Search Results (5,539)

The quality risks of land trusteeship services are increasingly prominent, leading to reduced crop yields for farmers and land degradation; however, relevant research remains insufficient. This paper aims to identify and evaluate the quality risk level of land trusteeship services. It comprehensively adopts a field survey, web crawler technology, and expert consultation methods to identify quality risk types, and then uses the fuzzy comprehensive evaluation method to assess the risk level based on survey data from Chinese farmers. The main conclusions are as follows: (1) Overall, the quality risk level of land trusteeship services is at a relatively high risk level. In terms of spatio-temporal patterns, the quality risk level shows an upward trend, and the quality risk level of mid-production services is increasing at the fastest rate. There are significant variations in service quality risk across prefecture-level cities in the Shandong Province of China. (2) In terms of risk heterogeneity, the quality risk level of small-scale pure farmers is higher than that of part-time farmers and large professional farmers, in that order. The quality risk level of the “farmer + service organization” model is higher than that of the “farmer + intermediary + service organization” model. According to the order of the quality risk level of different crops, the ranking (from highest to lowest) is cash crops, wheat, and corn. (3) The high quality risks of land trusteeship services will impact the multifunctionality of land systems. It exacerbates the land pollution and fertility degradation because of excessive application of chemical inputs like pesticides, fertilizers, and mulch by service organizations. It consequently destroys ecological systems, hinders sustainable agricultural development, and impacts farmers’ income and national food security by reducing yields. The research findings contribute to controlling the quality risks of land trusteeship services and protecting land. Full article

Background: Clinician empathy is associated with family satisfaction and reduced anxiety, but quantitative data from the parents’ perspective in pediatric psychiatry are limited. Objective: To assess parent-perceived physician empathy in pediatric psychiatry consultations and explore its associations with clinical and demographic factors. Methods: Cross-sectional, consecutive sample of parents attending an outpatient pediatric psychiatry clinic (n = 163 parents). A 10-item behavioral empathy scale (range 10–40) was used. Analyses included reliability testing, group comparisons, correlations, OLS regression, and exploratory PCA. Results: The mean total empathy score was 34.5 (SD 4.2); most parents rated physicians as highly empathic (65%). Parents of children with ASD reported lower empathy compared to those with anxiety/depression. Empathy increased modestly with child age and was associated with a calmer state at the end of the visit. PCA suggested exploratory evidence of potential subdimensions, including child-centered communication and listening/facilitation. Conclusions: Parent-perceived empathy in this sample was generally high; however, behaviors that directly involve and facilitate the child (listening, encouraging questions) may need strengthening, particularly for children with ASD. Results should be interpreted in light of the single-center design, the absence of a recorded participation rate, parent-proxy reporting, and the exploratory nature of the PCA. Full article

Driving-impairing medicines (DIMs) are associated with an increased risk of traffic accidents. While Dutch pharmacy staff are expected to counsel patients at the first and second dispense of DIMs, current practice suggests that second-dispense consultations are underutilized. This study explored pharmacy staff’s experiences and perceived barriers in addressing driving impairment during the second dispense. Qualitative, semi-structured interviews were performed with 17 staff members in community pharmacies across the Netherlands. Transcripts were coded using thematic analysis in Atlas.ti, applying both deductive and inductive coding strategies to explore current practices and improvement needs. Participants reported that they provided detailed information on medication use, side effects, and driving impairment during the first dispense. In contrast, driving fitness was only discussed during the second dispense when patients initiated the topic, which rarely happened. Barriers to discuss DIMs included time constraints, a lack of protocols or prompts in pharmacy software, limited privacy, and patients’ reluctance to communicate about this topic. Many pharmacy technicians relied on closed questioning and observed a lack of patient initiative. Facilitators included strong patient relationships, access to medical records, and a desire for training in consultation skills. Pharmacy staff expressed the need for improved protocols, better ICT (Information and Communication Technology) integration, and targeted communication tools to support safe use of DIMs. In conclusion, second-dispense consultations for DIMs are underused and can support patients in safer medication use. Improved implementation will lead to better-informed choices about medicines and driving, and strengthen the pharmacy’s contribution to traffic safety. Full article

