Survey of Canadian specialised palliative radiotherapy programs.

This study aimed to clarify the structure of the individual matching support process within Team Orange, a community-based dementia support initiative in Japan. Using reflexive thematic analysis, we qualitatively examined semi-structured interviews with seven coordinators who facilitate matching between people living with dementia and community supporters. We also analysed 14 implementation reports documenting actual support cases from community comprehensive support centres in Sapporo, Hokkaido. Analysis identified seven themes constituting a cyclical support process: 'diverse triggers for initiating matching', 'assessing needs and evaluating support potential', 'safe and sustainable support coordination', 'building trust relationships to facilitate matching', 'reaching consensus among people living with dementia, families and supporters', 'implementing individual matching support' and 'reviewing and readjusting toward sustainable support'. These findings suggest that individual matching is not simply a combination of volunteer activities, but rather a support process in which the coordinator's clinical reasoning and relational coordination cyclically support the agency of people living with dementia, family members and supporters. This practice has the potential to serve as an implementation model that flexibly connects informal community resources with individuals whose needs fall outside the scope of formal care services.

Techno-economic and environmental analysis of a hybrid renewable energy system with V2H support for remote Australian communities

BackgroundEmotional and behavioral problems (EBPs) in children significantly influence developmental domains, including interpersonal relationships, academic performance, and life skills.MethodsA cross-sectional study was adopted with purposive sampling. The study includes 120 children aged 6-14years from West Bengal, equally divided into groups with and without EBPs. Standardized tools such as the Pediatric Symptom Checklist (PSC), Child Interpersonal Relationships and Attitudes Assessment (CIRAA), Academic Performance Scale (APS), and Life Skills Assessment Scale (LSAS) were used.ResultsChildren with EBPs significantly scored lower in interpersonal relationships (p = .015) and life skills (p < .001) compared to peers without EBPs. However, they seem to scored slightly better in academic performance (p = .026). Correlation analyses showed a weak but significant relationship between EBPs and interpersonal relationships (r = 0.198, p = .030), a negative correlation with academic performance (r = -0.217, p = .017), and a moderately strong positive correlation with life skills (r = 0.457, p < .001).ConclusionThese EBPs obstruct the development of interpersonal and life skills, while their impact on academics varies with contextual factors. Thus, the study stresses that interventions should provide academic support, social-emotional learning and life skills training in schools and communities.

Psychological burden is a central aspect of living with chronic cardiovascular disorders and profoundly affects how individuals experience and cope with fear, dependency and loss of control. Understanding these experiences is essential for delivering high-quality, holistic and person-centred care. This study explored the experiences of psychological burden among individuals living with chronic cardiovascular disorders in a low- and middle-income context. We conducted a qualitative descriptive study. Nineteen individuals were purposively recruited using maximum variation sampling and interviewed using a semi-structured interview guide between May and September 2024. Data were analysed using reflexive thematic analysis software (MAXQDA). The analysis of 19 interviews generated three overarching themes: (a) multifaceted disruption of life from acute onset to enduring dependency; (b) burden of existential fear and struggle for control; and (c) faith-based burden management: prayer, practice and spiritual resilience. Individuals with chronic cardiovascular disorders experience a significant psychological burden, including sudden illness onset, dependency and existential fear, despite available treatment. Faith, family and community support serve as key sources of coping. The integration of psychological care, spiritual support and culturally sensitive interventions alongside biomedical management is essential for improving outcomes in low and middle-income countries. Health care professionals should integrate psychological screening and counselling to address existential fears, social withdrawal and suppressed emotional expression among individuals with chronic cardiovascular disorders. Patients with chronic cardiovascular disorders informed the design of the interview guide, participated in interviews and helped validate the interpretation of findings, ensuring that the study reflected their lived experiences. This study adhered to the Consolidated Criteria for Reporting Qualitative Studies (COREQ).

Prevalence and factors associated with post-traumatic stress disorder among internally displaced populations due to gang violence in Haiti.

