Connecting education, tourism and archaeology: A journey towards sustainability

Chronic Obstructive Pulmonary Disease (COPD) is an irreversible lung disease. People with COPD and their next of kin are affected in daily life and need support from each other, health care, and the surrounding society. This systematic integrative review aims to identify which support is given to persons affected by COPD and/or their next of kin from the health care and surrounding society. A second aim was to evaluate the support. A systematic integrative review was conducted to aggregate the knowledge by searching PubMed, CINAHL, PsycINFO, Scopus, and Web of Science databases. Search terms were chronic obstructive pulmonary disease (COPD) and support. The time limit was 2014-2023. The review protocol was registered on PROSPERO (CRD42023462784). The inclusion was selected from the aim, and quality review instruments checked quality. The result was analyzed with a constant comparison method. PersonswithCOPD receive support from their next of kin, practically and emotionally. Health care also supplies support through information, knowledge, and different training programs.Health carecan be in all types of health care, from hospital and primary care to care in the home, all with varying types of support. The next of kin supplies support to their sick relative, becomes support from health care on a small scale, and wishes for more information, knowledge, and understanding about the disease, symptoms, and treatment. The sick person and their carer want to be acknowledged and supported more on their terms. Support for next of kinisvirtually non-existent. Next of kin needsmore supportfrom healthcare and the surrounding society. Healthcare interventions in the future need to involve the person with COPD and the next of kin in a person-centered approach outof every person´s needs and support more on their terms.

The tourism business is thriving in the post-pandemic era. Similarly, numerous studies have attempted to ascertain the benefits of sustainable tourism on the country's economic growth. This study will give fresh insights into sustainable tourism by examining published book chapters, conference papers and articles from the Web of Science database. The findings showed that between 2020 to 2022, academic interest in this field skyrocketed. This paper shed light on studies on sustainable tourism in order to identify key themes, present state of research in sustainable tourism, and suggest how prominent works have shaped it. Using bibliometrics analysis, this study examined 951 papers published in Web of Science (WoS) database between 1990 to 2022. Academic interest in this area shows a positive trend as the annual scientific productivity shows a gradual increase over these years.

The present study aimed to characterize, through descriptive statistics, data from scientific articles selected in a systematic integrative review that performed a microbiological diagnosis of Salmonella spp. in aquaculture. Data were obtained from research articles published in the BVS, Scielo, Science Direct, Scopus and Web of Science databases. The selected studies were published between 2000 and 2020 on samples of aquaculture animal production (fish, shrimp, bivalve mollusks, and other crustaceans) and environmental samples of aquaculture activity (farming water, soil, and sediments). After applying the exclusion criteria, 80 articles were selected. Data such as country of origin, categories of fish investigated, methods of microbiological diagnosis of Salmonella spp., sample units analyzed and most reported serovars were mined. A textual analysis of the word cloud and by similarity and descending hierarchical classification with the application of Reinert's algorithm was performed using R® and Iramuteq® software. The results showed that a higher percentage of the selected articles came from Asian countries (38.75%). Fish was the most sampled category, and the units of analysis of the culture water, muscle and intestine were more positive. The culture isolation method is the most widespread, supported by more accurate techniques such as PCR. The most prevalent Salmonella serovars reported were S. Typhimurium, S. Weltevreden and S. Newport. The textual analysis showed a strong association of the terms "Salmonella", "fish" and "water", and the highest hierarchical class grouped 25.4% of the associated text segments, such as "aquaculture", "food" and "public health". The information produced characterizes the occurrence of Salmonella spp. in the aquaculture sector, providing an overview of recent years. Future research focusing on strategies for the control and prevention of Salmonella spp. in fish production are necessary and should be encouraged.

