Search Results (3,234)

Background/Objective: Despite the vital role of nurses in health policy development, their involvement and influence in such development remain challenging. The involvement of nurse managers in health policy development in the Kingdom of Saudi Arabia (KSA) is not well examined. This study examined the extent of involvement of nurse managers in health policy development in the KSA and identified related barriers, benefits, confidence, and perceived impacts. Methods: A descriptive correlational cross-sectional design was used to achieve the study aim and objectives. An electronic self-administered questionnaire (Registered Nurses Involvement in Health Policy) was distributed to nurse managers working in the KSA. A total convenience sample of 238 nurse managers willingly and voluntarily agreed to participate. Data were collected from 10 February 2022 to 30 April 2022. Descriptive statistics and the Spearman rho correlation coefficient were used to analyze the data. Results: Among 238 nurse managers surveyed, 58% had received policy-related training, 73% reported high involvement as professionals, and 43% rated their confidence as high. Findings show the high level of involvement in health policy development of the nurse managers and their increased interest in influencing health policies. The policy activity most frequently chosen by the nurse managers is “provided health policy-related information to consumers or other professionals.” Moreover, the participants reported “lack of time, support, and resources” as their most perceived barrier and “improving public health” as their most perceived benefit. The majority of the nurse managers reported receiving information or training on health policies, and more than half of the participants rated their skills as “very good” or “excellent.” Our findings show the participants’ moderate level of confidence in performing health policy activities and moderate level of their perceived impact of their involvement in health policy activities on health outcomes. The results indicate a positive relationship between health outcomes and the ability of the nurse managers to influence health policy activities. Conclusions: The study findings suggest that Saudi nurse managers are increasingly engaged in policy development, but greater institutional support and targeted training are needed to strengthen their policy impact. Full article

Studies show that BIM has compelling benefits for work health and safety performance. Its capabilities for visualisation, information management, collaboration and simulation make it a powerful enabler for enhancing training, hazard identification, risk management and site monitoring. However, BIM adoption is inconsistent, even in advanced countries such as the United Kingdom, Finland and Singapore. While significant work has been conducted on technical, organisational and cultural features of BIM solutions, there is a lack of literature on conceptual and empirical studies on government policy that could strengthen BIM adoption. Our study investigated the Australian policy landscape to encourage widespread BIM adoption for improved work health and safety performance. This study had two research questions: (1) To what extent does the Australian policy landscape support the adoption of BIM for work health and safety? (2) What changes can be made to the policy landscape to better support the adoption of BIM for work health and safety? This study employed interpretivism and in-depth qualitative methods. We addressed the first research question with an explanatory model comprising 19 interrelated barriers, and the second with another explanatory model showing diverse strategies across six interrelated types of policy instruments, leading to outcomes that strengthen BIM adoption. Full article

Background: Aging populations make expanded workforce participation among older adults an economic and public health priority. The COVID-19 pandemic accelerated the growth of virtual work, providing new opportunities for healthy aging in the workplace through increased flexibility and less physical strain. However, digital exclusion, ergonomically challenging tasks, and social isolation can limit these opportunities for older populations. Objective: This scoping review aimed to synthesize interdisciplinary research on the relationship between remote work and labor force participation among adults aged 45 years and older, focusing on health-related outcomes, barriers, and facilitators. Methods: Following the JBI Manual for Evidence Synthesis and PRISMA-ScR guidelines, we conducted a comprehensive search across seven databases for peer-reviewed and gray literature published between 2000 and 2025. Of 2108 records screened, 33 studies met the inclusion criteria. Data were extracted using a standardized charting tool and analyzed thematically. Results: Most studies were published after 2020 and originated in North America (45%) and Europe (40%). Core barriers included digital exclusion, ageism, and adverse ergonomic environments. Facilitators involved flexible working hours, a supportive organizational environment, and digital skills. Health-related outcomes such as stress reduction and improved well-being were commonly reported. However, only 18% of studies assessed policy effects, and very few examined intersectionality (e.g., gender, socioeconomic status). Conclusions: Remote and flexible work options can improve the health and participation of older adults in the workforce, but technology, infrastructure, and social barriers remain. Age-inclusive policies, digital equity efforts, and inclusive workplace practices are necessary to maximize the benefits of remote arrangements for aging populations. Full article

