Search Results (1,496)

Background/Objectives: As population ageing accelerates, integrated care has become an important strategy for addressing the complex care needs of older adults. Although gerontological nurse specialists (GNSs) are expected to contribute to integrated care, their roles remain inconsistently defined and insufficiently synthesized across healthcare systems and professional role titles. This scoping review aims to systematically map the roles of GNSs in supporting integrated care for older adults within hospital-based settings. Methods: This scoping review protocol will follow the JBI methodology for scoping reviews and will be reported in accordance with the PRISMA-ScR guidelines. Searches will be conducted in PubMed, CINAHL, Web of Science, China National Knowledge Infrastructure, and Ichushi-Web, with no date restrictions. Studies published in English, Chinese, and Japanese will be included. The review will consider studies involving nurses with recognized specialist or advanced nursing practice competence in gerontological or older-adult care and will focus on their roles in supporting integrated care for older adults within hospital-based settings and hospital-linked transitional care services. Two independent reviewers will conduct study selection and data extraction. The findings will be synthesized descriptively and presented using tabular, narrative, and diagrammatic formats. Conclusions: This review is expected to contribute to a clearer understanding of the roles of GNSs in integrated care for older adults and provide evidence to inform future nursing practice, workforce development, education, and research in gerontological integrated care. Registration: This protocol was registered within the OSF database on 19 May 2026. Full article

In a policy context characterized by both supportive initiatives (e.g., school-based mental health services) and enforcement-oriented approaches that may contribute to student stress, schools are increasingly tasked with addressing trauma-related needs. A rapid umbrella review was conducted on existing systematic reviews of trauma-informed school practices. The umbrella review synthesized findings from multiple systematic reviews to provide a comprehensive assessment of the evidence, identify areas of consensus or inconsistency, and explain discrepancies across studies. Fifteen reviews met the inclusion criteria of a systematic or scoping review of mental health and academic outcomes associated with trauma-informed school practices. Nine of these included studies with newcomer students. Overall, most reviews reported positive associations between trauma-informed practices and student outcomes, including reductions in trauma symptoms and behavioral problems, as well as improvements in resilience, engagement, and academic performance. Evidence was strongest for targeted clinical interventions delivered by trained mental health professionals, while classroom and schoolwide approaches showed promising but less conclusive results due to methodological limitations. Findings suggest that while trauma-informed approaches are beneficial, their implementation remains fragmented and often incremental. Greater attention to cultural, linguistic, and relational dimensions of displacement, along with improved cross-system coordination and rigorous evaluation, is needed. Trauma-informed school practices represent a promising but underdeveloped strategy for supporting newcomer students within complex and evolving policy environments. Full article

Large Language Models (LLMs) are emerging as key enablers of Future Internet ecosystems, supporting intelligent, adaptive, and context-aware services across distributed cyber-physical environments. Beyond traditional natural language processing, LLMs are increasingly integrated into Smart Internet of Things (SIoT) systems to enable semantic interoperability, edge intelligence, multimodal interaction, and autonomous service orchestration. This paper presents a taxonomy-based review of LLM architectures, training paradigms, deployment strategies, and emerging applications within Future Internet infrastructures. The review classifies existing studies by deployment environment, architecture, training strategy, accessibility, and application scope, and analyses the role of LLMs in intelligent IoT environments, with emphasis on edge-based reasoning, agentic AI, human-centric automation, and context-aware decision-making. Key challenges are examined, including scalability, inference latency, privacy, trustworthiness, security, hallucination, and energy efficiency in resource-constrained environments. A comparative analysis of representative LLMs is presented, based on deployment feasibility, multimodal capability, accessibility, and suitability for distributed intelligent services. The originality of the review lies in conceptualizing LLMs as cognitive middleware that provides semantic, reasoning, and coordination capabilities across Smart IoT infrastructures. Finally, future research directions are highlighted, including decentralized AI architectures, digital twins, the Model Context Protocol, retrieval-augmented generation, multimodal sensing, and autonomous agent-based ecosystems. Full article

