Search Results (121)

Background: Cancer is one of the leading causes of morbidity and mortality worldwide and in Spain. Individuals with cancer are at a higher risk of suicide compared to the general population due to both general and disease-specific risk factors. Objective: To update knowledge on nursing care measures to address the risk of suicide in cancer patients. Methods: A narrative review was conducted by searching PubMed, WOS, Scopus, and CINAHL during February and March 2025. The inclusion criteria comprised original qualitative, quantitative, and/or mixed-methods studies related to the topic of the review. Results: Of the 289 identified studies, 23 were selected. Twelve studies of cancer patients, ten studies of healthcare professionals, and one study of caregivers and survivors were included. Regarding suicide risk factors, eight studies addressed demographic aspects, fifteen socio-economic factors, twenty-one psycho-emotional factors, and seventeen physical factors. Key risk factors included male sex, advanced age, social isolation, lack of social support, hopelessness, and physical deterioration. Seventeen studies highlighted the need for continuous and comprehensive nursing care using validated tools for systematic assessment of suicide risk. Eight emphasised the importance of ongoing training in suicide prevention, which is essential for developing communication skills and improving therapeutic relationships. Five studies underscored the relevance of a holistic approach that addresses the physical, emotional, social, and spiritual dimensions of patient care. Six extended this approach to include family members and caregivers. Conclusions: Suicide risk in cancer patients is associated with multiple risk factors. Emotional support and a comprehensive, continuous nursing approach—based on systematic assessments, specialised training, and a holistic focus—are key to effective suicide prevention. Full article

Emergency calls, including medical emergency team and code blue calls, aim to respond to and assess patients at an earlier stage of clinical deterioration (to potentially avoid cardiac arrest and death). With an increasing prevalence of hospital access block, more admitted patients are boarding in the Emergency Department (ED). Although emergency calls were traditionally a ward-based system, they are now occurring more often in the ED. Large variations exist in the staffing mix and specialist skill sets between ED- and ward-based care. There is a paucity of evidence describing the epidemiology of patients that require emergency calls in the ED setting. Objectives: We aim to evaluate the population of adult patients that require emergency calls in our tertiary ED. Methods: This study utilised the Tasmanian Emergency Care Outcomes registry (TECOR) to perform a retrospective cohort study of emergency calls occurring over a 13-month period. Descriptive statistics are used to summarize the data. Categorical variables are presented as frequencies and their percentages and continuous variables are depicted as means and standard deviations (SDs) or medians and interquartile ranges (IQRs), as appropriate. Results: There were 600 emergency calls in the ED, involving 423 unique patients and 596 (99.33%) MET calls. The mean patient age was 68.68 years (SD 17.87). The mean ED length of stay for patients with an emergency call was 18.28 h (SD 8.96). Calls made were predominantly for systolic blood pressure < 90 mmHg (310, 51.67%). The mean duration of an emergency call was 40.89 min (SD 20.48). Most patients had a single emergency call (311, 73.18%). For our cohort, goals of care remained unchanged following 341 (56.83%) emergency calls. Conclusions: Emergency calls in the ED are uncommon, representing 2.08% of all admissions from the ED. Patients in the ED requiring an emergency call have a mean length of stay twice that of all ED presentations. Recognising and responding early to address the concerns that trigger a call may help to mitigate this additional burden. More research is required to explore the factors that will lead to effective and appropriate care before, during, and after an ED emergency call is made. Full article

Food loss and waste are critical challenges in Taiwan’s agri-food supply chain, deteriorating security and resource efficiency. By employing the best–worst method (BWM), a multi-criteria decision-making model was developed in this study to evaluate the severity of losses and wastes. Combining literature review results with expert survey analysis results, key loss points, and mitigation strategies were identified to enhance sustainability and efficiency in Taiwan’s agricultural food system. Among the seven stages of the agricultural food supply chain, supermarket waste (16.95%) was identified as the severest, followed by government policies (16.63%), restaurant waste (15.35%), processing loss (14.71%), production site loss (13.64%), household waste (11.93%), and logistics/storage/distribution loss (10.79%). In the subcategories of each supply chain stage, the eight severe issues were identified as “Inadequate planning and control of overall production and marketing policies” under government policies, “Adverse climate conditions” and “Imbalance in production and marketing” under production site loss, “Inaccurate market demand forecasting” and “Poor inventory management at supermarkets” under supermarket waste, and “Improper storage management of ingredients leading to spoilage” as well as “Inability to accurately forecast demand due to menu diversity” under restaurant waste. The least severe issues included “Poor production techniques” under production site loss. Other minor issues included “Inefficient use of ingredients due to poor cooking skills”, “Festive culture and traditional customs”, and “Suboptimal food labeling design”, all of which contributed to household waste. Based on these findings, we proposed recommendations to mitigate food loss and waste in Taiwan’s agricultural food supply chain from practical, policy, and academic perspectives. The results of this study serve as a reference for relevant organizations and stakeholders. Full article