Purpose This research examines the literature on public policies and innovation ecosystems, proposing a research agenda. Public policies and the development of innovation ecosystems are strategies to promote economic development and achieve the Sustainable Development Goals. Design/methodology/approach Using an integrative systematic review by the PRISMA-P protocol, data were collected from the Scopus and Web of Science databases. Initially, 119 documents were identified, and after applying inclusion and exclusion criteria, 51 articles were analysed. The main discussions were represented in analytical categories generated by artificial intelligence codes from the ATLAS.ti24 software, organised in a strategic diagram with four themes: specialised themes, driving themes, basic themes and emerging themes. Findings Regarding the four identified thematic categories, the following results were obtained: Specialised themes: Open innovation and public policies, showing how public policies can create environments conducive to innovation; Driving themes: Sustainability and digital platforms and innovation, fundamental for the circular economy and sustainable business models; Basic/Transversal themes: Partnerships and collaboration, highlighting the importance of mentoring networks and institutional support and Emerging themes: Circular economy, with significant opportunities for future research, especially in integrating education, entrepreneurship and sustainability. Originality/value The study details how different dimensions of public policies impact the effectiveness and resilience of innovation ecosystems in various geographical contexts. It proposes a practical and theoretical research agenda, suggesting adaptive policies to improve stakeholder dialogue and reinforce intersectoral collaboration. Recommendations include strengthening public funding policies for startups, promoting open innovation and encouraging digital platforms to facilitate interaction between governments, businesses and civil society.

Telehealth technologies can enhance patients' and their families' access to high-quality resources in home-based palliative care. Nurses are deeply involved in delivering telehealth in home-based palliative care. However, no previous integrative systematic reviews have synthesized evidence on nurses' roles, facilitators, and barriers to implementing nurse-delivered telehealth in home-based palliative care. This integrative systematic review aimed to provide a comprehensive understanding of the roles of nurses and the multilevel facilitators and barriers to implementing nurse-delivered telehealth in home-based palliative care, which could inform future policy development, research, and clinical practice. This integrative systematic review was conducted using Joanna Briggs Institute methodological guidance. We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. We systematically searched articles published from January 1, 2014, to May 2024 in PubMed, Embase, Web of Science, CINAHL, and Cochrane Library. We included English-language; peer-reviewed; original; and qualitative, quantitative, and mixed methods studies that centered on nurse-delivered telehealth in home-based palliative care. We used the Mixed Methods Appraisal Tool to assess the quality of the included articles. Furthermore, 3 authors independently assessed eligibility, extracted data, and assessed the quality of articles. The entities to extract were identified by research questions of interest regardless of the type of study. We applied a convergent synthesis approach to integrate quantitative and qualitative data. Guided by the updated Consolidated Framework for Implementation Research (CFIR) 2.0, we synthesized the facilitators and barriers to implementing nurse-delivered telehealth in home-based palliative care. This integrative systematic review identified 4819 unique articles, including 34 papers encompassing 29 unique primary research studies. Innovations were mainly delivered by nurses (n=8) and nurse-involved multiprofessional teams (n=18). The roles of nurses in telehealth home-based palliative care involve palliative care nurses, community nurses, nurse coordinators, nurse coaches or nurse navigators, and nurse case managers. Guided by CFIR 2.0, facilitators and barriers to implementing nurse-delivered, telehealth, home-based palliative care were identified to 6 implementation levels and 20 constructs. The key facilitators included the COVID-19 pandemic, cost avoidance to the health care system, engagement of patients and their family caregivers, and so on. The barriers included a lack of reimbursement and payment mechanisms, technical problems, insufficiently trained health care providers, and so on. This integrative systematic review synthesizes evidence on nurses' evolving roles in telehealth home-based palliative care and identifies multilevel facilitators and barriers to nurse-delivered, home-based palliative care implementation. With the empowerment of telehealth technologies, nurses could establish a stronger professional identity and develop leadership in home-based palliative care. Nurses should leverage influence to promote nursing practice, clinical management, and policy support in the implementation of telehealth home-based palliative care. PROSPERO CRD42024541038; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024541038.

