Search Results (92)

The right to development, an inherent human right for all, emphasizes that all individuals and communities have the right to participate in, contribute to, and benefit from development that ensures the full realization of human rights. In Kenya, where a significant portion of the population faces poverty and vulnerability to climate change, access to rights-based needs such as clean water, healthcare, and education still remains a critical challenge. This study explored the implementation of a Human Rights-Based approach to community development through a Public–Private Development Partnership model (PPDP), with a focus on alleviating poverty and improving access to rights-based services at the community level in Narok and Nakuru counties. The research aimed to identify critical success factors for scaling the PPDP model and explore its effects on socio-economic empowerment. The study employed a mixed-methods approach for data collection, using questionnaires to obtain quantitative data, focus group discussions, and key informant interviews with community members, local leaders, and stakeholders to gather qualitative data. We cleaned and analyzed all our data in R (version 4.4.3) and used the chi-square to establish the significance of differences between areas where the PPDP model was implemented and control areas where it was not. Results reveal that communities with the PPDP model experienced statistically significant improvements in employment, income levels, and access to rights-based services compared to control areas. The outcomes underscore the potential of the PPDP model to address inclusive and sustainable development. This study therefore proposes a scalable pathway beginning with access to rights-based needs, followed by improved service delivery, and culminating in economic empowerment. These findings offer valuable insights for governments, development practitioners, investment agencies, and researchers seeking community-driven developments in similar socio-economic contexts across Africa. For the first time, it can be adopted in the design and implementation of development projects in rural and local communities across Africa bringing into focus the need to integrate rights-based needs at the core of the project. Full article

Housing affordability is a major determinant of quality of life. Despite the relatively high GDP per capita in Hong Kong (HK) (USD 460,000), about one-third of the population lives in public rental housing (PRH) because they cannot afford private housing. Existing research estimating the benefits of PRH or direct housing supports faces methodological limitations. Addressing this research gap, our study adopts an “in-kind subsidy” approach to estimate the monetary value of PRH, quantifying how much less PRH households might save monthly if they resided in private rental units, after controlling for confounding factors. This paper examines the association of housing types and household savings by applying ordinary least squares (OLS) regression to compare savings among PRH tenants, non-PRH tenants, and mortgage-free homeowners, based on seven rounds of the Household Expenditure Survey data (1989/1990 to 2019/2020). PRH tenants saved significantly more than private housing tenants. In terms of household savings, the value of HK PRH has steadily increased from HKD 4483 in 1999/2000, to HKD 9187 in 2019/2020. For every dollar increase in income, a household would have the propensity to save 0.7 dollars in 2019/2020. Given limited public resources, our findings offer robust evidence regarding the value of public housing. The results underscore the importance of the equitable allocation and effective management of current PRH stock to enhance the upward mobility of low- to middle-income households amid limited housing resources in HK. Full article

This paper proposes an incentive scheme based on a public–private partnership (PPP) to encourage low-carbon travel behavior by inducing the mode choice shift from private cars to public transit. The scheme involves three key entities: travelers, the government, and the private sector. Travelers can choose between private cars and public transit, producing different emissions. As the leader, the government aims to reduce total emission to a certain level with limited budgets. The private sector, as an intermediary, invests subsidies in low-carbon rewards to attract green travelers and benefits from a larger user pool. A two-layer multi-objective optimization model is proposed, which includes travel time, monetary cost, and emission. The objective of the upper level is to maximize the utilities of the private sector and minimize social costs to the government. The lower layer is the user equilibrium of the travelers. The numerical results obtained through heuristic algorithms demonstrate that the proposed scheme can achieve a triple-win situation, where all stakeholders benefit. Moreover, sensitivity analysis finds that prioritizing pollution control strategies will be beneficial to the government only if the unit pollution control cost coefficient is below a low threshold. Contrary to intuition, larger government subsidies do not necessarily lead to better promotion of low-carbon travel. Full article