In recent decades, Japan has faced rural depopulation due to urban migration, resulting in widespread property abandonment, the “Akiyas”. This paper presents RE-HAK (Refurbish to Host in Akiyas), a blockchain-based framework promoting a circular economy (CE). RE-HAK enables occupants to live rent-free in Akiyas by completing AI-managed refurbishment milestones via smart contracts. Each milestone—waste removal, structural repairs, or energy upgrades—is verified and recorded on the blockchain. Benefits include: (1) rural economic revival through restoration incentives; (2) sustainable CE adoption; (3) preserving property values by halting deterioration; (4) safeguarding cultural heritage via traditional architecture restoration; and (5) transparent management through automated contracts, minimizing disputes. Findings from three case studies demonstrate RE-HAK’s adaptability across skill levels and project scales, though limitations such as rural digital literacy gaps and reliance on government support for scalability are noted. The framework advances Japan’s revitalization goals while offering a replicable model for nations facing depopulation and property abandonment, contingent on addressing technological and policy barriers. Full article

Background and Objectives: The connection between cognitive decline and autonomy represents a complex and multifactorial area of research. Cognitive decline manifests as a progressive impairment of higher mental functions and is typical of neurodegenerative conditions such as dementia. Autonomy, on the other hand, is defined as an individual’s ability to independently manage activities of daily living and make informed decisions. The objective of this study was to investigate whether certain daily living skills can persist despite the advancement of dementia, and what factors contribute to their preservation in maintaining autonomy. Materials and Methods: A literature review was conducted using the databases PubMed, Web of Science, Scopus, Cochrane Library, Embase, and PsycInfo. Out of an initial pool of 12,113 studies, only 19 met the inclusion criteria and were selected for analysis. Results: The findings indicate that, in non-institutionalized settings, some daily living abilities may remain preserved despite cognitive deterioration. In contrast, within institutionalized environments, a significant correlation emerged between cognitive decline and the progressive loss of personal autonomy. Conclusions: This study highlights the importance of assessing residual abilities in individuals with dementia. Recognizing and supporting these remaining skills can play a crucial role in enhancing quality of life, delaying institutionalization, and promoting autonomy even in the presence of advanced cognitive decline. Full article

This study investigated the small-strain dynamic properties of expanded polystyrene (EPS) lightweight soil (ELS), a low-density geosynthetic material used to stabilize slopes and alleviate the subgrade settlement of soft soil. Resonant column tests were conducted to evaluate the effects of EPS’s granule content (20–60%), confining pressures (50 kPa, 100 kPa, and 200 kPa), and curing ages (3 days, 7 days, and 28 days) on the dynamic shear modulus (G) of ELS within a small strain range (10⁻⁶–10⁻⁴). The results indicate that ELS exhibits a high dynamic shear modulus under small strains, which increases with higher confining pressure and longer curing age but decreases with an increasing EPS granule content and dynamic shear strain, leading to mechanical property deterioration and structural degradation. The maximum shear modulus (G_max) ranges from 64 MPa to 280 MPa, with a 60% reduction in G_max observed as the EPS granule content increases and increases by 11% and 55% with higher confining pressure and longer curing ages, respectively. A damage model incorporating the EPS granule content (a_E) and confining pressure (P) was established, effectively describing the attenuation behavior of G in ELS under small strains with higher accuracy than the Hardin–Drnevich model. This study also developed an engineering testing experiment that integrates materials science, soil mechanics, and environmental protection principles, enhancing students’ interdisciplinary knowledge, innovation, and practical skills with implications for engineering construction, environmental protection, and experimental education. Full article