In the recent years, the rapid growth of the tourism industry has risen to prominence as a global concern. Tourism empowers communities and uplifts the economy. However, it poses social and environmental challenges, which in turn draws attention to tourism patterns. Sustainable tourism promises protection of the environment and the social-cultural elements of any given destination. Hence, this study aims to understand the complex relationship between sustainability policy, management, and tourist behavior. Thus, we examined the relationships between sustainable tourism policy and destination management, destination social responsibility, and tourist value orientation with sustainable tourism development. We recruited participants at managerial level coming from 163 Malaysian companies and conducted a cross-sectional quantitative study, using partial least square structural equation modeling. We propose that sustainable tourism policy and destination management and destination social responsibility significantly impact sustainable tourism development. Moreover, destination social responsibility partially mediates the relationship between sustainable tourism policy destination management and sustainable tourism development.

BackgroundThe number of self-organizing teams is increasing in long-term care organizations. These teams have been implemented for various reasons among which improving the quality of care and the quality of working life. However, self-organizing teams are not always delivering these favorable outcomes. To evaluate the success of self-organizing teams, it is important to understand the reasons for their varying levels of success in long-term care organizations. In the long-term care context, little is known about the role of the organization structure in self-organizing team success, while organization theory indicates that this factor strongly affects their outcomes.MethodsAn integrative systematic review was conducted across four electronic databases: PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Business Source Complete, and Web of Science, from inception until May 2023. Reference lists of the included studies were screened to identify other relevant studies. Quality appraisal was undertaken using MMAT for empirical studies and JBI checklists for systematic reviews, and text and opinion. Thematic analysis was conducted to synthesize the findings.ResultsForty-one articles were included. Findings were categorized based on structure characteristics that we extracted from organization theory: centralization, specialization, formalization, and functional concentration. We found different forms of each structure characteristic and their influence on self-organizing teams. A higher degree of these structure characteristics generally hinders self-organizing team success, meaning lower quality of care and lower quality of working life. Conversely, a lower degree of these characteristics generally facilitates self-organizing team success, meaning higher quality of care and higher quality of working life. However, the findings also highlight that structure characteristics can reach detrimentally low degrees when too many tasks and responsibilities are allocated to the teams, diminishing self-organizing team success.ConclusionsWhile self-organizing teams hold promise for enhancing the quality of care and improving the quality of working life, they are not always successful in practice. This integrative systematic review highlights the importance of organization structure characteristics for self-organizing team success in long-term care organizations.RegistrationThis review was registered with the PROSPERO International prospective register of systematic reviews (CRD42023418288).

Taste and smell disorders (TSDs) are common side effects in patients undergoing cancer treatments. Knowing which treatments specifically cause them is crucial to improve patients’ quality of life. This review looked at the oncological treatments that cause taste and smell alterations and their time of onset. We performed an integrative rapid review. The PubMed, PROSPERO, and Web of Science databases were searched in November 2022. The article screening and study selection were conducted independently by two reviewers. Data were analyzed narratively. Fourteen studies met the inclusion criteria and were included. A high heterogeneity was detected. Taste disorders ranged between 17 and 86%, while dysosmia ranged between 8 and 45%. Docetaxel, paclitaxel, nab-paclitaxel, capecitabine, cyclophosphamide, epirubicin, anthracyclines, and oral 5-FU analogues were found to be the drugs most frequently associated with TSDs. This review identifies the cancer treatments that mainly lead to taste and smell changes and provides evidence for wider studies, including those focusing on prevention. Further studies are warranted to make conclusive indication possible.

