Search Results (732)

Background/Objectives: It is essential to explore and disseminate positive deviance strategies that promote resilience, mindfulness, and well-being beyond stress and burnout reduction strategies for residents and physicians who experience high levels of occupational stress. This scoping review maps studies that investigate positive deviance strategies to enhance the well-being of residents and physicians. Methods: A scoping review was conducted by PRISMA guidelines to identify English-language studies on strategies for physician well-being. PubMed, MEDLINE, Embase, and ERIC were searched using terms related to well-being, coping, and medical education. Results: Among the 38 studies included, 17 (44.7%) targeted physicians in graduate medical education (GME), while 19 (50%) focused on continuing medical education (CME). Positive deviance strategies were identified in 26 studies and were most frequently implemented at the microsystem level, such as small group interventions (e.g., coaching, mentoring, and workshops). These strategies addressed individual and organisational factors that contribute to physician well-being and were associated with improvements in life satisfaction, resilience, professional identity, and psychological safety. The review found that positive deviance strategies were often proactive, values-driven, and disseminated organically over time, emphasising the importance of longitudinal engagement and sustained institutional support. Conclusions: This scoping review highlights the growing use of positive deviance strategies, especially at the microsystem level, to promote physician well-being. These approaches emphasise sustainable, values-driven practices and may offer effective, context-sensitive solutions within healthcare systems. Full article

This exploratory study investigated how health concerns related to chronic environmental contamination and how satisfaction with the human biomonitoring (HBM) process influence the perceived quality of life in the context of per- and polyfluoroalkyl substances (PFAS) contamination in the Veneto Region (Italy). We administered a questionnaire to 84 residents of the Red Area, where PFAS exposure is classified as most severe. The main findings revealed that satisfaction with HBM was positively correlated with perceived quality of life and showed a statistically significant but modest moderation effect on the relationship between PFAS-related health concerns and quality of life (explaining 17.4% of the variance). Particularly, it attenuates the negative effect that PFAS health concerns have on quality of life. Differences between subgroups revealed heightened concern regarding PFAS health risks among women vs. men and participants with children vs. those without. These results underscore the central role of relational and communication aspects of HBM programs to mitigate psychological distress and possibly contribute to higher perceived well-being. The study highlights the need for tailored public health interventions, including transparent communication, empathetic support, and community engagement, to address the psychosocial dimensions of environmental contamination. Full article

To address the challenge of dispatching emergency resources for community residents under extreme ice disaster, this paper proposes an emergency resource dispatch strategy based on pre-disaster prediction and dynamic scheduling. First, the fast Newman algorithm is employed to cluster communities, optimizing the preprocessing of resource scheduling and reducing scheduling costs. Subsequently, mobile energy storage vehicles and mobile water storage vehicles are introduced based on the ice disaster trajectory prediction to enhance the efficiency and accuracy of post-disaster resource supply. A grouped scheduling strategy is adopted to reduce cross-regional resource flow, and the dispatch routes of mobile energy storage and water vehicles are dynamically adjusted based on real-time traffic network conditions. Simulations on the IEEE-33 node system validate the feasibility and advantages of the proposed strategies. The results demonstrate that the grouped dispatch and scheduling strategies increase user satisfaction by 24.73%, average state of charge (SOC) by 30.23%, and water storage by 31.88% compared to global scheduling. These improvements significantly reduce the cost of community energy self-sustainability, enhance the satisfaction of community residents, and ensure system stability across various disaster scenarios. Full article

The structure and interpersonal interactions of traditional residential communities have also been impacted and recreated as a result of the fast development of urban space and related communities. This study explores the interrelationship between neighborhood social cohesion and the life satisfaction of urban adult residents through the mediating effect of place attachment. A comprehensive theoretical model was constructed to analyze the action mechanism among these variables. Data were collected through an online questionnaire platform (n = 301), and structural equation modeling (PLS-SEM) was employed for analysis. The findings revealed a significant positive relationship between neighborhood social cohesion and residents’ place attachment. Place attachment appeared to play a mediating role between neighborhood social cohesion and life satisfaction, in which place dependence was also a potential effective mediator between the three dimensions of neighborhood social cohesion (neighborliness, sense of community, and neighborhood attractiveness) and life satisfaction. The results suggest that enhancing community cohesion may contribute to urban adult residents’ well-being by strengthening their functional dependence on the community. Full article

