Search Results (16,332)

Background: Artificial intelligence (AI) is increasingly integrated into healthcare systems, with important implications for nursing practice and clinical workflows. However, evidence regarding nurses’ digital skills, perceptions, and readiness to adopt AI-enabled technologies remains limited, particularly in national healthcare contexts such as Greece. Objectives: This study examined nurses’ digital skills, perceptions of AI, and readiness for AI adoption in clinical practice, and explored demographic and professional factors associated with these outcomes. Methods: A cross-sectional survey was conducted among 166 nurses working in two public hospitals in Greece. Results: Nurses reported moderate digital skills, with 59.1% indicating competence in email/video communication and 27.2% reporting adequate use of digital security tools, while exposure to AI remained limited (18.0% reported using AI products/services in daily life). Perceived professional impact of AI was moderate, whereas readiness for AI adoption was comparatively lower, with only 7.8% considering health professionals adequately prepared and 7.2% reporting adequate AI training. Statistical analyses indicated that educational level and computer literacy certification were positively associated with digital skills, whereas longer professional experience was negatively associated with readiness for AI adoption. Conclusions: These findings highlight a gap between general digital competence and preparedness for AI-driven healthcare applications and underline the need for targeted education and implementation strategies to support effective and ethical integration of AI in nursing practice. From a nursing workforce perspective, the results underscore the importance of integrating AI literacy into continuing professional education and aligning digital health implementation strategies with clinical nursing practice. Full article

Objective: Village Health Volunteers (VHVs) are vital to Thailand’s primary healthcare, yet many face high risks for non-communicable diseases (NCDs). This preliminary study aimed to implement health empowerment theory-based personalized health promotion for individuals in the NCD-risk group. Methods: The preliminary mixed-methods study implemented a 6-month empowerment-based health promotion program for 21 VHV leaders (mean age 62.43 ± 7.28 years) at risk for NCDs. The intervention integrated laboratory data, behavioral and qualitative focus-group insights, and quantitative anthropometric data obtained via bioelectrical impedance analysis (BIA). Results: Participants’ exercise adequacy significantly improved after the intervention, increasing from 8.3% to 61.9% (p = 0.03). BIA revealed a physiological shift toward improved energy homeostasis, including decreased body weight, reduced visceral fat area, and increased muscle hydration. While biochemical markers did not reach statistical significance, clinically favorable downward trends were observed in median HbA1c (8.0% to 7.3%) and LDL cholesterol (141.8 to 119.0 mg/dL), alongside stable renal and liver function. Qualitative thematic analysis identified four primary domains of impact: sustainability and systemic advocacy, personal transformation, broad competence acquisition, and enhanced social capital. Participants reported a marked increase in self-efficacy, transitioning from inactive beneficiaries to active health advocates. This change was largely driven by mastery experiences, such as visible improvements in body composition and functional health literacy. Conclusions: The empowerment program significantly improved physical activity and body composition while fostering the social capital and health literacy necessary for community leadership, suggesting that personal health mastery is a critical precursor to effective systemic advocacy and long-term sustainability in community-led health programs. Full article

Wastewater-based epidemiology (WBE) has emerged as a powerful approach for population-level monitoring of chemical exposure, health status, and disease transmission by analysing wastewater. Although chromatographic and molecular techniques remain the gold standard in WBE, their high cost, infrastructural demands, and limited suitability for decentralized and real-time monitoring motivate the development of complementary sensing technologies. In this context, optical (bio)sensors, particularly fluorescence-based platforms, have attracted increasing attention due to their high sensitivity, rapid response, and potential for on-site monitoring. This review discusses recent advances in fluorescent optical (bio)sensors for WBE, with a particular focus on carbon dots (CDs), including waste- and biomass-derived CDs produced via green synthesis as well as CDs obtained from commercial chemicals. The applicability of CD-based sensors to wastewater-relevant analytes is evaluated, highlighting current achievements, as well as existing limitations and challenges related to real-sample validation and the translation of these platforms into robust, field-deployable systems for their implementation in sustainable wastewater monitoring and public health surveillance. Full article

