Search Results (205)

Mental disorders and impairments are part of the occupational risk for emergency personnel. This study examines the impact of a deadly knife attack on police officers’ mental health. Aims: We hypothesized that police officers who knew the deceased team member would report higher levels of psychological distress compared to those who did not, regardless of the deployment status. Methods: Six months after a fatal knife attack in which a police officer was killed, a total of N = 254 officers participated in the study. Of these, n = 115 reported knowing the victim personally, n = 126 did not (n = 78 deployed; n = 176 not deployed), while n = five did not provide any information. Posttraumatic stress disorder (PTSD), posttraumatic stress symptoms (PTSS), anger and adverse childhood experiences (ACEs) were assessed using questionnaires. Chi-square tests examined group differences in probable PTSD prevalence; t-tests assessed differences in anger and Posttraumatic Stress Disorder Checklist for DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; DSM-5; PCL-5) symptom scores. Linear regression analyses tested deployment, acquaintance with the victim, gender, and childhood emotional neglect as predictors. Results: Police officers who personally knew the deceased colleague exhibited significantly higher PTSS scores. In addition, the deployed group showed significantly higher trait anger than the non-deployed. Acquaintance with the victim and emotional neglect in childhood were significantly related to negative cognitions, whereas deployment to the knife attack or gender were not. Discussion: Police officers with a personal connection to the deceased showed significantly higher mental health impact than those with direct exposure alone, placing them in a higher-risk group due to increased exposure to feelings of guilt and shame due to their professional role. Police officers who were emotionally neglected in their childhood may be more prone to negative cognitions in adulthood, when faced with critical events. These results underline the importance of addressing risk factors in both pre-deployment training and post-event debriefing, especially with regard to anger management after major critical incidents. Full article

Mid-sized Philippine cities commonly rely on fixed-time traffic signal plans that cannot respond to short-term, demand-driven surges, resulting in measurable idle time at stop lines, increased delay, and unnecessary emissions, while adaptive signal control has demonstrated performance benefits, many existing solutions depend on centralized infrastructure and high-bandwidth connectivity, limiting their applicability for resource-constrained local government units (LGUs). This study reports a field deployment of TrafficEZ, a lightweight edge AI signal controller that reallocates green splits locally using traffic-density approximations derived from cabinet-mounted cameras. The controller follows a macroscopic, cycle-level control abstraction consistent with Transportation System Models (TSMs) and does not rely on stationary flow–density–speed (fundamental diagram) assumptions. The system estimates queued demand and discharge efficiency on-device and updates green time each cycle without altering cycle length, intergreen intervals, or pedestrian safety timings. A quasi-experimental pre–post evaluation was conducted at three signalized intersections in El Salvador City using an existing 125 s, three-phase fixed-time plan as the baseline. Observed field results show average per-vehicle delay reductions of 18–32%, with reclaimed effective green translating into approximately 50–200 additional vehicles per hour served at the busiest approaches. Box-occupancy durations shortened, indicating reduced spillback risk, while conservative idle-time estimates imply corresponding CO₂ savings during peak periods. Because all decisions run locally within the signal cabinet, operation remained robust during backhaul interruptions and supported incremental, intersection-by-intersection deployment; per-cycle actions were logged to support auditability and governance reporting. These findings demonstrate that density-driven edge AI can deliver practical mobility, reliability, and sustainability gains for LGUs while supporting evidence-based governance and performance reporting. Full article

Background/Objectives: In recent decades, new technologies have been progressively integrated into various areas of mental health care. Mobile applications are potentially effective tools that allow psychiatric patients themselves to access self-management resources and tools within the community setting. Mental health nursing plays a key role in enabling patients to take an active role in their care and in promoting activities that foster their involvement and empowerment. The primary aim of this pilot study was to develop the PsyAPP mobile application to support both nurses and individuals with mental illness in managing care and improving health outcomes, and to assess its feasibility within a real-world clinical setting. Methods: A mobile application (PSYAPP) and a complementary web-based nursing management platform were designed and implemented. A total of 20 psychiatric patients enrolled in a partial hospitalization program in Soria (Spain) participated. Participants were assigned to experimental (app users) and control groups. Psychological empowerment, global functioning, and suicide risk were assessed before and after the intervention. Results: Patients who used the application showed significantly greater psychological empowerment (W = 2.04, p ≤ 0.04) compared with the control group. Statistically significant improvements were observed in psychological, social, and occupational functioning. Regarding suicide risk, no statistically significant changes were detected between pre- and post-intervention measurements in either group. Overall, PSYAPP demonstrated feasibility and potential utility as an innovative tool to support mental health care follow-up. Conclusions: This study developed and implemented a mobile application designed to enhance mental health care by supporting both patients and psychiatric nurses. Results showed significant improvements in global functioning in both the app and control groups, suggesting that rehabilitative treatment contributed to overall progress. Suicide risk did not significantly change within groups, although improvements were seen in the full sample, likely due to clinical care rather than app use. Only the experimental group demonstrated increased psychological empowerment, indicating that the app may effectively enhance patient engagement and involvement in their own care. Full article

