Search Results (63)

Background: Undergraduate nursing students (UNSs) often enter clinical training just as they are still mastering the emotional labor of the profession. In Nepal, where teaching hierarchies discourage upward dialogue and hospitals routinely struggle with overcrowding, supply shortages, and outward nurse migration, these learners confront a distinct, under-documented burden of psychological distress. Objective: This study examines how UNSs interpret, negotiate, and cope with the mental health challenges that arise at the intersection of cultural deference, resource scarcity, and migration-fueled uncertainty. Methods: A qualitative design employing reflexive thematic analysis (RTA), guided by the Reflexive Thematic Analysis Reporting Guidelines (RTARG), was used. Fifteen second-, third-, and fourth-year Bachelor of Science in Nursing students at a major urban tertiary institution in Nepal were purposively recruited via on-campus digital flyers and brief in-class announcements that directed students (by QR code) to a secure sign-up form. Participants then completed semi-structured interviews; audio files were transcribed verbatim and iteratively analyzed through an inductive, reflexive coding process to ensure methodological rigor. Results: Four themes portray a continuum from silenced struggle to systemic constraint. First, Shrouded Voices, Quiet Connections captures how students confide only in trusted peers, fearing that formal disclosure could be perceived as weakness or incompetence. Second, Performing Resilience: Masking Authentic Struggles describes the institutional narratives of “strong nurses” that drive students to suppress anxiety, adopting scripted positivity to satisfy assessment expectations. Third, Power, Hierarchy, and the Weight of Tradition reveals that strict authority gradients inhibit questions in classrooms and clinical placements, leaving stress unvoiced and unaddressed. Finally, Overshadowed by Systemic Realities shows how chronic understaffing, equipment shortages, and patient poverty compel students to prioritize patients’ hardships, normalizing self-neglect. Conclusions: Psychological distress among Nepalese UNSs is not an individual failing but a product of structural silence and resource poverty. Educators and policymakers must move beyond resilience-only rhetoric toward concrete reforms that dismantle punitive hierarchies, create confidential support avenues, and embed collaborative pedagogy. Institutional accountability—through regulated workloads, faculty-endorsed wellbeing forums, and systematic mentoring—can shift mental health care from a private struggle to a shared professional responsibility. Multi-site studies across low- and middle-income countries are now essential for testing such system-level interventions and building a globally resilient, compassionate nursing workforce. Full article

African, Caribbean, and Black (ACB) communities face increased COVID-19 morbidity and mortality, coupled with significant barriers to vaccine acceptance and uptake. Addressing these challenges requires innovative, multifaceted strategies. Peer-led interventions, grounded in critical health literacy (CHL) and critical racial literacy (CRL), and integrating collaborative equity learning processes, can enhance community capacity, empowerment, and health outcomes, contributing to long-term health equity. This paper describes and presents the evaluative outcomes of a peer-led intervention aimed at enhancing COVID-19 vaccine confidence and acceptance. The Peer-Equity Navigator (PEN) intervention consisted of a specialized training curriculum grounded in CHL and CRL. Following training, PENs undertook a 5-month practicum in community or health settings, engaging in diverse outreach and educational activities to promote vaccine literacy in ACB communities. The evaluation utilized a modified Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) Framework, using quantitative and qualitative methods to collect data. Sources of data included tracking records with community feedback, and a PEN focus group, to assess program feasibility, outreach, and effectiveness. From 16 September 2022, to 28 January 2023, eight trained PENs conducted 56+ community events, reaching over 1500 community members. Both PENs and community members reported high engagement, endorsing peer-led, community-based approaches and increased vaccine literacy. The PEN approach proves feasible, acceptable, and effective in promoting positive health behaviors among ACB communities. This intervention has clear implications for health promotion practice, policy, and research in equity-deserving communities, including immigrants and refugees, who also face multiple and intersecting barriers to health information and care. Full article

