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Chiropractic vertebral manipulation is indicated in patients with acute and uncomplicated low back pain. Nowadays, many people seek care for low back pain from manual practitioners. However, within the overall legislative framework regulating in Italy professionals practicing in healthcare, chiropractors remain unevenly regulated. In fact, they are trained abroad and hold internationally recognized degrees that are not regulated under Italian healthcare professionals' legislation. Neither the educational profile, nor a Ministry technical expert committee, nor a national board for ongoing professional evaluation has been established, despite a law in 2007 aimed to regulate the profession and define the national register of doctors in chiropractic. Meanwhile, given their involvement in the healthcare sphere as part of multiprofessional teams, issues of liability arise, made more complex by the fact that chiropractors are not eligible for certain more favourable legal measures for liability assessment granted to healthcare professionals under Italian Law on healthcare safety and liability. Moreover, health-related information for obtaining informed consent cannot be managed independently by these practitioners, again due to their non-healthcare professional status. As a result, prescribing physicians must necessarily be involved in the overall care process. The interaction between healthcare and non-healthcare professionals presents complexities in the patient care and in the proper liability assessment. These aspects are also urgently needed for the definitive recognition and valorisation of the practitioners working in health sphere, which must include State oversight.

Professional identity formation in healthcare professions education (HPE) is a complex and often fraught process. Physicians and trainees experience identity struggles as they navigate their personal and professional development, along with the conflicting expectations, cultural norms and systemic pressures within the healthcare environment. Despite growing attention to these challenges, conceptual clarity around identity struggle remains limited. To advance theoretical understanding of identity struggle, we conducted a critical narrative review of identity theories from developmental psychology, social psychology and sociology. We selected three major theoretical traditions-Neo-Eriksonian, symbolic interactionist and social identity theories-and analysed their conceptualizations of identity, identity development and identity struggle. We examined these diverse perspectives to inform research and educational practice on professional identity formation in HPE. Each theoretical tradition offers distinct insights into identity struggle. Neo-Eriksonian theories emphasize exploration and commitment as central processes, framing struggle as developmental and potentially productive. Symbolic Interactionist theories highlight the role of socialization and identity dissonance, viewing struggle as emerging from tensions between personal agency and societal norms. Social Identity theories focus on group belonging and intergroup dynamics, conceptualizing struggle at both individual and socio-contextual levels. We provide common critiques and limitations of each theoretical tradition. These perspectives illuminate varied mechanisms through which identity struggle manifests and evolves. This review underscores the multifaceted nature of identity struggle and the value of theoretical pluralism in understanding professional identity formation. Struggle is not inherently negative; rather, it can be a catalyst for growth when appropriately framed and supported. We propose how educators and researchers might use these theoretical lenses to design interventions that foster productive identity development and address systemic contributors to identity struggles. We invite scholars drawing on critical perspectives of power and structure to challenge and deepen the conversation on identity struggle in HPE.

This study aimed to investigate health-promoting lifestyle behaviors and associated factors among Chinese workers residing in Japan. A cross-sectional survey was conducted between May and July 2017 among 313 Chinese workers (response rate: 69.4%; 62.6% female), recruited through convenience and snowball sampling in Japanese-language schools in Hiroshima Prefecture. The health-promoting lifestyle profile II revised (HPLP-IIR) was used to assess six dimensions: health responsibility (HR); physical activity (PA); nutrition (NU); spiritual growth (SG); interpersonal relations (IR); and stress management (SM). Demographics, Japanese language proficiency, residence and employment status, and workplace health education were included as independent variables. The mean total HPLP-IIR score was 2.68 (SD = 0.57). The highest subscale scores were for IR (M = 3.02), NU (M = 3.01), and SG (M = 2.99), while the lowest were for HR (M = 2.37), PA (M = 2.42), and SM (M = 2.77). Stepwise multiple regression analysis revealed that higher Japanese language proficiency, participation in workplace health education, and clerical occupations were positively associated with HPLP-IIR scores. In contrast, student status, fixed-term or contract-based employment, current illness, and longer residence in Japan were negatively associated with overall and subscale scores. The model explained 17% of the variance in total HPLP-IIR. Japanese language proficiency, occupational type, and workplace health education are key factors in promoting healthier lifestyles among Chinese workers. Interventions that provide language support and stable employment conditions are essential for improving their health behaviors and integration.