Obesity is a growing public health issue worldwide affecting one in three adults in Australia and two in five adults in the United States. Globally, the prevalence of obesity has doubled or even tripled in many countries over the past two decades, predominately driven by urbanization, sedentary lifestyles and increased consumption of high-calorie processed foods. The aim of this viewpoint article is to highlight recent policy changes and public health Initiatives to curb this obesity epidemic. Traditional strategies that focus on individual behaviour have proven insufficient and broader public health policy models to address both societal and environmental contributors to obesity have emerged. Recent public health initiatives directed their focus on promoting healthier lifestyles through policies, family-based interventions, dietary education and sustained community support. Effective obesity prevention requires collaborative efforts across policy, healthcare and community sectors to mitigate its far-reaching physical, psychological and economic impacts from individual to population levels. Policy and public health efforts against obesity are evolving into comprehensive systems-oriented models. They combine regulation, fiscal tools, healthcare integration, education campaigns, measurement systems and equity-focused approaches. Together, they form a layered strategy aimed at preventing obesity, supporting individuals living with it and ensuring accountability across sectors.

The ongoing system of coloniality, sustained through dehumanisation, racialised violence, oppression, war, and genocidal acts of violence, has left many from the Global South socially divided, economically depleted, wounded, materially impoverished, socially precarious and politically vulnerable. As a result, individuals and communities continue to endure trauma from systemic abuse, oppression and violence. Dismantling these colonial systems requires a form of healing that transcends mainstream, Western biomedical and psychological interventions, which have little to say on enduring systems of violence. From the perspective of radical healing, healing is an embodied, collective, and action-oriented praxis that engages individual and collective trauma and resists both historical and ongoing structures of oppression. In this article, we explore the ways in which radical healing is enacted, embodied and sustained in three marginalised South African communities. Grounded in decolonial thought and a participatory approach, the study centred the lived experiences and knowledge practices that emerged from within these communities. Two focus group discussions were facilitated in each community. Using thematic analysis, we identified three interwoven themes: (1) Faith and Spirituality, which focuses on the role of churches, religious gatherings, and faith-based practices in fostering healing; (2) Collective and Action-Oriented Healing, which looks at activism, volunteering, community-led initiatives and political engagement as sites of psychosocial and collective recovery; and (3) Micro and Everyday Acts of Healing, which includes the significance of everyday communal support. These interconnected practices illustrate that healing in marginalised communities extends beyond individual recovery. It is a collective process tied to resistance and survival. Through these practices, communities challenge historical and ongoing harms while creating spaces of care, belonging, and possibility.

Land degradation is a threat to global ecosystems and livelihoods of billions of people. Nearly 85% of Ethiopia's land is degraded, costing more than USD 4.3billion per year. Area closures for excluding human and livestock disturbances have been widely adopted as a restoration strategy for degraded lands to enable natural regeneration. However, integrated ecological and socio-economic assessments are scarce in the Siltie Zone of Central Ethiopia and evidence-based interventions are limited. A comparative study design was used in the study area of Hulberag District, to assess 14-years-long area closures and adjacent open grazing lands. Data collection comprised vegetation surveys, physicochemical analyses of soils at different soil depths and household questionnaires. Statistical analysis was performed by ANOVA and post-hoc Tukey's HSD tests to compare land-use types and topographic positions. Area closures significantly improved ecosystem metrics. Woody species richness increased by 200%, stem density increased by 154%, and Shannon diversity was significantly higher than in open grazing lands. Soil organic carbon increased by 50%, available phosphorus by 33%, and cation exchange capacity by 25%. Bulk density decreased by 19%, indicating reduced soil compaction and improved soil quality. The greatest improvements occurred on lower slopes. Surveys revealed strong community support, with 79.8% of respondents identifying livestock fodder as the primary benefit and 53.1% associating area closures with increased crop yields through improved erosion control. Area closure represents an effective, low-cost intervention for restoring degraded semi-arid ecosystems in Ethiopia, promoting native woody vegetation recovery and enhancing soil fertility while providing tangible livelihood benefits. For long-term success, adaptive co-management frameworks that integrate clear resource-use guidelines, equitable benefit-sharing, and alignment with broader watershed conservation strategies are recommended.

ObjectiveTo summarize and compare the literature on social support and its effect on psychological well-being among older adults in low- and middle-income countries of the Asian region.DesignA Systematic review. The review was registered in the International Prospective Register of Systematic Reviews with identification number XXXXXXXXXX.Data SourcesRetrieved data from PubMed, CINAHL (EBSCO), PsycINFO, Scopus, and Cochrane Centre Register of Controlled Trials databases. The literature review was conducted from 2018 to 2024.Review MethodsThe review complies with the Joanna Briggs Institute methodology and follows the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines.ResultsInitially, 4,615 records were identified using the predefined search strategy. Out of 95 articles selected for full-text screening, 27 met the inclusion criteria. This review identified family and friends as the primary source of social support, enhancing their overall well-being. The higher levels of social support, whether emotional, informational, companionship, or tangible, improve older adults' psychological well-being and quality of life, including reduced depression, anxiety, and loneliness.ConclusionsThe emotional and mental health of older adults can be diminished significantly due to the lack of adequate social support, leading to a cascade of adverse outcomes. This challenge is especially prevalent in low- and middle-income countries (LMICs), where older adults often struggle to access formal healthcare, social services, and a structured community support system. Promoting robust social networks is crucial for older adults' well-being and sustainable aging strategies in low-resource settings.