As global urbanization accelerates, biophilic urbanism has emerged as a key nature-based strategy for enhancing public health. While plants are critical active agents for psychological restoration, the specific pathways through which vegetation characteristics influence human–environment interactions remain fragmented. This knowledge gap hinders the evidence-based translation of biophilic principles into actionable urban design and governance. This study conducts a systematic bibliometric analysis of 443 peer-reviewed articles (2000–2025) at the intersection of restorative landscapes, urban settings, and plant-based interventions retrieved from the Web of Science Core Collection. Employing multiple visualization tools (VOSviewer, bibliometrix, and CiteSpace), we map publication trends, international collaborations, and thematic evolution. The results demonstrate a significant shift in the field, moving beyond the validation of foundational restorative theories (e.g., ART and SRT) to a more precise, implementation-oriented framework. This shift is characterized by the operationalization of vegetation attributes as controllable design variables, increasingly relating biophilic principles to broader nature-based solutions (NbS) agendas and evidence-informed urban governance. Thematic clustering analysis identified three core knowledge domains: (1) the role of plants as active exposure agents and behavioral mediators in psychological restoration; (2) the impact of specific plant characteristics—such as canopy structure, species diversity, and seasonal variation—on therapeutic outcomes; and (3) the integration of urban green spaces into broader governance frameworks to promote health equity and inclusive well-being. Our analysis highlights that plant-based interventions are evolving from aesthetic ornaments into precision design levers for fostering human–nature interactions. This study provides a science-based foundation for developing practical design guidelines and policy frameworks, shifting biophilic urbanism toward a robust governance strategy for creating equitable, restorative, and resilient cities. Full article

The literature on the Commercial Determinants of Health has primarily focused on the political power and interventions of corporations versus countermeasures by civil society. However, there is a gap in the discourse concerning industry use of legal threats and actions to silence public health organizations and their public health communication campaigns (PHCCs). This legal review aims to understand legal challenges brought against PHCCs and provide best practices for effective campaigns while minimizing legal risk. We used jurisprudence in Mexico and the United States as proxies for civil and common law countries, supplemented by international law and principles to identify the best defenses and mitigation strategies against defamation and trademark infringement actions. Legal frameworks in these countries demonstrate the ability of aggressive evidence-based public health campaigns to withstand these legal challenges. Based on these legal protections, we recommend that advocates implement PHCCs that (1) contain facts that are true and substantiated with evidence, (2) frame messaging as opinion or satire, (3) highlight the non-commercial purpose of informing people about the impact of their consumption choices on health and well-being and (4) explain how the messaging advances the rights to health and access to information. A PHCC’s success in court can also set important precedents regarding the right of advocates to disseminate and the right of populations to receive important health messages. Following these recommendations and best practices, health advocates can minimize legal risk and continue to provide effective evidence-based PHCCs that promote and protect public health. Full article

Urban neighborhood parks are essential infrastructure for sustainable cities, supporting physical and mental health, social cohesion, and climate adaptation. Equity-oriented park planning, however, requires accurate identification of residents who can access parks within network-constrained travel time thresholds. Many accessibility studies estimate served populations using coarse administrative zones and areal-weighting assumptions, which can bias results in heterogeneous, vertically developed districts. This study develops a building-based population allocation framework (implemented via a building centroid overlay) that integrates Statistics Korea’s census output areas (2023 Q4 release) with the Ministry of Land, Infrastructure and Transport (MOLIT)’s GIS Integrated Building Information database (2023 Q4 release) and applies it to Yongsan-gu (Yongsan District), Seoul. Park entrances were verified and digitized using street-view imagery available on multiple web map platforms, and walkable service areas (5 and 10 min) were delineated via network analysis. Potential service coverage and unserved population were then estimated under three spatial configurations—administrative dong (neighborhood-level administrative unit in Seoul; hereafter administrative unit), census output area, and building-based allocation—and compared. Under the 10 min scenario, the unserved share reached 24.6% at the administrative unit level but decreased to 5.9% and 4.3% when using census output areas and building-based allocation, respectively. The building-based approach additionally revealed micro-scale clusters of unserved residents near localized pedestrian constraints and boundary-crossing areas that are obscured by zone-based methods. These findings demonstrate the sensitivity of access-based potential service coverage diagnostics to spatial unit choice and population disaggregation and suggest that building-based population allocation can improve the targeting of park pro-vision policies and promote spatial equity in dense, vertically developed cities. Full article