For many women who experience hypertension in pregnancy, raised blood pressure continues into the postpartum period, usually settling over the first 6-12 weeks. Blood pressure control during this time appears to be important for long-term cardiovascular health but care appears to be haphazard. This study aimed to understand UK National Health Service usual postpartum care for such women. A cross-sectional online survey was designed and piloted by a multidisciplinary team of midwives, obstetricians, primary care researchers, patient representatives, and a general practitioner, to capture current practice including blood pressure monitoring, antihypertensive prescribing, and use of self-monitoring; there were 38 questions. The survey was delivered via the Doctors.net (for obstetricians and general practitioners) and Joint Information Systems Committee (JISC) online platforms (for Midwives) from May to November 2023. A total of 253 clinicians responded to the survey, including 101 General Practitioners, 100 doctors working in maternity care, trained in obstetrics (obstetricians) or with specialist expertise in medical disorders in pregnancy (obstetric physicians), 50 midwives, and 2 maternity support workers. Women's care generally transferred from secondary to primary care at around two weeks postpartum, although this was not consistent, and there were differences in practice, awareness, and expectations between professions around the management of hypertension and responsibility. Communication barriers between professional groups and a need for better guidance and co-ordination were highlighted, and most professionals agreed that self-measured blood pressure readings could support postpartum care for those with hypertension. The survey highlighted variations in the practice and expectations of different healthcare professionals involved in postpartum care. The time when care was transferred from hospital to primary care was not consistent, with potential for women's care to fall through gaps. The transfer of information and women's ability to access care at this time were highlighted as problematic.

To explore the impact of epidemic diseases outbreak on the psychological status of medical workers. A total of 266 online questionnaires were distributed to medical staff in several mobile cabin hospitals in Beijing. The questionnaires were divided into a General Demographic Characteristics Questionnaire and the 12-item General Health Questionnaire (GHQ-12), and a total score of ≥4 in the GHQ-12 was considered to be a decline in mental health. A total of 266 members of medical staff participated in this study, and 30.1% experienced a decline in mental health recently. The highest prevalence of emotional distress was found among those who were female, married without children, working as doctors and other occupations, aged 30-39 years, working in the confirmation department, supporting the mobile cabin hospitals three times or more, the duration of this support for 1 month or longer, and having a previous state of anxiety and depression. In addition, females experienced higher rates of insomnia due to worry compared to males, as did medical staff in the confirmation department compared to the administration and logistics departments. In the same stressful environment, men and doctors had a greater rate of perceived loss of self-worth than women and nurses. The outbreak of epidemic makes medical workers face the risk of emotional distress. To achieve the purpose of preventing and treating emotional distress of medical workers, we need to carry out continuous and strict research and evaluation on the mental health planning of medical workers, formulate relevant policies and carry out professional psychological intervention.

The COVID-19 pandemic created unprecedented ethical challenges for nurses, often culminating in moral distress. The aim of this study was to explore the experiences of Spanish nurses in relation to moral distress and ethical conflicts experienced during the COVID-19 pandemic. Qualitative phenomenological study. Nurses who had tended COVID-19 patients were given a semi-structured interview via the Zoom application. Thematic analysis was carried out, identifying units of meaning and assigning codes that were grouped into the different categories using Open Code software. Seventeen nurses participated and four categories emerged: (i) Difficulties in the general management of the pandemic on the institutional level, (ii) Limitation of patients' rights in a pandemic situation, (iii) Influence on the humanization of healthcare, (iv) Impact on professionals and on the profession. Restrictions on patients' and families' rights during the pandemic generated ethical conflicts for healthcare professionals. In addition, the scarcity of both human and material resources, together with limited access to information, intensified value conflicts in clinical practice. This project provides evidence on ethical conflicts experienced by nurses during the pandemic, both in the quality of care and professionals' well-being. Findings will contribute to and have an impact on future action protocols and public policies aimed at better managing ethical challenges in health emergency situations.