Background/Objectives: Qualitative child-centered research on pediatric obesity treatment and body image remains limited. This study aimed to explore children’s and adolescents’ experiences with hospital-based obesity treatment and how these experiences relate to body image. Methods: A full-day workshop including three main participatory tasks was conducted in two groups of children (9–13 years) and adolescents (14–18 years), focusing on their experiences with obesity treatment and body image. Data were audiotaped, transcribed verbatim, and analyzed using reflexive thematic analysis. Results: Four main themes emerged, reflecting different aspects of participants’ experiences. The first theme, Talk with me and not my parents, encompassed participants’ desire for greater agency, as children described lacking information and feeling excluded from consultations. The second theme, Experiences of communication with healthcare professionals (HCPs) about obesity, concerned participants’ perceptions of trust, support, and non-judgmental communication, with some adolescents expressing a need for additional psychological support. The third theme, Internalization of lifestyle advice, indicated that healthy diet was viewed as the primary focus of obesity treatment, while physical activity received less attention. The final theme, Perceptions of the body, conveyed mixed experiences with weighing and most participants perceived weight loss as success in treatment and weight gain as failure. The participants shared experiences of weight-based bullying, perceived stigma, and challenges with maintaining a positive body image in a society with stereotypical thin and muscular body ideals. Conclusions: Body image was influenced by HCPs’ emphasis on health and body size, and by their own internalized perceptions, influenced by societal ideals and experiences of stigma. Full article

Performance management is critical for aligning human capital with organizational strategy, particularly in the increasingly competitive service sector. However, universally effective performance appraisal systems (PASs) exist, as effectiveness depends on contextual and organizational specificities. In Portugal, where services account for nearly three-quarters of gross value added, PAS implementation remains underdeveloped, highlighting a gap between strategic intent and practice. This study aims to address that gap by investigating how a performance appraisal model can be tailored to the service sector. A case study was conducted at PCI—Creative Science Park, S.A., a consulting firm, using a qualitative approach. The research design combined a literature review to identify theoretical dimensions of performance evaluation with an employee questionnaire to capture organizational perceptions and priorities. Integration of both strands of evidence informed the construction of the framework. The findings indicate that employees value objective-based evaluation as the most relevant dimension, complemented by customer feedback, adaptive performance, and organizational citizenship. Furthermore, the integration of 360° feedback mechanisms and regular review cycles emerged as key enablers of fairness and engagement. By combining theoretical insights with employee perspectives, this study contributes to a customized and flexible PAS that enhances strategic alignment in the service sector. The proposed model provides both scholarly value, by advancing the discussion on context-specific PAS design, and practical value, by offering a reference for organizations seeking to align human performance with mission-critical outcomes. Full article

(1) Background: trays are surgery-specific sets of required materials and medical devices, assembled in consultation between manufacturer and user, and provided in a sterile package. (2) Methods: in a high-volume urological center performing 11,920 operations/procedures annually (2023), we prospectively evaluated the effect of trays compared with the standard approach in a comparative study of 64 operations conducted between 29 October and 30 November 2024. The primary endpoints were the amount of operating room (OR) waste (volume/cm³, weight/g) and setup time (minutes). The secondary endpoint was the workflow assessment by nursing staff, rated on a numerical score (0–10) across seven relevant domains. (3) Results: for endourological procedures, setup time was reduced by 35%, operating room (OR) waste by 34%, and waste volume by 19.0%. Workflow was positively rated with a mean score of 9.75/10. For major open procedures, setup time was reduced by 43%, waste weight by 24.8%, and waste volume by 32%. Workflow was positively rated with a mean score of 8.9/10. (4) Conclusions: Trays have a sustainable and significant impact on reducing OR waste, save nursing staff preparation time, and facilitate improved workflow in the operating room. Full article

