceptive use and subsequently guide educational interventions. Full article

Background/Objectives: The use of physical and mechanical restraints and seclusion in psychiatric facilities to manage violent and aggressive behaviours has long been a contentious issue, balancing patient safety with ethical considerations. With advancements in psychiatry and increased understanding of mental illness, there have been expectations that such interventions would no longer be required; however, their use persists in clinical practice. Management policies differ across countries and are largely influenced by legal frameworks. This study aimed to identify the factors influencing the incidence of these interventions across two psychiatric facilities in Saudi Arabia and to examine associations among inpatient variables. Methods: A prospective cohort study was conducted over six months (September 2021–March 2022) across two psychiatric facilities in Saudi Arabia (Eradah Complex, n = 1120; King Fahd University Hospital (KFUH), n = 268). Data from 333 restriction events were analysed using descriptive statistics, chi-square tests, and negative binomial regression to calculate incidence rates and explore associated factors. Results: The findings revealed a complex interplay of factors related to patient characteristics and clinical and environmental conditions within the facilities. Key contributing variables included symptom deterioration and the duration of observation required. Longer observation periods were associated with certain diagnoses, particularly schizophrenia and mood disorders. Conclusions: Restraints and seclusion remain influenced by multiple interacting factors within psychiatric settings. These findings highlight the need to reduce their use and ensure they are applied cautiously, with greater emphasis on minimising patient trauma and promoting safer, person-centred care. Full article

Background: Despite the general interest in WPV against healthcare workers, there is evidence that this topic has comparatively fewer studies conducted in the context of community settings than in hospital settings. Given the current general transition of care from hospital to community, this study aims to analyze whether community settings present different characteristics in comparison with hospital settings on this topic in Italy. Methods: A retrospective observational study was conducted from 2020 to 2024 on aggressions reported by HCWs in hospitals and community settings belonging to a Local Health Authority of Turin in Piedmont. For physical and non-physical aggressions, a monthly time trend series was constructed. A Mantel–Haenszel fixed-effect meta-analysis was performed to obtain the odds ratio (OR) in two settings. Variables relative to aggressions included the gender of victims, their professional category (medical doctors, nurses, other HCWs), the type and gender of perpetrators (relative, patient, or unknown person), age groups of perpetrators (under 30, 30–49, ≥50), the nature of aggression (physical, non-physical), recidivism, involvement of law enforcement, and time of occurrence (morning, afternoon, or evening/night). Events within hospitals were further classified into emergency department, psychiatric ward, and other wards, while events within community settings were classified as drug addiction service units (serDs), long-term care (including specialist outpatient services, home services, and nursing homes) (LTC), mental health centres, and penitentiary assistance. Results: The results highlighted that fewer WPV incidents were reported in community settings than in hospital settings, even though reported incidents showed a more pronounced increase over time. Differences were observed in a few characteristics of WPV (age classes of aggressors, recidivism, time of aggression, profession of the assaulted worker, and specific location). Only the gender of the assaulted (female workers) (OR = 3.11, 95% CI: 1.27–7.61; p = 0.013; OR = 0.32, 95% CI: 0.13–0.79; p = 0.013 for non-physical and physical violence, respectively, compared to male workers) was identified as a specific risk factor for community settings. Conclusions: Modern health systems are experiencing a transition from hospital-centred to community-centred care settings. This study suggested that WPV is a significant concern, even outside the hospital. Community-based services often involve direct interaction with frail and chronically ill patients and their caregivers, as well as care delivery in diverse and sometimes less controlled environments, which may influence exposure to aggressive behaviours. The identification of setting-specific risk patterns in both hospital and community contexts provides valuable insights into workplace violence and may support the planning and implementation of targeted interventions aimed at mitigating the frequency and burden of WPV. Full article