Industrial predictive maintenance programs often rely on SCADA historian signals characterized by low-frequency sampling and asynchronous reporting intervals. These data constraints, specifically non-uniform scan rates and inter-tag time misalignment, limit the applicability of high-resolution or sensor-intensive prognostic models. This study proposes a lightweight, physics-informed health proxy, the temperature-weighted work (TWW) index, designed to monitor motor stator-winding degradation within these industrial limitations. The TWW index accumulates mechanical work derived from torque and speed measurements, weighted by an adaptive exponential temperature-emphasis function that penalizes operation at elevated temperatures. The formulation is inspired by practical thermal-aging heuristics such as Montsinger’s rule in the qualitative sense that higher temperatures are treated as disproportionately more damaging, but it is not intended as a direct implementation of a fixed absolute-temperature life law. Instead, it is designed as a lightweight adaptive index suitable for online SCADA-based implementation. To address SCADA-specific irregularities, the framework incorporates data synchronization and resampling techniques to align heterogeneous tags, alongside power-thresholding to isolate degradation-relevant load periods. The resulting cumulative index is mapped to a normalized health/RUL proxy using failure-referenced thresholds identified from historical events. Validation using field data from industrial three-phase motors demonstrates that the TWW index provides a monotonic degradation profile that is consistent with documented winding-related failures and proactive removals. Case studies confirm that the model enabled proactive maintenance interventions by signaling the terminal phase of insulation life before catastrophic breakdown, offering a hardware-free and scalable solution for real-time asset management. Full article

Aims: This study aimed to examine the associations between both birth weight (BW) and body mass index (BMI)/waist circumference (WC) measured at ages 7–10 years, and adolescent overweight (OW)/obesity (OB), and central OB at ages 11–13 years. Methods: Longitudinal data were collected from children’s and parents’ questionnaires. Anthropometric data were obtained from health check-ups. BW (kg) was categorized into three groups: <3.0, 3.0–3.9 and ≥4.0 (macrosomia). Underweight (UW)/normal weight (NW), OW and OB were defined based on sex- and age-specific reference values for Chinese children. Central OB was identified using the sex-specific waist-to-height ratio (WHtR) cutoffs. Results: Of the 1204 children, 14.5% had a BW < 3.0 and 15.6% had macrosomia. The rates of OB and central OB were 10.13% and 28.32%, respectively, among children aged 7–10 years and 6.23% and 23.34%, respectively, among those aged 11–13 years. An increasing BW z-score was associated with higher odds of OW/OB in girls aged 11–13 years. Childhood BMI and WC z-scores were associated with higher odds of OW/OB and central OB, respectively, at ages 11–13 years. Childhood OW/OB and central OB were associated with a higher risk of OW/OB and central OB, respectively, at ages 11–13 years. Conclusions: BW was modestly associated with OW/OB in girls. Childhood BMI was the strongest predictor of OW/OB, while childhood WC was a strong and significant predictor of central OB in early adolescence. These findings highlight that early school age is a critical period for risk identification and the implementation of future preventive strategies. Full article

One of the main focuses of social innovation is the fight for social inclusion for all. The prevalence of violence against women with disabilities shows how the lack of recognition of diversity hinders real equality for these individuals. This violence is a structural problem that is caused by a combination of gender and disability dynamics, the perpetuating inequalities and social exclusion. Researchers have analyzed specific vulnerabilities in the areas of work, education and health, and point out that only by addressing diversity can we overcome the consequences of such discrimination. Using a qualitative methodological approach, this study utilized critical documentary analysis and a thematic review of recent scientific, academic, and institutional literature, alongside empirical data, to identify the most prevalent forms of violence faced by women with disabilities: sexual (affecting up to 80% of women with disabilities), economic (with wage gaps exceeding 24%), and institutional (a lack of accessibility to basic services). The barriers hindering these women’s access to resources and services are also highlighted. The results point to the urgent need to develop innovative public policies and social strategies that value social diversity as a driver of change. This study concludes with specific recommendations for implementing inclusive approaches that promote equality, universal accessibility, and comprehensive protection in order to move toward more just, cohesive, and innovative societies. Full article

