Search Results (356)

Background/Objectives: Seafarers are a particularly isolated workforce, as they are on-site only with their colleagues, both on and off duty. Long-term duties in the sea environment, irregular working hours, changing time zones, and lack of sleep are some of the many factors that negatively affect the physical and mental health of seafarers. This study aimed to explore the occupational stressors faced by seafarers in Lithuania using the HSE Management Standards Indicator Tool (HSE-MSIT). Methods: In 2023, a quantitative study, using a paper survey, of seafarers’ occupational stressors was conducted in Klaipeda city, Lithuania. A total of 385 Lithuanian seafarers participated in the study. Results: The greatest sources of stress at work were identified as changes at work, relationships, peer support, and management support. Role clarity, demands, and work control were not strong stressors for the seafarers. Analysis of perceived stress levels revealed notable differences between groups with different work experience and job positions. Analysis of years of service (0–11 years vs. 12+ years) found that seafarers with shorter service experienced more stress in terms of demands (p = 0.005), role clarity (p = 0.004), work control (p = 0.035), and relationships (p = 0.02). Based on job position (senior vs. junior), junior seafarers experienced significantly higher stress in the demands (p = 0.001) and role clarity (p = 0.009) subscales. The study revealed that job position and years of work had weak negative correlations with stress indicators at work. The Demands subscale was moderately positively correlated with relationships and change at work. The Relationships subscale was moderately positively correlated with peer support and change at work. Role clarity was moderately negatively correlated with change at work and relationships. Conclusions: Overall, changes at work, relationships, peer support, and management support in the working environment emerged as key factors of perceived stress among seafarers. Junior seafarers and seafarers with shorter years of service experienced higher stress at work. These findings may help in the development of targeted stress management and training strategies tailored to different profiles of seafarers. Full article

Background and Objectives: Breast cancer remains one of the most prevalent malignancies affecting women and one of the most emotionally distressing diagnoses. Emerging evidence suggests that chronic psychological stress may influence cancer progression via neuroendocrine and immune mechanisms. This rapid narrative review explores three key arguments for integrating psycho-oncologists into the multidisciplinary care of breast cancer patients: (1) early detection and reduction of psychological distress, (2) improvement of treatment adherence, and (3) enhancement of quality of life through personalized psychological interventions. Materials and Methods: The review was conducted through comprehensive searches in PubMed, Scopus, and Web of Science for peer-reviewed articles published between 2010 and 2025. Inclusion criteria comprised randomized controlled trials, systematic reviews, meta-analyses, and theoretical papers. Of 246 identified articles, 50 met the inclusion criteria. Results: Selected studies show that psycho-oncological interventions—including cognitive–behavioral therapy, mindfulness-based techniques, narrative therapy, and guided imagery—significantly reduce anxiety, depression, and fear of recurrence. These approaches improve adherence to endocrine therapy and chemotherapy, enhance emotional resilience, and promote overall well-being. Also, recent research concepts emphasize the role of psycho-oncologists in encouraging post-traumatic growth and helping patients redefine cancer as an opportunity for transformation. Conclusions: Integrating psycho-oncologists into standard breast cancer care improves psychological and clinical outcomes. By addressing emotional distress, strengthening coping mechanisms, and supporting existential resilience, psycho-oncologists contribute to a holistic, patient-centered model of oncology care. Wider implementation of psycho-oncological services is warranted as a core component of comprehensive cancer management. Full article

Background: Paramedics and firefighters frequently encounter critical incidents that require both deep learning and emotional processing. This study investigates how reflective writing facilitates these processes, addressing the need to understand professional development in high-stress environments. Methods: The research analyzed reflective writings from 57 second-year Management of Catastrophe Defense undergraduates who were active emergency service workers. Using Mayring’s qualitative content analysis, the study examined participants’ descriptions of critical workplace incidents, emotional responses, and long-term impacts. The theoretical framework combines Paul’s concept of transformative experiences, Schön’s reflective practice, and Jarvis’s experiential learning theory. Results: The analysis revealed three key dimensions: transformative experiences, the role of conversation with the situation in meaning making and the significance of whole-person learning in understanding emotional presence and absence, and the role of reflective writing in understanding learning processes. The study uncovered complex patterns in how professionals process critical incidents and manage emotions in high-stress environments. Conclusions: Reflective writing serves as an effective tool for processing experiences and developing professional resilience, although the process of engaging with traumatic memories through reflection presents its own complexities. These insights contribute to the understanding of learning processes and professional development in high-stress environments. Full article