Patterns of smartphone use vary across ages; however, adolescents and young adults may be at particular risk, with more behavioral addictions and adverse health effects. This study explored the prevalence of smartphone addictions among health adolescent professional students and examined how problematic smartphone usage interferes with their level of physical activity as well as health-related quality of life. A cross-sectional Analytical study based on self-perceived outcome measures such as the smartphone addiction scale-short version, the 'International Physical Activity Questionnaire-short form', and 'Patient-Reported Outcomes Measurement Information System 29'-item profile was done with a sample of 400 participants. A total of 400 individuals (125 Males & 275 females) with mean age being 20.8 + 2.06 years recruited for the study. Smartphone addiction was most prevalent in dentistry students (43 %), followed by medicine (32 %) and allied health science (30.5 %), with no statistically significant differences in the addiction rate among the three programs. Compared with smartphone-addicted individuals, nonaddicted individuals had marginally greater physical function (mean difference =0.670, p<0.001), and those addicted to smartphones had significantly higher. anxiety (mean difference = 2.776, p<0.001), depression (mean difference =2.264, p< 0.001), and fatigue (mean difference =2.264, p<0.001). Physical activity was found to have no statistically significant difference between addicted and non-addicted individuals and except for sleep disturbance, none of the domains of PROMISE-29 showed any statistically significant correlation with physical activity. The findings highlight the need for recommendation for setting a time limit for the usage of smartphones for formal and informal academic activities, as well as policy measures to promote normal smartphone use.

Despite being educated in a health-oriented environment, medical students are vulnerable to developing unhealthy habits that may compromise their well-being and future professional effectiveness. This study aimed to assess changes in lifestyle behaviors and psychological well-being among first-year medical students over one academic year. A longitudinal observational study was conducted on a cohort of 189 first-year medical students at Link Campus University (Rome, Italy). Assessments were performed at the beginning and end of the academic year (November 2024-June 2025). A total of 87 students completed all surveys. Measures included self-reported anthropometric data, the Mediterranean Diet Adherence Screener (MEDAS), International Physical Activity Questionnaire (IPAQ), Volition in Exercise Questionnaire (VEQ-I), Perceived Stress Scale (PSS-10), WHO5 Well-Being Index, and the Psychological General Well-Being Index (PGWBIS). Statistical analyses included paired t-tests or Wilcoxon signed-rank tests, and correlation analyses using Spearman's coefficients. Of the total of sample, 102 students were female (65%) and 55 were male (35%), with median age was 19.8 years old. At follow-up, a statistically significant increase in BMI was observed (p&#x2009;=&#x2009;0.009). No significant changes were found in physical activity levels or Mediterranean diet adherence. However, volitional facilitation for physical activity significantly declined (p&#x2009;=&#x2009;0.020), indicating reduced motivation. Psychological well-being worsened across the academic year, with increased perceived stress (p&#x2009;<&#x2009;0.001), and decreased WHO5 (p&#x2009;=&#x2009;0.046) and PGWBIS scores (p&#x2009;=&#x2009;0.055). Significant correlations were found between psychological well-being and both physical activity and diet adherence. Over the course of one academic year, medical students reported moderate levels of perceived stress and average emotional and psychological well-being. Despite increasing psychological strain, students maintained a stable core of eating behaviors, suggesting a remarkably resilient and structured dietary pattern. Nevertheless, they exhibited a predictable decline in psychological well-being during examination periods, accompanied by a reduction in motivation for physical activity and modest weight gain. Overall, these findings underscore the importance of targeted interventions within medical education to promote and sustain healthy lifestyle behaviors during the early stages of academic training.

