Search Results (2,601)

This narrative review examines the Comprehensive Geriatric Assessment (CGA), a multidisciplinary approach used to evaluate and manage the health of older adults. CGA has been shown to improve functional status, reduce hospital readmissions, delay institutionalization, and lower mortality. Despite these benefits, systematic implementation remains limited. Major barriers include shortages in the workforce and resources, a lack of standardized protocols, and insufficient training in geriatric competencies. These challenges leave many older adults with unmet healthcare needs, particularly in chronic disease management, functional limitations, mental health, and social support. Nurses are well positioned to address these gaps because of their expertise in patient-centered care, care coordination, and chronic disease management. Strengthening geriatric nursing education and integrating CGA into routine nursing practice can improve outcomes for the aging population. Although CGA is often associated with hospital settings, its future lies in broader application. Digital solutions scheduled health assessments, workforce planning, and community- or home-based evaluations can make CGA more accessible. Policymakers, healthcare systems, and educational institutions must work together to develop policies that embed CGA within primary healthcare. Full article

Background: Use of Artificial Intelligence (AI) is proliferating in society and in pharmacy practice. For some, this represents a great advancement that will enhance effectiveness and efficiency of health care. For others, it is an existential risk that will worsen inequalities, lead to deskilling of the workforce, and spiral beyond the comprehension or control of humans. Human-in-the-loop (HiL) vs. human-out-of-the loop (HoL) AI have different potential risks and challenges that raise questions regarding patient safety. Defining principles for responsible adoption of AI in pharmacy practice will be an important safeguard for both patients and the profession. Methods: Semi-structured interviews with 12 pharmacy regulators from across Canada and the United States were undertaken, with informed consent. Constant comparative data analysis using nVivo v15 was used to identify common themes. The COREQ framework was applied to assure quality of research processes used. Results: Pharmacy regulators highlighted the value of a principles-based, rather than rules-based, approach to AI. Core principles related to transparency, redundancy, audit and feedback, quality assurance, privacy/data security, alignment with codes of ethics, and interoperability were identified. There was limited consensus on the role of consent and choice as principles to be considered. Conclusions: The role of regulation in shaping responsible adoption of AI in pharmacy will be significant. This study highlighted a series of agreed-upon principles but also identified lack of consensus with respect to how consent and choice could be operationalized in pharmacy practice. Full article

(1) Background/Purpose: Our research focuses on stakeholders’ attitudes in the Slovak SME sector, which we assessed through a questionnaire. The ability to evolve and adapt continuously is critical for micro-enterprises in competitive markets. (2) Study Design/Methodology/Approach: The primary objective of our research is to gain a comprehensive understanding of the new work organization processes in SMEs operating in a rapidly changing economic environment. Our research employed a single-sample cross-sectional sampling method, wherein respondents completed a questionnaire within a defined time frame. The primary data collection was carried out using a questionnaire containing closed questions. The research assesses the opinions of the respondents regarding the problem under study over a given period of time. The survey was conducted online. (3) Findings: 31% of the companies surveyed considered that introducing new work organization processes would make the company more adaptable to the changing economic environment. Only one-third considered involving employees in the processes the most important means to achieve this. Higher employee satisfaction is reported as a positive by 24% of companies. However, only a quarter of them believe the best way to achieve this is to involve employees in processes. For micro-enterprises, limited resources and smaller staff prioritize effective communication, and gaps can cause significant difficulties. Regarding the sample examined, among the hypotheses based on the literature background, we were only able to accept hypothesis H3 with modifications, which states that the biggest challenge for micro-companies in the industrial sector in a competitive market is understanding new technologies when improving employee skills. (4) Originality/Value: The research shows that micro-enterprises are particularly sensitive to the challenges associated with new technologies, which can be important information for designing training programs and developing support strategies for enterprises. Full article