Objectives: Cardiovascular diseases (CVDs) represent the main global burden of morbidity and mortality, with an accelerated epidemiological transition in regions such as Latin America. The university environment constitutes a period of critical vulnerability due to increased sedentary lifestyles and cardiometabolic risk factors. The objective of this study was to evaluate the cardiovascular risk profile in a university community in the central Andean region of Colombia using anthropometric, haemodynamic and biochemical indicators. Methods: A cross-sectional, observational, and analytical study was conducted on a sample of n = 143 participants (students, teachers, and administrators) aged between 18 and 80 years. Haemodynamic parameters (SBP, DBP, MAP), anthropometric parameters (BMI, % body fat, waist-to-height ratio [WC/W]) and lipid profile were evaluated. Statistical analysis included multiple linear regression models to determine predictors of systolic blood pressure (SBP). Results: Significantly higher levels of SBP were found in the older age groups compared with the younger age groups, reaching stage 1 hypertension levels in the sixth decade. The biochemical profile revealed metabolic deterioration with an atherogenic index (TC/HDL) consistently above the clinical threshold (>4.5) in all groups. The regression model BMI was identified as the statistical predictor with the strongest association with SBP variability in the sample (β = 1.18), followed by age (β = 0.28). A marked sexual dimorphism was observed, with men presenting early haemodynamic risk, while women experienced an accelerated post-menopausal tension and metabolic crisis. Conclusions: The university community presents latent cardiometabolic vulnerability closely linked to modifiable anthropometric factors. These findings underscore the urgency of implementing institutional preventive health policies and weight control intervention programmes to mitigate the future burden of chronic diseases on campus. Full article

The authors of this study aimed to develop and validate the College Students’ Coping with Public Health Crisis Scale (CSPHCS) among Chinese students, designed to assess coping strategies used during public health crises. This study had a rigorous, three-phase process comprising item development, scale development, and scale evaluation. Within these phases, a total of nine systematic steps were implemented. A total of 548 questionnaires were distributed, with 525 valid responses retained. A random subsample of 300 participants was used for exploratory factor analysis, and the remaining 225 were reserved for confirmatory factor analysis. The exploratory factor analysis revealed a three-factor structure after removing items with high cross-loadings. These factors were identified as (1) Information and Mental Health Support Coping, (2) Communication and Preventive Action Coping, and (3) Self-Regulatory and Expressive Coping, accounting for 50.14% of the total variance. The confirmatory factor analysis supported the three-factor model with acceptable fit indices (CFI = 0.887; TLI = 0.892; RMSEA = 0.077). The scale showed good reliability (α = 0.763, ω = 0.745). To sum up, the CSPHCS is shown to be a psychometrically sound instrument with implications for research and practice in understanding how college students cope with public health crises. Full article

Background/Objectives: Chronic diseases pose a major challenge for healthcare systems, requiring integrated, patient-centered approaches that combine clinical management, prevention, and self-care. Lifestyle Medicine (LM) and lifestyle in general offers complementary frameworks to address these needs. However, the potential integration of LM within community nursing—particularly through the role of Family and Community Nurse (FCN)—has not been comprehensively synthesized. This narrative review aimed to synthesize international evidence on the role of community nursing—particularly FCN—in integrating chronic care management and LM view. Methods: For quality assessment, a narrative review was conducted in accordance with the SANRA criteria to enable the integration of heterogeneous evidence and a comprehensive synthesis of this complex topic. Literature searches were performed in the PubMed–Medline database, and the final screening of references from included studies was used to identify relevant manuscripts. Primary studies published in English over the past ten years were screened and analyzed using the PICOS framework. Sixteen eligible studies were included in the final synthesis. Results: The included studies indicated that nurse-led community interventions in LM view were associated with improvements in self-management, treatment adherence, and selected clinical outcomes, such as blood pressure, glycated hemoglobin, and physical activity levels. Empowerment-based approaches and the use of digital or telehealth tools supported patient engagement and health literacy. At the organizational level, multidisciplinary collaboration, shared protocols, and professional leadership emerged as key factors in sustaining continuity and quality of care, while organizational fragmentation and limited training in behavioral counseling were commonly reported barriers. Conclusions: Community nursing, particularly through FCNs, plays a relevant role in integrating chronic care management and LM approaches, contributing to improved self-management, treatment adherence, and selected clinical outcomes. The evidence highlights the importance of empowerment-based interventions, digital support tools, and multidisciplinary collaboration in enhancing care continuity and patient engagement. Addressing organizational barriers and strengthening behavioral counseling training remain essential to support effective implementation in community settings. Full article