Neonatal mortality remains a critical public health challenge in Sub-Saharan Africa, with The Gambia reporting one of the highest rates in the region. Despite global progress, the neonatal mortality rate has shown limited decline, and context-specific data on delivery setting-related risk factors remain needed to inform health system strengthening in The Gambia. We aimed to identify risk factors for neonatal mortality at Kanifing General Hospital (KGH), and examine the association between place of delivery and survival outcomes. We conducted a retrospective cohort study of 1,354 neonates admitted to KGH between January 2022 and December 2024. The primary outcome was neonatal death during admission. Kaplan-Meier survival analysis and Cox proportional hazards regression with robust standard errors clustered by facility were used to identify risk factors. During the study period, 137 deaths occurred (10.1% mortality; 95% CI: 8.6-11.9). Median follow-up was 96&#xa0;h. Overall, survival at 7 days was 87.8%, but differed substantially between neonates delivered at KGH Labour Ward (91.3%) versus peripheral facilities (78.9%; log-rank p&#x2009;<&#x2009;0.001). In multivariable analysis, delivery at KGH Labour Ward was strongly protective (adjusted hazard ratio [aHR] 0.41; 95% CI: 0.28-0.58; p&#x2009;<&#x2009;0.001), representing a 59% reduction in mortality risk. Higher birth weight was protective (aHR 0.58 per kg; 95% CI: 0.37-0.90; p&#x2009;=&#x2009;0.016), while birth asphyxia increased mortality risk (aHR 1.30; 95% CI: 1.11-1.53; p&#x2009;=&#x2009;0.001). The model demonstrated acceptable discrimination (C-statistic&#x2009;=&#x2009;0.713). E-value sensitivity analysis indicated robustness to unmeasured confounding (E-value&#x2009;=&#x2009;4.36 for facility effect). Study limitations include the retrospective design and single-center setting. Neonates referred from peripheral facilities experienced substantially higher mortality compared to those delivered at the referral hospital. Birth weight and birth asphyxia were independently associated with survival. These findings highlight the critical importance of strengthening referral hospital capacity and improving quality of care at peripheral facilities to reduce neonatal mortality in The Gambia.

Traditional simulation-based communication training remains resource-intensive and difficult to scale. While artificial intelligence (AI), particularly large language models, offers promising solutions for health care education, no blueprint exists for integrating AI-powered simulation training within operational quality improvement (QI) frameworks. This paper presents a 5-phase methodological blueprint, with evaluatory evidence, for implementing AI-powered simulation training to enhance transitional care communication skills. We developed a 5-phase methodological framework integrating AI simulation with QI and educational principles, grounded in the Donabedian model. The phases comprised: (1) content validation using Lawshe's methodology, (2) simulation development applying cognitive load theory, (3) platform selection through expert consensus evaluation, (4) structured implementation including structural foundations and sequential deployment, and (5) outcome measurement using statistical process control. Iterative testing across multiple AI platforms revealed that traditional debriefing approaches (advocacy-inquiry, plus-delta) could not be reliably delivered by AI systems. Microdebriefing with rubric-focused feedback emerged as optimal for AI-mediated learning, leveraging AI's strengths in consistent, structured feedback delivery while working within limitations in complex facilitation. Clinical outcomes derived from rubric-based evaluations of recorded patient calls will be reported separately to allow for a more detailed analysis of communication quality and training effectiveness, which falls outside the scope of the present methods-focused study. This 5-phase methodological blueprint provides an approach for health care organizations seeking to implement cost-effective, scalable AI-powered communication training. By embedding simulation within QI infrastructure, institutions can systematically enhance communication skills while maintaining educational rigor. This work contributes to simulation science, telehealth education, and QI by demonstrating how AI can serve as a scalable alternative to traditional facilitator-led training for foundational communication skills.