Background/Objectives: The internet has unquestionably altered how people acquire health information. Instead of consulting with a medical professional, billions of pages of information can be accessed by anyone with a smartphone. Women’s health issues have been historically and culturally taboo in many cultures globally; therefore, internet searches may be particularly useful when researching these topics. Methods: As an exercise in scientific information evaluation, we chose 12 non-cancer topics specific to women’s health and developed a scoring metric based on quantifiable webpage attributes to answer: What topics generate the highest and lowest scores? Does the quality of information (mean score) vary across topics? Does the variation (score deviation) differ among topics? Data were collected following systematic searches after filtering with advanced features of Google and analyzed in a Bayesian framework. Results: The mean score per topic was significantly correlated with the number of sources cited within an article. There were significant differences in the quality scores across topics; “pregnancy” and “sleep” scored the highest and had more sources cited per page than all other topics. The greatest variation in scores were for “cortisol” and “weight”. Conclusions: A purposeful, systematic internet search of 12 critical women’s health topics suggests that scrutiny is necessary when this information is obtained by a typical internet user. Future work should include review by medical professionals based on their interaction with patients who self-report what they know or think about a condition they present and respect, while educating, patients’ own internet searching. Full article

Information on care leaver outcomes in England is collected by local authorities to inform local services and national policy, but the focus of these measures reflects a narrow definition of ‘success’ imposed on care leavers by policy-makers and practitioners. Our article is a co-production by academics and care-experienced consultants, in which we conduct a rapid review of the journal articles, book chapters and Doctoral dissertations on definitions of ‘success’ for all young adults, drawing on Maslow’s hierarchy of needs. The analysis utilises expertise by experience to (a) compare these definitions against the measures currently collected for care leavers in England, and (b) centre the views of care leavers in considering how ‘success’ should be defined. We identify limitations of both depth and breadth in existing statutory outcome measures as indicators of success, and highlight how both quantitative and qualitative differences between care leavers and other young adults have implications for the types of outcomes that should be measured. We conclude that policy-makers and practitioners need a more comprehensive approach to understanding and measuring success using care leavers’ own definitions. Full article

Oral cancer remains a critical global health challenge, with delayed diagnosis driving high morbidity and mortality. Despite progress in artificial intelligence, computer vision, and medical imaging, early detection tools that are accessible, explainable, and designed for patient engagement remain limited. This study presents a novel system that combines a patient-centred chatbot with a deep learning framework to support early diagnosis, symptom triage, and health education. The system integrates convolutional neural networks, class activation mapping, and natural language processing within a conversational interface. Five deep learning models were evaluated (CNN, DenseNet121, DenseNet169, DenseNet201, and InceptionV3) using two balanced public datasets. Model performance was assessed using accuracy, sensitivity, specificity, diagnostic odds ratio (DOR), and Cohen’s Kappa. InceptionV3 consistently outperformed the other models across these metrics, achieving the highest diagnostic accuracy (77.6%) and DOR (20.67), and was selected as the core engine of the chatbot’s diagnostic module. The deployed chatbot provides real-time image assessments and personalised conversational support via multilingual web and mobile platforms. By combining automated image interpretation with interactive guidance, the system promotes timely consultation and informed decision-making. It offers a prototype for a chatbot, which is scalable and serves as a low-cost solution for underserved populations and demonstrates strong potential for integration into digital health pathways. Importantly, the system is not intended to function as a formal screening tool or replace clinical diagnosis; rather, it provides preliminary guidance to encourage early medical consultation and informed health decisions. Full article