Background: Postoperative free flap monitoring, traditionally performed by surgical residents, has shifted toward nurse-led models due to global workforce constraints. While this practice is widespread, its implementation is fragmented, creating a “standardization gap” between successful outcomes and reproducible protocols. This scoping review aimed to comprehensively map all available evidence on nurse involvement in free flap monitoring and synthesize the findings into an evidence-based framework for implementation. Methods: A scoping review was conducted following PRISMA-ScR guidelines. A comprehensive search of PubMed, CINAHL, and the Cochrane Library was performed without date or language restrictions. Data from included studies were charted and synthesized narratively to identify key themes related to protocols, education, and clinical outcomes. Results: Twelve studies met the inclusion criteria. The evidence demonstrates that well-structured, nurse-led monitoring protocols achieve high flap success rates (≥94%), comparable to physician-intensive models. Three major themes emerged from the analysis: (1) the equivalence of clinical outcomes under nurse-led care; (2) the role of technology as an enabler for objective assessment and anxiety reduction; and (3) a persistent “standardization gap” due to significant variation in protocols and training across institutions. A critical knowledge deficit among nurses regarding venous congestion was also identified as a key target for educational interventions. Conclusions: Nurse-led free flap monitoring is a safe and effective model of care. Successful implementation hinges on a framework built upon three pillars: standardized education, clear and actionable protocols, and the standardized integration of technology. This review provides the first comprehensive roadmap to bridge the existing standardization gap and offers a foundation for developing international best-practice guidelines. Full article

Background/Objectives: Menopause is a significant, universal hormonal transition, with symptoms impacting ~80% of women. Research shows that menopause can be professionally disruptive, contributing to decreased productivity, absenteeism, and early exit from the workplace. The objective of this study was to describe the landscape of menopause among Canadian women physicians and explore its potential impact on work performance, job satisfaction, and absenteeism. Methods: In this exploratory cross-sectional study, Canadian physicians self-identifying as women and peri-menopausal or menopausal were invited to participate in an online survey between May–September 2023. Demographic and practice characteristics data were collected. A modified Menopause Rating Scale (MRS) was used to quantify symptom burden. Qualitative data describing the menopausal experience were collected as well. Primary outcome was self-reported work performance. Secondary outcomes included perceived impact of menopause on promotional opportunities, absenteeism, and job satisfaction. Multivariable regression was used to examine associations between MRS scores and outcomes of interest. Results: Among 217 respondents, 47.7% reported a severe menopausal symptom burden; 40% felt menopause negatively impacted work performance, and 16.1% expressed job dissatisfaction. However, fewer than 10 respondents (4.6%) ever took time off for menopausal symptoms. Increasing MRS scores were significantly associated with negative perceived work performance (p < 0.001), fewer promotional opportunities (p < 0.001), and lower job satisfaction (p = 0.006) when controlling for confounders. Qualitative responses were provided by 43 participants, 6 of whom reported positive aspects of the menopausal transition, whereas 20 elaborated on the challenges. Conclusions: Canadian women physicians can experience severe menopausal symptoms, often without support. This needs assessment highlights an important occupational health issue and suggests that opportunities remain for medical institutions and employers to formally recognize and study this life stage of women physicians to improve well-being for this valuable workforce. Full article

This paper examines how organizations and regions integrate digital transformation with environmental sustainability (“twin transition”). Based on 43 semi-structured expert interviews across 27 countries, we identify five empirically grounded insights. First, adoption is propelled by competitive pressure, external shocks, and rising regulatory and stakeholder demands. Second, success depends on internal capabilities—clear leadership vision and workforce skills—together with supportive regional innovation ecosystems. Third, deliberate technological synergies—especially digital twins for lifecycle optimization, Artificial Intelligence (AI)/analytics and Internet of Things (IoT) for monitoring, and blockchain for traceability—enable measurable gains in resource efficiency and environmental performance. Fourth, integration strengthens eco-innovation capacity, resilience to disruption, competitive positioning, and regional innovation dynamics. Fifth, persistent barriers remain; organizational silos, key performance indicators (KPIs) misalignment, rebound effects from digital infrastructures, and uneven regional capabilities. By linking enabling conditions, integration mechanisms, and barriers, the study advances theory and offers actionable guidance for managers and policymakers on realizing the twin transition, using descriptive counts to indicate salience within a purposive expert sample rather than to draw statistical inferences. Full article