In recent years, the development of stretchable electronic devices with mechanical properties similar to those of human tissues has attracted increasing research interest in biomedical engineering, wearables, and other fields. These devices have demonstrated, and some other researchers have already shown, promising advancements towards applications that span from measurements of the disruption of model barrier tissues to wearable or implantable devices, soft robotics, and the development of flexible and stretchable batteries. For example, models of barrier tissues, consisting of two compartments separated by a porous membrane, have been used to measure their integrity as well as to investigate the passage of drugs, toxins, and cancer cells through these tissues. Some of these models include an elastomeric membrane which can be stretched to model processes such as breathing and gut peristalsis, while others include electrodes for real-time measurement of barrier tissue integrity. However, to date, microelectrodes have not been fabricated directly on a porous elastomeric membrane. Here, we present lithographically patterned gold electrodes on porous PDMS membranes that enable electronic sensing capabilities in addition to mechanical manipulation. These membranes are incorporated into vacuum-actuated devices which impart cyclic mechanical strain, and their suitability for electrical impedance measurements, even after 1000 stretching cycles under fluids similar to cell culture media, is demonstrated. In the future, we expect to use these electrodes to measure the disruption in model cell barriers as well as to dielectrophoretically trap cells in a region of interest for more rapid assembly of a model tissue. Other areas like wearables, robotics, and power sources will greatly benefit from the further development of this technology. Full article

This study focuses on highway service areas. Building upon prior research that identified key influencing factors through surveys and ISM–MICMAC analysis, it constructs a tripartite evolutionary game model involving the government, service area operators, and carbon reduction technology providers based on stakeholder theory. Combined with MATLAB simulations, the model reveals the dynamic patterns of the carbon reduction system. The results indicate that government strategies exert the strongest influence on the system and catalyze the other two parties, followed by service area operators. Carbon reduction technology providers adopt a more cautious stance in decision-making. Government actions shape system evolution through a “cost-benefit-incentive” triple mechanism, with its strategies exhibiting significant spillover effects on other actors. Enterprise behavior is markedly influenced by Xinjiang’s regional characteristics, where the core barriers to corporate carbon reduction lie in the costs of proactive equipment and technological investments. The willingness of technology providers to cooperate primarily depends on two drivers: incremental baseline benefits and enhanced economies of scale. The core trade-off in government decision-making lies between the cost of strong regulation (Cg1) and the cost of environmental governance under weak regulation (Cg2). An increase in Cg1 prolongs the government’s convergence time by 233.3% and indirectly suppresses the willingness of enterprises and technology providers due to weakened subsidy capacity. Enterprises are relatively sensitive to the investment costs of carbon reduction equipment and technology, with convergence time extending by 120%. Technology providers are highly sensitive to incremental baseline returns (Rt), with stabilization time extending by 500%. Compared to existing research, this model quantitatively reveals the “cost-benefit-incentive” triple transmission mechanism for carbon reduction coordination in “grid-end” regions, identifying key parameters for strategic shifts among stakeholders. Based on this, corresponding policy recommendations are provided for all three parties, offering precise and actionable directions for the sustainable advancement of carbon reduction efforts in service areas. The research conclusions can provide a replicable collaborative framework for decarbonizing transportation infra-structure in grid-end regions with high clean energy endowments. Full article