Nepal is known for its complex terrain, climate, and vegetation dynamics, resulting in tremendous hydrologic variability and complexity. Accurately quantifying the water balances at the national level in Nepal is extremely challenging and is currently not available. This study constructed long-term (2000–2022) water balances for 358 watersheds across Nepal by integrating watershed hydrometeorological monitoring data, remote sensing products including Leaf Area Index and land use and land cover data, with an existing ecohydrological model, Water Supply Stress Index (WaSSI). The WaSSI model’s performance is assessed at both watershed and national levels using observed water yield (Q) and evapotranspiration (ET) products derived from remote sensing (ETMonitor, PEW, SSEBop) and eddy flux network (i.e., FLUXCOM). We show that the WaSSI model captured the seasonal dynamics of ET and Q, providing new insights about climatic controls on ET and Q across Nepal. At the national scale, the simulated long-term (2000–2020) mean annual Q and ET was about half of the precipitation (1567 mm), but both Q and ET varied tremendously in space and time as influenced by a monsoon climate and mountainous terrain. We found that watersheds in the central Gandaki River basin had the highest Q (up to 1600 mm yr⁻¹) and ET (up to 1000 mm yr⁻¹). This study offers a validated ecohydrological modeling tool for the Himalaya region and a national benchmark dataset of the water balances for Nepal. These products are useful for quantitative assessment of ecosystem services and science-based watershed management at the national scale. Future studies are needed to improve the WaSSI model and remote sensing ET products by conducting ecohydrological research on key hydrologic processes (i.e., forest ET, streamflow generations of small watersheds) across physiographic gradients to better answer emerging questions about the impacts of environmental change in Nepal. Full article

Background: The quality of palliative care (PC) services is closely linked to the effectiveness of interdisciplinary collaboration. A coordinated approach among professionals from different fields fosters holistic, person-centered care, ensuring comprehensive support for patients with complex conditions and their families. In hospital settings, In-Hospital Palliative Care Support Teams (EIHSCPs) play a key role in delivering specialized care, enhancing interdepartmental communication, training other healthcare professionals, and optimizing resources. Strong leadership by PC specialists, combined with effective team management, contributes to symptom relief, improved quality of life, and cost reduction. However, interdisciplinary collaboration presents challenges, including competing priorities, resource constraints, and communication barriers. Despite its recognized benefits, research on its implementation in PC, particularly in Portugal, remains scarce. Objective: This study explores the perspectives and practices of professionals within an EIHSCP, examining team dynamics, interprofessional collaboration, and key facilitators and barriers. Methods: Twelve semi-structured interviews were conducted with physicians, nurses, psychologists, and social workers from the EIHSCP in the Médio Tejo region. Data were analyzed using Braun and Clarke’s reflexive thematic analysis. Results: The interview findings were organized into three themes: (1) Social Representations and Interdisciplinary Practice; (2) Competencies for Interdisciplinary Practice; and (3) Challenges in Interdisciplinary Practice. Participants consistently highlighted that interdisciplinary collaboration enhances communication between services and improves care quality. While teamwork is central, patient- and family-centered care remains the priority. Key competencies include empathy, ethics, active listening, and cultural sensitivity, alongside structural and procedural elements such as team meetings, integrated communication, and clear referral criteria. Continuous education and professional development are essential. Challenges primarily stem from limited human and material resources, staff workload and stress, communication gaps between hospital and community teams, and insufficient institutional recognition. Suggested improvements focus on investing in ongoing training, strengthening communication and inter-institutional collaboration, and revising the organizational model of PC within Portugal’s National Health Service. Conclusions: Interdisciplinary collaboration in PC is fundamental for holistic, patient-centered care but is hindered by structural and organizational barriers. Full article

This paper investigated sectoral water use and trends in the Mzimvubu to Tsitsikamma Water Management Area 7 (WMA7). The investigation considered the Water Authorisation and Registration Management System (WARMS) database and field surveys as a source of water use information. The study was able to successfully make use of time series statistical analysis to show water use trends for identified priority sectors over a 5-year period by sourcing historical water use data of the study area. Further, the groundwater stress index and streamflow impact were applied to assess water use impacts on the surface and groundwater. The WARMS database and field survey results identified major sectoral water users such as agriculture (irrigation), municipal water services, dam storage, afforestation, power generation, recreation, mining, and industries. Study findings revealed that the agricultural sector is a major water user, with an estimated 60% of the total water requirement over a 5-year period (2018 to 2022). The application of the groundwater stress index revealed that the majority of the Quaternary catchments have surplus groundwater available. The application of streamflow impact revealed that the majority of catchments have low flow or no flow. The rise of water use clearly indicates a lack of water use compliance and enforcement. An increase in total water use could put water resources under stress, including an impact on the aquatic ecosystem, reduced water quality, and economic and social consequences. Therefore, the study recommends that a follow-up on compliance of surface water and groundwater use licenses be regularly conducted. Full article