The 100-Day Mission, coordinated by the Coalition for Epidemic Preparedness Innovations (CEPI) and endorsed by significant international stakeholders, aims to shorten the timeframe for developing and implementing vaccines to 100 days after the report of a new pathogen. This ambitious goal is outlined as an essential first step in improving pandemic preparedness worldwide. This review highlights the mission’s implementation potential and challenges by examining it through the lens of low- and middle-income countries (LMICs), which often face barriers to equitable vaccine access. This article explores the scientific, economic, political, and social aspects that could influence the mission’s success, relying on lessons learned from previous pandemics, such as the Spanish flu, H1N1, and COVID-19. We also examined important cornerstones like prototype vaccine libraries, accelerated clinical trial preparedness, early biomarkers identification, scalable manufacturing capabilities, and rapid pathogen characterization. The review also explores the World Health Organization (WHO) Pandemic Agreement and the significance of Phase 4 surveillance in ensuring vaccine safety. We additionally evaluate societal issues that disproportionately impact LMICs, like vaccine reluctance, health literacy gaps, and digital access limitations. Without intentional attempts to incorporate under-resourced regions into global preparedness frameworks, we argue that the 100-Day Mission carries the risk of exacerbating already-existing disparities. Ultimately, our analysis emphasizes that success will not only rely on a scientific innovation but also on sustained international collaboration, transparent governance, and equitable funding that prioritizes inclusion from the beginning. Full article

This article investigates how digital competences contribute to the production of social capital and professional recognition through a systematic review of international literature. Drawing on 62 peer-reviewed articles indexed in Web of Science, Scopus, and ERIC, the review identifies the most frequently mobilized theoretical frameworks, the predominant types and sources of recognition, and the associated dimensions of social capital. The findings reveal a growing emphasis on communicative and network-based digital competences—particularly digital communication, information management, and virtual collaboration—as key assets in professional contexts. Recognition is shown to take predominantly non-material, extrinsic, and visibility-oriented forms, with social media platforms emerging as central sites for the performance and circulation of digital competences. The results indicate that social media proficiency has become a central determinant of social recognition, favoring individuals who possess not only digital fluency but also the ability to strategically develop and mobilize their networks. This dynamic reframes signal theory in light of today’s platformed ecosystems: recognition no longer depends increasingly on one’s capacity to render competences legible, visible, and endorsed within algorithmically mediated environments. Those who master the codes of visibility and reputation-building online are best positioned to convert recognition into social capital and professional opportunity. Full article

The United Kingdom has long been a frontrunner in green finance, establishing programs like the Green Finance Institute to promote corporate engagement in sustainable initiatives. The Green Finance Strategy, enacted in 2019, aligns UK financial procedures with international standards, including the EU taxonomy for sustainable Activities. The study examined how sustainable finance enhances the corporate reputation of the firms listed on the London Stock Exchange. A purposive sampling yielded 17 years of data from 143 non-financial companies from the Thomson Reuters Eikon DataStream between 2007 and 2023. In dealing with the issue of endogeneity and auto-serial correlation, the Generalized Methods of Movement (GMM) was employed to provide reliable and unbiased estimation results. The study revealed a positive impact of green bond issues, environmental expenditures, and policies for emission reduction on corporate reputation. The moderating relationship between green bond issues, environmental expenditures, and board diversity revealed a positive and significant relationship with corporate reputation. Managers should ensure that their endorsed activities gain public recognition and align with sustainability goals, particularly by emphasizing the issuance of green bonds in their financing strategy. They should also collaborate with environmental experts and stakeholders to ensure that the outcomes of funded projects are evaluated in line with international ESG standards. Full article

Background: Social isolation, national turmoil, and an adolescent mental health crisis in the wake of the COVID-19 pandemic have resulted in a significant uptick in inpatient admissions and re-admissions for high-risk patients. This trend persists even as the pandemic wanes. Intensive outpatient programs (IOPs) serve as a critical steppingstone between the community and inpatient mental health services, providing comprehensive psychiatric care for at-risk youth. Significant research has identified family engagement as a key element of successful collaborative care in adolescents. Objectives: This article provides models of family-centered care in the adolescent IOP through a case study detailing the six-week course of care of an adolescent struggling with increased emotionality and distress intolerance in the context of family conflicts. Methods: This case highlights five family engagement components, including (1) family-centered psychiatric medication management, (2) individualized case management, parental education, and peer support, (3) Measurement Based Care (MBC) family assessment and feedback sessions, (4) Dialectical Behavior Therapy (DBT) multi-family skill groups, and (5) Compassionate Home Action Together (CHATogether) family intervention to address teen–parent relational health and communication. Results: This case showed improvement in depressive and anxiety symptoms, family conflict behaviors, self-reported suicide risk, and help-seeking attitudes towards parents/adults. The case family, along with others (n = 26), endorsed the parent peer support groups’ acceptability and feasibility implemented in the adolescent IOP. Conclusions: This article emphasizes the importance of family engagement during clinical care and provides a practical guide to implement collaborative family-centered therapeutic interventions in intensive outpatient services. Full article