Background: Sexuality is a central aspect of being human, even if people experience it in different ways in various stages of life. Sexuality in older people may be expressed, as well as affection, companionship, touch, and physical contact. However, older peoples’ sexual needs are not properly considered by themselves, caregivers, or healthcare professionals. Reviews on barriers related to identification and satisfaction of sexual needs of people living in nursing home are scarce. In this scenario we intended to summarize the state of evidence regarding sexual need identification and satisfaction among older people living in nursing homes and possible barriers that could limit sexual need identification and satisfaction. Methods: We carried out a narrative review. The included studies responded to the research question, using the following key words: nursing homes, sexuality or sexual need, or sexual behavior, older people. Searched databases included PubMed, Embase, CINAHL, PsycInfo, and Scopus. Results: After searching and screening we included 22 studies, finding three main topics: 1. identification of sexual needs by residents and healthcare personnel attitude and practice; 2. barriers and reasons hindering the identification of sexual needs; and 3. manifestation and satisfaction of sexual needs. Conclusions: The findings showed that nursing homes’ residents have different sexual needs, but there are many organizational, educational, and cultural barriers and negative attitudes of healthcare personnel. Supporting nursing home residents to express their sexual needs is a challenge for the healthcare professionals and managers of nursing homes. Full article

The construction industry is one of the main areas of energy consumption and carbon emissions, and strengthening research on the thermal performance of building facades can effectively promote energy conservation and emission reduction. Compared with traditional static enclosure structures, dynamic skin can adapt its functions, characteristics, and methods based on constantly changing environmental conditions and performance requirements. It has great potential in adapting to the environment, reducing energy consumption, adjusting shading and natural ventilation, and improving human thermal and visual comfort. To comprehensively understand the key technologies of dynamic skin energy-saving design, previous research results were comprehensively compiled from relevant databases. The research results indicate that various types of dynamic skins, intelligent materials, multi-layer facades, dynamic shading, and biomimetic facades are commonly used core technologies for dynamic facades. Parametric modeling, computer simulation, and multi-objective algorithms are commonly used to optimize the performance of dynamic skin. In addition, integrated technology design, interaction design, and lifecycle design should be effective methods for improving dynamic skin energy efficiency, resident satisfaction, and economic benefits. Despite current challenges, dynamic skin energy-saving technology remains one of the most effective solutions for future sustainable building design. Full article

Assessing a city’s level of smartness according to global indices is a relatively new area of investigation. It is useful in encouraging a rethinking of urban digital strategies, although the different approaches to global smart city rankings have been subject to criticism. This paper highlights the methodological features of constructing the Smart City Index (SCI) from the IMD (International Institute for Management Development) based on residents’ assessments, their satisfaction with electronic services, and their perception of the priority of urban infrastructure areas. The Central European cities of the Visegrad region (Prague/Czech Republic, Budapest/Hungary, Bratislava/Slovakia, Warsaw and Krakow/Poland) were chosen as the basis for an in-depth analysis. The architectonics, i.e., the internal system of constructing and calculating city rankings by SCI, is analyzed. A comparative analysis of the technology indicators (e-services) in five cities of the Visegrad region, presented in the SCI, showed the smart features of each city. The progressive and regressive trends in the dynamics of smartness in the cities in the Visegrad region were identified in five urban spheres indicated in the Index: Government, Activity, Health and Safety, Mobility, and Opportunities. This also made it possible to identify certain methodological gaps in the SCI in establishing interdependencies between the data on the residents’ perception of the priority of areas of life in a particular city and the residents’ level of satisfaction with electronic services. In particular, the structural indicators “Affordable housing” and “Green spaces” are not supported by e-services. This research aims to bridge this methodological gap by proposing a model for evaluating the e-service according to the degree of coverage of different spheres of life in the city. The application of the project, as well as cross-sectoral and systemic approaches, made it possible to develop basic models for assessing the value of e-services. These models can be implemented by municipalities to assess and monitor e-services, as well as to select IT projects and elaborate strategies for smart sustainable city development. Full article

As urbanization intensifies, high-density communities have become a dominant urban form, making Child-Friendly Community (CFC) development crucial for sustainable urban growth. However, transforming these communities poses challenges, particularly regarding residents’ risk perceptions—an area largely overlooked in existing research. To address this gap, this study introduces “Risk Tolerance (RT)” as a key variable and constructs a multidimensional model of Child-Friendly Community Transformation Risk Tolerance (CFCTRT) to examine its structure and influencing factors. Based on survey data from residents in high-density communities in China’s first- and second-tier cities, Structural Equation Modeling (SEM) is used for empirical analysis. The results show that residents exhibit lower tolerance toward changes in safety, economy, and daily life, but higher tolerance in resource and aesthetic dimensions. Expectations for CFCs and satisfaction with current communities both positively influence CFCTRT, with satisfaction also mediating the relationship between expectations and tolerance. These findings provide a novel perspective on residents’ psychological responses to CFC transformations and offer empirical support for more inclusive and adaptive urban planning strategies. Full article