Background: Children and adolescents with pediatric inflammatory bowel diseases (PIBD) face significant challenges, including emotional stress, social isolation, and interrupted education due to symptoms. Effective counseling and education empower these young patients and their families to actively participate in healthcare. This paper investigates the IBD needs analysis (CEDNA), focusing on counseling and transition services. Methods: The Study Group distributed questionnaires to PIBD patients and the parents of children and adolescents with PIBD across Germany, with all responses provided anonymously. We conducted a subgroup analysis based on patient age and time since diagnosis, as well as aspects of regional distribution and city size. Parents’ responses were analyzed by corresponding age groups to facilitate comparison with the patients’ responses. Results: From October 2021 to April 2022, 1158 questionnaires (patients 38.9%, n = 450; parents 61.1%, n = 708) were completed. In the group of 16–17-year-old patients, only 14.1% (n = 239) feel well informed about transition programs (parents 6.7% of n = 360). Depending on the disease duration, 2.1% to 6.9% of the patients surveyed (n = 292) feel well informed about PIBD (parents 3.3% to 7.5%, n = 361). Nutritional counseling is the most requested support service (patients 49.2%, n = 382; parents: service used for their children 41.9%, n = 578; parents: service used for themselves 46.1%, n = 575). Conclusions: PIBD patients, especially aged 12–17, lack knowledge and preparation for transition to adult care. While general PIBD management awareness is fair, targeted educational efforts are necessary. Trustworthy information sources and early, tailored counseling services could enhance transition experiences and improve long-term disease management and patient outcomes. Full article

Nature-based solutions (NBSs) offer a promising framework for addressing urban environmental challenges while also enhancing social and economic resilience. As cities seek to achieve carbon neutrality, the integration of NBSs with renewable energy sources (RESs) presents both an opportunity and a challenge, requiring an interdisciplinary approach and an innovative planning strategy. This study aims to explore potential ways of achieving synergies between NBSs and RESs to contribute to urban resilience and climate neutrality. Focusing on the railway station district in western Thessaloniki (Greece), this research is situated within the ReGenWest project, part of the EU Cities Mission. This study develops a comprehensive, well-structured framework for integrating NBSs and RESs, drawing on principles of urban planning and energy systems to address the area’s specific spatial and ecological characteristics. Using the diverse typologies of open spaces in the district as a foundation, this research analyzes the potential for combining NBSs with RESs, such as green roofs with photovoltaic panels, solar-powered lighting, and solar parking shaders, while assessing the resulting impacts on ecosystem services. The findings reveal consistent benefits for cultural and regulatory services across all interventions, with provisioning and supporting services varying according to the specific solution applied. In addition, this study identifies larger-scale opportunities for integration, including the incorporation of NBSs and RESs into green and blue corridors and metropolitan mobility infrastructures and the development of virtual power plants to enable smart, decentralized energy management. A critical component of the proposed strategy is the implementation of an environmental monitoring system that combines hardware installation, real-time data collection and visualization, and citizen participation. Aligning NBS–RES integration with Positive Energy Districts is another aspect that is stressed in this paper, as achieving carbon neutrality demands broader systemic transformations. This approach supports iterative, adaptive planning processes that enhance the efficiency and responsiveness of NBS–RES integration in urban regeneration efforts. Full article

