The integration of Artificial Intelligence (AI) in providing quality dental care to individuals with special needs has been scarcely explored and holds the potential to be transformative. This study aimed to map the current evidence and research gaps on the application of AI tools in special care dentistry. This study was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines to ensure transparency. A systematic search was carried out across PubMed, Google Scholar, Scopus and Web of Science, including studies on AI for dental care of special needs groups published from 2015 to 2025. The data were charted on an evidence map, and study characteristics were evaluated to identify existing evidence and gaps. Five studies were included in the review. Some of the major themes explored were AI tools used for diagnosis, treatment planning, behavior management, remote consultation and communication assistance for these groups, with one of the five studies assessing dentists' perceptions of their use. This study highlighted the lack of robust evidence and the narrow focus of the existing studies. This study highlighted the research gap in AI tools for special needs groups and noted the dearth of scientifically and conceptually rigorous studies on the topic. Thus, serving as the preliminary evidence for directing subsequent research on clinical translation of AI tools for special needs groups.
Since 2019, Dutch hospitals have been developing approaches aiming to bridge the gap between hospital care and community-based lifestyle support. This has led to the introduction of the so called 'Lifestyle Front Office" (LFO) in 2022. The LFO enables healthcare professionals to refer patients for lifestyle and (psycho)social support adjacent to medical treatment in the context of specialist medical care. After a consultation at the LFO, patients are referred to the appropriate community-based lifestyle interventions. LFOs have been quickly adopted in Dutch hospitals, leading to conceptual differences. This study aimed to evaluate similarities, differences and future needs of LFOs in the Netherlands, striving for a more unified concept. A cross-sectional survey was sent out between December 2023 and September 2024 to all Dutch hospitals with an operational LFO (n = 17 hospitals). The survey focused on referral processes, patient eligibility criteria, departmental involvement, screening methods, consultation practices, follow-up procedures, financing, and capacity. The collected data were analyzed quantitatively and qualitatively to identify common practice, challenges, and opportunities for improvement. The survey response rate was 82% (14/17). Primary referral groups were patients with lifestyle-related conditions such as obesity, type 2 diabetes mellitus and cardiovascular diseases. Most LFOs conducted pre-visit screenings by using questionnaires, employed lifestyle care coordinators with diverse professional backgrounds, utilized structured tools during consultations and used the electronic patient records for screening and communication. Future needs included the need for (long-term) funding, which was only secured in 21% of the LFOs. Furthermore, inconsistent eligibility criteria, limited capacity, and follow-up procedures were seen as priorities for future attention. This study highlights the similarities, differences and future needs of LFOs in the Netherlands. To achieve a more unified concept, LFOs need to better align patient-related eligibility criteria, use of structured tools, referral to community-based support, follow-up strategies and long-term funding. While the LFO concept emphasizes strong inter-organizational collaboration, further research is needed to assess its impact by investigating success rate of referrals and (long-term) health outcomes after referral. Additionally, for maintaining LFOs in the Dutch healthcare system, additional research is required to better understand the barriers and facilitators regarding structural implementation.
Rheumatology and immunology nursing involves complex, long-term patient care. However, the effectiveness of current training in supporting early-career nurses remains unclear. Therefore, this study aimed to explore stakeholders' perspectives on training experiences and perceived learning needs, and to identify key implications for competency-based continuing professional development, with a focus on enhancing sustained patient safety. This descriptive qualitative study employed semistructured interviews with 26 participants (15 trainees and 11 trainers) from six county-level hospitals in Ningxia, China. Data were analyzed using Braun and Clarke's reflexive thematic analysis, and reporting followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. Three main themes emerged: (1) Trainees reported misalignment between training content and daily clinical demands, insufficient support for safe routine practice, and limited opportunities for supervised skill development; (2) Trainers highlighted gaps in preparation and educational resources, resulting in primarily didactic approaches and variable training quality, which may hinder the development of patient safety-related competencies; (3) Trainers emphasized the need for a structured, progressive training framework integrated with clinical practice. Shared priorities included clearly defined competency progression, contextually relevant content, experiential learning strategies such as case discussions and supervised practice, and the integration of psychological support, humanistic care, and lifelong learning awareness and methods. Faculty development and standardized teaching materials were considered essential to ensure consistent and safe practice standards. Strengthening specialist nursing capacity in resource-limited county hospitals requires not only structured, practice-integrated training curricula but also sustainable continuing professional development pathways that support progressive competency development. Embedding competency-based learning within routine clinical practice, alongside investment in trainer capability and standardized educational resources, may help reinforce patient safety competencies and promote sustained professional growth across the early stages of nursing careers.