Background/Objectives: The aim of this study was to assess the short-term and long-term effectiveness of group voice therapy in changing vocal behaviour and improving voice quality (VQ) among teachers with hyperfunctional voice disorders (HFVD), using both subjective and objective measures. Methods: Thirty-one teachers participated in a structured group voice therapy programme. Participants underwent videoendostroboscopic evaluation of laryngeal morphology and function, perceptual assessment of voice, acoustic analysis of voice samples, and aerodynamic measurements of phonation. Patients’ self-assessment of VQ and its impact on quality of life were measured using a Visual Analogue Scale (VAS) and the Voice Handicap Index-30 (VHI-30). Evaluations were conducted at four time points: pre-therapy (T0), immediately post-therapy (T1), and at 3-month (T3) and 12-month (T12) follow-up visits. Results: Significant improvement was observed between T0 and T1 in perceptual voice evaluations: grade, roughness, asthenia, strain, loudness, fast speaking rate, as well as in neck muscle tension, shimmer, patients’ most harmful vocal behaviours, VHI-30 scores, patients VQ evaluation, and its impact on quality of life (all p < 0.05). Almost all parameters of subjective and objective voice assessment improved over the 12-month observation period, with the greatest improvement between T0 and T12 (all p < 0.05), indicating lasting reduced laryngeal tension and improved phonatory efficiency. Conclusions: Group voice therapy has been shown to be an effective treatment for teachers with HFVD, leading to significant and long-lasting improvements in perceptual, acoustic, and self-assessment outcomes. Therapy also promoted healthier vocal and lifestyle behaviours, supporting its role as a successful and cost-effective rehabilitation and prevention method for occupational voice disorders. Full article

Background/Objectives: Shift-working healthcare professionals are exposed to high psychophysiological demands associated with occupational stress, anxiety, and depressive symptoms. Salivary chromogranin A (sCgA) and secretory immunoglobulin A (sIgA) are non-invasive biomarkers reflecting sympathetic nervous system activation and mucosal immune function, respectively, and are increasingly used to assess biological stress responses. This study examined changes in these biomarkers and their associations with anxiety and depression. Methods: This cross-sectional comparative observational study was conducted among healthcare professionals working 12-h shifts (n = 95) and non-shift-working controls (n = 95) and included a within-shift pre-post assessment, with saliva samples collected before and after the work shift. Salivary biomarkers were determined using ELISA methods. Anxiety and depression were assessed using the State–Trait Anxiety Inventory and the Zung Self-Rating Depression Scale. Data were analyzed with t-tests, correlation, and multiple linear regression. Statistical analyses included between- and within-group comparisons, correlation analyses, and multiple linear regression models to examine independent associations between salivary biomarkers and psychological outcomes. Results: After a 12-h shift, healthcare professionals showed increased sCgA (3.82 ± 0.95 vs. 4.68 ± 1.02 ng/mL; p < 0.001) and decreased sIgA (165.3 ± 32.4 vs. 142.6 ± 29.8 mg/dL; p < 0.001). Psychological scores were higher in healthcare professionals than in controls (p < 0.001). Salivary sCgA correlated positively with anxiety and depression (r = 0.41 to 0.45), while sIgA correlated negatively (r = −0.29 to −0.36). Regression analysis confirmed occupational group (healthcare professionals vs. controls) as the strongest predictor, with independent contributions of sCgA and sIgA to psychological scores. Conclusions: A 12-h work shift in healthcare professionals leads to increased salivary chromogranin A, indicating sympathetic activation, and decreased secretory IgA, reflecting reduced mucosal immune activity. The combined assessment of sCgA and sIgA provides a sensitive and non-invasive approach for monitoring occupational stress and identifying early risks of anxiety and depressive symptoms among shift-working healthcare professionals. Full article