Polyester-glass laminates are widely used to reinforce underground steel fuel tanks due to their excellent corrosion resistance and mechanical performance. However, the management of these composites at the end of their service life poses significant challenges, particularly in terms of material recovery and environmental impact. This study investigates both the structural benefits and recyclability of polyester-glass laminates. Numerical simulations confirmed that reinforcing corroded steel tank shells with a 5 mm GFRP (Glass Fiber Reinforced Polymer) coating reduced the maximum equivalent stress by nearly 50%, significantly improving mechanical integrity. In parallel, thermogravimetric and microscopic analyses were conducted on waste GFRP samples subjected to pyrolysis, gasification, and combustion. Among the methods tested, pyrolysis proved to be the most favorable, allowing substantial organic degradation while preserving the structural integrity of the glass fiber fraction. However, microscopy revealed that the fibers were embedded in a dense char matrix, requiring additional separation processes. Although combustion leaves the fibers physically loose, pyrolysis is favored due to better preservation of fiber mechanical properties. Combustion resulted in loose and morphologically intact fibers but exposed them to high temperatures, which, according to the literature, may reduce their mechanical strength. Gasification showed intermediate performance in terms of energy recovery and fiber preservation. The findings suggest that pyrolysis offers the best trade-off between environmental performance and fiber recovery potential, provided that appropriate post-treatment is applied. This work supports the use of pyrolysis as a technically and environmentally viable strategy for recycling polyester-glass laminates and encourages further development of closed-loop composite waste management. Full article

Climate change is reshaping urban environments, intensifying the need for resilient green space design and management that supports biodiversity, improves ecosystem services, and adapts to changing conditions. Understanding the trade-offs between native and non-native species selection is important for developing climate-resilient urban green spaces. This review examines public preferences for native versus non-native plant species and their implications for urban green space design and management. We critically analyse the ecosystem services and biodiversity benefits provided by both native and non-native plants in urban spaces, highlighting the complex trade-offs involved. Our findings indicate that while native plants can be underrepresented in urban landscapes, they offer significant ecological benefits including support for local wildlife and pollinators. Some studies have highlighted the climate resilience of native plants; however, they are likely to be more affected by climate change. Therefore, conservation strategies are needed, especially for endemic and threatened plant species. Several studies suggest a more flexible approach that integrates plant species from diverse climatic origins to improve resilience. We also explore conservation gardening (CG) as a socio-ecological strategy to integrate endangered native species into urban landscapes, promoting biodiversity and ecosystem resilience. This review stresses the importance of informed plant species selection and community involvement in creating climate-resilient urban green spaces. Full article

The unique demands of teaching contribute to elevated stress levels among educators worldwide. Equipping teachers with adaptive coping skills is increasingly important. However, there is a gap in understanding which coping strategies are essential for pre-service teachers and how universities can best promote them. This study examines pre-service teachers’ coping strategies during a long-term internship and evaluates a low-threshold intervention to enhance stress management and self-care. Three seminar groups were randomly assigned to the experimental group (n = 54), while the remainder formed the control group (n = 119). The experimental group received a self-directed workbook at the start of their internship and three brief face-to-face sessions during accompanying seminars. The workbook modules and seminars guided the pre-service teachers in identifying stressors, developing coping skills, and utilizing personal resources. Data were collected before and after the 18-week internship, measuring well-being, internship-related stressors, and coping strategies. Structural equation modeling showed that positive self-instruction and rumination significantly predicted well-being at the internship’s end, reducing or increasing stress from the internship. Despite the positive response of the pre-service teachers, the workbook did not have an impact. However, the results provide clear implications for the design of future interventions in this area. This study highlights the need for universities to integrate stress management into their curricula. Full article

This study investigates how workplace stressors influence the intention to quit among male employees working in five-star hotels in Egypt, with a focus on the mediating role of psychological distress and the moderating role of psychological flexibility. A cross-sectional survey was conducted with 334 full-time male hospitality workers. Using partial least squares structural equation modeling (PLS-SEM), the study examined the relationships between workplace stressors, psychological distress, the intention to quit, and psychological flexibility. The results showed that higher levels of workplace stressors were significantly associated with increased psychological distress and a stronger intention to quit. Psychological distress partially explained (mediated) the link between stressors and quitting intentions. Moreover, psychological flexibility acted as a buffer (moderator), reducing the negative impact of workplace stress on distress and, in turn, on quitting intentions. These findings highlight the unique contribution of the study in applying the transactional model of stress and coping within a Middle Eastern hospitality context, focusing exclusively on male workers—an understudied group in the existing literature. To address these challenges, hospitality managers are encouraged to adopt evidence-based interventions such as mindfulness-based stress reduction (MBSR) and acceptance and commitment therapy (ACT) to strengthen employees’ psychological flexibility and reduce the turnover risk. The study offers valuable insights for researchers, organizational leaders, and HR practitioners aiming to improve employee well-being and retention in high-pressure service environments. Full article