Family-centred approaches are being increasingly recognized as integral to inclusive mental health care. Although substantial evidence-based exists for specific interventions particularly family intervention for psychosis, there is no synthesis that maps how family-centred approaches are conceptualized, implemented, and linked to inclusivity across diagnoses, service contexts, and levels of evidence. Existing reviews are largely disorder-specific or outcome-focused and do not examine family-centred care as a system-level strategy for inclusive practice. This scoping review aimed to map and synthesize the existing literature on family-centred approaches used to promote inclusive mental health care for individuals with psychiatric disorders. This review followed the Joanna Briggs Institute (JBI) methodology for scoping reviews and the PRISMA-ScR reporting guidelines. Searches were conducted in PubMed, PsycINFO, CINAHL, Scopus, Embase, and Web of Science for English-language empirical studies published between 2000 and 2025. Studies involving individuals with psychiatric disorders and any form of family-centred, family-focused, or family-inclusive approach were eligible. Data were charted and analyzed thematically to map intervention types, reported outcomes, and implementation influences; the review did not evaluate intervention effectiveness. Twenty-four studies met the inclusion criteria. Only five themes emerged from this study. Across the literature, family involvement was associated with improved engagement, enhanced communication, and increased caregiver competence. Psychoeducation featured prominently in evidence-based interventions, while newer models emphasized shared decision-making and service co-production. Family-centred approaches are conceptualized in diverse ways across mental health services and are commonly linked to more inclusive and collaborative care. However, the strength of evidence varies substantially between intervention types. This review clarified how family-centred practices are situated across levels of evidence and service contexts, highlighting the need for greater precision in distinguishing established interventions from emerging practices and for system-level strategies to support consistent, culturally responsive family inclusion. Full article

During long-term service, asphalt pavements undergo environmental stress and ageing, which cause cracking, rutting, and other distresses and raise maintenance costs. Polyurethane (PU) has high mechanical strength, elastic recovery, and ageing resistance due to its unique molecular structure. As an asphalt modifier, PU has been reported to improve high-temperature stability, moisture resistance, and durability. However, PU and asphalt differ greatly in polarity, density, viscosity, and phase structure, and these differences often lead to segregation and phase separation. The prepolymer method can mitigate these compatibility limitations by adjusting molecular weight, terminal-group activity, and soft/hard segment ratio before dispersion, chain extension, crosslinking, and post-curing in asphalt, resulting in better compatibility and more controllable processing. This review discusses PU soft/hard segment structures, asphalt composition, prepolymer synthesis and curing, microstructural evolution, pavement performance, storage stability, and use in other systems to clarify modification mechanisms and potential applications. This critical review aims to clarify material–reaction–process–performance relationships within the prepolymer route, with scope limited to molecular design, preparation mechanisms, performance, storage stability, and representative engineering applications. Future work should consider real service conditions and build multiscale evaluation frameworks that jointly optimise prepolymer design, processing, storage stability, and pavement performance, helping translate laboratory findings into low-carbon, long-life road materials that can be produced at scale. Full article

Indigenous Knowledge (IK) is the traditional wisdom used to manage and sustain ecosystem services (ES). This review paper presents the integration of ES and IK for sustainable natural resource management and policy in Ethiopia, suggesting that despite increased research in recent years, there is a lack of uptake at the policy and program implementation levels. A total of 75 studies published between 2015 and 2025 were systematically reviewed, covering an 11-year sequential scope following PRISMA 2020 guidelines and including articles from the Web of Science, Scopus, Google Scholar, African Journal Online and Indigenous Knowledge Documentation Centre (IKDC) databases. The findings show that provisioning services dominate the literature (67.4%), followed by regulating (18.3%), cultural (9.2%), and supporting services (5.1%). IK documented across 22 ethnic groups demonstrated important contributions to biodiversity conservation, sustainable agriculture, forest management, and water resource management. However, only 26.8% of the reviewed studies successfully integrated IK into ES frameworks. Policy content analysis tool (PCAT) of 23 national documents showed weak institutional support for IK integration, with an average integration score of only 5.8 out of 20. Major barriers include limited policy implementation, institutional fragmentation, and negative perceptions toward IK. Successful integration cases were strongly associated with community ownership, participatory monitoring, legal recognition, and long-term funding support. This review is important because it systematically shows that IK delivers confirmed environmental and livelihood benefits over this 11-year time frame. It highlights the urgent need for stronger policy frameworks, inclusive governance, and recognition of IK to improve ecosystem conservation and sustainable resource management in Ethiopia. Full article