The prevalence of diabetes, particularly type 2, in sub-Saharan Africa is rising at an alarming rate. This surge has exposed deep structural challenges, including an over-reliance on hospital-based services and strong cultural and faith-based influences that shape health-seeking behaviours. These factors, combined with socioeconomic inequalities and urbanisation, contribute to poor glycaemic control. Several strategies have been proposed to tackle this problem, including task shifting, integrated models that make use of HIV care infrastructure, digital health tools such as SMS reminders, culturally adapted lifestyle and nutrition programmes, community-based and faith-based interventions, and public-private partnerships. Despite these promising approaches, evidence of long-term sustainability, scalability, cost-effectiveness, and the impact of these interventions remains scarce. Additionally, stigma, gender-related barriers, and patient-reported outcomes are insufficiently studied in sub-Saharan Africa. Large-scale, longitudinal research is urgently needed to assess health system strengthening and culturally grounded models. Achieving effective diabetes care will require resilient, inclusive systems that integrate clinical, community, and digital innovations within the sociocultural and economic realities of the region.

Depressive symptoms in displacement settings are often framed as consequences of refugee status, which can obscure the shared structural conditions emphasized in the Social Determinants of Health (SDoH) framework that shape mental health for refugees and host communities and limit the identification of practical intervention targets. This study examines the relative contribution of health, socioeconomic, protection, and contextual factors to depressive symptom severity among adults living in displacement-affected settings in South Sudan. We analyzed nationally representative data from 3,055 adults (2,066 refugees, mean displacement duration 11.15 years; 989 host community members) from the 2023 Forced Displacement Survey. Depressive symptom severity was measured using the PHQ-9. We compared Elastic Net regression, Random Forests, and Extreme Gradient Boosting (XGBoost) using 10 &#xd7; 5 nested cross-validation. The best-performing model was interpreted using SHapley Additive exPlanations (SHAP) to estimate the marginal contribution of each predictor in PHQ units. Mean depressive symptom severity was low to moderate overall (M = 4.43, SD = 5.00) and did not differ by population type (p = 0.783). XGBoost showed the highest predictive performance [Root Mean Squared Error (RMSE) = 4.47, R 2 = 0.247], significantly outperforming Elastic Net regression (p = 0.006). Model explanations identified self-rated health status as the dominant predictor (19.3% of total importance), followed by perceived community violence (11.1%), perceived poverty (9.6%). Age (9.3%), discrimination (9.2%), food insecurity (8.6%), and citizenship (8.2%, pooled model only) contributed at moderate levels, whereas social protection (3.4%) and remittances (0.7%) contributed minimally. Predictor profiles were broadly similar across refugee and host models, with differences primarily in magnitude rather than rank ordering. Depressive symptoms in South Sudan appear to be structured primarily by health, material hardship, and protection-related gradients rather than refugee status per se. Findings support integrated, area-based public health responses that link mental health support with primary health care access, poverty-oriented assistance, and protection and safety interventions rather than programming organized primarily around legal status distinctions.

Synthesizing the literature on college students in urban settings, this study addresses how systemic disparities amplify food insecurity and poor sleep health in minority college students in the Bronx. We posit that their relationship is a predictor of higher body mass index (BMI) and lower grade point average to assess academic performance (GPA). This cross-sectional study investigated the association between self-reported sleep duration and food insecurity among 710 minority undergraduate students at two urban institutions in the Bronx, NY. The research used a QR-code-based survey to collect socio-demographics, food security data (US Household Food Security Module), and sleep duration (a PSQI sub-section). SPSS Version 29 was used for analysis. Multiple logistic regression was performed to examine the relationships between food security, sleep duration, demographics, BMI, and the GPA. The findings reveal a high prevalence of food insecurity (52.1%) in this population. Chi-square analysis demonstrated statistically significant associations between food insecurity and household income (p < 0.0001), sleep duration (p = 0.007), and BMI (p = 0.037). A multiple logistic regression confirmed that obtaining the recommended sleep duration (7-9 h) was associated with 2.3 times higher odds of being food secure (p = 0.005, Exp(B) = 2.327). Additionally, students with a normal or overweight BMI were significantly more food secure than their obese counterparts. The current study highlights the interrelationship between sleep duration, food insecurity, socioeconomic status, and BMI among minority students. No correlation was observed between sleep duration, food insecurity, and GPA. However, our findings underscore the necessity for comprehensive, multifaceted interventions to effectively address these challenges faced by urban minority college students.