Background/Objectives: Postpartum hemorrhage (PPH) is the most prevalent complication of childbirth and the most preventable cause of maternal mortality worldwide. Maternity nurses and midwives are often the first-line providers responding to PPH. As a result, maternity nurses have the potential to save the lives of women who are clinically deteriorating because of PPH. Simulation-based training is an effective way to develop maternity nurses’ knowledge, skills, and experience to save a woman’s life after PPH. Aim: to investigate the effect of simulation-based training on nurses’ knowledge and performance about primary postpartum hemorrhage management. Design: an experimental design (pre-test/post-test control group). Setting: the study was conducted in the labor and delivery room at KAUH in Jeddah, Saudi Arabia. Sample: A convenient sample of 54 nurses and midwives who were working in the labor and delivery room and the postnatal unit was randomly divided into two equal groups, the control group and study group. Tools: A structured tool was used for data collection and consisted of four parts: I—sociodemographic data, II—assessment of nurse’s/midwives’ knowledge about prevention and management of primary PPH, III—nurse’s/midwives’ performance observational checklist for primary PPH management, and IV—nurse’s/midwife’s satisfaction of the simulation-based training session. Results: The study group had a significantly higher knowledge level immediately after training (X² = 9.39, p = 0.002) and one month after training (X² = 5.51, p = 0.02). Regarding the performance level and total practice level immediately after the intervention, the study group had statistically significantly better practices (X² = 50.143, p = 0.000 *) and this continued one month later (X² = 50.143, p = 0.000 *). Conclusions: The nurses’ knowledge and performance skills related to primary postpartum hemorrhage care improved after receiving simulation-based training. We recommend that all the maternity nurses and midwives participate in an ongoing in-service simulation training program to enable nurses to demonstrate an active role in PPH prevention and management. Full article

This paper presents the theoretical foundation, practical implementation, and empirical evaluation of a glove for interaction with 3-D virtual environments. At the dawn of the “Spatial Computing Era”, where users continuously interact with 3-D Virtual and Augmented Reality environments, the need for a practical and intuitive interaction system that can efficiently engage 3-D elements is becoming pressing. Over the last few decades, there have been attempts to provide such an interaction mechanism using a glove. However, glove systems are currently not in widespread use due to their high cost and, we propose, due to their inability to sustain high levels of performance under certain situations. Performance deterioration has been observed due to the distortion of the local magnetic field caused by ordinary ferromagnetic objects present near the glove’s operating space. There are several areas where reliable hand-tracking gloves could provide a next generation of improved solutions, such as American Sign Language training and automatic translation to text and training and evaluation for activities that require high motor skills in the hands (e.g., playing some musical instruments, training of surgeons, etc.). While the use of a hand-tracking glove toward these goals seems intuitive, some of the currently available glove systems may not meet the accuracy and reliability levels required for those use cases. This paper describes our concept of an interaction glove instrumented with miniature magnetic, angular rate, and gravity (MARG) sensors and aided by a single camera. The camera used is an off-the-shelf red, green, and blue–depth (RGB-D) camera. We describe a proof-of-concept implementation of the system using our custom “GMVDK” orientation estimation algorithm. This paper also describes the glove’s empirical evaluation with human-subject performance tests. The results show that the prototype glove, using the GMVDK algorithm, is able to operate without performance losses, even in magnetically distorted environments. Full article

Background/Objectives: The extensive exposure of physicians to the COVID-19 pandemic has contributed to occupational stress and burnout in their daily lives. This study aimed to explore the lived experiences of intern physicians who experienced burnout during the COVID-19 pandemic and to identify potential solutions to enhance clinical practices in future pandemics. Methods: This study employed a qualitative, phenomenological study utilizing in-depth interviews. The participants were 19 first-year intern physicians from public hospitals in Thailand, selected through a purposeful sampling approach who had experienced burnout. Semi-structured interviews were conducted face-to-face and via online platforms. A thematic narrative analysis approach was used. Results: Phenomenological explorations included two parts: the first explored physicians’ workplace conditions while providing patient care, and the second focused on their proposed solutions for policy changes in clinical practices and hospital management. Four main themes in the first part were derived: (1) emotional suffering and burnout; (2) engaging with a high-intensity workplace; (3) hostile work environments; and (4) deterioration of relationships with staff and colleagues. The second part identified three main themes: (1) changes in policy of clinical practices; (2) effective hospital management; and (3) building interpersonal skills. Conclusions: The COVID-19 pandemic has exacerbated challenges faced by intern physicians, such as high-pressure working conditions, deteriorated relationships with colleagues, and ineffective management, all of which contribute to burnout. These challenges require targeted policy changes in clinical practices, effective hospital management, and building interpersonal skills. Recommendations include improved clinical practices, increased academic support, comprehensive orientation programs, effective communication, teamwork assistance, stress management, and transforming organizational culture to value physicians during internships. Full article