The increasing popularity of carnivore and animal-based diets among athletes has generated substantial interest, despite limited direct scientific evidence supporting their efficacy and safety in sport-specific contexts. This narrative review critically evaluates the current evidence and examines the physiological, performance, and health-related implications of these dietary models in athletic populations. These dietary models, characterized by the partial or complete exclusion of plant-derived foods, are often promoted on the basis of mechanistic arguments, anecdotal reports, and extrapolations from research on ketogenic and very low-carbohydrate diets. However, their physiological relevance, long-term health implications, and compatibility with the demands of athletic training remain poorly defined. This narrative review provides a critical perspective on the current evidence related to carnivore and animal-based diets in sport, integrating findings from studies on low-carbohydrate, ketogenic, high-protein, and elimination-based dietary patterns. The analysis focuses on metabolic adaptations, body composition, exercise performance, gastrointestinal function, micronutrient adequacy, hormonal responses, and potential long-term health risks. Particular attention is given to the distinction between metabolic adaptations and functional performance outcomes, as well as to the high interindividual variability in dietary responses. The available evidence suggests that while carbohydrate restriction may induce specific metabolic adaptations, such as increased fat oxidation, these changes do not consistently translate into improved performance, particularly in high-intensity or high-volume training contexts. Moreover, the highly restrictive nature of carnivore and animal-based diets raises concerns about micronutrient deficiencies, alterations in the gut microbiota, changes in the lipid profile, and potential effects on eating behaviours, particularly in competitive athletic populations. Given the absence of well-controlled, long-term intervention studies in athletes, carnivore and animal-based diets cannot currently be recommended as safe or optimal nutritional strategies for sports performance. Rather than representing viable alternatives to established sports nutrition guidelines, these dietary models may be better understood as experimental or short-term tools within highly controlled research or diagnostic frameworks. Future research should prioritize rigorous, sport-specific study designs, long-term safety outcomes, and personalized approaches that account for individual metabolic and physiological variability. Full article

Objectives: Dementia prevalence continues to rise, predicted to reach 150 million by 2050, making development of effective, person-centred, non-pharmacological interventions an urgent healthcare priority. Music therapy and music (MTAM) are increasingly recognised as low-cost options to alleviate behavioural and psychological symptoms of dementia (BPSD), particularly in acute hospital environments. This scoping review evaluates national dementia strategies and clinical practice guidelines (CPGs) to determine how far MTAM are acknowledged as formal components of dementia care. Methods: A scoping review of databases identified the most recent national clinical strategies or CPGs for people with dementia (PWD), published between 2015 and 2025. Using the PRISMA guidelines in June 2025, with pre-determined inclusion and exclusion criteria we examined four databases, supplemented with an internet search and reference snowballing. National strategies and CPGs that included MTAM were examined in more detail. Results: Of the 37 national strategies or CPGs, 19 were eligible for inclusion, identified from 16 countries. Although non-pharmacological interventions were widely endorsed, only seven guidelines referenced MTAM, and fewer acknowledged its potential value in hospital. In contrast, interventions such as occupational therapy, reminiscence therapy and cognitive behavioural therapy appeared far more frequently. Further analysis was not in the scope of this review. Conclusions: Our findings underscore the gap between emerging evidence supporting music-based interventions and its inclusion in national policy. Clinical Implications: These findings highlight the need for further robust research demonstrating the benefit of MTAM for PWD to strengthen future policy recommendations and promote integration of music-based approaches in dementia care. Full article

Employees’ green workplace attitudes and behaviours represent a driving force for organizations’ contributions to environmental sustainability. The present quasi-experimental (pre-post-test) study aimed to assess the feasibility of a novel psychoeducational intervention grounded in a metacognitive-motivational approach and focused on promoting environmental awareness and proneness toward acting pro-environmentally at work among energy sector employees. A sample of 78 employees from the operational level attended three in-person group-based sessions. Pre-post testing surveys assessed green workplace attitudes and behaviours, environmental awareness, and employees’ expectations and satisfaction with the intervention. Results show that employees reported greater environmental awareness and lower self-reported ease to identify and communicate environmental anomalies with potential harmful impacts at post-intervention compared with pre-test. Employees’ satisfaction regarding the intervention’s usefulness, motivation, and interest at post-test exceeded their initial expectations. Employees also rated the intervention capable of providing a greater understanding of environmental issue management at work and in daily life to a greater extent than what was expected at pre-test. Overall feedback on the content, structure, and activities was highly positive. Our findings support the feasibility of applying a metacognitive-motivational approach, showing employees’ acceptability and increased environmental awareness after the intervention, as a promising intervention strategy for organizations to prompt environmental sustainability within organizational contexts. Full article