(1) Background: University food service establishments are complex environments, where high turnover and handling practices create conditions for microbial persistence. Food-contact surfaces (FCSs) and handlers’ hands (FHs) function as dynamic reservoirs, facilitating the circulation of contaminants within these institutional settings. This study aimed to characterise the microbiological contamination of FCSs and FHs in university food service establishments in Northern Portugal and to evaluate their role as interconnected environmental reservoirs within the indoor built environment. (2) Methods: A total of 590 samples were analysed from two universities in Northern Portugal (L1, L2), comprising 380 FCS and 210 FH samples. Aerobic colony counts (ACCs), Enterobacteriaceae, and Moulds and yeasts (MYs) were analysed according to ISO methods. FH samples were additionally screened for Escherichia coli and Staphylococcus spp. (3) Results: Overall, 35.5% of FCSs were classified as non-compliant, according to microbial criteria based on guideline values from the National Health Institute Dr. Ricardo-Jorge (INSA), with non-compliance primarily driven by elevated ACCs and MYs. Based on a Generalised Linear Model (GLM), establishment types (canteens vs. cafes) were associated with Enterobacteriaceae levels (p = 0.016), whereas ACCs and MYs were not significantly associated with district, establishment type, or functional surface category (p > 0.05). Differences between left and right hands showed small effect sizes, and location was a highly significant determinant of hand hygiene acceptability. (4) Conclusions: FCSs and FHs act as relevant contamination reservoirs in these settings. The results indicate that Enterobacteriaceae levels on FCSs differed between establishment types, while ACCs and MYs showed no significant variation across the evaluated environmental factors. Marked differences in hand hygiene acceptability between campuses support the implementation of targeted interventions, including the optimisation of cleaning and disinfection protocols, the structured training of food handlers, and the routine microbiological monitoring of surfaces and hands to improve institutional food safety. Full article

Background: Vitamin D deficiency remains a widespread public health issue in Europe, despite the availability of sunlight, dietary sources, supplements, and food fortification. National fortification strategies differ substantially in their regulatory approaches, food vehicles, and fortification levels, influencing the population’s vitamin D intake and status. Objective: The primary objective of this study was to map vitamin D food fortification policies across European Union (EU) Member States, European Free Trade Association (EFTA) countries, and the United Kingdom (UK), focusing on regulatory frameworks, eligible food categories, and implementation models. Methods: A structured review of national legislation and official guidance on vitamin D food fortification was conducted between December 2025 and March 2026 across EU Member States (n = 27), EFTA countries (n = 4), and the UK. For EU Member States, the framework established by Regulation (EC) No 1925/2006 was examined alongside national implementation measures. For EFTA countries and the UK, corresponding national legislation and official regulatory guidance were reviewed. Data were extracted on fortification policy status, eligible food categories, legal basis, and fortification levels. Targeted searches of PubMed and Scopus were performed to identify modeling studies and policy analyses supporting the interpretation of the findings. Results: Fortification policies show marked heterogeneity. Mandatory fortification is limited to a few countries and specific foods: Finland (homogenized skim milk), Sweden (low-fat milk, fermented dairy, plant-based alternatives, and fat spreads), Belgium (margarine and selected fats), and Poland (margarine and fat spreads). In most other European countries, vitamin D fortification is voluntary under EU legislation or equivalent national legislation, depending on market uptake. Food vehicles vary regionally, with Northern Europe extending fortification beyond fats to include fluid milk and plant-based drinks, whereas other regions mainly fortify margarines, cereals, dairy products, and plant-based beverages. Fortification levels also differ, with some countries specifying maximal or exact levels, while others lack national standards. Data on fortified foods are limited in several Central and Southern European countries. Modeling indicates that multi-vehicle fortification is more effective than single-vehicle approaches, safely increasing population intakes while reducing deficiency prevalence. Conclusions: Vitamin D fortification policies across Europe are highly heterogeneous. Most countries rely on voluntary approaches, which provide limited coverage. Strengthening policy through mandatory and well-coordinated multi-vehicle strategies, informed by modeling and population-based studies, can improve vitamin D intake, reduce deficiency prevalence, and enhance health equity. Full article