Groundwater is one of the major sources of water supply for human needs. But anthropic activities such as agriculture are causing significant volume depletion and quality deterioration, favoring microbial contamination that has a negative impact on human health. The geological characteristics of the ground can influence the transport of microorganisms, especially if made of permeable rock. Furthermore, irrigation with untreated or partially treated wastewater can represent an additional health risk due to the potential transmission of pathogens to food. The aim of our research is to provide an interdisciplinary perspective on this issue by integrating hygienic, geological, and agronomic skills. Water samplings are scheduled seasonally by four monitoring campaigns in five sampling points placed in two Southern Italy regions, Apulia (one point at the outlet and two wells near the wastewater plant at Carpignano Salentino, Lecce province, Italy) and Sicily (two wells at Scicli and Pozzallo, Ragusa province, Italy) Laboratory experiments of microorganism transport in permeable rocks will be carried out under saturated and unsaturated conditions. A mathematical model of transport through porous media will be implemented and validated with laboratory measurements. The model will be used to develop a monitoring tool to control sites in Apulia and Sicily where periodic cultural and molecular detection of pathogenic bacteria, viruses, and protozoa will also be taken. In addition, an analysis of the microbiological contamination of herbaceous crops due to the use of low-quality water will be conducted to assess the Quantitative Microbial Risk Assessment (QMRA). The project will provide methodological tools to evaluate anthropogenic pressures and their impact on environmental matrices. The results will allow these pressures to be modulated to minimize environmental and agri-food microbiological contamination and protect public health. Full article

In research focusing on esports, studies have been conducted on designs that attract competitors, performance estimation, training methods, and motivational factors. However, quantitative and convenient methods for performance evaluation are still in the development stage among the numerous performance evaluation methods. In particular, few method has been developed to objectively measure an individual’s mental state utilizing limited equipment. It has been observed that when players’ performance deteriorates or they are under pressure, they occasionally operate the controller in accordance with their state, resulting in the sound of the controller increasing. Therefore, this study aimed to clarify the relationship between the sound of esports players’ controller operations and their objective as well as subjective metrics, including their emotional state and performance during the game. Initially, the controller sounds of players of various ranks in Super Smash Bros. Ultimate (SSBU) by Nintendo were explored, aiming to elucidate the connection between the operation sounds of adept and intermediate esports competitors and their day-to-day fluctuations in game performance and emotional well-being. The findings revealed a discernible pattern: the more proficient the player, the more resonant the sounds emanating from their controller during gameplay. Furthermore, the operational sounds of skilled players exhibited an escalation when their performance faltered. Full article

Background: Due to the enormous caregiving burden faced by informal caregivers, providing appropriate skills training has become an important supporting strategy in many countries/regions. Understanding caregivers’ training needs is instrumental in designing effective training intervention programs, which are expected to reduce the caregiving burden of informal caregivers and avoid the health deterioration associated with caregiving. This paper aims to explore the potential training needs of informal caregivers in Shanghai, and to identify the factors associated with these perceived training needs. Methods: A total of 196 eligible informal caregivers participated in this survey. A multivariate analysis was conducted to explore the factors associated with informal caregivers’ perceived training needs. Results: 86.7% (N = 170) of the caregivers reported at least one need for targeted training activity, and 62.7% (N = 123) of them identified two or more training needs. The top three activities requiring training included the following: self-care skills; safety supervision; and functional rehabilitation. The factors associated with various training needs included the health status of the care recipient, complementary caregiving support, caregiving stress, and the personal attributes of the informal caregiver. The technical skills training needs were more related to the care recipients’ health status (e.g., dependency level, disease progression) and formal care support resources. Conversely, the intangible skills training needs were more sensitive to caregiver attributes (e.g., gender, age, and education level). Conclusions: A personalized training strategy and early-stage intervention program are critical to providing effective support to informal caregivers. The potential implications are to raise awareness of the importance of skills training for informal caregivers, and to inform the implementation of effective training strategies for improving the quality of informal care and the well-being of informal caregivers in China. Full article