Objectives: The aim was to measure wait times for rheumatologist consultation and disease-modifying antirheumatic drug (DMARD) treatment and examine their association with travel time to primary care practitioners (PCP) and rheumatologists within a centralized intake system, respectively. Methods: Within a centralized intake system serving 4.2 million people, we measured wait time for rheumatologist consultations and DMARD treatment for an RA incidence cohort between 1 April 2015 and 31 March 2020. Wait times were reported as the median with the interquartile range (IQR). Using multivariate logistics regression models, we examined the impact of travel times to primary/rheumatology care on wait times for rheumatologist consultation (28-day benchmark) and DMARD treatment (14-day benchmark). Travel times were defined according to quantiles and pre-defined categories. Results: The median wait time was 47 days (IQR: 18–114) for rheumatologist consultations (36% meeting the benchmark) and 35 days (IQR: 1–132) for DMARD treatment (43% meeting the benchmark). Patients living >120 min away had lower odds of meeting the 28-day consultation benchmark compared with those within 30 min (OR 0.64; 95% CI: 0.42–0.97). Compared with patients driving ≤30 min, lower odds of meeting the 14-day benchmark for DMARD treatment were observed for those driving over 60 min to PCPs (OR 0.62; 95% CI: 0.39–0.99) and patients driving 30–60 min to rheumatologists (OR 0.68; 95% CI: 0.55–0.85). Conclusion: RA management was suboptimal due to low rates of meeting RA consultation and treatment benchmarks, which was significantly associated with long travel times to both primary and RA care within a centralized triage system. This highlights the need for complementary strategies (e.g., tele-rheumatology, travel support, or alternate care providers) to ensure timely RA care in rural and remote communities. Full article

Background/Objectives: Family physicians are key stakeholders in the implementation of cancer prevention strategies, including risk factor assessment, lifestyle counseling, and early detection. Despite this, integration of personalized prevention into routine practice remains limited. This study aimed to explore family physicians’ perspectives on barriers, training needs, and collaboration opportunities in cancer prevention. Methods: A mixed-methods study was conducted using an exploratory sequential design. The qualitative phase involved semi-structured interviews with 12 family physicians from the North-West Region of Romania. Thematic analysis was employed to identify main challenges and opportunities. Findings informed the development of a structured online survey completed by 50 family physicians. Descriptive and comparative statistical analyses were applied to assess trends and subgroup differences. Results: Interviews and survey data revealed multiple barriers to cancer prevention in primary care: insufficient consultation time, limited access to diagnostic tools, administrative workload, and low patient health literacy. Physicians reported moderate familiarity with personalized prevention but expressed strong interest in further training, particularly through flexible and interactive learning formats. Collaboration with cancer centers was considered suboptimal; participants emphasized the need for streamlined referral pathways and improved communication. Conclusions: The study highlights systemic and educational gaps affecting cancer prevention efforts in family medicine. Tailored training programs, digital integration with cancer centers, and targeted policy adjustments are needed to enhance prevention capacity within primary care. Full article

This study evaluates the impact of Generative AI (Artificial Intelligence) algorithms on human decision making in complex problem-solving tasks. Rather than assessing the algorithms in isolation, we focus on how their use shapes three critical cognitive components of decision making: analytical thinking, creative thinking, and systems thinking. In an experimental setting, student participants were randomly assigned to solve management consulting cases either with or without access to an AI algorithm. Their solutions were evaluated using a structured rubric that captures sub-skills across the three cognitive dimensions. The results of this exploratory study reveal that AI-supported participants achieved stronger outcomes in logical reasoning, structuring, and problem definition, but showed weaknesses in novel idea generation, multidisciplinary integration, and critical rejection of unsupported conclusions. These findings highlight how algorithmic support influences the configuration of human cognitive processes in decision making. Full article

Introduction: This study evaluates the efficacy of a nurse practitioner-managed, computer algorithm-supported institutional fracture liaison service (FLS) that provides treatment recommendations for patients with hip fractures. Methods: A retrospective study included patients hospitalized in the Orthopedic ward with hip fractures between April 1 and October 31. The decision-making algorithm recommends zoledronic acid as the default medication, except for patients younger than 65 years, with estimated glomerular filtration rate (eGFR) <35 or prior osteoporosis therapy, who are ordered to undergo endocrinology consultation. Patients with vitamin D deficiency/insufficiency are given a loading dose. Results: Two hundred and eight hip fracture patients were identified. The cohort was predominantly female (137/208, 65.9%); the mean age was 79.9 ± 9.6 years. Nurse practitioner evaluation was performed in 200/208 patients (96.2%). The algorithm provided a treatment recommendation in 140 out of 200 (70.0%), while 60 out of 200 (30.0%) required an endocrinology consultation. A Vitamin D loading dose was given in 89/99 (89.9%) deficiency and 44/62 (71.0%) insufficiency cases. Conclusions: This simplified algorithm-based FLS model demonstrated practicality and feasibility in providing therapeutic recommendations with minimal physician intervention. Full article