Background: Emotional intelligence (EI), particularly the ability to regulate one’s emotions, is a key protective factor against stress and burnout in high-demand occupations, including leadership and healthcare. Compassion and gratitude practices have been proposed as brief, scalable methods to strengthen emotion regulation, yet empirical evidence from randomised controlled trials remains limited. Objective: This study evaluated whether a four-week, self-directed online programme combining daily loving-kindness meditation and gratitude journaling improves EI among leaders. Methods: Forty-five leaders in Germany from diverse occupational sectors were recruited via LinkedIn and Xing and were randomised using a computer-generated random sequence to an intervention or wait-list control group. EI was measured pre- and post-intervention with the Emotional Competence Questionnaire (EKF), comprising recognising one’s own feelings (RU), recognising others’ feelings (RO), regulating one’s own feelings (RC; primary outcome), and expressing feelings (RE). Adherence was reported in categorical form (e.g., daily, 3–5×/week, 1–2×/week). Treatment effects were tested using mixed-design ANOVAs. Results: A significant Group × Time interaction emerged for emotion regulation (RC), indicating greater improvement in the intervention group compared with the control group. No significant interaction effects were found for RU, RO, or RE. Adherence data did not permit dose–response analysis. Conclusions: A brief, self-directed online compassion and gratitude programme selectively improved emotion regulation—the EI facet most strongly linked to stress buffering and resilience. Although effects did not extend to other EI dimensions, findings suggest that low-threshold digital practices may strengthen a core emotional skill relevant to psychological well-being in leadership roles. Because the sample did not primarily comprise healthcare professionals, implications for healthcare settings re-main conceptual; targeted trials in clinical populations are warranted. Full article

Background/Objectives: Cognitive deficits are common after stroke and often compound motor impairments, hindering functional recovery—yet cognition remains under-addressed in stroke care. This pilot trial evaluated the feasibility and acceptability of a novel stroke telerehabilitation program—COG + OT—that delivers brief, functionally oriented cognitive rehabilitation as a primer to activity-based occupational therapy (OT). Methods: Twenty stroke survivors with arm/hand paresis participated in this single-arm pilot trial. The 8-week COG + OT program included 13 sessions across three phases: (1) cognitive rehabilitation (sessions 1–4), (2) application of cognitive strategies to task-practice OT (sessions 5–10), and (3) integration of cognitive skills into OT (sessions 11–13). Outcomes included feasibility (retention, adherence), acceptability (self-reported interest and usefulness of cognitive strategies, intervention acceptability), and engagement (digital literacy, barriers, and self-reported strategy use). Results: Retention was 95% and adherence was 99.6%. Participants reported moderate interest in cognitive strategies pre-intervention (M = 3.86/5) and found them moderately to very useful post-intervention (M = 4.42/5). Intervention acceptability and appropriateness were rated highly (M = 4.4/5). Common barriers included cognitive, environmental, and language factors; digital/technological barriers were infrequent. Self-reported use of cognitive strategies was moderate to high. Conclusions: The results of this trial strongly support the feasibility and acceptability of the COG + OT program for stroke survivors. Importantly, all participants were able to meaningfully engage in the program despite marked variability in cognitive and clinical characteristics. These findings support further investigation through randomized controlled trials to evaluate efficacy. Full article

Background: There is a growing gap between the increasing prevalence of children with neurodevelopmental disorders (NDDs) and the limited availability of developmental services. This raises an urgent need for effective and accessible intervention models. Hybrid intervention offers an innovative and practical solution, yet evidence regarding its feasibility and efficacy for children remains limited. This study aimed to adapt an evidence-based occupational therapy (OT) intervention model for remote delivery and to examine its feasibility and preliminary efficacy among children with NDDs. Methods: Using a quasi-experimental pre–post, mixed-methods design, children aged 5–8 years with NDDs were recruited from child development units in southern Israel. The intervention comprised 12–15 weekly video-conference sessions utilizing the Cognitive Orientation to (daily) Occupational Performance (CO-OP) approach. Standardized outcome measures assessed feasibility and preliminary efficacy. Focus groups with parents and therapists explored facilitators and barriers to implementation. Results: Of the 26 participants enrolled, 14 children (71% boys) completed the intervention and reported high satisfaction. Clinically significant improvements were observed in personal goal training, reported by both children (80%) and parents (73.68%). Content analysis identified three key themes: parents’ engagement, ecological intervention, and technological literacy. Conclusions: Tele-CO-OP intervention was found to be feasible for children with NDDs and showed potential to improve occupational performance in personal goals. Findings provide a practical foundation for developing hybrid OT services as a valuable complement to in-person care for this growing population. Full article