This study focuses on Roblox as a case study to explore the legal and technical challenges of content moderation on child-focused social media platforms. As a leading Metaverse platform with millions of young users, Roblox provides immersive and interactive virtual experiences but also introduces significant risks, including exposure to inappropriate content, cyberbullying, and predatory behavior. The research examines the shortcomings of current automated and human moderation systems, highlighting the difficulties of managing real-time user interactions and the sheer volume of user-generated content. It investigates cases of moderation failures on Roblox, exposing gaps in existing safeguards and raising concerns about user safety. The study also explores the balance between leveraging artificial intelligence (AI) for efficient content moderation and incorporating human oversight to ensure nuanced decision-making. Comparative analysis of moderation practices on platforms like TikTok and YouTube provides additional insights to inform improvements in Roblox’s approach. From a legal standpoint, the study critically assesses regulatory frameworks such as the GDPR, the EU Digital Services Act, and the UK’s Online Safety Act, analyzing their relevance to virtual platforms like Roblox. It emphasizes the pressing need for comprehensive international cooperation to address jurisdictional challenges and establish robust legal standards for the Metaverse. The study concludes with recommendations for improved moderation strategies, including hybrid AI-human models, stricter content verification processes, and tools to empower users. It also calls for legal reforms to redefine virtual harm and enhance regulatory mechanisms. This research aims to advance safe and respectful interactions in digital environments, stressing the shared responsibility of platforms, policymakers, and users in tackling these emerging challenges. Full article

Background/Objectives: Advance care planning is essential in a community; however, intervention studies by care managers remain scarce. This study aims to determine the relationship between frailty and post-traumatic stress disorder among long-term care service users (hereinafter referred to as “users”) following advance care planning conversations with their care managers. Methods: We conducted a secondary analysis using raw data from the Japanese University Hospital Medical Information Network Study No. 000048573, published on 23 September 2024. In this previous study, trained care managers provided advance care planning conversation interventions to 30 users. Care managers conducted a convenience sample of 30 mentally and physically stable users who were 65 years old or older, had a family member or healthcare provider assigned, and had never used ACP. Our analysis in the present study focuses on the Clinical Frailty Scale and Impact of Events Scale-Revised, both of which measure post-traumatic stress disorder. Results: The Impact of Events Scale-Revised score was significantly higher in users with a clinical frailty score ≥ 5 compared to those with a clinical frailty score < 5. Logistic regression analysis, using the Impact of Events Scale-Revised as the objective variable, also revealed an association between a clinical frailty score ≥ 5 and a higher Impact of Events Scale-Revised. The four groups, selected through hierarchical cluster analysis for sensitivity analysis, demonstrated results consistent with the above analysis. Conclusions: The degree of post-traumatic stress disorder among users is associated with their degree of frailty following an advance care planning conversation with their care manager. Frailty in users may be a valuable predictor of stress related to advance care planning conversations. Users with a clinical frailty scale score ≥ 5 can be provided with more personalized care through more careful communication. University Hospital Medical Information Network Trial ID: 000048573. Full article

The strategic incorporation of low-cost management practices, such as cover crops (CCs), to citrus production in southern Texas could add valuable ecosystem services that increase trees’ resilience to changing climatic conditions. To provide insight into how producers can manage CCs to optimize ecosystem services, we conducted a study in controlled conditions to examine the potential of adding three annual summer CCs species: common buckwheat (Fagopyrum esculentum), sunflower (Helianthus annuus L.), and sunn hemp (Crotalaria juncea L.) as monocultures growing in two representative soil types of the citrus region in Texas, and receiving one of these irrigation volumes based on calculated daily water losses [i.e., evapotranspiration (ET)] corresponding to 100, 75, 50, and 25% field capacity replenishment. Sunflower and sunn hemp produced the highest aboveground dry matter, which was on average 338 and 342% greater than buckwheat. Sunn hemp emerged faster than the other CCs, and mortality was relatively uniform across CCs, but buckwheat exhibited the highest sensitivity to drought and heat distress. Sunn hemp exhibited superior aboveground biomass accumulation, height, and chlorophyll content. All CCs performed similarly in both experimental soils, under native fertility conditions, and without the addition of mineral fertilizers. Irrigation at 75 and 100% ET levels were conducive to enhanced plant growth, which indicates that a minimum of 86.4 mm (75% ET) is required during CCs lifespan, but sunn hemp and sunflower were also capable of tolerating medium (50% ET) drought stress. Overall, our findings suggest that sunflower and sunn hemp exhibited traits desirable for incorporation as CCs to a perennial citrus production system. The primary benefit was the addition of organic matter with minimum management; however, both CCs’ performance was dependent on planting timing, successful early establishment, and favorable environmental conditions. Full article