This study aimed to implement an effective power prediction method to support the optimal management of the 30 MW Nagréongo solar photovoltaic (PV) plant in Burkina Faso. Initially, the performance of the PV plant was assessed by an external consultant based on data recorded in 2023 and 2024, revealing efficiency with a performance ratio (PR) of 73.73% in 2023, which improved to 77.43% in 2024. To forecast the plant’s power output, several deep learning models—namely LSTM, a GRU, LSTM-GRU, and an RNN—were applied using historical power data recorded at five-minute intervals during the 2024 periods of January–February; March–April; and July–August. All the deep learning models achieved accurate short-term forecasting for the 30 MW Nagréongo PV plant, with the seasonal performance shaped by the Sahelian weather regimes. The GRU performed best during the dry season (nRMSE ≈ 4%) and LSTM excelled in the hot months (nRMSE ≈ 2%), while the hybrid LSTM-GRU model proved most robust under rainy-season variability. Overall, the forecasting errors remained within 2–5% of plant capacity, demonstrating the suitability of these architectures for grid integration and operational planning in Sahel PV systems. Full article

Background: Globally, uncorrected refractive errors are recognized as the primary cause of visual impairment and blindness. According to a report by the World Health Organization (WHO), providing spectacle lenses at an affordable cost remains a significant challenge, particularly for underprivileged populations in developing countries. This challenge contributes to the low compliance with spectacle wear worldwide. However, the benefits of wearing spectacles are influenced by the perceptions of the population regarding spectacle use. Methods: A quantitative, cross-sectional survey-based study was conducted at a superior educative center in Oman, the University of Buraimi. Participants were recruited from the four major colleges, namely, the College of Health Sciences (COHS), College of Business (COB), College of Engineering (COE), and College of Law (COL), and the Center for Foundation Studies (CFS). This study was conducted over the period from 18 December 2022 to 18 December 2023. Essential data were collected using an electronic questionnaire facilitated by the Google platform. The initial section of the questionnaire outlines this study’s objectives and its benefits to the community. The digital survey comprises three sections: the first section addresses the sociodemographic profile of the participants; the second section explores perceptions related to spectacles; and the third section examines visual symptoms associated with spectacle wear. In this study, a pre-tested survey was administered following consultation with a panel of three subject matter experts who reviewed the clarity and content validity of the test items. Data analyses were performed using descriptive statistics, and linear regression was applied to assess the effect of socioeconomic profile on perceptions of spectacles. Additionally, data entry, processing, and analysis were conducted using SPSS 25 software. The overall mean score for spectacle-related visual symptoms was 2.51 ± 0.75, indicating a moderate level of symptom occurrence. Results: A total of 415 participants (N = 415) were included in this study, comprising 133 males (32.0%) and 282 females (68.0%). The most prominent symptoms related to spectacle perception were “light sensitivity” and “eye pain”, with mean values of 3.03 ± 1.30 and 3.04 ± 1.25, respectively. Additionally, 249 participants (60%) reported moderate concern regarding spectacle-related visual symptoms. Among female participants, 118 (41.8%) exhibited little concern about visual symptoms associated with spectacle wear, whereas this was observed in 25.6% of male participants. Descriptive statistics indicated the mean perceived spectacle-related disadvantages score measured on a scale of 0 to 4 was 2.88 ± 1.16 (57.69% ± 23.15% in percentages), reflecting a moderate perception of such disadvantages. The linear regression model demonstrated statistical significance, as indicated by the likelihood ratio chi-square = 199.194 (df = 15, p < 0.001). The most significant predictor was study major (χ² = 72.922, p < 0.001). Conclusions: The present study indicates that undergraduate students generally exhibit a low perception of the disadvantages associated with wearing spectacles. Randomized sampling should be preferred in future studies to the convenience sampling technique. The most frequently reported visual symptoms include “light sensitivity and eye pain” among spectacle wearers. Therefore, it is imperative to implement health education programs and foundational studies across colleges to address these issues among undergraduate university students. Full article