Under complex terrains and extreme environmental conditions such as high wind speeds, prestressed rock anchor foundations for onshore wind turbines are subjected to multiple coupled adverse effects during long-term service, including cyclic wind loading, temperature variation, groundwater intrusion, and rock mass weathering. These factors significantly affect structural performance and service life through corrosion and material degradation processes, while conventional design methods mainly focus on ultimate bearing capacity and lack a systematic consideration of corrosion-induced deterioration mechanisms and long-term performance evolution. Without changing the theoretical framework of current design codes, this study introduces a durability-oriented design concept and explicitly incorporates corrosion effects and material degradation into the analytical system of prestressed rock anchor foundations. First, from the perspective of anchor force evolution, a time-dependent analysis method for long-term prestress loss is established, considering the coupled effects of steel corrosion, material relaxation, and cyclic loading. Second, for the mechanical behavior of group anchor systems, a shear capacity model is proposed that accounts for rock mass strength degradation and grout–rock interface deterioration. Meanwhile, the coupling relationship between foundation void development and groundwater seepage is analyzed, revealing its critical role in the corrosion evolution process. On this basis, a coordinated design method for foundation dimensions and prestress parameters is developed to satisfy both load-bearing capacity and durability requirements. Finite element analysis is further conducted to verify the stress and deformation characteristics of the foundation–rock–anchor system under nonlinear conditions. Engineering case studies demonstrate that the proposed method not only meets bearing capacity requirements, but also effectively suppresses void development, reduces corrosion risk, delays structural performance degradation, and improves long-term service reliability. The findings provide a theoretical basis and engineering reference for the durability design and lifecycle performance optimization of prestressed rock anchor foundations for onshore wind power structures in extreme environments. Furthermore, the study underscores the critical role of advanced anti-corrosion coatings and surface protection systems in mitigating the coupled corrosion-degradation mechanisms, aligning with the scope of this Special Issue on corrosion protection and durability of infrastructure in harsh environments. Full article

River crossing bridges in low-gradient floodplains can be affected by limited conveyance, backwater control, and scour-related foundation risk. This study evaluates a proposed IL 13 bridge replacement over the Mid Fork Saline River, Illinois, using HEC-RAS 1D steady-flow modeling, hydrologic inputs from USGS StreamStats for a drainage area of 236.45 mi², bridge opening analysis, multiple-opening interpretation, and HEC-18 scour assessment. Natural, existing, and proposed conditions were compared under design floods and Ohio River tailwater scenarios. The proposed bridge increased the effective waterway opening under all evaluated hydraulic scenarios, with increases of approximately 68.5–79.5% under the no-tailwater case, 76.1–76.9% under the 10-year Ohio River tailwater case, and 71.7–72.1% under the 50-year Ohio River tailwater case. Bridge opening velocity decreased by about one-third, indicating lower local hydraulic intensity and improved conveyance through the main opening. Contraction scour was not controlling, while computed pier scour decreased by approximately 8–10% and the controlling right abutment scour decreased slightly. Because empirical HEC-18 scour equations can have large uncertainty, commonly approaching an order of a factor of two in practical scour prediction, these reductions are interpreted only as comparative trends. They do not provide a basis for reducing foundation design requirements, but they indicate that the proposed replacement does not worsen the controlling scour response. Overall, the replacement improves hydraulic compatibility, reduces local hydraulic stress, and does not worsen the governing scour response. The study supports SDG 9, SDG 11, and SDG 13 in a hydraulic-infrastructure sense by promoting resilient bridge serviceability, safer transport connectivity, and adaptation-oriented flood risk assessment; however, full life-cycle carbon, cost, and network-resilience metrics were outside the scope. Full article

Background/Objectives: This scoping review examined recent evidence on the use of transformer-based language models, encompassing encoder-only architectures (e.g., BERT and its clinical variants) and generative large language models (LLMs; e.g., GPT-4 and Llama), to support clinical decision making from unstructured clinical notes, with implications for behavioral-health services where narrative documentation is central. Methods: Following PRISMA-ScR guidelines, PubMed, PsycINFO, and Web of Science were searched for peer-reviewed studies published between 1 January 2023, and 5 August 2025. Studies applying transformer-based language models to clinical narratives for healthcare tasks and reporting evaluative outcomes were included. We extracted data on clinical tasks, model architectures, enhancement strategies, and evaluation metrics; mapped each study by primary purpose, care setting, and primary model approach; and charted reported validation design, direct human comparison, fairness assessment, workflow evaluation, and clinical deployment. Results: Thirty-six studies were included. Information extraction/de-identification and classification/prediction predominated, whereas summarization/generation was less commonly represented. Model approaches appeared to align with task characteristics: encoder-only and decoder-only systems were frequently used for extraction, encoder–decoder systems for generation, and hybrid or pipeline-based approaches for classification and prediction. Standard task-specific metrics (e.g., F1 and AUROC) predominated, whereas evidence beyond retrospective task performance, including direct human comparison, fairness assessment, workflow evaluation, clinical deployment, and temporal or external validation, was rare. No included study evaluated a transformer-based language model application within a behavioral-health service or behavioral-health workflow. Conclusions: Transformer-based language models have been applied across diverse clinical-note tasks, but the evidence base more strongly supports retrospective task feasibility than transportability, equitable performance, workflow benefit, or safe clinical deployment. Future research should prioritize transparent reference standards, external and prospective validation, clinically meaningful human comparison, and equity-focused evaluation, including direct studies in behavioral-health services. Full article