In the sustainable evolution of the entrepreneurial ecosystem, the efficiency of early-stage capital allocation directly affects the intergenerational transmission capacity of innovation resources. The financing barriers caused by information asymmetry urgently require institutional solutions. This study, based on tracking data from 19,463 startups in China’s information technology sector (2016–2019), analyzes how government-certified incubators (GCIs) optimize the sustainability of the entrepreneurial ecosystem through signaling mechanisms. The empirical results show that collaboration with a GCI can significantly increase the likelihood of IT startups securing venture capital by approximately 25%. This effect is not only due to the strict screening and resource support provided by GCIs, but also due to their role in amplifying internal signals from startups, such as the experience of founders and intellectual property. Notably, in the IT sector, the impact of GCIs is more significant for startups traditionally disadvantaged, particularly those led by female founders. Our research demonstrates that GCIs drive the sustainable development of the entrepreneurial ecosystem through three signaling mechanisms: (1) institutional certification screening, which optimizes the intergenerational allocation efficiency of ecosystem resources; (2) the signaling validation–amplification mechanism, which enhances the value of intellectual property and founder experience, alleviating investors’ challenges in quantifying startup potential; (3) inclusive signal rebalancing, where GCI certification significantly improves the funding success rate of female founders, breaking traditional market biases in screening disadvantaged groups and supporting the inclusive and sustainable development of the entrepreneurial ecosystem. These findings provide a new pathway for emerging economies to optimize the resilience of their entrepreneurial ecosystems through policy tools: for governments, GCIs achieve sustainable development goals at low institutional cost; for investors, the signal integration mechanism reduces investment information friction; and for entrepreneurs, certification endorsements accelerate market validation of sustainable business models. Full article

This study is focused on assessing the impacts of different regional climate model targeted simulations performed at convection-permitting resolution (CPRCM) in the AgS crop model yield simulations, evaluating to what extent climate model uncertainty impacts the modeled yield—considering the spatial and temporal variability of crop yield simulations over central-south Brazil. The ensemble of CPRCMs has been produced as part of a Flagship Pilot Study (FPS-SESA) framework, endorsed by the Coordinated Regional Climate Downscaling Experiment (CORDEX). The AgS simulated crop yield exhibited significant differences, in both space and time, among the simulations driven by the different CPRCMs as well as when compared with the simulations driven by observations. Rainfall showed the highest uncertainty in CPRCM simulations, particularly in its spatial variability, whereas modeled temperature and solar radiation were generally more accurate and exhibited smaller spatial and temporal differences. The results evidenced the need for multi-model simulations to account for different uncertainty, from different climate models and climate models parameterizations, in crop yield estimations. Inter-institutional collaboration and coordinated science are key aspects to address these end-to-end studies in South America, since there is no single institution able to produce such CPRCM-CropModels ensembles. Full article

Background/Objectives: Digital and computational pathology (DP/CP) tools have the potential to improve the efficiency and accuracy of the anatomic pathology workflow; however, current adoption among US hospital and reference labs remains low. Methods: To better understand the current utilization of DP/CP technology and barriers to widespread adoption, we conducted a survey among 63 anatomic pathologists and lab directors within the US health system. Results: The survey results indicated that current use cases for DP/CP involve streamlining traditional manual pathology and that labs would have substantial difficulty providing AI-guided image analysis if it were required by physicians today. Among potential catalysts for the broader adoption of DP/CP, pathologists identified clinical guidelines as a key resource for anatomic pathology, whose endorsement of DP/CP would be highly impactful for reducing current barriers. Conclusions: Expanded access to DP/CP may ultimately benefit all major stakeholders—patients, physicians, clinical laboratory professionals, care settings, and payers—and will therefore require collaboration across these groups. Full article