Coping with prolonged periods of low availability of wind and solar power, also referred to as variable renewable energy droughts or "Dunkelflaute", emerges as a key challenge for realizing decarbonized energy systems based on renewable energy. Here we investigate the role of long-duration electricity storage and geographical balancing through transmission in dealing with such events in Europe, combining a time series analysis of renewable availability with power sector modeling of 35 historical weather years. We find that extreme droughts define long-duration storage operation and investment. Assuming policy-relevant interconnection, the least-cost system in our model capable of coping with the most extreme event requires 351 terawatt hours long-duration storage capacity, corresponding to 7% of yearly European electricity demand. While nuclear power can partially reduce storage needs, the storage-mitigating effect of fossil backup plants in combination with carbon removal is limited. Policymakers and system planners should prepare for a rapid expansion of long-duration storage to safeguard the renewable energy transition in Europe.
Older adults with complex needs (CN), commonly defined as the coexistence of multiple chronic conditions and functional limitations, are associated with high levels of medical and long-term care (LTC) utilization. However, evidence on real-world patterns of joint medical and LTC service use among this population in China remains limited. This cross-sectional study utilized data from 177,807 individuals aged ≥ 60 years who underwent LTC insurance assessment in Shanghai between January and May 2023. CN was defined as having three or more chronic conditions with at least one limitation in activities of daily living. Within an integrated care framework, latent class analysis (LCA) was applied to identify patterns of medical and LTC service utilization based on 10 indicators informed by the Andersen Behavioral Model of Health Services Use. Multinomial logistic regression was used to examine the association between CN status and class membership, adjusting for demographic, socioeconomic, and health-related factors. Older adults with CN (n = 42,277) differed significantly from those without CN (n = 135,530) across demographic, socioeconomic, health status, and service utilization. Six latent classes of medical and LTC service utilization were identified: Low Medical & Low Care, Moderate Medical & Low Care, High Medical & All Care, High Medical & Informal Care, High Medical & Formal Care, and High Inpatient & Formal Care. Compared to non-CN individuals, CN individuals had higher probabilities of belonging to high-utilization classes, particularly High Medical & All Care, High Medical & Informal Care, and High Medical & Formal Care classes, with the Low Medical & Low Care Class as the reference. These associations remained significant after adjusting for covariates. Older adults with CN in China showed heterogeneity in patterns of medical and LTC service utilization and were more frequently represented in intensive and multi-sector service use profiles. Early identification of CN individuals and the development of risk-stratified integrated care models may help inform more coordinated and people-centered service delivery approaches.