Background/Objectives: Artificial intelligence (AI) is increasingly used in youth mental health services, including clinical decision support, risk prediction, and digital therapeutics. However, existing frameworks provide limited guidance for integrating ethical, cultural, and relational considerations into the design, governance, and implementation of AI-enabled mental health technologies. This scoping review examined how digital humanities-informed approaches have been incorporated into AI-supported mental health interventions for children and adolescents. Methods: A scoping review was conducted following the PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines. Peer-reviewed literature published between 2015 and 2025 was searched using PubMed and supplemented by semantic searches through Elicit. Systematic reviews, scoping reviews, and meta-analyses examining AI-enabled digital mental health interventions and digital humanities perspectives were included. Data were synthesized using inductive thematic analysis. Results: Seventeen review-level studies met the inclusion criteria. Six recurring themes were identified: engagement, participatory co-design, human oversight, equity, ethical governance, and implementation. Across the included reviews, humanities-informed approaches were associated with greater attention to relational engagement, stakeholder participation, transparency, contextual adaptation, and culturally responsive implementation. Evidence supporting intervention effectiveness was strongest in systematic reviews and meta-analyses, whereas findings related to ethics, governance, equity, and implementation were derived primarily from scoping reviews and conceptual syntheses. Conclusions: This review suggests that digital humanities provides a valuable interdisciplinary perspective for informing the design, governance, and implementation of AI-enabled youth mental health interventions. Although the current evidence base remains heterogeneous, integrating humanities-informed approaches may support the development of AI systems that are more ethical, equitable, and developmentally responsive. Future research should evaluate these approaches through empirical implementation studies and emerging generative AI applications. Full article

Autonomous vehicles (AVs) are moving from pilots to regular urban service, yet the speed of large-scale implementation remains uncertain. While prior research emphasizes technological feasibility and adoption, less attention has been paid to the socio-technical dynamics that constrain deployment. This study examines how unintended consequences shape the pace of AV implementation in cities. Drawing on a mixed-methods design combining a structured scoping review with 18 expert interviews, interrelated dynamics are identified across institutional, behavioral, economic-platform, spatial, and normative-societal domains. The findings indicate that implementation speed is not determined by technology alone but emerges from reinforcing feedback loops that generate systemic frictions, including governance lag, demand rebound, spatial bottlenecks, and legitimacy challenges. The study advances a systems-oriented framework that conceptualizes implementation speed as an emergent property of socio-technical dynamics, highlighting the importance of adaptive and anticipatory governance for sustainable urban mobility transitions. Full article

Background: Artificial intelligence (AI) is increasingly proposed to augment early-stage assistance for survivors of sexual and gender-based violence (GBV), including intimate partner and domestic violence, across crisis hotlines, specialist services, digital reporting channels, legal support tools and healthcare pathways. However, the scope, maturity and evaluative strength of the peer-reviewed evidence remain uncertain. We aimed to map the application domains, evaluative maturity, and implementation and safety gaps of this evidence base. Methods: We conducted a scoping review reported according to the PRISMA Extension for Scoping Reviews (PRISMA-ScR), using a Population–Concept–Context framework focused on AI-enabled first-response and early support. Searches in Scopus, Web of Science Core Collection and PubMed were supplemented by targeted searches of IEEE Xplore and ACM Digital Library. Records were screened against predefined criteria, charted using a structured form and synthesised descriptively. Results: Original searches yielded 187 records and 21 included sources of evidence. The supplementary search identified 539 records/candidates; 27 full texts were assessed and 6 additional sources met eligibility criteria, yielding 27 included sources of evidence. Evidence covered survivor-facing conversational support; screening and triage in emergency and specialist services; social-triage and online disclosure models; survivor-informed help-seeking and chatbot design; legal/support routing; and enabling modalities such as speech-based approaches. Most sources reported technical performance, usability, acceptability or systems-audit findings, while no workflow-integrated evaluation was identified and survivor-centred effectiveness outcomes, service uptake and adverse-event monitoring were rarely reported. Conclusions: The evidence remains heterogeneous and early-stage, with limited support for service-integrated effectiveness or safety. Included sources more often assessed models, interfaces or prototypes than downstream pathway outcomes. The findings support cautious, pathway-aware interpretation and identify recurring concerns regarding escalation, accountability, equity, digital trace safety and human handover. The proposed practice considerations and outcome domains are author-informed priorities for future pilot and implementation studies, not validated guidelines. Full article