Background/Objectives: Embryo selection in IVF is traditionally based on morphology, yet many high-quality embryos fail to implant. Preimplantation genetic testing for aneuploidy (PGT-A) using next-generation sequencing (NGS) has been proposed to improve selection by identifying euploid embryos. However, its effectiveness in women of advanced maternal age remains unclear due to limited randomized data. This pilot trial assessed the feasibility of a full-scale RCT comparing PGT-A to morphology-based selection in women aged 35–42. Methods: This single-centre, two-arm parallel RCT (NCT05009745) enrolled women aged 35–42 undergoing IVF/ICSI with ≥3 good-quality day-3 embryos. Participants were randomized (1:1) to either embryo selection by morphology with fresh transfer or PGT-A with frozen transfer of a single euploid embryo. Allocation concealment was achieved via a secure web-based randomization platform; patients and clinicians were unblinded, but the biostatistician remained blinded. The primary outcome was feasibility of recruitment, randomization, and adherence. Results: Between June 2021 and January 2023, 138 women consented (recruitment rate: 55.8%, 95% CI: 49.7–62.0%) and 100 were randomized. Protocol adherence was 94%. Barriers to recruitment included preference for private PGT-A (19%) or fresh transfer (6%). Among biopsied embryos, 51.4% were euploid and 6.6% low-level mosaic. Intention-to-treat analysis showed no significant differences between PGT-A and control groups in clinical pregnancy rate (50% vs. 40%), live birth rate (50% vs. 38%), or miscarriage rate (12% vs. 8%). Cumulative live birth rate after up to three SETs was 72% vs. 52%, respectively (p > 0.05). No multiple pregnancies occurred. Conclusions: RCTs of PGT-A in older women are feasible. A multicentre design with broader inclusion criteria could improve recruitment and allow better assessment of clinical benefit. Full article

Smart water management (SWM) represents a transformative shift in urban water governance, integrating advanced digital technologies—including the Internet of Things (IoT), Artificial Intelligence (AI), big data analytics, and digital twin modeling—to enable real-time monitoring, predictive analytics, and adaptive decision-making. While drawing extensively on a structured literature review to build its theoretical foundation, this manuscript is primarily presented as a research paper that combines conceptual analysis with empirical insights derived from comparative case studies, rather than a standalone comprehensive review. A five-layer system architecture—encompassing data sensing, transmission, processing, intelligent analysis, and decision support—is introduced to evaluate how technological components interact across operational layers. The model is applied to two representative cases: Singapore’s Smart Water Grid and selected pilot programs in Chinese cities (Shenzhen, Hangzhou, Beijing). These cases are analyzed for their level of digital integration, policy alignment, and performance outcomes, offering insights into both mature and emerging smart water implementations. Findings indicate that the transition from manual to intelligent governance significantly enhances system performance and robustness, particularly in response to climate-induced disruptions. Despite benefits such as reduced non-revenue water and improved pollution control, challenges including high initial investment, data interoperability issues, and cybersecurity risks remain critical barriers to widespread adoption. Policy recommendations focus on establishing national standards, promoting cross-sectoral data sharing, encouraging public–private partnerships, and investing in workforce development to support the long-term sustainability and scalability of smart water initiatives. Full article

This article reviews the current scientific literature that relates to automated vehicles (AVs), vehicles controlled by a computer instead of a human driver, and people living with a disability (PLWD). The aim of this review is (1) to explore how AVs might improve mobility for PLWD, (2) to identify research gaps to guide future studies, and (3) to examine the real-world applicability of existing research. A structured search following PRISMA guidelines identified 66 relevant peer-reviewed publications. The findings suggest that AVs hold promise in reducing transport-related social exclusion by increasing autonomy, flexibility, and accessibility for PLWD, thereby supporting the transition toward more inclusive and environmentally sustainable transport systems. However, the potential benefits of AVs for the mobility of PLWD depend on the type of vehicle considered (e.g., private vs. public transport) as well as the potential challenges related to the legal framework, accessibility standards, and addressing PLWD concerns, opinions, and needs. To overcome the existing obstacles to the widespread adoption of AVs and make them a real opportunity for PLWD, collaboration between all stakeholders in the sector (i.e., governments, industries, and disability associations) is needed. This review supports cross-sector collaboration for inclusive AV implementation. Full article