Good communication is vital to high-quality care for adults with learning disabilities in long-term care settings, influencing their health and well-being. Evidence on how best to support their communication needs is limited. To develop an initial programme theory that synthesises knowledge on how communication interventions work in these settings, how they can be best designed, implemented, and evaluated, and the resources needed. A realist review was conducted following RAMESES II standards, using seven databases (CINAHL, EMBASE, Medline, PsycINFO, Scopus, Web of Science, Cochrane Library). After screening, included studies were assessed for quality and relevance, with data extracted from those rated moderate to high. Context-mechanism-outcome configurations were developed and refined through consultation with experts and stakeholders, including in meetings with 53 adults with learning disabilities, carers, and professionals. The review was registered on PROSPERO [BLINDED FOR REVIEW]. Of 5576 studies screened, 29 were assessed as moderate or highly relevant, contributing to ten context-mechanism-outcome configurations describing changes in: staff knowledge and awareness of communication; ability to assess individuals' needs; and use of practices, techniques, tools, and support for choice-making. Organisational resources key to enabling staff skill development referred to changes in leadership, policies and procedures, environmental modifications, training and ongoing support. Outcome measures include those reflecting effective communication. Good communication is a complex process that requires systemic support prioritising communication and meaningful relationships between staff and individuals. This initial program theory offers a framework to guide the implementation and evaluation of such support.
Diabetes mellitus type 2 (T2D) is a growing burden in Switzerland, where general practitioners (GPs) face increasing workload. To evaluate the quality of T2D care, the Swiss Society of Endocrinology and Diabetology (SGED) developed the SGED score to help GPs overview aggregated patient parameters at the practice level. However, the practical use of the SGED score is hampered by paper-based workflows and fragmented documentation. Currently, no dashboard exists to specifically visualize the SGED score, which overviews aggregated population parameters such as HbA1c or blood pressure. To address this gap, this study examined: (1) what functional requirements healthcare professionals consider essential for such a potential SGED dashboard, and (2) how do healthcare professionals evaluate the usability and clinical relevance of an iteratively developed dashboard prototype. We employed an iterative, user-centered three-step approach involving 10 semi-structured interviews with 14 Swiss T2D healthcare professionals. Step 1 involved defining the project scope, identifying predefined functional requirements, and developing an initial SGED score dashboard prototype. Step 2 collected user-generated requirements and prioritized all requirements using the "Must Have", "Should Have", "Could Have", "Won't Have" (MoSCoW) method. In step 3, the high-fidelity Figma dashboard prototype was iteratively refined based on the requirements and interviewee feedback. Key functional requirements of the digital SGED score included reminder and alert functions for missing or overdue SGED-relevant assessments, color-coded critical values such as low nephropathy screening rates, demographic overviews, trend analyses of SGED indicators at practice level, benchmarking within practice networks, and exportable reports. Additional needs emerged for patient-level views, integrated checklists, inclusion of comorbidities, and personal or practice-specific goal-setting features. Iterative refinements based on user feedback improved clarity, usability, and visual appeal. Some participants highlighted the dashboard's intuitive design, clear and diverse visualizations, and benchmarking functionalities, describing it as both engaging and efficient. Others raised concerns about limited suitability for daily clinical workflows, potential integration challenges with existing systems, and the need for interactive, patient-centered features to support routine care. The proposed SGED score dashboard could enhance T2D care through features like population overviews, long-term visualizations, and anonymized benchmarking, meaning the ability to compare a practice's SGED performance with those of other practices. Successful clinical adoption will heavily depend on interoperability and seamless integration into existing workflows. The identified requirements provide a foundation for future digital T2D management systems.
This study examined specific mental health diagnoses groupings among patients admitted to specialty addiction treatment in the United States from 2006 to 2022. Joinpoint regression was used to examine annual data from the publicly available Treatment Episode Data Set - Admissions. Sample selection criteria included having a primary substance listed and any of the following conditions: (a) anxiety disorders, (b) bipolar disorders, (c) depressive disorders, and (d) schizophrenia and other psychotic disorders. Prior to sample selection, across the full dataset of 31 152 649, cases with anxiety disorders accounted for 0.1%, bipolar disorders accounted for 0.3%, depressive disorders accounted for 0.4%, and schizophrenia and other psychotic disorders accounted for 0.1%. The total sample size was N = 224 051 with: (a) 13% for anxiety disorders (n = 29 111), (b) 30.3% for bipolar disorders (n = 67 926), (c) 43.4% for depressive disorders (n = 97 293), and (d) 13.3% for schizophrenia and other psychotic disorders (n = 29 721). Count data identified significant decreases including the following: 12.29% from 2008 to 2022 among the bipolar disorder group, 16.69% from 2019 to 2022 among the depressive disorder group, and 6.96% from 2006 to 2022 among the schizophrenia and other psychotic disorders group. This study has important implications for future research and clinical care related to co-occurring mental health and substance use disorders. Its findings demonstrate the need for further studies to examine how addiction treatment facilities are screening for and recording mental health disorder diagnoses. Future research is needed to clarify the prevalence of specific mental health diagnoses in the addiction treatment setting, including diagnoses such as anorexia nervosa and generalized anxiety disorder. This research would help determine specific treatment needs by using epidemiological data to provide a snapshot of the prevalence of these co-occurring conditions.