Frailty is a common but complex phenomenon that is approached from theoretical and professional perspectives but rarely from the perspectives of older people and their essential stakeholders. Different or opposing perspectives on frailty at personal, organisational, and community levels can negatively affect care for frail older people. This systematic integrative review synthesises the perspectives on frailty of older people, health/social care professionals, informal caregivers, managers and policymakers, using thematic analysis. We use the Joanna Briggs Institute–Critical Appraisal Checklist to appraise the quality of 52 qualitative and mixed-method studies drawn from the PubMed/MEDLINE, CINAHL, PsycINFO, Embase, and Web of Science databases (inception–December 2023). Of these, 33 include the perspectives of older people, 27 of health/social care professionals, four of managers, and six of informal caregivers. Structuring the perspectives along six themes – ‘the multi-dimensional nature of frailty’, ‘the dynamics of frailty’, ‘the complexity of frailty’, ‘frailty in relation to age’, ‘frailty in relation to health’ and ‘frailty in relation to dependence’ – revealed substantive similarities in the conceptualisation of frailty between older people and professionals, e.g. regarding frailty’s dynamic and multi-dimensional nature. However, older people and professionals differ in their interpretations of frailty: older people take a personal view, while professionals take a more practical view. The identified discrepancies in perspectives may affect care relationships and care for frail older people. Therefore, we advocate a systems approach that incorporates multiple perspectives to form a comprehensive view of frailty and allows for a situation-specific shared understanding of frailty in older people.

A systematic literature review (SLR) was designed to analyse the current state of knowledge on rural tourism development, sustainable tourism, and outdoor activities to consolidate and interlink these three topics. For this purpose, 28 articles published in the Scopus and Web of Science databases were reviewed through the Preferred Articles for Systematic Reviews and Meta-Analyses (PRISMA). This research aims to develop a SLR to identify the association between rural tourism, sustainable tourism, and outdoor activities, searching to answer the research question (RQ): what is the relationship between rural tourism development, sustainable tourism and outdoor activities for the scientific literature? First, through a qualitative approach, this study considered 215 articles from the respective databases and excluded 54 repeated articles, resulting in 161 articles for analysis. In a second step, after conducting a more detailed analysis, 54 articles were excluded due to their title and abstract, and 79 articles were excluded for not meeting the objectives. In the end, 28 articles were considered for the SLR. This analysis provides knowledge about sustainability, outdoor activities, and rural tourism from a co-occurrence perspective to emphasise the valuable content addressed by the researchers. Hence, the main results of this study highlight the relationship between rural tourism and sustainable tourism as concepts that operate in partnership and simultaneously. In addition, there were some references for outdoor activities about the participation of rural tourism and sustainable tourism destinations in outdoor contexts.

IntroductionAboriginal and Torres Strait Islander children in Australia experience a higher prevalence of disability and socio-economic disadvantage than other Australian children. Early intervention is vital for improved health outcomes, but complex and fragmented service provision impedes access. There have been international and national policy shifts towards inter-sector collaborative responses to disability, but more needs to be known about how collaboration works in practice.MethodsA systematic integrative literature review using a narrative synthesis of peer-reviewed and grey literature was undertaken to describe components of inter- and intra-sector collaborations among services to Aboriginal and Torres Strait Islander children with a disability and their families. The findings were synthesized using the conceptual model of the ecological framework.ResultsThirteen articles published in a peer-reviewed journal and 18 articles from the grey literature met inclusion criteria. Important factors in inter- and intra-sector collaborations identified included: structure of government departments and agencies, and policies at the macro- (government) system level; communication, financial and human resources, and service delivery setting at the exo- (organizational) system level; and relationships and inter- and intra-professional learning at the meso- (provider) system level.ConclusionsThe policy shift towards inter-sector collaborative approaches represents an opportunity for the health, education and social service sectors and their providers to work collaboratively in innovative ways to improve service access for Aboriginal and Torres Strait Islander children with a disability and their families. The findings of this review depict a national snapshot of collaboration, but as each community is unique, further research into collaboration within local contexts is required to ensure collaborative solutions to improve service access are responsive to local needs and sustainable.

This systematic integrative review provides a unique pioneering perspective on community support practices in social, community, and cooperative housing, improving our understanding of the practice and its outcomes. Two research questions guided this work: 1) What are the community support practices in social and community housing serving individuals in the context of socioeconomic deprivation in permanent housing structures? And 2) What are the outcomes of the community support practices in social and community housing. Studies describing and/or reporting on outcomes of community support practices in social and community housing (psychosocial, economic, and health/mental health) were included from the journals’ inception to September 2022. A total of 42 studies were included in the systematic review, of which 20 were qualitative, 14 quantitative, and eight mixed-method studies. Of them all, 34 studies reported on public housing, four on community housing, and four on cooperative housing. Results inform practitioners and decision makers on issues related to community practices in permanent supportive housing and their outcomes in relation to tenure orientations and potential impact. Community practice workers are pillars in housing settings who provide bridging, bonding, and linking that builds social capital in adverse conditions. This review provides insight into innovative research avenues in this domain, while bringing to the forefront the fundamental challenges of individual support pathways to collective empowerment, increased health needs, and unequalled peer-tenant support engagement, as well as their precarious conditions.