In November 2020, an alert for a "mysterious disease" among fishermen was issued. Fishermen are particularly subjected to dermatoses due to their constant contact with seawater, fish, crustaceans, and fishing equipment that may contain harmful agents. The study aimed to examine the alert, identify the causative agent and suggest preventive and control measures. This was a cross-sectional study of dermatoses in Dakar (Senegal) from October 11 to November 30, 2020, using quantitative and qualitative methods within a 'One Health' approach." The investigation included bacterio-virological, anatomopathological and toxicological examinations. Data were analyzed using Epi info and QGIS (case mapping), We observed all confidentiality measures during the study. A total of 555 cases were diagnosed with an attack rate of 5.4% among fishermen and no deaths were reported. There was a delay in epidemic detection and notification. The epidemic was most prevalent among people from coastal areas. Average age of cases was 22&#x2009;&#xb1;&#x2009;9 years, and all were male and artisanal fishermen by profession. Patients presented with fever (16%), cutaneous pain (100%) and mucocutaneous lesions (100%) consisting of vesicles, papules and ulcerations localized on exposed areas of the body, external genitalia and oral mucosa, with severe cases (8%). Toxicology revealed the presence of a toxic alga (V. rugosum) in marine equipments. The notion of a sea trip in the 24-48 hours before the onset of the disease was found in 92%. Majority of cases (74%) did not have full personal protective equipment (PPE). The proportion of people without full protection was 83% among those who developed severe forms. People without full protection were more exposed to severe forms than those with full PPE; (OR = 1.818; 95% CI [0.829 - 3.988]). The investigation has linked the epidemic to a probable algal origin. We need to promote the use of personal protective equipment and improve the early warning and notification system.