Sexual and gender minorities (SGMs) experience discrimination and stigma when accessing healthcare due to the prevalence of dominant heterocisnormative culture, which leads to poorer health outcomes when compared to the general population. Current international perinatal care policies mostly do not acknowledge the existence of SGMs or their health care needs. To conduct a scoping review that examines the existing international literature on the experiences of childbearing SGMs accessing perinatal care. English-language primary evidence discussing the experiences of SGMs accessing perinatal care. Eligibility was not restricted by country or study design. Studies were sourced from CINAHL, Scopus and OVID Medline using standardised search strategies.Chartings Methods:Data were charted in accordance with the guidelines and recommendations outlined by the Joanna Briggs Institute Evidence Synthesis and the Preferred Reporting Items for Systematic Reviews extension for Scoping Reviews (PRISMA-ScR). Sixteen studies were identified as eligible for inclusion. Studies originated from predominantly western countries and contexts. Participants were predominantly white and highly educated where demographic data were available. Five themes were identified: structural stigma, interpersonal stigma, affirmation of identity, resilience and positive experiences. Intersex experiences are under-researched. The findings demonstrate several barriers and facilitators experienced by SGMs while accessing perinatal care. Policies should be developed to address stigma and barriers and support inclusive practice, alleviating the burden on SGM people to resist heterocisnormativity when seeking care in perinatal settings.
Community Health Centres (CHCs) are community-governed organizations often located in communities facing significant challenges with social determinants of health. To date, no review has summarized the evidence on the effects of team-based models of care on patient outcomes. The objective of this systematic review was to synthesize the evidence on the characteristics of interprofessional teams practicing in CHCs and their associations with patient outcomes. A systematic review was conducted following the guidelines of the Cochrane Handbook for Systematic Reviews of Interventions. In October 2024, an electronic search was performed in five databases and the grey literature using a combination of descriptors and keywords. No restrictions were applied regarding language or year of publication. Screening and data extraction were independently conducted by two reviewers. The included papers focused on interprofessional teams composed of at least three different types of providers (e.g., physician, nurse, and nutritionist) practicing in CHCs and addressing at least one patient outcome (e.g., satisfaction, diabetes management). The risk of bias was assessed by two independent reviewers using the Joanna Briggs Institute checklist. From 6,309 identified papers, 36 papers were included. Most papers focused on team composition (n = 18) and staffing patterns (n = 8). Adjustments to staffing patterns-such as increasing full-time equivalents, expanding team size, and diversifying skill mixes-were associated with improved patient satisfaction and increased number of visits. Adding a chiropractor reduced opioid prescriptions and patient pain, while including a pharmacist improved hepatitis management and patient satisfaction. Inconsistent findings were observed regarding the inclusion of nurse practitioners and physician assistants in interprofessional teams and their impact on the number of patients seen in CHCs. Specialized interprofessional teams addressing diabetes, pain management, and childhood obesity had better health outcomes and care management compared to standard care, highlighting the value of tailored interprofessional collaboration in achieving improved health outcomes for specific populations. Specific team compositions are associated with improved health outcomes for the populations served by CHCs. Future research is needed to deepen the understanding of the associations between team composition, the type of care provided, and patients' clinical and psychosocial needs.