Background: Cognitive and mood impairments are common in Stroke Survivors (SSs), leading to worse outcomes and poorer quality of life measures. Current methods of assessment of mood and cognitive performance are time consuming and rely on health care professionals. This makes assessment in hyper-acute stroke units (HASU) difficult. Here we describe the use of CognoStroke, an automated assessment of mood and cognitive impairment in the HASU. Methods: Using conversational interaction delivered through a virtual, web-based agent (CognosStroke), speech analysis was performed using three large language models (GPT2, Facebook.BART-based, and RobERTa-base) to classify thresholds levels of MoCA (threshold: 22,23,24,25,26), GAD-7 (above 5 and 10), and PHQ-9 (above 5 and 10). Results are presented as Macro F1-scores (MFSs). Patients were asked about barriers to using CogonStroke. Results: A total of 151 SSs agreed to perform CognoStroke, with 75 completing the full assessment. The best MFS of 0.723 was achieved using CognoStroke for thresholding a MoCA of 26. The MFS improved further to 0.783 when single prompts or a smaller combination of prompts from the CognoStroke bank were used. For the PHQ-9 a MFS of 0.686 was achieved thresholding above 10 and on the GAD-7 a MFS of 0.617 was achieved for thresholding above 5. Single prompts or smaller prompt combinations again achieved higher MFSs. Discussion: CognoStroke has potential to classify SSs into groups with high or low cognitive and mood thresholds, highlighting benefits for improving post-stroke cognitive assessment. Challenges of automated assessment on the HASU include patient computer access, anxiety in using technology, post-stroke fatigue, and computer literacy. Full article

Sarcodon aspratus fruiting polysaccharides (SAFP) exhibit multiple therapeutic properties. In this study, a type 2 diabetes mellitus (T2DM) mouse model was established using a high-fat diet (HFD) and streptozotocin to evaluate the antidiabetic potential of SAFP. Then the benefits of SAFP on glucolipid metabolism, gut barrier integrity and intestinal microbiota were evaluated. The results indicated that SAFP alleviated disturbances in glycolipid metabolism and insulin resistance through activating Adenosine 5′-monophosphate (AMP)-activated protein kinase (AMPK) signaling pathway. Furthermore, SAFP ameliorated hepatic inflammation and hepatic steatosis, as well as restored dysbiosis in hepatic function. Notably, SAFP enhanced intestinal mucosal architecture and strengthened epithelial barrier functionality through upregulated expression of tight junction components such as Zonula occludens-1(ZO-1), Claudin-1, and Occludin proteins. The 16S rRNA analysis indicated that SAFP has the potential to restore the intestinal microbial barrier in T2DM mice through elevation of short-chain fatty acids (SCFAs) concentrations and regulation of microbial community imbalances. This research offers foundational evidence supporting the utilization of SAFP as an innovative dietary supplement or prospective prebiotic component in functional food formulations targeting diabetes management. Full article

Plastic recycling is critical to transitioning toward a circular economy (CE), yet traceability systems for recycled plastics remain unevenly adopted. While effective traceability supports transparency, compliance, and supply chain accountability, its implementation is shaped not only by technological readiness but also by organisational behaviours and strategic priorities. This study explores how traceability adoption is influenced by company size, internal CE strategy, and perceptions of cost, risk, and regulatory demand. A survey of 65 Australian industry stakeholders reveals that 76% of companies with a CE strategy have implemented traceability systems, compared to 42% without. Larger firms report higher adoption rates than small and medium enterprises, largely due to resource advantages and differing interpretations of traceability’s value. Key barriers include high perceived costs, lack of standardised frameworks, and scepticism toward digital tools. Conversely, motivations such as reputational benefits, regulatory alignment, and inter-organisational trust were identified as enablers, alongside emerging technologies like blockchain and chemical tracers. The findings underscore the role of organisational context in shaping traceability practices and highlight the need for tailored interventions. Recommendations include financial incentives, harmonised standards, and sector-specific guidance that address not only technical gaps but behavioural and structural factors limiting uptake. Positioning traceability as an integrated organisational strategy may accelerate its adoption and support broader circular economy outcomes across the plastics value chain. Full article