Background/Objectives: This study examined gender-specific psychological and interpersonal correlates of suicidal behaviour using the framework of the Interpersonal Theory of Suicide (IPTS). Methods: The study included a total of 181 respondents from a clinical group (N = 93) and a control group (N = 88). Logistic regression analyses were conducted separately for women (N = 86) and men (N = 80) for cases that met leverage values (LEV) ≤ 0.2. Variables included personality traits, coping style, hopelessness, self-esteem, hope, perceived burdensomeness, thwarted belongingness, and acquired capacity for suicide. Interaction terms were also tested. Results: Among women, hopelessness (Exp(B) = 1.37; p = 0.038) and perceived burdensomeness (Exp(B) = 1.12; p = 0.033) were identified as significant correlates of suicidal behaviour. Among men, an avoidance-focused style (Exp(B) = 1.18; p = 0.009) and the interaction of general capacity for suicide x perceived burdensomeness x thwarted belongingness (Exp(B) = 5.29; p = 0.043) emerged as significant correlates. Further analysis indicated that thwarted belongingness became a significant factor in men only when perceived burdensomeness and capacity for suicide were high (Nagelkerke R² = 0.33; Exp(B) = 1.17; p = 0.042). Conclusions: Gendered expressions of suicidality appear to follow distinct pathways. Within the IPTS framework, women’s suicidality is more closely shaped by internalized cognitive and affective processes, including hopelessness and perceived burdensomeness, whereas men’s behaviour is influenced by maladaptive coping, social disconnection, and acquired capacity for suicide. These findings highlight the importance of gender-specific prevention and intervention strategies across clinical and community contexts. Early identification of these correlates may reduce suicidal intent, prevent rehospitalization, and improve mental health outcomes. Full article

Background/Objectives: Sustainable diets are essential for public health, food system resilience, and environmental protection, yet engagement with healthy sustainable dietary actions is varied. This study investigated knowledge, perceived importance, current uptake, and willingness to adopt healthy sustainable dietary actions among the general UK population. Methods: A cross-sectional study was conducted using a self-report questionnaire completed by 635 adults (205 males and 430 females; mean (SD) age = 43 (16.8) years) in the UK. Results: Considerable variation in knowledge, perceived importance, and current engagement was found across the dietary actions investigated. All three were highest for familiar, health-aligned behaviours, while actions with a stronger environmental focus that were less conventional or culturally unfamiliar were less well understood, perceived as less important, and less often engaged with. Willingness to adopt actions not currently practised was most strongly predicted by perceived importance (smallest β = 1.21, p < 0.001), with perceived value also significant for several actions (smallest β = 0.86, p < 0.001). Knowledge and perceived impact were generally non-significant. Demographic and lifestyle factors showed smaller effects, with greater willingness among younger individuals (smallest β = −0.24, p = 0.01) and those with higher education (smallest β = 0.51, p = 0.01). Conclusions: These findings suggest some knowledge and engagement with healthy sustainable dietary actions in the UK. However, future campaigns may need to go beyond awareness-raising to emphasise the personal significance and value of these actions. These cognitive factors also showed broad applicability across demographic and lifestyle variables, suggesting potential for widely effective interventions. Full article

Background: Sleep disturbances are common in dementia and adversely affect both the person with dementia and their caregiver. Non-pharmacological options exist but are seldom dyadic or culturally tailored, limiting their reach and relevance across diverse communities. Objective: We aimed to co-develop DREAM (Dyadic Resilience, Engagement, Awareness & Mind–body intervention)—an 8-week dyadic mind–body programme (mindfulness + gentle Tai Chi) for improving sleep and wellbeing in people with dementia and their caregivers. Methods: The process was informed by Intervention Mapping (Stages 1–4) and underpinned by established behaviour change frameworks, including the Behaviour Change Wheel (BCW), the COM-B model (Capability, Opportunity, Motivation → Behaviour), and the Theoretical Domains Framework (TDF), to systematically identify determinants of engagement. Co-design involved dementia–caregiver dyads, Patient and Public Involvement (PPI) contributors, clinicians, mind–body practitioners, and community stakeholders. Results: The intervention was co-developed and culturally grounded through engagement with White British, Caribbean, Chinese, and South Asian communities. Participants reported high cultural resonance, endorsing DREAM’s concise practices, caregiver-supported home routines, and delivery in trusted community venues. Behavioural insights highlighted the importance of motivational framing (perceived dyadic benefits, cultural meaning), practical enablement (simplified guidance, prompts/cues, environmental restructuring), and caregiver facilitation to support adherence. Conclusions: DREAM demonstrates the practicability of using Intervention Mapping to co-develop a culturally responsive, theory-informed dyadic mind–body intervention for people with dementia and their caregivers. This groundwork supports progression to a feasibility trial focused on implementation processes and preliminary sleep and wellbeing outcomes. Full article