Previous editions of the International Glossary on Infertility and Fertility Care (2006, 2009, 2017) established internationally recognized definitions related to clinical practice, research, and policy. The 2017 edition comprised 283 terms and, among many other changes, expanded the definition of infertility to include not only its recognition as a disease causing disability, but also as resulting from an impairment of a person's capacity to reproduce either as an individual or with his/her partner. The glossary has been extensively used worldwide and has contributed to international standardization of data collection, appropriate comparison of outcome measures, and provided a reference for all stakeholders, including policy makers. Updates are now required to reflect contemporary scientific knowledge, social needs, and inclusive definitions, while harmonizing international communication across clinical, research, policy, and public domains OBJECTIVE: To update the latest International Glossary on Infertility and Fertility Care, 2017 to reflect current scientific knowledge, evolving social contexts, and inclusive terminology, thereby promoting harmonized international communication across clinical, research, policy, and public domains. Under guidance of the organizing committee, 21 professionals from across the world representing expertise in different sub-specialties formed five working groups: clinical definitions; outcome measures; embryology laboratory; clinical and laboratory andrology; and epidemiology, public health and gender related definitions. The definitions from the previous glossary were evaluated and new terms identified. All definitions were then reviewed by an international advisory panel of nine experts that evaluated the glossary from scientific, ethical, cultural, and policy perspectives. Following several virtual discussions and a one-day in-person meeting, most terms and definitions were agreed. In the absence of agreement, further discussions were held between the organizing committee, working group chairs and members of the advisory panel. It had been determined at the outset that final disagreement would be resolved via a two-thirds majority vote. All terms and definitions were, however, reached by consensus and adopted following a final round of review and approval by all authors. The glossary now includes 348 terms. Compared to the previous edition, 14 terms were deleted, numerous terms were modified and 79 new terms were added. Modifications reflect current scientific knowledge, technological advancements, and inclusivity related to gender and family structures. This updated glossary provides a global reference for standardized terminology, supporting clinical care, research, international comparisons, policy making, patient communication, and reproductive health literacy. Periodic updates will be required as scientific and societal contexts evolve.
Depression is becoming an increasingly significant challenge for public and societal health, affecting both adults and children and adolescents worldwide. Diagnosis is based on identifying five characteristic symptoms persisting for at least two weeks. Diagnosing children may be more challenging due to the masking of symptoms in behavioral patterns. Treatment mainly involves medications such as selective serotonin reuptake inhibitors (SSRIs), but due to limited availability of approved drugs, off-label use is often resorted to. Fluoxetine is an important drug in the treatment of depression in children, showing efficacy and good tolerability. However, patients should be monitored for suicidal thoughts. Sertraline, although not registered for the treatment of depression in children, is often used off-label and shows a positive response to treatment. Escitalopram, approved for the treatment of depression in children over 12 years of age, is stronger and more selective than citalopram, but its approval is based on limited clinical trials. Children and adolescents have different pharmacokinetic and pharmacodynamic profiles, requiring a personalized approach to therapy. Therapy monitored by drug concentration in the blood (TDM) is an important tool for adjusting the dose to the patient's needs. The role of pharmacists in monitoring antidepressant therapy in children and adolescents is valuable and can contribute to improved clinical outcomes. The article analyzes the efficacy and safety of antidepressant drugs in children and adolescents, with an emphasis on SSRIs, and identifies issues related to therapy selection, with particular emphasis on personalized care and the growing role of TDM in optimizing treatment outcomes.