Objective: In the United Kingdom (UK) and most countries worldwide, midwives are professionally required to undertake an initial perinatal mental health (PMH) risk assessment at every maternity contact. However, studies have found that midwives feel that they are not well-equipped to provide effective care for women with PMH needs. This study explores how the newly qualified midwives (NQMs) are prepared through pre-registration midwifery education and placements to have sufficient confidence in their knowledge, attitude, skills, and habits (KASH) for their post-registration PMH role. Methods: This explanatory sequential mixed methods study collected survey data from two independent groups: NQMs (n = 50), who qualified from 10 UK universities, and senior specialist midwives (SSMs) (n = 32). Descriptive and inferential responses were analysed using SPSS. Statistical differences between the ranged Likert scale responses of the NQMs and SSMs were analysed using the Mann-Whitney U test. The p-value of <0.05 was considered statistically significant. The semi-structured interview phase comprised of NQMs (n = 12) and SSMs (n = 8). The qualitative data were thematically analysed using NVivo. Results: The pre-registration midwifery programme significantly prepared the NQMs to have sufficient confidence in their knowledge of the related PMH role, multidisciplinary team (MDT) role, and available services (p < 0.05) and good attitude towards women with varying PMH conditions (p < 0.0005). The NQMs had sufficient confidence in their skills in using the validated tool for PMH assessment, to build rapport to facilitate disclosure, and recognise deteriorating PMH (p < 0.01). They had regular habits of discussing PMH well-being at booking and made prompt referrals (p < 0.05). The NQMs were not prepared to have sufficient knowledge of PMH medications, perinatal suicide prevention, and the impact of maternal mental health on partners (p < 0.01) including children (p < 0.05); skills in managing PMH emergencies (p < 0.05), and to regularly discuss suicidal thoughts (p < 0.01), issues of self-harm, and debrief women following pregnancy or neonatal losses and traumatic births (p < 0.05). Some aspects were either confirmed or contradicted at the interviews. Conclusions and recommendations: The pre-registration midwifery programme prepares the NQMs to some extent for their post-registration PMH role. Perceived areas for improvement suggest implications for the development of educational, practice, policy, and preceptorship to facilitate the NQMs’ sustainable confidence in their KASH. Full article

Accurate surface soil moisture (SM) data are crucial for agricultural management in Jiangsu Province, one of the major agricultural regions in China. However, the seasonal performance of different SM products in Jiangsu is still unknown. To address this, this study aims to evaluate the applicability of four L-band microwave remotely sensed SM products, namely, the Soil Moisture Active Passive Single-Channel Algorithm at Vertical Polarization Level 3 (SMAP SCA-V L3, hereafter SMAP-L3), SMOS-SMAP-INRAE-BORDEAUX (SMOSMAP-IB), Soil Moisture and Ocean Salinity in version IC (SMOS-IC), and SMAP-INRAE-BORDEAUX (SMAP-IB) in Jiangsu at the seasonal scale. In addition, the effects of dynamic environmental variables such as the leaf vegetation index (LAI), mean surface soil temperature (MSST), and mean surface soil wetness (MSSM) on the performance of the above products are investigated. The results indicate that all four SM products exhibit significant seasonal differences when evaluated against in situ observations between 2016 and 2022, with most products achieving their highest correlation (R) and unbiased root-mean-square difference (ubRMSD) scores during the autumn. Conversely, their performance significantly deteriorates in the summer, with ubRMSD values exceeding 0.06 m³/m³. SMOS-IC generally achieves better R values across all seasons but has limited temporal availability, while SMAP-IB typically has the lowest ubRMSD values, even reaching 0.03 m³/m³ during morning observation in the winter. Additionally, the sensitivity of different products’ skill metrics to environmental factors varies across seasons. For ubRMSD, SMAP-L3 shows a general increase with LAI across all four seasons, while SMAP-IB exhibits a notable increase as the soil becomes wetter in the summer. Conversely, wet conditions notably reduce the R values during autumn for most products. These findings are expected to offer valuable insights for the appropriate selection of products and the enhancement of SM retrieval algorithms. Full article

The crisis of civilization we are experiencing unbalances the inter-relational, interdependency and intergenerational relationships of the planetary ecosystem, putting all species at risk. The current relationship between the unlimited economic development model and its social impacts in all regions, territories and communities is analyzed. These are more severe in the global South and the most impoverished populations, which often leads to conflicts, the deterioration of subsystems of life, and, as a result, movements of people. These challenges highlight the close interrelationship between social justice and issues of ecological injustice acting as a new source of inequality. The responsibility of social work, which is called on to incorporate the ecosocial perspective in all its areas and dimensions of practice, is becoming consolidated. To achieve this, five measures are proposed: expanding and strengthening the ethical and political basis of the profession; promoting the skilling-emancipatory models; cutting across all levels, methodologies and action areas; new fields of practice for ecosocial work; and introduction into social work curriculums. Social justice cannot be fully achieved without taking ecological justice into account. Full article