The nonprofit sector provides roughly one in ten jobs in the United States. Yet retirement benefits remain uneven and often inadequate compared to those in the public and private sectors. This article examines disparities in nonprofit access to retirement plans and analyzes how organizational and community characteristics shape retirement benefit provision. The study uses panel regression approaches with data from the NCCS Core PC files and the U.S. Census. The analysis shows that most nonprofits do not offer retirement plans, and those that do often contribute only minimally. Larger organizations and those with higher levels of donative revenue are more likely to offer and contribute to retirement plans. By contrast, the arts and humanities nonprofits and nonprofits in communities with lower educational attainment are significantly less likely to do so. Racial and geographic disparities also persist. Nonprofits in whiter communities are more likely to offer plans, though not necessarily at higher contribution levels. These findings underscore the need for targeted policy and philanthropic interventions. Supporting under-resourced organizations in providing competitive retirement benefits can promote workforce stability and advance equity across the nonprofit sector. Full article

The earthquakes that impacted Kahramanmaraş on 6 February 2023, caused multidimensional destruction across the southeastern provinces of Türkiye and incurred severe business losses. This study provides a comparative assessment of four heavily affected provinces (Adıyaman, Hatay, Kahramanmaraş, and Malatya) in terms of business losses. Eleven criteria, grouped as human and operational losses (HOL) and commercial and economic losses (CEL), were considered in the evaluation. For the first time, the Ranking Comparison (RANCOM) method was integrated into the Modified Kemeny Median Ranks Accordance (KEMIRA-M) framework to determine the weights of the criteria and ensure consistency in the ranking process. The findings indicate that Hatay suffered the highest level of losses, followed by Adıyaman, Kahramanmaraş, and Malatya, respectively. This study fills a gap in the disaster economics literature by emphasizing workforce and business continuity dimensions, an area where business losses have received relatively less attention. The results highlight that post-disaster recovery policies should not be limited to physical reconstruction but should also emphasize human capital, supply chain resilience, and sustainability-focused recovery strategies. Full article

Radioligand therapy (RLT) is a targeted treatment modality that combines a tumour-specific ligand with a therapeutic radionuclide. Once administered, the radiopharmaceutical binds selectively to cancer-associated targets, delivering cytotoxic radiation directly to tumour cells while sparing surrounding tissues. Two RLT agents, [¹⁷⁷Lu]Lu-DOTA-TATE (Lutathera^®) and [¹⁷⁷Lu]Lu-PSMA-617 (Pluvicto^®), have received regulatory approval for the treatment of advanced gastroenteropancreatic neuroendocrine tumours and metastatic castration-resistant prostate cancer, respectively. As of July 2025, more than 400 clinical trials are registered, exploring novel molecular targets such as FAP, CAIX, and GRPR, as well as alternative radionuclides and combination regimens in both solid and haematologic malignancies. In this review, we describe the design principles and mechanisms of action of RLT, summarise clinical evidence for approved and emerging radiopharmaceuticals, and discuss current global disparities in access and availability. Finally, we outline the main clinical challenges, including fixed dosing regimens, resistance, toxicity, and variability in patient selection and response assessment. Continued research to optimise radiopharmaceutical design, together with investment in infrastructure, workforce capacity, and international collaboration, will be essential to expand access and realise the full potential of RLT as a leading treatment strategy in modern oncology. Full article

Recent research has increasingly emphasized the synergies between Supply Chain Management Practices (SCMPs) and Quality Management Principles (QMPs), particularly through the emerging concept of Supply Chain Quality Management (SCQM). Despite this recognition, empirical evidence on how these practices interact to influence performance remains very limited, especially in the context of developing countries. This study addresses the gap by interviewing 70 Tunisian agri-food companies to investigate the relationships between five dimensions of SCMP, strategic supplier partnerships, customer relationship, information sharing, information quality and postponement, and the seven principles of ISO9001 QMP: leadership, engagement of people, improvement, customer focus, process approach, evidence-based decision making, and relationship management. Using factor analysis and structural equation modelling, the study explores the mediating role of competitive advantage (CA): price/cost, product quality, product innovation, delivery dependability and time-to-market—on operational performance. The findings indicate that analyzing SCMP, QMP, and CA as aggregated blocks does not produce significant explanatory correlations. Instead, judiciously reorganizing their sub-constructs into five integrated groups provides a more effective model: (1) information and decision capacity, (2) customer-centric innovation, (3) process management and agility, (4) supplier and network management, and (5) leadership and workforce engagement. This integrated classification offers managers a coherent framework for implementing SCMP and QMP to enhance competitiveness results. Full article