This research proposes a framework for Eudaimonic well-being in destination competitiveness. This framework is based on the theoretical Ritchie and Crouch’s model (1993, 2000, 2003) and the recent theoretical notion that a travel trip may influence life satisfaction through tourists’ experiences. We conducted a qualitative study based on 34 in-depth interviews with key tourism stakeholders in Cape Verde, a small island developing country (SIDS) dependent on the tourism sector. The findings contribute to identifying specific sources of positive and negative effects that may affect the tourists’ and residents’ overall sense of well-being and thus affect the overall destination competitiveness. Full article

Objectives: This study aimed to evaluate the success rates of NSRCT performed by AEGD residents and to identify predictive factors associated with clinical outcomes and patient satisfaction. Methods: A retrospective chart review was conducted on cases treated between 2012 and 2021. Eligible cases included fully developed permanent teeth that underwent NSRCT and received a final restoration by general dentistry residents, with a minimum of 12 months of follow-up. Data collected included demographic information, medical history, clinical symptoms, radiographic findings, instrumentation, type and timing of final restorations, and patient satisfaction scores. Treatment success was defined as the absence of symptoms and either the resolution or stability of periapical radiolucency. Patient satisfaction and pain levels were also analyzed. Results: AEGD residents achieved radiographic and clinical RCT success rates of 93.3% and 91.5%, respectively. Multivariate logistic regression showed that the presence of an intact restoration was significantly associated with increased odds of tooth retention (odds ratio [OR] = 3.4, p < 0.001), while post placement in a straight root was also a significant predictor of survival (OR = 4.2, p = 0.02). Conversely, pre-existing radiolucency (OR = 0.37, p = 0.018) and the use of a metal post (OR = 0.23, p = 0.012) were significantly associated with lower odds of tooth retention. Worse periodontal health was significantly associated with increased odds of pain on percussion, with a 74.19% increase in odds per worsening category (OR = 1.74, p = 0.002). Patient satisfaction was significantly higher when restorations remained intact, with esthetic satisfaction increasing by a factor of 3.08 (OR = 3.08, p < 0.001) and functional satisfaction increasing by a factor of 3.9 (OR = 3.9, p < 0.001). Conclusions: Endodontic treatments performed by AEGD residents demonstrated high success rates and favorable patient-reported outcomes. Restoration integrity, periodontal health, and post and final restoration selection play critical roles in treatment success and patient satisfaction. Full article

The underlying tension between national park development and local community interests presents a significant challenge for contemporary ecological governance. Resident empowerment (RE) is increasingly recognized as a crucial pathway to mitigate this tension and achieve effective national park governance (NPG). However, the intrinsic mechanisms through which RE influences NPG have not been thoroughly explored in existing research. Drawing on the practice of government–resident interaction in China’s national parks, this paper investigates how the decentralization of power can balance the dual goals of environmental protection and social development. Using Three-River-Source National Park as a case study, we employ an ordered Logit regression model to examine the impact of RE on NPG. The study finds that RE is significantly and positively associated with NPG. Its influence is primarily mediated through three mechanisms: an identity effect (enhancing community belonging), an income effect (improving livelihood capabilities), and an environmental effect (strengthening participation in and perception of ecological conservation). Based on this empirical analysis, we recommend policies that further expand residents’ decision-making and management rights and broaden participation channels, thereby promoting the sustainable development and social equity of NPG. Full article

(1) Background: Knee osteoarthritis (KOA) induces pain, stiffness, and impaired mobility, particularly in aging populations. Despite providing symptom relief, the long-term efficacy of intra-articular hyaluronic acid (HA) injections remains unclear. With its longer intra-articular residence time and potential chondroprotective effects, porcine-derived atelocollagen is an alternative to HA. We aimed to compare the safety and efficacy of collagen versus HA injections in symptomatic KOA. (2) Methods: This retrospective observational study included 40 patients with KOA who received either two cycles of collagen or HA injections at 6-month intervals. Clinical outcomes were assessed using the visual analog scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at baseline and 6 months after the first and second injections (Cycle 1 and Cycle 2, respectively). Patient satisfaction and adverse events were recorded. Non-inferiority analysis was conducted for VAS and WOMAC score changes. (3) Results: Significant intragroup improvements in VAS and WOMAC scores were noted after each injection cycle (p < 0.05), albeit without significant between-group differences, non-inferiority of collagen to HA based on predefined margins, and comparable patient-reported satisfaction (>85% reported improvement after each cycle), with similar incidence of mild adverse events (collagen: 20%, HA: 25%, p = 0.705). (4) Conclusions: Intra-articular collagen injections were clinically non-inferior to HA in reducing pain and improving function in patients with KOA across two treatment cycles. Given its favorable safety profile and potential structural benefits, collagen may serve as a viable alternative injectable therapy for the non-surgical management of KOA. Full article