Background/Objectives: A history of cancer has been linked to stress and concerns about its recurrence. We aimed to test the benefits of an evidence-based self-help stress reduction method, the Clinical Emotional Freedom Technique (EFT), in survivors of cutaneous melanoma, and to contrast its effects on wellbeing and perceptions of cancer recurrence when delivered in a group versus individual instruction setting. Methods: This study was preregistered at clinicaltrials.gov (NCT05421988, 3 April 2022). Fifty-three patients aged 18 and above, diagnosed with melanoma (stage T1a–T2a) at least 6 months prior, and not in active treatment were recruited from a private skin cancer clinic. After consent, all participants were randomized in one step into three condition groups: Group EFT (G-EFT; n = 16), Individual EFT (I-EFT; n = 18), and a waiting-list control condition (CC; n = 19). G-EFT and I-EFT participants attended weekly treatment sessions for four weeks. Perceptions of cancer recurrence and wellbeing measures were obtained pre- and post-intervention and at three-months follow-up using online questionnaires. Subjective units of distress (SUDs) were recorded by the EFT instructor at the beginning and end of each session. Results: Two-way repeated measures ANOVAs revealed significant improvements from pre- to post-intervention in both EFT conditions in terms of participants’ understanding of how to prevent recurrence and in their spiritual wellbeing. No statistically significant effects were found for fear of recurrence, recurrence perceptions, and affect. Significant decreases in SUD scores were observed in both EFT conditions. Over 80% of the experimental conditions’ participants reported positive changes and satisfaction. Conclusions: The findings provide support for offering EFT instruction as a non-pharmacological and noninvasive self-help method to ameliorate the stress of cancer diagnosis and treatment, and for its similar effectiveness in either a group or individual format. Full article

Although the transition to electric vehicles (EVs) is well underway and expected to continue in global car markets, most vehicles on the world’s roads will be powered by internal combustion engine vehicles (ICEVs) and fossil fuels for the foreseeable future, possibly well past 2050. Thus, good environmental performance and effective emission control of ICE vehicles will continue to be of paramount importance if the world is to achieve the stated air and climate pollution reduction goals. In this study, we review 228 publications and identify four main issues confronting these objectives: (1) cheating by vehicle manufacturers, (2) tampering by vehicle owners, (3) malfunctioning emission control systems, and (4) inadequate in-service emission programs. With progressively more stringent vehicle emission and fuel quality standards being implemented in all major markets, engine designs and emission control systems have become increasingly complex and sophisticated, creating opportunities for cheating and tampering. This is not a new phenomenon, with the first cases reported in the 1970s and continuing to happen today. Cheating appears not to be restricted to specific manufacturers or vehicle types. Suspicious real-world emissions behavior suggests that the use of defeat devices may be widespread. Defeat devices are primarily a concern with diesel vehicles, where emission control deactivation in real-world driving can lower manufacturing costs, improve fuel economy, reduce engine noise, improve vehicle performance, and extend refill intervals for diesel exhaust fluid, if present. Despite the financial penalties, undesired global attention, damage to brand reputation, a temporary drop in sales and stock value, and forced recalls, cheating may continue. Private vehicle owners resort to tampering to (1) improve performance and fuel efficiency; (2) avoid operating costs, including repairs; (3) increase the resale value of the vehicle (i.e., odometer tampering); or (4) simply to rebel against established norms. Tampering and cheating in the commercial freight sector also mean undercutting law-abiding operators, gaining unfair economic advantage, and posing excess harm to the environment and public health. At the individual vehicle level, the impacts of cheating, tampering, or malfunctioning emission control systems can be substantial. The removal or deactivation of emission control systems increases emissions—for instance, typically 70% (NO_x and EGR), a factor of 3 or more (NO_x and SCR), and a factor of 25–100 (PM and DPF). Our analysis shows significant uncertainty and (geographic) variability regarding the occurrence of cheating and tampering by vehicle owners. The available evidence suggests that fleet-wide impacts of cheating and tampering on emissions are undeniable, substantial, and cannot be ignored. The presence of a relatively small fraction of high-emitters, due to either cheating, tampering, or malfunctioning, causes excess pollution that must be tackled by environmental authorities around the world, in particular in emerging economies, where millions of used ICE vehicles from the US and EU end up. Modernized in-service emission programs designed to efficiently identify and fix large faults are needed to ensure that the benefits of modern vehicle technologies are not lost. Effective programs should address malfunctions, engine problems, incorrect repairs, a lack of servicing and maintenance, poorly retrofitted fuel and emission control systems, the use of improper or low-quality fuels and tampering. Periodic Test and Repair (PTR) is a common in-service program. We estimate that PTR generally reduces emissions by 11% (8–14%), 11% (7–15%), and 4% (−1–10%) for carbon monoxide (CO), hydrocarbons (HC), and oxides of nitrogen (NO_x), respectively. This is based on the grand mean effect and the associated 95% confidence interval. PTR effectiveness could be significantly higher, but we find that it critically depends on various design factors, including (1) comprehensive fleet coverage, (2) a suitable test procedure, (3) compliance and enforcement, (4) proper technician training, (5) quality control and quality assurance, (6) periodic program evaluation, and (7) minimization of waivers and exemptions. Now that both particulate matter (PM, i.e., DPF) and NO_x (i.e., SCR) emission controls are common in all modern new diesel vehicles, and commonly the focus of cheating and tampering, robust measurement approaches for assessing in-use emissions performance are urgently needed to modernize PTR programs. To increase (cost) effectiveness, a modern approach could include screening methods, such as remote sensing and plume chasing. We conclude this study with recommendations and suggestions for future improvements and research, listing a range of potential solutions for the issues identified in new and in-service vehicles. Full article