Smart devices and emerging technologies are highly popular devices and technologies that considerably improve our daily living by reducing or replacing human workforces, treating disease, monitoring healthcare, enhancing service performance, improving quality, and protecting the natural environment, and promoting non-gas emissions, sustainable working, green technologies, and renewable energy. Triboelectric nanogenerators (TENGs) have recently emerged as a type of advanced energy harvesting technology that is simple, green, renewable, flexible, and endurable as an energy resource. High-performance TENGs, denoted as advanced TENGs, have potential for use in many practical applications such as in self-powered sensors and sources, portable electric devices, power grid penetration, monitoring manufacturing processes for quality control, and in medical and healthcare applications that meet the criteria for smart devices and emerging technologies. Advanced TENGs are used as highly efficient energy harvesters that can convert many types of wasted mechanical energy into the electric energy used in a range of practical applications in our daily lives. This article reviews recently advanced TENGs and their potential for use with smart devices and emerging technology applications. The work encourages and strengthens motivation to develop new smart devices and emerging technologies to serve us in many fields of our daily living. When TENGs are introduced into smart devices and emerging technologies, they can be applied in a variety of practical applications such as the food processing industry, information and communication technology, agriculture, construction, transportation, marine technology, the energy sector, mechanical processing, manufacturing, self-powered sensors, Industry 4.0, drug safety, and robotics due to their sustainable and renewable energy, light weight, cost effectiveness, flexibility, and self-powered portable energy sources. Their advantages, disadvantages, and solutions are also discussed for further research. Full article

The escalating frequency and complexity of cyber threats have made cybersecurity education a national priority, yet a practical gap persists between theoretical instruction and workforce readiness. This study presents a comprehensive, modular framework for designing and implementing cybersecurity laboratories in academic institutions, environments that foster hands-on learning, skill mastery, and curricular innovation. Using a mixed-methods, multi-stage case study approach, the research combined qualitative analysis of institutional practices and instructional methods with quantitative evaluation of learning outcomes to comprehensively examine technical and pedagogical considerations impacting lab development. Data sources included literature analysis, direct observation, document review, and semi-structured interviews. The study synthesized best practices across these domains into a scalable lab design model grounded in experiential learning theory. Results demonstrate that the framework supports enhanced student performance, instructional adaptability, and simulation fidelity. Case study data revealed measurable gains in participant competency, with all participants achieving at least a 20% improvement in post-training test scores, high engagement levels demonstrated through consistent session attendance and active participation in hands-on exercises, and successful adaptation to logistical and technological barriers, including facility relocations and system downtime incidents. The lab’s modularity enabled curricular alignment, resource efficiency, and expansion to serve workforce training initiatives beyond the classroom. By integrating pedagogical (structured, teacher-guided instructional approaches) and andragogical (adult learning) design with technological scalability, this research contributes an actionable roadmap for institutions seeking to modernize cybersecurity education and respond effectively to evolving digital threats. The findings offer broad implications for future curriculum development, facilitator training, and sustainable program implementation. Full article