Ulster University’s School of Medicine embraces a problem-based learning (PBL) approach, yet crafting scenarios for this method poses challenges, requiring collaboration among medical and academic experts who are often difficult to convene. This obstacle can compromise scenario quality and ultimately impede students’ learning experiences. To address this issue, the school trialed the use of AI technology to develop a case scenario focusing on headaches caused by cerebral haemorrhage. The process involved a dialogue between a single “author” and ChatGPT, with their outputs combined into a complete clinical case adhering to the school’s standard template. Six experienced PBL tutors conducted quality checks on the scenario. The tutors did not immediately endorse its use, recommending further enhancements. Suggestions included updating terminology, names, spelling, and protocols to align with current best practices, providing additional explanations such as interventions and improvements post-initial stability, incorporating real scans instead of descriptions, reviewing symptoms and timelines for realism, and addressing comprehension issues by refraining from directly providing answers and including probing questions instead. From this trial, several valuable lessons were learned: AI can assist a single author in crafting medical scenarios, easing the challenges of organizing expert teams. However, the author’s role shifts to reviewing and enhancing depth, guided by a template, with clinician input crucial for authenticity. ChatGPT respects patient data privacy and confidentiality by abstaining from providing scanned images, and while AI can generate discussion questions for tutorials, it may require modification to enhance specificity and provoke critical thought. Furthermore, AI can generate multiple-choice questions and compile reading resources to support self-directed learning. Overall, adopting AI technology can improve efficiency in the case-writing process. Full article

This positioning paper explores integrating smart in-process inspection and human–automation symbiosis within human–cyber–physical manufacturing systems. As manufacturing environments evolve with increased automation and digitalization, the synergy between human operators and intelligent systems becomes vital for optimizing production performance. Human–automation symbiosis, a vision widely endorsed as the future of human–automation research, emphasizes closer partnership and mutually beneficial collaboration between human and automation agents. In addition, to maintain high product quality and enable the in-time feedback of process issues for advanced manufacturing, in-process inspection is an efficient strategy that manufacturers adopt. In this regard, this paper outlines a research framework combining smart in-process inspection and human–automation symbiosis, enabling real-time defect identification and process optimization with cognitive intelligence. Smart in-process inspection studies the effective automation of real-time inspection and defect mitigation using data-driven technologies and intelligent agents to foster adaptability in complex production environments. Concurrently, human–automation symbiosis focuses on achieving a symbiotic human–automation relationship through cognitive task allocation and behavioral nudges to enhance human–automation collaboration. It promotes a human-centered manufacturing paradigm by integrating the studies in advanced manufacturing systems, cognitive engineering, and human–automation interaction. This paper examines critical technical challenges, including defect inspection and mitigation, human cognition modeling for adaptive task allocation, and manufacturing nudging design and personalization. A research roadmap detailing the technical solutions to these challenges is proposed. Full article

Introduction: As the pharmaceutical advertising landscape evolves with digital advancements, this study examines public awareness and perceptions of medication advertisements in Saudi Arabia. It focuses on the effects of regulatory frameworks and evaluates how they influence public understanding and attitudes toward these advertisements. Method: A cross-sectional study was conducted using an electronic survey in Saudi Arabia in December 2023. The survey was distributed on social media platforms and reached a diverse sample of 440 participants. It covered public perception and attitudes toward drug advertisements, knowledge of regulatory laws, and preferences regarding advertising mediums. Results: Out of the 440 participants in the study, who were primarily employees with bachelor’s degrees, there was a clear awareness of drug advertisements. The average age of the group was 33 years, and a significant portion (71.1%) held a bachelor’s degree, with 51.1% being employed. The findings revealed that 25.5% of participants frequently noticed drug ads, while 22.7% saw them very often. Although many found the ads informative, there were significant concerns about unrealistic expectations and the risk of overmedication; 89.8% believed the ads set unrealistic expectations about the effectiveness of medications. Additionally, 60.7% thought that celebrity endorsements might mislead the audience, and 91.1% felt that ads should provide more detailed information about potential risks and side effects. Regarding preferred advertising platforms, mobile apps and websites were favored (47%), followed closely by social media (46.4%). A striking 93.2% of participants believed that drug ads on social media should be subject to stricter regulations, and 96.4% wanted more proactive monitoring of online advertising. Many also reported using other sources, such as medical review sites, to verify medication information. Conclusions: Pharmaceutical advertising in Saudi Arabia must balance ethical transparency with educational value. The influence of digital platforms underscores the necessity for stricter regulation and accurate information dissemination. A collaborative approach is essential to align advertising practices with public health interests and regulatory standards. Full article