Everyday services are increasingly being digitalised, while the proportion of older adults continues to grow. Ensuring that digital services are accessible to this population is essential to prevent digital exclusion and support autonomy. This study aimed to explore older adults' perspectives, experiences, and needs regarding digital services, identify perceived barriers to accessibility, and examine associated ethical and societal concerns. This qualitative descriptive study recruited 48 French community-dwelling older adults in France (28 women, 20 men; mean age = 76.06 years, SD = 9.21; 42 urban, 6 rural). Semi-structured interviews were conducted using an 18-item guide developed from a review of the literature on digital accessibility. The study design and reporting were informed by the COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist. Interviews were audio-recorded, transcribed verbatim, pseudonymised, and analysed using inductive thematic analysis. Coding was performed independently by two researchers, and discrepancies were resolved through discussion. All participants reported using at least one digital technology, primarily for communication, information-seeking, administrative procedures, entertainment, and, more rarely, for professional or obligatory tasks. Participants described both advantages (e.g., convenience, ergonomic interfaces) and difficulties (e.g., lack of support, interface complexity, technical failures), leading to diverse coping strategies such as seeking help, self-learning, delegation, or avoiding digital tools when possible. Feelings toward digitalisation were ambivalent, combining perceived benefits with frustration, concerns about data security, and reflections on the impact of digitalisation on autonomy and human relationships. Participants also identified barriers to accessibility (e.g., lack of digital literacy, financial constraints, poor design, insufficient support) and proposed concrete solutions, emphasising the importance of accessible design, non-digital alternatives, adapted training, and human assistance. Digitalisation offers opportunities for older adults but also raises accessibility, ethical, and societal challenges. While many participants recognised the usefulness of digital services, they also highlighted risks related to autonomy, perceived choice, and reduced human contact. These findings underscore the need for digital services that are inclusive, intuitive, and supported by continuous human assistance to avoid reinforcing existing inequalities.
Implementing evidence-based interventions to improve nurse-patient communication is essential for enhancing patient satisfaction and clinical outcomes in oncology. However, robust evidence guiding the selection of effective and feasible communication training models for oncology nurses remains limited. This study aimed to compare the effectiveness of two structured communication training approaches, including case-based training and simulation-based training, in oncology nursing education. A quasi-experimental non-randomized controlled trial with a pretest-posttest design was conducted among 258 oncology nurses and 650 cancer patients. Oncology nurses were assigned to one of three groups based on pre-existing clinical shift rotations rather than random allocation: no training (NTG, n = 84), case-based training (CTG, n = 88), or simulation-based training (STG, n = 86). Both intervention groups received structured communication training covering therapeutic communication, needs assessment, instruction delivery, referral practices, and outcome evaluation. The STG used video-based scenarios with standardized patients (20 h), whereas the CTG used written clinical cases (16 h). Outcomes were measured using the Nursing Care Satisfaction Questionnaire, the Health Professionals Communication Skills Scale, and the Occupational Coping Self-Efficacy Scale for Nurses. Data were analyzed using repeated-measures ANOVA with sensitivity analyses. For patient satisfaction with nursing care, a significant time × group interaction was observed (F(2, 255) = 17.2, p < 0.001, partial η² = 0.12). Both CTG and STG showed significant improvements from pre- to post-intervention (p < 0.001), whereas the NTG showed no significant change (p = 0.81). Similarly, nurses' communication skills demonstrated a significant interaction effect (F(2, 255) = 19.6, p < 0.001, partial η² = 0.21), with significant improvements in both intervention groups compared with the control group (p < 0.001). For occupational coping self-efficacy, the interaction effect was also significant (F(2, 255) = 15.8, p < 0.001, partial η² = 0.19), indicating increased self-efficacy in both intervention groups (p < 0.001). No statistically significant differences were observed between CTG and STG at post-test for any outcomes. These findings indicate that case-based and simulation-based communication training may be effective in improving communication-related outcomes in oncology nursing, although conclusions regarding their relative effectiveness should be drawn with caution. Not applicable.