Self-perception of aging is considered one of the indicators of health and vulnerability. Understanding how older adults perceive their aging can be an effective way to develop strategies to prevent vulnerability and promote healthy aging. The aim of this study was to investigate the self-perception of aging and its associated factors in a group of older adults in Morocco to contribute to healthy aging. This was a cross-sectional study conducted between June 2022 and July 2023 among 496 people aged 60 years and over who visited health centers in the province of Essaouira. A positive or negative self-perception of aging was established using the Attitudes Toward Own Aging subscale, which includes five items from the Philadelphia Geriatric Center Morale Scale. Sociodemographic characteristics and data related to lifestyle and health status were collected through interviews, by consulting health records, and were supplemented with anthropometric measurements. Binary logistic regression was used to determine the potential factors influencing self-perception of aging. A negative self-perception of aging was identified in 21.4% of participants. Multivariate analysis revealed that being unmarried (OR 2.027; 95%CI 1.261-3.259), having depressive symptoms (OR 1.729; 95%CI 1.082-2.765), and being dependent (OR 1.926; 95%CI 1.134-3.272) were the main factors statistically associated with a negative self-perception of aging. A strategy to prevent loneliness and social isolation, as well as screening programs for depression and dependency in older adults, could contribute to successful and healthy aging. A auto-percep&#xe7;&#xe3;o do envelhecimento &#xe9; considerada um dos indicadores de sa&#xfa;de e vulnerabilidade. Compreender como os idosos percebem o seu envelhecimento pode ser uma forma eficaz de desenvolver estrat&#xe9;gias para prevenir a vulnerabilidade e promover um envelhecimento saud&#xe1;vel. Este estudo teve como objetivo investigar a auto-percep&#xe7;&#xe3;o do envelhecimento e os fatores associados em um grupo de idosos no Marrocos, a fim de contribuir para o envelhecimento saud&#xe1;vel. Trata-se de um estudo transversal realizado entre junho de 2022 e julho de 2023, envolvendo 496 pessoas com idade igual ou superior a 60 anos que frequentaram centros de sa&#xfa;de na prov&#xed;ncia de Essaouira. A auto-percep&#xe7;&#xe3;o positiva ou negativa do envelhecimento foi avaliada por meio da subescala Attitudes Toward Own Aging, que inclui cinco itens da Philadelphia Geriatric Center Morale Scale. As caracter&#xed;sticas sociodemogr&#xe1;ficas e os dados relacionados ao estilo de vida e ao estado de sa&#xfa;de foram coletados por meio de entrevistas, consulta aos registros de sa&#xfa;de e complementados por medidas antropom&#xe9;tricas. A regress&#xe3;o log&#xed;stica bin&#xe1;ria foi utilizada para identificar os fatores potenciais que influenciam a auto-percep&#xe7;&#xe3;o do envelhecimento. Uma auto-percep&#xe7;&#xe3;o negativa do envelhecimento foi identificada em 21,4% dos participantes. A an&#xe1;lise multivariada revelou que n&#xe3;o ser casado(a) (OR 2,027; IC95% 1,261&#x2013;3,259), apresentar sintomas depressivos (OR 1,729; IC95% 1,082&#x2013;2,765) e ser dependente (OR 1,926; IC95% 1,134&#x2013;3,272) foram os principais fatores estatisticamente associados a uma auto-percep&#xe7;&#xe3;o negativa do envelhecimento. Estrat&#xe9;gias de preven&#xe7;&#xe3;o da solid&#xe3;o e do isolamento social, bem como programas de rastreamento da depress&#xe3;o e da depend&#xea;ncia em idosos, podem contribuir para um envelhecimento bem-sucedido e saud&#xe1;vel.

BackgroundSmart home technologies and assistive robots play a role in enhancing the well-being of older adults. This study aims to evaluate the factors and acceptance level of these technologies among seniors and to explore the factors affecting their acceptance.MethodsThree databases were systematically searched using keywords to identify relevant articles. The retrieved studies were screened based on eligibility criteria. Key features of the studies and the acceptance status of the aforementioned technologies among seniors were documented in a data extraction form.ResultsTwenty-seven studies met the eligibility criteria. Robots (74.1%), sensors (18.5%), wireless technologies (3.7%), and smart home voice assistants (3.7%) were utilized by seniors. Remote patient monitoring (33.3%) was the most prevalent application of these technologies. Approximately 89% of the studies reported positive attitudes toward these technologies. "Technology convenience" (22.2%) emerged as the most significant reason for smart technology acceptance. Conversely, "concerns about privacy and security" (14.8%) and "lack of need for technology" (14.8%) were the most frequently cited reasons for non-acceptance.ConclusionsTo enhance the adoption of reviewed technologies, it is crucial to implement strategies that raise awareness, ensure data security, and address the actual needs of this demographic in both the design and implementation phases.