Digital tools and platforms offer significant potential to address critical gaps in market access, credit availability, and agricultural knowledge, particularly in urban and peri-urban areas. This is especially relevant in regions like Sudan, where these opportunities remain largely underexplored. By providing real-time market information, facilitating financial access, and offering essential agricultural training, these tools can help bridge traditional barriers, improve decision-making capabilities, and contribute to sustainable agriculture. Such advancements strengthen economic resilience and promote equity in agriculture, enabling these farmers to drive innovation and sustainability in the industry. Our study was conducted in Omdurman’s Algamwai area during 2022 and 2023, and involved interviews with 100 female farmers. It explored the intersection of gender, technology, and socioeconomic equity. It highlighted how technological advancements can enhance agricultural productivity and market access while addressing challenges such as limited digital literacy and socioeconomic constraints. Despite structural inequalities—including restricted land ownership (45%), limited credit access (5%), and inadequate extension services—female farmers are driving innovation and sustainability by adopting sustainable practices, enhancing food security, and building community resilience. Digital urban agriculture provides income opportunities (76% rely on it) and serves as a platform for equitable participation. From a social science perspective, this research underscores the need to address systemic disparities to unlock the full potential of farmers. Policies ensuring equitable access to resources, credit, and technology are essential for fostering participation and maximizing the socio-economic benefits of digital agriculture in Sudan and similar contexts. Full article

Since increasing attention has been given to predictive maintenance (PdM) of industrial equipment, in order to enhance operational efficiency, improve reliability, and reduce downtime, this powerful strategy offers significant benefits, holds clearly great promises, and is now regarded as a key for future perspective in Industry 4.0. There are various approaches to PdM, each offering its own set of advantages and disadvantages which are single and hybrid approaches to carrying out diagnostics and prognostics in PdM. In this paper we will compare these approaches according to different aspects such as complexity of data and interpretability of results. Moreover, we also discuss the barriers to successful adoption, such as data quality, system complexity, and the need for workforce training. Finally, this paper concludes by identifying future research directions in response to scientific problems, which will drive the next wave of innovation in predictive maintenance solutions. Full article

Background: The maintenance of an aseptic barrier between the surgical team and patient aids in the prevents the exposure of the patient to pathogens. Variations in gloving practice may have safety implications due to glove failure. Indicator gloving, where two pairs of different colored gloves are worn, is thought to add protection as it alerts the wearer to a breach. The aim of this systematic review and meta-synthesis was to assess the evidence in the literature on the benefit of indicator systems versus other forms of double gloving on puncture identification during surgery. Methods: A four-arm, parallel, systematic review of the literature was undertaken in accordance with the PRISMA statement using four distinct research questions regarding glove fit, double gloving, indicator gloves, and the association between glove damage and glove change frequency. Searches on PubMed, Embase, Cochrane Collaboration of Systematic Reviews and Metanalyses, and Google Scholar were performed between 1 May 2022 and 24 January 2023. Studies were assessed for eligibility against pre-defined inclusion and exclusion criteria. Risk of bias was determined using multiple assessment tools. Results: This systematic review included 32 studies, 10 of which were high-quality Level IA trials, alongside multiple observational analyses. Across studies, indicator glove systems consistently demonstrated a two- to six-fold higher detection rate of glove perforations compared with standard double-gloving using identical glove colors. The majority of studies confirmed that early perforation identification significantly reduces intraoperative contamination risk and improves maintenance of the aseptic barrier. However, evidence regarding the direct impact on surgical site infections remains limited due to study heterogeneity. Conclusions: The use of an indicator glove provides a two- to six-fold higher rate of glove perforation detection, compared to two standard gloves of the same color, therefore aiding the maintenance of the aseptic barrier between surgical team members and patients. Further research into the impact of double gloving on the incidence of surgical site infections is required. Full article

Background: The growing global demand for grains and the pursuit of greater efficiency in agroindustrial production processes have fueled scientific interest in technologies for automatic visual inspection of agricultural grains (AVIAG). Despite the increasing number of studies on this topic, few have addressed the practical implementation of these technologies within industrial environments. Objective: This study aims to investigate the technological demands, analyze the potential applications, and identify the challenges for technology transfer of AVIAG technologies to the agroindustrial sector. Methods: The methodological approach combined a comprehensive literature review, which enabled the mapping of AVIAG technology applications and technological maturity levels, with a structured survey designed to identify practical demands, challenges, and barriers to technology transfer in the agricultural sector. Results: The results show that most of the proposed solutions exhibit low technological maturity and require significant adaptation for practical application, which undermines the discussion on technology transfer. Conclusions: The main barriers to large-scale adoption of AVIAG technologies include limited dissemination of scientific knowledge, a shortage of skilled labor, high implementation costs, and resistance to changes in production processes. Nonetheless, the literature highlights benefits, such as increased automation, enhanced operational efficiency, and reduced post-harvest losses, which reinforce the potential of AVIAG technologies in advancing the modernization of the agroindustrial sector. Full article