To introduce a new service delivery intervention to improve equity of access to home dialysis therapy and describe the process of intervention development. Despite strong evidence in favour of home dialysis, its uptake remains stubbornly low in England and elsewhere. Furthermore, uptake levels vary between kidney services and between population groups. The Inter-CEPt study identified several enablers of access to home dialysis, including: receptive organisational cultures; adoption of reflective practice; engagement in quality improvement, and shared belief in the benefit of home dialysis. Drawing on the Inter-CEPt study, and using established intervention development frameworks, we developed 'Location of Dialysis Care in Kidney Life' as a targeted intervention for improving the uptake of home dialysis. In this paper, the intervention and the processes involved in its design are described. This involved co-design workshops with professional stakeholders and people with lived experience. The Location of Dialysis Care in Kidney Life intervention consists of two principal components: (1) quality improvement activities focussed on supporting dialysis care in the home, and (2) dedicated home therapies leadership roles and activities in kidney services. The rationale of the intervention is to develop and sustain a culture that improves equitable access to home dialysis. We report a staged process of intervention development that combines the principles of evidence-based intervention development and user co-design. The resulting intervention proposal can be adapted by kidney services to meet their specific needs and challenges. The study identifies organisational culture as one of the biggest determinants of uptake in home dialysis. No other study to our knowledge has fully investigated this as a barrier to home dialysis, nor indeed how to begin to change it. The Location of Dialysis Care in Kidney Life intervention requires future piloting and evaluation.
People with experiences of homelessness are at higher risk for suicide-related thoughts, behaviors, and deaths by suicide compared to those without homeless experience. This complex risk can be tied in part to extreme social need and multimorbidity. To meet these needs and reduce this risk, people with experiences of homelessness frequently require care from multiple providers. Continuity of care is protective against suicide risk, with care coordination playing a central role. Despite the importance of continuity of care in suicide prevention and the potential for mental health nurses to provide care coordination, few studies have explored this potential in relation to people with experiences of homelessness. Provide a potential practice application to illustrate the possible value of using the Alberta Continuity of Services Scale for Mental Health (ACSS-MH) to measure and improve continuity of care as an important element of suicide prevention for people with experiences of homelessness. Using the U.S. Department of Veteran Affairs (VA) Homeless Patient-Aligned Care Team (HPACT) model and universal VA suicide risk screening protocol as a practice exemplar, we discuss the ACSS-MH subscales to illustrate a potential care delivery evaluation and way the psychiatric nursing community can optimize continuity of care, suicide risk detection and suicide prevention in this population. Innovative screening and practice models are needed to effectively prevent suicide in high-risk populations, like people with experiences of homelessness. This case study provides insight into the ACSS-MH measure and VA-based homeless-specific primary care as an example of how psychiatric nurses could similarly use this measure to impact the safety of patients with experiences of homelessness by intentionally fostering continuity related to suicide prevention. This discussion of a practice application shows how the use of a validated measurement tool could drive quality improvement and research that begins with the measurement of continuity related to suicide prevention for high-risk populations.
Genetic Counselors (GCs) hold the dual responsibility to engage in patient-centered psychosocial counseling and to recognize when a patient's needs require referral to another healthcare professional (HCP). While previous work has shown that GCs use a variety of patient factors to determine when they could benefit from additional supportive services, we sought to better understand how GCs determine whether to refer a patient to another HCP or engage in more complex psychosocial counseling. Utilizing a multimethods approach, we used two sets of surveys to learn about our participants but ultimately prioritized the qualitative data from in-depth semistructured interviews with 15 participants (N = 15). Initial data collection and analysis relied on constructivist interpretive frameworks of grounded theory, which supported learning directly from participants while maintaining our ability to delve into issues raised by the participants. An iterative process of coding, reviewing, memoing, and testing resulted in the development of several conceptual models of possible theories. Through continued review of the data and guided by an interpretivism paradigm, we elected to honor the breadth of information shared by participants, abandoning our initial goal of defining a single theory to instead define three core conceptual categories related to GCs' consideration of providing psychosocial counseling or referring: (1) For GCs, it's personal! GC beliefs in themselves, their personal identities, and their conceptualization of the role of a "GC" influence their engagement in psychosocial assessment and support; (2) Training matters, but experience is key; and (3) Referrals occur when GCs are aware of and trust that another HCP/resource will be a good fit for a patient's need and that a patient can actually access it. These findings suggest that GC confidence in managing patient care evolves with experience and highlight the value of ongoing skill development for all practitioners.