Various studies on the envelope renovation of existing residential buildings have quantified energy savings effects across various climate conditions and building types yet have also reported discrepancies between predicted and actual energy savings performance. Given that identical technical improvements can yield substantially different actual outcomes depending on occupants’ behavioral adaptation patterns, renovation effect evaluation requires a multifaceted approach incorporating occupant behavioral changes. This case study empirically analyzed the effects of envelope renovation on occupants’ actual heating operation patterns. Envelope renovation effects applied to a 30-year-old apartment were analyzed by subdividing temperature conditions, with comparative evaluation using a non-renovated adjacent unit within the same building as a reference. While recognizing the inherent limitations of single-case analysis, this study presents a novel methodological framework for capturing subtle behavioral shifts through high-resolution temperature-specific analysis. Change-point models utilizing utility billing data were employed to analyze threshold temperature changes, and daily heating water-consumption estimation algorithms were applied to track heating pattern changes according to outdoor temperature variations. Results showed heating energy reduction despite more severe climate conditions post-renovation, with particularly pronounced savings under mild conditions. The upper limit of temperature ranges showing high heating dependency shifted downward from pre-renovation levels, improving to levels lower than the reference unit’s upper limit, demonstrating envelope performance enhancement effects. These results provide quantitative evidence that envelope improvements directly influence occupants’ heating decision-making criteria, though broader validation across multiple cases would strengthen these findings. This study quantifies envelope renovation effects not only in terms of energy savings, but also from the perspectives of occupant behavioral changes and comparison with reference units, presenting a novel evaluation methodology for effective energy efficiency improvements in aging buildings. Full article

Background: Hand function is critical for daily living, occupational performance, and sports. Optimal training approaches for healthy adults remain unclear. Objective: To evaluate the effects of hand-focused strength and proprioceptive training on grip strength, pinch strength, manual dexterity, maximum voluntary contraction, joint position sense, and force sense in healthy younger and older adults. Methods: PubMed, Google Scholar, Semantic Scholar, Web of Science, Cochrane CENTRAL and registers were searched until July 2025 for randomized controlled trials (RCTs) involving adults (≥18 years) without upper limb dysfunction. Studies with clinical populations, single-session interventions, or lacking pre–post outcome data were excluded. Risk of bias was assessed using the Cochrane RoB 2 tool. Random-effects meta-analyses (Hedges’ g) pooled pre–post change score differences for each outcome; subgroup analyses examined age, training type, and comparator. Results: Twenty-two RCTs (n = 1017 participants; 19–78 years) met the inclusion criteria. Strength and proprioceptive training produced a small-to-moderate improvement in grip strength (g = 0.44, 95% CI [0.23–0.64], 95%PI [–0.09, 0.96]) and a large improvement in manual dexterity (g = 1.11, 95% CI [0.52–1.71], 95%PI [–0.01, 2.23]). Effects on pinch strength were positive but non-significant (g = 0.63, 95% CI [–0.09–1.35], 95%PI [–1.38, 2.63]) and showed substantial heterogeneity. Moderator analyses indicated greater effects in older adults (g = 0.97) compared to younger adults (g = 0.18). Strength-only protocols showed significant effects, while combined protocols yielded smaller, non-significant effects; however, the difference between them was not statistically significant. Effects were also larger when compared with passive controls than with untrained hands. Limitations: Evidence quality was limited by high risk of bias, measurement variability, and small study numbers for some outcomes. Conclusions: Strength-focused hand training, particularly in older adults, yields meaningful improvements in grip strength and dexterity. Further high-quality RCTs are needed for under-studied outcomes. Full article