Background and Objectives: Timely recognition of deteriorating ward patients is critical to prevent adverse outcomes. The Deep learning–based Cardiac Arrest Risk Score (DeepCARS), an AI-based early warning system developed in Korea, has demonstrated high sensitivity and specificity, but its impact on real-world physician decision-making remains unclear, especially under healthcare resource constraints. Materials and Methods: We retrospectively analyzed 830 adult ward patients (March 2024–February 2025) who triggered DeepCARS alerts (score ≥ 91) at a tertiary hospital during a nationwide workforce shortage. Physician responses were classified as active intervention (ICU transfer, life-sustaining treatment [LST] decision, or specialty consultation) versus observation. Results: Among patients with DeepCARS ≥ 91, 58.9% received active intervention, with higher in-hospital mortality compared with those observed only (34.8% vs. 9.7%). ROC analysis suggested a cutoff of ≥94 for better intervention discrimination (AUC = 0.708). In multivariable analysis, DeepCARS ≥ 94 (OR 3.52) and chronic liver disease (OR 1.78) independently predicted active intervention. Multinomial analysis showed that patients admitted to medical departments were more often directed toward LST decisions rather than ICU transfer. Hemato-oncologic comorbidities were associated with both ICU transfer and LST decisions, while elevated respiratory rate consistently predicted either ICU transfer or LST discussions. Conclusions: DeepCARS alerts effectively triggered physician-driven decisions regarding ICU transfer and end-of-life care during a healthcare crisis. However, the ultimate clinical responses were shaped by comprehensive clinical judgment that integrated AI-generated risks with patient-specific factors, such as functional status and frailty, not captured by the algorithm. This underscores the indispensable role of individualized clinical assessment in interpreting and acting upon AI-based alerts in high-risk ward patients. Full article

Background/Objectives: Pediatric mental health is a major public health concern worldwide and primary care providers struggle to meet the growing demand for mental healthcare. Child Psychiatry Access Programs have emerged to fill gaps in primary care provider (PCP) training, confidence, and workflow support. This study aimed to describe the iterative development of a Child Psychiatry Access Program and present initial findings on its reach and feasibility in supporting PCPs. Methods: The Practical, Robust Implementation and Sustainability Model (PRISM) implementation framework guided the development and evaluation of the program. Pre-implementation surveys and invested partner interviews informed the creation of a multidisciplinary program comprising three components: (1) consultation services and resource navigation, (2) education and training, and (3) provider care guides. The program was then implemented, and reach was assessed via consultation calls, attendance at education and training series, resource navigation encounters, and care guide usage. Feasibility was evaluated through pre- and post-series self-reported ratings across six learning objectives. Results: Pre-implementation evaluation indicated high provider interest across all educational modalities. The resulting program included consultation services, education and training, resource navigation, and provider care guides. Educational trainings led to significant improvements in self-reported knowledge and confidence across six learning objectives, including assessment, treatment planning, family engagement, and navigating local resources. Resource navigation primarily facilitated ongoing management within the primary care setting, with PCPs retaining care in the majority of cases. Engagement with the Colorado Care Guide demonstrated sustained reach, with over 4600 page views from 1300 active users, reflecting broad and ongoing utilization of program resources. Consultation call data mirrored these trends, highlighting both frequently addressed diagnoses and expanding program reach over time. Conclusions: Child psychiatry access programs help support access to youth mental health care in the primary care space and offer potential solutions to workforce limitations during an era of increasing mental health concerns in youth and teens. Findings from this implementation may inform adaptation of child psychiatry access programs in other regions seeking to expand mental health support for children and adolescents in primary care settings. Full article

Currently, corporate social responsibility and environmental/social/governance topics are gaining more relevance in business and finance. Attention to corporate diversity in boards and the workforce is included in this trend. Although most studies focus on executive boards and objective scores, the perception of diversity by employees and its rankability are not fully understood or researched. In this paper, we analyze corporate diversity rankings from the perspective of predictive and prescriptive analytics. Inside predictive analytics, the perceived diversity of a sample of 350 European diversity leader companies is predicted by using three different feature sets (raw financial data, ratios and objective diversity variables) and three machine learning algorithms (K Nearest Neighbors, Logistic Regression, Decision Tree). The best performing algorithm is the Decision Tree, and all three feature sets outperform one random dummy algorithm; the best performing set is the financial ratios set. Inside prescriptive analytics, several rankings involving American companies are intersected and compared in three exercises (studying diversity categorization, ethnic origin and comparing diversity with other unrelated metrics). From these, global rankings were built to search for the best possible agreement among the rankings. These results with both predictive and prescriptive analytics encourage managers to strategize and include diversity in management, as well as employ new technologies in their decision-making processes. Full article