In the rapidly evolving landscape of Natural Language Processing (NLP), transfer learning has emerged as a game-changing methodology, fundamentally altering how machine learning models are trained and deployed. The study at hand dives deep into the intricacies of transfer learning techniques, specifically focusing on their application in complex deep learning architectures within the NLP domain. By exploring a variety of architectural designs, fine-tuning methodologies, and alternative training paradigms, we aim to demystify the optimal strategies for harnessing the power of pre-trained models. To quantify the effectiveness of these approaches, we conducted a comprehensive series of experiments targeting key NLP tasks, such as text classification and language generation. Transfer learning significantly accelerated training and improved model accuracy, highlighting its practical advantages in NLP tasks. This dual benefit underscores the immense potential of advanced transfer learning techniques, making them an indispensable tool for future NLP applications. By implementing state-of-the-art transfer learning methodologies, companies can offer faster and more accurate NLP solutions, aligning perfectly with the ethos of "Business Digitalized" and catering to a broad spectrum of client needs in the market.
Diagnostic radiographers work in environments where ionizing radiation is used, making radiation protective measures essential for occupational safety. Personal Radiation Monitoring Devices (PRMDs) are used by diagnostic radiographers to monitor cumulative occupational exposure, resulting from faulty equipment or unsafe work practices; however, research indicates that strict adherence to PRMD use is not consistent. The study aimed to explore radiographers' knowledge, awareness and adherence to PRMD use in five major state hospitals in Namibia. A quantitative, cross-sectional and descriptive study was conducted using an online questionnaire. Fifty radiographers from five major Namibian public hospitals were targeted through convenience sampling. Data were analysed using IBM SPSS version 26 to assess levels of knowledge, awareness and adherence. Thirty radiographers participated in the study with a mean age of 32 years. Most respondents, n = 23 (77%), demonstrated adequate knowledge regarding PRMDs, with n = 26 (87%) 'strongly agreeing' that they understood the purpose of PRMDs. Regarding awareness, n = 14 (47%) showed good awareness; however, n = 22 (73%) reported not knowing their cumulative radiation exposure. Access to dose results was limited, with only n = 7 (23%) regularly reviewing their readings. Additionally, n = 22 (73%) reported that they would continue working without a PRMD. Namibian radiographers demonstrated adequate knowledge and awareness of PRMDs; however, adherence was low. It highlights the need for stricter compliance policies and enforcement. Further research is needed to investigate barriers to consistent usage and identify effective strategies to improve adherence.
Human teams excel at dynamically restructuring both task assignments and team composition in response to emerging challenges, proactively recruiting or releasing members as needed. This capacity for autonomous adaptation is a cornerstone of effective teamwork, yet remains difficult to achieve in heterogeneous multi-robot systems, which typically operate under fixed team configurations or adapt only responsively to external disruptions. In this work, we present a systematic investigation of the Proactive Collaboration paradigm for robot teams, where the working team autonomously recruits or releases members as tasks evolve. We implement this paradigm by equipping robots with the developed Autonomous Interaction framework, which utilizes need-driven multi-round communication to facilitate discussions over task progress, negotiated task allocation, and dynamic team resizing. Through real-world and simulated experiments, we demonstrate that our framework effectively realizes the Proactive Collaboration. By resolving capability gaps via anticipatory planning and minimizing action redundancy, it yields consistent and measurable gains in team efficiency and robustness. Our findings suggest that enabling individual-level initiative may offer a promising pathway toward more adaptive and cohesive collective behavior in multi-robot systems.