This systematic integrative literature review explores how clinicians make decisions for patient management plans in telehealth. Telehealth is a modality of care that has gained popularity due to the development of digital technology and the COVID-19 pandemic. It is recognized that telehealth, compared to traditional clinical settings, carries a higher risk to patients due to its virtual characteristics. Even though the landscape of healthcare service is increasingly moving towards virtual systems, the decision-making process in telehealth remains not fully understood. A systematic integrative review. Databases include CINAHL, APA PsycInfo, Academic Search Complete, PubMed, Web of Science and Google Scholar. This systematic integrative review method was informed by Whittemore and Knafl(2005). The databases were initially searched with keywords in November 2022 and then repeated in October 2023. Thematic synthesis was conducted to analyse and synthesize the data. The search identified 382 articles. After screening, only 10 articles met the eligibility criteria and were included. Five studies were qualitative, one quantitative and four were mixed methods. Five main themes relevant to decision-making processes in telehealth were identified: characteristics of decision-making in telehealth, patient factor, clinician factor, CDSS factor and external influencing factor. The decision-making process in telehealth is a complicated cognitive process influenced by multi-faceted components, including patient factors, clinician factors, external influencing factors and technological factors. Telehealth carries higher risk and uncertainty than face-to-face encounters. CDSS, rather than bringing unification and clarity, seems to bring more divergence and ambiguity. Some of the clinical reasoning processes in telehealth remain unknown and need to be verbalized and made transparent, to prepare junior clinicians with skills to minimize risks associated with telehealth. Not applicable.

This paper reviews the management and business research field of autonomous vehicles (AVs) in a bibliometric context aiming to identify strategies, practices, and management tools; and summarises the existing studies and highlight research gaps. Methodologically, the study is qualitative and descriptive, based on a bibliometric review on Web of Science, Scopus, and Science Direct, followed by a systematic integrative review. Results show that, in the near future, AVs will certainly be introduced in the society. However, such insertion is still surrounded by uncertainties, doubled by governments' lack of planning. The absence of business-related studies can be a determinant for AVs introduction, once business models (BM) play an important for AVs advancement. Nevertheless, especially in Europe, studies related to AVs 'car-sharing' seem to be predominant. As such, we observe a research gap regarding BM and platforms and radical and responsible innovation theories.

Although team-based work is deemed key to improving the quality of national health care systems, adverse events related to teamwork account for up to one third of all incidents. Health care teams are typically multiprofessional and diverse in many aspects, but cultural diversity is one of the most challenging. The objective of this review is to systematically analyze the literature to better understand the impact of cultural diversity in health care teams on team processes as well as team and patient outcomes. This study also explores the conditions that enable or hinder team functioning. Through a systematic integrative literature review, this study builds on the input-process-output-context framework. Multiple searches of the main databases led to identifying 43 relevant articles. The results suggest that, when not proactively managed, cultural diversity may have a negative effect on team communication and integration, increasing team conflict and thereby negatively influencing team performance, team climate, and patient safety, both directly and indirectly. Yet, when managed properly and in the presence of engaged and culturally sensitive leadership, cultural training, and open and transparent procedures, cultural diversity in health care teams can be an asset to health care organizations. Analyzing and aggregating these findings into an integrative framework, our study identifies several themes and a research agenda for future studies on culturally diverse health care teams. Our findings suggest that culturally diverse health care teams experience a number of challenges, pointing to the need for action or structures that enable these teams to perform better, such as emphasizing learning and allowing team members time to get to know each other outside work.