Background: The hepatitis A virus (HAV) is a major cause of acute viral hepatitis and a significant global health concern. This study provides a pre-vaccination baseline for Oman, enabling longitudinal comparison with post-hepatitis A vaccination cohorts. This study aimed to determine the pre-vaccination seroprevalence of HAV antibodies (anti-HAV) in Oman and explore the associated demographic factors. Methods: A cross-sectional study was conducted from April 2014 to August 2015 among patients attending the medical outpatient clinic of the Medical City Hospital for Military and Security Services. Demographic data were collected via a structured questionnaire, and serum samples were tested for anti-HAV immunoglobulin IgG and IgM using enzyme-linked immunosorbent assays. Multivariate analysis was performed to identify the predictors of anti-HAV seroprevalence. Results: Among 1975 participants, 88.1% were positive for anti-HAV IgG. The mean age was 37.4 ± 16.1 years; however, those negative for anti-HAV IgG were considerably younger (mean age: 24.8 ± 15.7 years). Anti-HAV IgG seroprevalence was 37% in individuals aged ≤18 years and 91% in those >18 years (p < 0.001). The factors associated with seropositivity included older age (p < 0.001), consuming food prepared outside the home (p < 0.001), occupation (p < 0.001), and education level (p = 0.003). In the multivariable analysis, only age showed a strong independent association with serostatus: per 10-year increase, the aOR for anti-HAV IgG seropositivity was 2.87 (95% CI 2.25–3.63; p < 0.001). Conclusions: Our study estimates show high anti-HAV IgG seroprevalence and serve as a pre-vaccination baseline for evaluating the hepatitis A vaccination program in Oman over time. Given the lower natural exposure among younger cohorts, continued routine vaccination, scheduled serosurveys, and strengthened surveillance are required to identify emerging immunity gaps and prevent future HAV outbreaks. Full article

Due to the burdens of critical operations, firefighters are at occupational risk of developing mental health problems such as post-traumatic stress symptoms (PTSS) or anger. In this study, we assessed the impact of a firefighting operation with two fatalities and eleven injuries among colleagues on the mental health of those involved. Aims: The study hypothesizes that firefighters who were acquainted with the wounded or deceased show more PTSS and score higher on the STAXI-2 State Anger, Anger Expression-In/Out, and Anger Control-In/Out compared to those who were not. The second hypothesis assumes that the deployed group shows more PTSS and scores higher on the STAXI-2 State Anger, Anger Expression-In/Out, and Anger Control-In/Out compared to the grouping of non-deployed colleagues. Methods: A total of N = 138 firefighters were included, of which n = 32 were deployed and n = 106 were not (n = 26 acquainted with wounded or injured; n = 107 not acquainted with wounded or injured; n = 5 not specified). Both groups completed a standardized questionnaire voluntarily and after providing written informed consent ten months after the incident. The questionnaire consisted of the Posttraumatic Stress Checklist for DSM-5 (PCL-5) and the State-Trait Anger Inventory (STAXI-2) questionnaire. Results: Firefighters who knew the injured or deceased colleagues had significantly higher PTSS [T(23.7) = −2.5; p = 0.019; d = 0.67; 95% CI = (−10.8, −1.0)], state anger [T(74.2) = 2.4; p = 0.021; d = 0.41; 95% CI = (0.2, 2.0)], and anger control scores [T(124) = −2.7; p = 0.008; d = 0.71; 95% CI = (−5.9, −0.9)]. In addition, the deployed group showed higher anger control [T(134) = 2.0; p = 0.046; d = 0.42; 95% CI = (0.0, 4.2)] and outward anger expression [T(73.5) = −2.2; p = 0.032; d = 0.40; 95% CI = (−2.3, −0.1)] scores compared to their non-deployed colleagues. Discussion: Future psychological pre- and post-deployment interventions should place more focus on the increased vulnerability of those acquainted with wounded or deceased colleagues. Full article