This research examines the governance of carbon rights in comparison with 7 other countries, focusing on Vietnam’s carbon markets and Reducing Emissions from Deforestation and Forest Degradation in Developing Countries implementation. Through constitutional theory and comparative analysis, the study explores carbon rights and their governance frameworks. It utilizes surveys, in-depth interviews, and literature reviews to scrutinize governance mechanisms. A comparative analysis of Vietnam with countries such as Australia, New Zealand, Sweden, Brazil, Democratic Republic of Congo, Indonesia, and the Philippines was performed. It highlights differences in legal, institutional, and policy frameworks. Australia and New Zealand, early adopters of carbon rights policies promoting private ownership, have developed strong markets. In contrast, Indonesia and other Global South nations are still evolving their frameworks, with a focus on state-controlled systems that restrict participation and equity. The findings indicate substantial gaps in Vietnam’s carbon rights governance compared to other countries, especially in terms of legal clarity, stakeholder engagement, and policy coherence. Accordingly, this study recommends that Vietnam should adopt a robust legal framework for carbon rights, improve transparency in carbon markets, and integrate Reducing Emissions from Deforestation and Forest Degradation in Developing Countries strategies within broader environmental governance objectives. Vietnam’s carbon rights ought to be designated as national assets to ensure equitable distribution among various forest ownership groups. Benefit-sharing mechanisms could be fashioned following the successful implementation of the Payment for Forest Environmental Services policy. The research concludes that, with these enhancements, Vietnam could emerge as a key player in the global carbon market and effectively leverage Reducing Emissions from Deforestation and Forest Degradation in Developing Countries for sustainable development and climate objectives. Full article

As of 2023, China’s transportation energy carbon emissions account for over 10%, which has a significant impact on achieving “dual carbon” goals. China has successively issued various policies to address pollution emissions in the transportation industry. This study mainly analyzes the synergistic effects of pollution reduction and carbon reduction measures implemented in this industry. We selected 2023 as the base year, focused on promoting new energy vehicles (NEVs), advocating bus transit (ABT), and advancing rail transit (ART) as the three major emission reduction policies, and analyzed their synergistic effects on air pollutant control and greenhouse gas emission reduction. Based on national scale data on driving conditions, energy consumption, and emission factors, the synergistic emission reductions in greenhouse gases and air pollutants brought about by the three policies were first calculated. Then, using the coordinate system of synergistic control effects, cross elasticity analysis of pollutants, and normalization evaluation methods, the multi pollutant synergistic control capabilities of each policy were quantified. Quantitative results revealed that the NEV substitution policy achieved a CO₂ reduction of 100.966 million tons in 2023, alongside reductions of 1.0196 million tons (CO), 59,506 tons (NO_x), 103,500 tons (NMHC), 6266 tons (PM₁₀), and 3071 tons (SO₂). Based on the AP_eq ranking, its comprehensive benefits (AP_eq = 166,734.52) significantly outperform ART (AP_eq = 97,414.89) and ABT (AP_eq = 19,796.80). The main research conclusion shows that replacing private gasoline cars with new energy vehicles can have a synergistic emission reduction effect on all five types of air pollutants and greenhouse gases involved in this study, with a positive synergistic effect. Moreover, the policy development priority is relatively better based on the synergistic emission reduction equivalent. Both buses and rail transit have not brought about SO₂ emission reduction, nor have they had a positive synergistic effect on SO₂ and CO₂ emission reduction. On this basis, buses also contribute to NO_x emissions. For other air pollutants, both rail transit and buses can have a synergistic effect of reducing pollution and carbon emissions. Full article