The growing need for collaborative healthcare teams to meet complex health challenges has led to physical therapists (PTs) being embedded in adult primary care settings for many years now. However, this model of care has not been found in pediatrics. This qualitative study sought to gain insights from pediatricians on the potential of embedding pediatric PTs in primary care. Participants were nine pediatricians practicing in both urban and rural, hospital-based and private settings. Semi-structured interviews were recorded, transcribed, and analyzed via thematic analysis per published methods, assuring trustworthiness. Three overarching themes emerged: pediatricians’ priorities aligned with the Quadruple Aim of Healthcare, embedded PTs could fill multiple roles in pediatrics, and they could see a wide variety of patients, highlighting real potential benefits in primary care. Participants endorsed in-office focused treatments, screening to determine optimal care pathways, and ongoing patient follow-up as potential PT roles in this setting. Providers thought that PTs could help manage care for musculoskeletal complaints, high-risk infants, medically complex children, autism, and obesity. An advanced-trained PT having attributes of confidence, adaptability, and open-mindedness was desired. All participants endorsed pediatric primary care PTs as having potentially high value in their practice. This is the first known study on the potential of embedding a PT in the pediatric primary care setting, offering valuable insights from pediatricians to be leveraged in implementation planning. Full article

Background: The WHO Regional Office for Africa developed a Member States (MS)-endorsed regional strategy to fast-track the implementation of MS’ national action plans (NAP) on Antimicrobial resistance (AMR). This study explored the perspectives of AMR’s national focal points in MS on the implementation of the priority interventions of the regional strategy in their countries. Methods: An online survey consisting of ratings and discussions covering the implementation of the six priority interventions was conducted. Sums of the scores per priority intervention were obtained, and their percentage to the total possible scores were calculated to categorize the implementation as inadequate (0–25%), basic (26–50%), intermediate (51–75%), or advanced (76–100%). Results: Thirty-six of the forty-seven national AMR focal points responded to the survey between 12 November 2023 and 8 January 2024. The implementations were rated as 37–62% (basic-to-intermediate), with the multisectoral coordination and collaboration committee receiving the highest overall rating (62%, 421/684), while the promotion of sustainable investment for the NAP on AMR received the least overall rating (37%, 257/700). The focal points mainly recommended awareness campaigns, capacity building, and regulations and guidelines to improve the implementation of the AMR strategy. Conclusions: The survey revealed a need to enhance awareness campaigns, support the establishment and functioning of AMR evaluation and monitoring systems, and build the capacity of AMR staff with cost-benefit analysis and budgeting skills. It also showed the necessity to improve awareness and conduct education on AMR, streamline evidence generation through One Health Surveillance systems, integrate initiatives to reduce hospital-acquired infections in the antimicrobial stewardship programs, and enhance regulations and guidelines to optimize the use of antimicrobials. Full article

Artificial Intelligence (AI) biosensors are devices that can detect and measure biological or chemical signals of interest, such as glucose, DNA, hormones, toxins, pathogens, etc. They have many applications in various fields, such as healthcare, environmental monitoring, food safety, biodefense, and bioengineering. However, AI biosensors also pose some regulatory and ethical challenges that need to be addressed before they can be widely used and accepted by society. Some of these challenges are safety and reliability, privacy and data protection, social and cultural implications, innovation, and regulation. AI biosensors are constantly evolving and innovating with new technologies, materials, methods, or applications. This may pose challenges for the existing regulatory frameworks and authorities that may not be able to keep up with the pace and scope of innovation. AI biosensors should balance between innovation and regulation, and we should ensure that they are developed and used in a responsible and sustainable manner. Various stakeholders, such as researchers, regulators, policy makers, industry partners, civil society groups, and end-users should engage with AI biosensors to foster dialogue, collaboration, and public trust. Proposed in April 2021, endorsed by the European Council on 21 May 2024 and expected to be fully applicable from 2 August 2026, the European Union Artificial Intelligence Act (EU AI Act) will be the first EU regulatory framework for AI and could serve as a law model for the regulation of AI biosensors. There are some scattered international instruments and frameworks that address some of the ethical, legal, and social issues related to biosensors. States and the World Health Organization (WHO), with its constitutional mandate to deal with global public health, should regulate the use of AI biosensors and adopt legally binding rules and international standards in this sensitive field. Full article