Background: Practical field experiences (PFEs) in teacher education aim to foster pre-service teachers’ career-oriented reflection processes. Although aspects of occupational well-being are thought to shape reflection, empirical evidence remains limited. This study investigated how different facets of occupational well-being—including positive and negative affect as well as job satisfaction—predict distinct dimensions of pre-service teachers’ career-oriented reflections during a four-week PFE. Methods: Using a quantitative pre-post design, we analyzed data from 242 German bachelor’s degree students. Occupational well-being was assessed using the Positive and Negative Affect Schedule (PANAS) and a job satisfaction scale; reflection processes were measured via five subscales capturing information, exploration, critical reflection, career guidance, and development. Results: Findings indicate a significant increase in positive affect (d = 0.75), a slight decrease in negative affect (d = 0.15), and stable job satisfaction. Regression analyses reveal that baseline positive affect and job satisfaction enhanced career guidance and exploration, whereas negative affect promoted critical reflection. Increases in positive affect and job satisfaction further strengthened career guidance and development. Conclusion: Aspects of occupational well-being can substantially shape career-oriented reflection processes. These findings highlight the importance of explicitly considering pre-service teachers’ emotional experiences in the design of field experiences and reflection opportunities within teacher education. Full article

Background: With the progressive aging of the in institutionalized settings population, functional decline—manifested as reduced proprioception, joint stiffness, and muscle loss—poses a growing threat to the autonomy and quality of life of older adults. Occupational therapy plays a central role in addressing these challenges through targeted, evidence-based interventions. Objectives: This clinical trial evaluates the effectiveness of a multicomponent occupational therapy intervention that integrates balance and postural stability exercises, proprioceptive stimulation, and lower-limb strengthening with conventional gerontogymnastics. The program was designed to improve gait performance, reduce fall risk, and promote independence in institutionalized older adults. Methods: A total of 35 community-dwelling older adults were randomly assigned to three groups: gerontogymnastics intervention (n = 13), multicomponent intervention (n = 13), and control (n = 9). Participants underwent a 6-week intervention comprising two 45 min sessions per week. Pre- and post-intervention assessments focused on postural stability and balance-related functional outcomes. Results: The multicomponent group exhibited trends toward improvement in balance, proprioception, and functional mobility, although these did not reach statistical significance. Clinically meaningful improvements were defined using minimally clinically important differences (MCIDs) for functional measures such as Timed UP and Go (TUG) (>1.3 s) and Performance-Oriented Mobility Assessment (POMA) (≥3 points). The multicomponent group showed a 22.1% improvement in proprioceptive accuracy and a 13.9% improvement in mobility (TUG). Additionally, this trend may indicate a potential protective effect against age-related functional decline. Conclusions: These findings suggest that a multicomponent occupational therapy intervention may help maintain mobility and reduce functional decline in institutionalized older adults. Statistically significant gains were observed in lower-limb strength, while other improvements—such as proprioception and balance—did not reach significance but approached clinical relevance. These preliminary results support further investigation into balance-specific training within occupational therapy to promote independence and reduce fall risk. Interpretation should remain cautious due to the small sample size (n = 35) and short intervention duration, which limit statistical power and generalizability. Full article

Background/Objectives: Workplace conflict and aggression pose significant psychosocial risks across diverse professional sectors. This protocol outlines a novel, university-based educational intervention. Developed by a multidisciplinary team from the University Hospital of Pisa, Italy, including occupational physicians and a psychiatrist specializing in work and organizational psychology, its primary purpose is to enhance conflict prevention and crisis management skills. While initially developed and tested within the veterinary sector due to its identified vulnerabilities, the intervention is inherently generalizable to any high-stress professional environment characterized by intense client, customer, or public interactions. Methods: The intervention integrates didactic instruction with active, immersive learning through tailored role-playing scenarios simulating real-world challenging encounters. This study protocol details the structured methodology for evaluating the immediate effectiveness of this training. We are using a specifically developed efficacy scale to assess outcomes. Results: The results demonstrate a significant improvement in all assessed skills from the pre-training to the post-training evaluation. For every item on the scale, the median scores increased, indicating a positive shift in overall group performance. The p-value for each item was <0.001, confirming that the observed improvements were statistically significant. These results demonstrate enhanced conflict resolution skills, improved communication, and an increased sense of self-efficacy among participants. Conclusions: This protocol offers a comprehensive and generalizable approach to addressing workplace psychosocial risks through an innovative educational intervention. A key future goal involves advancing this training methodology by integrating virtual reality (VR) environments with AI-driven avatars for role-playing, aiming to achieve a more realistic and impactful learning experience and sustained behavioral change. Full article