Background/Objectives: Digital interventions are essential for dementia care, particularly for older and isolated populations, and provide valuable support for caregivers. This umbrella review aimed to evaluate the acceptability and barriers to implementing the use of digital tools for health monitoring and management in older people with dementia and/or their caregivers. Methods: The review included studies assessing acceptability factors and barriers related to technology use in these groups. A total of 612 studies were identified across three databases. After removing duplicates, 400 articles remained. Following title and abstract screening, thirty articles were selected for full-text evaluation and five met the eligibility criteria for inclusion in this review. These systematic reviews collectively covered 93 primary studies, encompassing 12 to 279 participants with dementia and 11 to 2761 caregivers. Results: Frequently reported factors included self-management support, information access, and enhanced communication, although these were not consistently addressed across all reviews. The most significant barrier was a lack of technical knowledge, which hindered effective use. This gap in knowledge could compromise self-management and potentially increase burden on caregivers. Conclusions: In conclusion, digital interventions offer significant benefits in addressing accessibility challenges and are generally well-received by people with dementia, their caregivers, and healthcare providers. However, addressing the lack of technological proficiency is crucial to ensuring these interventions are effective and do not inadvertently create additional challenges. Practical strategies should include tailored digital literacy training for older adults and caregivers, simplified user interfaces, and ongoing technical support to enhance engagement and long-term adherence. Full article

Interleukin 17 (IL-17) is a crucial mediator at the interface of periodontal dysbiosis and host immunity. This review synthesizes current evidence on IL-17 in periodontitis (PD), its systemic connections, and the role of IL-17 gene variants. Clinical and experimental studies show that IL-17 rises in periodontal disease and is associated with the severity of PD via action on epithelial, stromal and osteoblastic cells to promote chemokine release, neutrophil recruitment, cyclooxygenase 2 and prostaglandin E2 synthesis, RANKL expression, osteoclastogenesis, and matrix metalloproteinase activity. Periodontopathogens Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans pre-activate the local inflammation-maintaining Th17 response. There is converging evidence linking IL-17-centered signaling with rheumatoid arthritis, diabetes mellitus, and psoriasis in favor of a shared inflammatory network in barrier tissues and synovium. Despite these associations, IL-17 biology is contextually determined with mucosal defense and bone homeostatic roles that caution against unidimensional explanations. Evidence on IL-17A and IL-17F polymorphisms is still heterogeneous across populations with modest and variable risk associations with PD. Clinically, IL-17 in gingival crevicular fluid, saliva, or serum is a potential monitoring biomarker when utilized along with conventional indices. Therapeutically, periodontal therapy that reduces microbial burden may inhibit IL-17 function, and IL-17-targeted therapy has to balance potential benefit to inflammation and bone resorption against safety in oral tissues. The following research must utilize harmonized case definitions, standardized sampling, and multiethnic cohorts, and it must include multiomics to be able to differentiate between causal and compensatory IL-17 signals. Full article

Atopic dermatitis (AD) is a chronic inflammatory skin disease marked by pruritus and eczematous lesions that significantly impacts patient quality of life. This review covers the intricate interplay of barrier dysfunction, immune dysregulation, and microbial dysbiosis in the complex pathophysiology of AD. The roles of epigenetic factors and environmental exposures are also examined. The evolving understanding of these factors has revolutionized AD treatment. Beyond foundational topical agents, the landscape for moderate-to-severe AD treatment is now dominated by highly targeted immunotherapies, such as biologics and Janus Kinase (JAK) inhibitors, that precisely block specific inflammatory pathways. Emerging strategies explore microbiome modulation and vitamin D supplementation. This paradigm shift from broad immunosuppression to precision medicine offers improved disease control and reduced systemic toxicities and enables more personalized AD management, significantly benefiting patients. Full article