Dogs and humans have shared a complex relationship throughout history, with law serving as an important tool to manage dogs’ integration into human societies. As dogs increasingly become regarded as family members in Western countries, and as similar trends emerge globally, it is vital to understand how legislation balances the interests of stakeholders. Existing studies often focus on localised disputes and fragmented legal areas, limiting understanding of how dog-related laws interact and potentially conflict. We developed a conceptual framework to systematically analyse dog-related legislation, using the United Kingdom as a case study. Identified through a systematic search, laws were evaluated using content analysis based on the benefits provided to stakeholders, the regulated aspects of dog ownership, and whether benefits afforded to stakeholders occur in public or private spaces. We found that the greatest legislative focus was on dog welfare, dangerous dogs, and dog control, with little emphasis on areas like the breeding and sale of dogs. Eighty-two percent of laws that manage dogs in public space predominantly benefit the general public, often disadvantaging dogs and their owners, while 81% of laws that govern dogs within the home favour dogs. Owners consistently face legal obligations, but gain few benefits. These findings highlight misalignments between the law and dogs’ evolving societal roles, potentially contributing to public space conflicts and low compliance. The framework offers a tool for cross-country comparisons and assessing legislation for other species with similarly shifting roles. Full article

Background and Objectives: While shoulder injuries represent the musculoskeletal disorders (MSDs) most encountered in physical therapy, there is no consensus on their management. In attempts to provide standardized and personalized treatment, a robotic-assisted device combined with EMG biofeedback specifically dedicated to shoulder MSDs was developed. This study aimed to determine the efficacy of an 8-week rehabilitation program (3 sessions a week) using a robotic-assisted device combined with EMG biofeedback (RA-EMG group) in comparison with a conventional program (CONV group) in patients presenting with shoulder MSDs. Materials and Methods: This study is a retrospective cohort study including data from 2010 to 2013 on patients initially involved in a physical rehabilitation program in a private clinic in Chicoutimi (Canada) for shoulder MSDs. Shoulder flexion strength and range of motion were collected before and after the rehabilitation program. Forty-four patients participated in a conventional program using dumbbells (CONV group), while 73 completed a program on a robot-assisted device with EMG and visual biofeedback (RA-EMG group); both programs consisted of two sets of 20 repetitions at 60% of maximal capacity. Results: We showed that the RA-EMG had significantly greater benefits than the CONV group for shoulder flexion strength (4.45 [2.6;6.15] kg vs. 2.3 [0.90;4.775] kg, U = 761, p = 0.013) and for normalized strength (77.5 [51.3;119.1] % vs. 39.1 [16.6;89.2] %, U = 755, p = 0.016). In addition, the RA-EMG group showed a trend to greater absolute gain of ROM than the CONV group (10.0 [0;24.3] degrees vs. 5.5 [0;12.0] degrees, U = 1931, p = 0.067), and a greater benefit in normalized ROM was observed for the RA-EMG (7.4. [0;17.7] %) than the CONV group (4.6 [0;10.8], U = 1907, p = 0.046). Conclusions: The current retrospective cohort study showed that a specific and tailored 8-week rehabilitation program with constant effort by automatic adjustment of the level of resistance by EMG feedback induced greater benefits for shoulder flexion strength and a trend to improve range of motion compared to conventional rehabilitation in patients with shoulder MSDs. Future research should be pursued to determine the added potential of this approach for abduction and external rotation with a randomized controlled design. Full article