Offshore wind can diversify the Brazilian electricity matrix, but foundation design on the Ceará continental shelf must account for carbonate sands whose stiffness, crushability and stress-dependent response differ from those of quartz sands. This study contribution is the use of carbonate-sand parameters calibrated from consolidated-drained triaxial tests on Ceará-shelf sediments and the direct comparison of two sands with contrasting carbonate contents. The measured responses calibrated the Hardening Soil model in PLAXIS 2D, and the resulting parameters drove PLAXIS 3D simulations of monopiles with different diameters, embedment lengths and tower heights under monotonic lateral loading. The more calcareous sand showed higher frictional strength but lower stiffness—as a result, it mobilised larger mudline displacements, making the Serviceability Limit State more restrictive than the Ultimate Limit State. Pile diameter controlled lateral capacity, whereas reduced L/D lowered system stiffness and serviceability performance. Within the monotonic, homogeneous-profile scope adopted here, M3 (D = 9 m, L = 36 m, L/D = 4) gave the most favourable response for the medium-rated turbine class. The results provide screening-level comparative evidence, not a design-ready proof of feasibility. Full article

Despite significant biomedical advances in the prevention of mother-to-child transmission (MTCT) of HIV, residual transmission and suboptimal maternal outcomes persist across Europe. The challenge is no longer primarily virological but structural: aggregated ART coverage indicators mask important discontinuities across the perinatal care pathway. This scoping review maps evidence on clinical and psychosocial dimensions of the perinatal HIV pathway among adult women living with HIV (WLHIV) in Europe, and identifies key gaps in their integration across the continuum of care. Following PRISMA-ScR guidelines, five databases were searched for studies published between 2010 and 2026. Of 1881 records identified, 109 met inclusion criteria. Findings were synthesized thematically using an inductively developed framework spanning preconception through long-term postpartum outcomes. MTCT rates declined from approximately 1–1.2% in the mid-2000s to below 0.5% in recent data, and vaginal delivery rates increased markedly with sustained viral suppression. However, persistent inequalities remain among younger women, migrants, and those with histories of injecting drug use. Stigma, migration-related vulnerability, mental health difficulties, constrained disclosure, and socioeconomic insecurity shape engagement with care, influencing treatment continuity, retention, and virological outcomes, particularly during the postpartum period. Equitable perinatal HIV outcomes require integrated care models that combine clinical HIV and obstetric services with mental health support, social needs screening, and migration-sensitive services to address the structural conditions shaping care trajectories. A substantial proportion of WLHIV in Europe originate from high-prevalence regions, making perinatal HIV in this context a direct interface between global infectious disease burden and migration health. Addressing care in European settings therefore contributes to broader global health equity goals in HIV elimination. The protocol was pre-registered on Open Science Framework with registration number: 10.17605/OSF.IO/9BZGY. Full article

Complete neighbourhoods, places where residents can meet their daily needs on foot, have become a central component of healthy and sustainable urban planning. Yet most assessment frameworks are calibrated for dense metropolitan environments, leaving rural and peri-urban municipalities without operational tools suited to their territorial needs. This article presents MilieuxVie, an open-source, browser-based interactive mapping application developed for the Laurentides health region of Québec (76 municipalities, 11 land-based unorganised territories, 2 indigenous territories and 4 aquatic administrative units; 93 territorial units in total; ~680,000 inhabitants). The tool evaluates the spatial accessibility of 12 service categories drawn from the Vivre en Ville (2026) complete-neighbourhood framework and OpenStreetMap data, using 2026 residential parcels from the provincial property assessment roll as origin points and weighting results by number of dwelling units. Three adaptive radius tiers (dense, intermediate, rural), based on residential dwelling-unit density (dwellings per km² of residentially designated urban land), scale the distance standards to settlement density. Because thresholds are scaled to settlement density, scores express context-relative service proximity rather than a uniform pedestrian standard and should not be read as directly comparable absolute accessibility across rural, peri-urban, and urban settings. A dedicated urban perimeter mode further disaggregates analysis to sub-municipal built-up zones, aligning the tool with Québec’s provincial Government land-use planning guidelines (GLPG). Gap analysis outputs identify which service types fall below the 70% coverage target, helping elected officials and planners identify where to focus further analysis. Results illustrate the scope of accessibility deficits across the region and highlight the analytical limits of uniform distance thresholds when applied beyond metropolitan contexts. Scores differ significantly across different settings (Kruskal–Wallis p = 0.006); the adaptive radius tiers narrow but do not close the structural gap, with rural municipalities scoring significantly lower than dense ones. The tool is freely available and requires no software installation, making it directly deployable by local planning offices. Full article