Amid the accelerating processes of modernization and commercialization, traditional rural public spaces are increasingly losing their cultural value and social functions. This study investigates the transformative role of art intervention in enhancing the quality and cultural significance of rural public spaces, with a focus on Machang Village in Tengchong, China. The study first develops a conceptual model to explore the causal relationships and pathways between these influencing factors. Drawing on this framework, the research then uses Structural Equation Modeling (SEM) to empirically test a multi-dimensional resident satisfaction model that incorporates spatial aesthetics, functional suitability, historical-cultural identity, and emotional cognition. Through field surveys and data collected from 224 residents, the study reveals that cultural emotions and functional completeness are the most influential factors in driving overall satisfaction. Artistic innovation and aesthetics contribute moderately, indicating that visual creativity alone is insufficient without deeper cultural integration and functional coherence. The findings suggest a dual-pathway satisfaction mechanism, where both symbolic emotional resonance and practical usability shape residents’ perceptions of public space quality. The study offers theoretical and practical insights into optimizing rural public space design, advocating for art-led, community-engaged, and culturally embedded approaches to rural revitalization. Full article

Well-being is an important goal pursued by humans, and the living environment has a profound impact on various aspects of human health. The objective of this study is to explore the mechanism by which the built environment affects the well-being of residents, specifically how multiple, distinct domains of life satisfaction mediate the effects of diverse built environment features on well-being—a nuanced pathway not yet comprehensively examined. Based on questionnaire data collected from 22 statistical districts in Macau, with a sample size of 1313 individuals, a multilevel linear regression model and mediation analysis were applied (model R² ≈ 47%). When leisure satisfaction is used as a mediator variable alone, the explanatory power of the original model increases the most (from 7.6% to 32%). Complete Mediation via Specific Domains: Health satisfaction fully mediated the effects of intersection density (p < 0.05) and bus stop accessibility (p < 0.05). All four satisfaction domains collectively fully mediated income diversity (Shannon index, p < 0.01). The 14 built environment metrics (5 socioeconomic, 9 morphological) exhibited differential mediation mechanisms: while transportation-related metrics (intersection density, bus stops) primarily operated through health/social satisfaction, diversity indices (income, education, land use) and unemployment rate engaged all satisfaction domains. Some variables showed partial mediation through various satisfaction pathways (p < 0.01–0.05). These findings underscore the necessity of considering multidimensional life satisfaction as critical pathways in urban well-being research and policy. Full article

Background and Objectives: Evidence regarding how dispositional traits, antenatal anxiety, substance use, and obstetric events converge to shape post-partum depression (PPD) in South-East Europe is limited. We analysed 102 third-trimester women and followed them to six weeks post-partum, and 102 age-matched community controls were used to (i) compare baseline psychological profiles, (ii) chart antenatal-to-post-partum symptom trajectories, and (iii) build an integrated model of clinically relevant PPD (Edinburgh Post-natal Depression Scale, EPDS ≥ 12). Materials and Methods: All 96 raw variables were forward–backward translated from Romanian, reconciled, and harmonized. The principal instruments used were EPDS, State–Trait Anxiety Inventory form Y (STAI-Y), Revised Obsessive–Compulsive Inventory (OCI-R), NEO Five-Factor Inventory (NEO-FFI-60), and the four-item Maternal Worry and Satisfaction Scale (MWSS). Results: Groups were age-matched (31.1 ± 5.4 vs. 30.3 ± 5.1 years, p = 0.268) but differed in urban residence (39% vs. 17%, p = 0.001) and current substance use (smoking 21% vs. 34%, p = 0.041; alcohol 6% vs. 22%, p = 0.002). Of five personality domains, only openness scored lower in peripartum women (26.1 ± 4.6 vs. 29.3 ± 5.2, p < 0.001). State anxiety rose significantly from pregnancy to puerperium (+5.1 ± 8.4 points, p < 0.001). Post-partum EPDS correlated most strongly with state anxiety (r = 0.62) and neuroticism (r = 0.50). A final model (pseudo-R² = 0.30) identified post-partum state anxiety (OR 1.10 per point, 95% CI 1.05–1.15, p < 0.001) as the independent predictor; neuroticism showed a trend (OR 1.08, p = 0.081). Obstetric factors (prematurity, birth weight, caesarean section) were not significant. Conclusions: In this Romanian cohort, heightened state anxiety—in synergy with high neuroticism and lower openness—dominated the risk landscape of early onset PPD, whereas delivery mode and neonatal status were neutral. Routine perinatal mental health screening should therefore incorporate anxiety metrics alongside depression scales and brief trait inventories to refine preventive targeting. Full article