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Occupational therapy plays a vital role in enhancing engagement and quality of life for people living in nursing homes. However, in Australia, funding for occupational therapy in nursing homes is limited, and its scope is restricted. The Enhancing Allied Health for Older People (EAHOP) trial aimed to assess the feasibility and impact of embedding a multidisciplinary allied health model, including occupational therapy, in a nursing home. This paper describes the occupational therapy implementation and outcomes of the EAHOP trial. A convergent mixed-evaluation was conducted. Twenty-seven residents at an Australian nursing home received occupational therapy by occupational therapists and occupational therapy students. The Canadian Occupational Performance Measure (COPM) was used to set goals and evaluate changes in occupational performance. Data included median therapy minutes per resident and service occasions. Qualitative data were gathered using semi-structured and unstructured interviews and analysed using content analysis. The EAHOP trial included a Stakeholder Committee that included residents of the nursing home who were participants in the trial. This group advised the research team on all aspects of the intervention throughout the trial. Residents received a median of 895&#x2009;minutes of occupational therapy and 203&#x2009;minutes from allied health assistants for a 1-to-36-week programme where the intervention period varied according to individual need. This equated to a median of 3.9&#xa0;minutes/resident/day. COPM scores showed clinically meaningful improvements in performance and satisfaction. Interventions addressed diverse occupational performance issues across self-care, productivity, and leisure. Qualitative findings supported these outcomes, highlighting the benefits of the service and identifying barriers and implementation challenges. Embedding a comprehensive occupational therapy service within a multidisciplinary team model is both feasible and beneficial in a nursing home. The improvements in occupational performance and satisfaction, along with the diversity of interventions required, highlight the important contribution of occupational therapy in a nursing home. Occupational therapy may help older people in nursing homes manage daily tasks more easily and safely. In Australia, occupational therapy currently has only a small role in these homes. Researchers from the University of Canberra ran a study called Enhancing Allied Health for Older People to see if a team of health workers in a nursing home would help. The study was held in a nursing home in Australia, with 27 residents receiving occupational therapy to do activities that were important to them. Each person's progress was measured by listing key activities and rating how well they could do them before and after support. Each resident got 895&#x2009;minutes of occupational therapy and 203&#x2009;minutes of help from allied health assistants based on their need and wishes. Researchers also talked to family members, staff and students to understand if occupational therapy support was useful and to know of any challenges. The study showed that occupational therapy in a nursing home can make it easier for people to engage in occupations and improve their quality of life.

Multiple medication safety recommendations to reduce preventable medication-related hospitalisations have been introduced in the Netherlands. Still, these hospitalisations remain prevalent. This might be due to suboptimal implementation in clinical practice. Therefore, more insight is needed into barriers and facilitators for the implementation of these medication safety recommendations across healthcare sectors. This study aimed to identify barriers and facilitators for implementing medication safety recommendations across healthcare sectors from the perspective of various stakeholders. A selection of 17 Dutch medication safety recommendations targeting medications responsible for a large proportion of medication-related hospitalisations was evaluated in focus groups to identify barriers and facilitators to their implementation. These included recommendations for: reducing fall risk in elderly; initiating prophylactic medication; monitoring patients at risk of electrolyte disorders; clarifying responsibilities for patient care; informing patients about alarm symptoms; and prescribing antithrombotics on strict indication. Stakeholders were selected through purposive sampling based on their profession and healthcare sector. Transcripts of audio-recordings were analysed inductively, after which implementation factors were categorised using the Consolidated Framework for Implementation Research. Thirty stakeholders were divided into five focus groups. These included community pharmacists (n&#x2009;=&#x2009;9), general practitioners (n&#x2009;=&#x2009;4), hospital pharmacists (n&#x2009;=&#x2009;3), representatives from healthcare knowledge organisations (n&#x2009;=&#x2009;3), patient representatives (n&#x2009;=&#x2009;2), medical specialists (n&#x2009;=&#x2009;2), nurses (n&#x2009;=&#x2009;2), and other stakeholders (n&#x2009;=&#x2009;5). Forty-nine barriers and facilitators were identified. Key themes were lack of specified responsibilities, limited information exchange, local collaboration and protocol adherence. Recommendations with a lower level of implementation often required collaboration with multiple healthcare providers, whereas recommendations with a higher level of implementation were frequently supported by clinical decision support systems. A broad range of barriers and facilitators to the implementation of medication safety recommendations was identified. Overall, the findings highlight the need for recommendations with specified responsibilities, improved information exchange, strengthened local collaboration, and increased protocol adherence.