Background: Achieving evidence-based practice change in surgery has always been challenging, with many aspects of common clinical practice evolving through lower-level studies that are susceptible to bias and confounding rather than high-quality evidence. This challenge is even more pronounced in the setting of low-volume, high-complexity surgical oncology. Additionally, when the costs of interventions or technologies are high, designing and developing such studies within financially constrained national healthcare systems becomes even more complicated, potentially widening perceived healthcare inequalities between private and publicly funded systems. However, this is precisely the area where a lack of evidence can either hinder the development of significant new clinical advances or lead to the adoption of expensive and ineffective treatments. Here, we describe the novel approaches adopted in the design, development, and implementation of the ELECTRA trial, a randomised, controlled, double-blinded feasibility study with a planned extension to a late-phase trial. Methods: The Cancer Research UK ELECTRA (NCT05877352) trial is a three-armed randomised, controlled clinical trial designed to evaluate the incremental benefit of adding intraoperative electron beam radiotherapy (IOERT) to pelvic exenteration surgery for locally advanced and locally recurrent rectal cancer. ELECTRA is double-blinded, with patients, surgeons, and oncologists unaware of whether IOERT is administered or not. The primary feasibility outcome focuses on the ability to successfully recruit and randomise participants, while the subsequent primary outcome assesses IOERT field local control. Results: We describe the collaborative process involved in developing the trial, including national and international consultations to determine the best study design and the most optimal outcome measures to evaluate. We outline the extensive patient participation and input into the study design. Given the complexity and evolving nature of the field, with no clear international standardisations, we outline the processes used to address internationally agreed definitions, radiological standardisation, surgical learning curves, quality assurance, and pathological standardisation, as well as the broader impact and benefits of these activities. Finally, we describe the novel design utilised to facilitate the involvement of national and international units with varying levels of equipoise regarding IOERT. Conclusions: Historically, randomised clinical trials have not been the standard approach for evaluating surgical interventions due to their practical and methodological challenges, particularly in high-complexity, low-volume settings. Despite these difficulties, they remain the gold standard for evidence-based practice. The ELECTRA trial exemplifies a complex, innovative trial design that addresses an unmet need in a specialised area of high-complexity surgery. Using ELECTRA as an example, we highlight the genuine challenges in designing such complex trials and provide recommendations to facilitate the conduct of future well-designed surgical studies. Full article

The study investigates controlled environment agriculture (CEA) in Nigeria focusing on its feasibility, economic benefits, environmental impact, and socio-economic implications. While CEA technologies such as hydroponics, vertical farming, automation, and greenhouse systems offer efficiency and yield improvements, this review highlights the extent to which they can be utilized in solving the food challenges facing the country including food shortages, wasteful use of land, and climatic disturbances in agriculture. However, their adoption faces challenges like high initial costs, technical knowledge gaps, and unstable energy infrastructure. Additionally, there is a lack of localized research on resource utilization, crop profitability, and the scalability of these systems in Nigeria’s urban and rural contexts, which further hinders adoption. Government policy reforms, renewable energy access, and capacity-building programs are crucial to overcoming these barriers. Localized pilot projects and field studies are also necessary to validate the feasibility of CEA systems under Nigeria’s unique socio-economic and climatic conditions. Cross-country comparisons with South Africa and Kenya reveal actionable insights for Nigeria’s CEA implementation such as South Africa’s public-private partnerships and Kenya’s solar-powered vertical farms which can serve as actionable blueprints for Nigeria’s CEA adoption and expansion. Nigeria with its teeming population is food import-dependent, with agricultural imports reaching 3.35 trillion Naira between 2019 and 2023. This is unsustainable and requires alternative measures including targeted CEA interventions to increase its agricultural productivity. Overall, for CEA to contribute meaningfully to the Nigerian agricultural sector, specific changes including targeted subsidies, policy reforms, renewable energy access, stakeholder engagement, capacity-building programs, and infrastructure development must be instituted to achieve sustainable agricultural growth. Furthermore, strategies such as hybridizing traditional and CEA practices and creating “pay-as-you-grow” financial models for CEA infrastructure can make the transition more viable for smallholder farmers, who dominate Nigeria’s agricultural sector. Full article

Background/Objectives: Dental fear and anxiety are prevalent issues in both children and adult patients, often leading to avoidance of dental care and deterioration in overall health. While virtual reality (VR) has been increasingly studied as a distraction tool in pediatric dentistry, its effectiveness among adults remains under-researched. This study aims to evaluate the impact of VR distraction on reducing anxiety and physiological stress indicators in adult dental patients. Methods: The study was conducted in a private dental office in Dobrodzień, Poland, involving 90 adult dental patients divided into three groups: two experimental (VR1 and VR2) and one control (C), with 30 patients each. Patients in the VR1 group experienced VR distraction during the first visit, and the second visit was conventional; the VR2 group experienced this in reverse; and the control group underwent traditional treatment in both visits. Physiological parameters (heart rate, saturation, and stress) and psychological anxiety levels (MDAS and STAI-X1) were measured at three time points during each visit. Results: Significant reductions in heart rate and stress levels were observed after VR exposure compared to the control group. VR also demonstrated a significant effect in decreasing anxiety levels (based on STAI-X1) during the visit with VR distraction. No significant changes were found in the saturation levels across the groups. Conclusions: The use of VR as a distraction tool during dental procedures effectively reduces physiological stress and anxiety in adult patients, suggesting its potential as a valuable tool in managing dental anxiety. Further research is recommended to explore the long-term benefits and patient satisfaction with VR-based interventions in dental care. Full article