ABSTRACT The Arctic archipelago of Svalbard is currently undergoing a profound energy transition, shifting from coal-based infrastructure towards a low-carbon hybrid energy system. Following the closure of the last coal mine in 2025, a range of renewable energy technologies is expected to be implemented in accordance with a new national energy plan. This article investigates the expectations that residents of Longyearbyen have for this socio-technical transformation, with particular attention to the roles of institutional trust, energy citizenship, identification with nature and climate change denialism. Drawing on survey data, the study identifies five distinct public expectation profiles regarding the renewable energy transition. Two of these – Risk and Unreliable – reflect deep-seated concerns, while three – Opportunities, Climate and Innovation – express more optimistic outlooks. The findings highlight institutional trust as a key predictor of optimistic expectations, often in conjunction with energy citizenship. In contrast, identification with Svalbard’s natural environment and climate change denialism are more strongly associated with the concerned profiles. While prior research has emphasized the importance of institutional trust in energy transitions, this study demonstrates how trust also shapes future-oriented expectations and operates in tandem with energy citizenship norms. The article concludes by outlining strategic opportunities for fostering inclusive community support and mitigating the risk of political polarization in Svalbard’s evolving energy landscape.

Korean immigrant families face complex barriers to accessing services for their children with autism and developmental disabilities due to intersecting cultural, linguistic, and socioeconomic factors. However, there is limited information in the literature on strategies to close this gap. This tutorial reports on leveraging an academic-community partnership to establish and sustain a parent support group for Korean immigrant families of children with autism and other developmental disorders. Academic and community partners worked together to develop family-centered support. The partnership focused on iteratively tailoring support to a localized context to increase knowledge, self-efficacy, and community support for navigating service systems. The development of the parent support group progressed through three phases: (a) establishing two separate support groups led by a parent and a faculty member, (b) merging the groups and building capacity to empower families, and (c) supporting community partners in formalizing the group and securing grant funding for partner-driven initiatives. In all phases, academic partners contributed university resources, whereas community partners provided insider knowledge to create effective programming. This approach has resulted in a strong, ongoing academic-community partnership that has lasted for more than 2 decades and successfully engaged over 400 families. The lessons learned offer an example of how to reduce barriers to autism-related services by leveraging community strengths and fostering collaboration and by revisiting both the partnership and supports for families to more strongly address community priorities.

ABSTRACT Parental migration in Zimbabwe’s prolonged economic crisis has created a generation of left-behind children in high-density suburbs such as Cowdray Park, Bulawayo, where emotional distress, stigma, and educational disengagement are intensified by density pressures. This study asked how psychosocial and community factors shape the resilience of left-behind children in such urban contexts, moving beyond remittance sufficiency to examine attachment and systemic boundaries. Using a sequential mixed-methods design guided by Attachment and Family Systems Theories, surveys of 398 children were combined with 30 interviews and focus groups, triangulated with attendance logs and policy audits to ensure validity. The evidence indicates that resilience in peri-urban Zimbabwe is not determined by financial inputs alone but by psychosocial buffers and community support systems. Faith-school hybrids emerged as adaptive strategies offering practical and emotional support, yet sibling households and adolescents with gendered caregiving burdens remained excluded, exposing systemic fractures in child protection. Emotional wellbeing consistently outweighed material stability in shaping scholastic trajectories, underscoring the primacy of attachment restoration and boundary reinforcement. The study concludes that effective interventions must integrate psychosocial care with material support, including school-faith partnerships, counseling, stigma reduction, and policy recalibration ensuring density-resilient futures for Zimbabwe’s children.

Youth mental health systems worldwide face increasing demand, workforce shortages, and fragmented pathways to care. Addressing these challenges requires approaches that extend beyond specialist clinical treatment to incorporate prevention, participation, education, and recovery-oriented support. While Recovery Colleges are increasingly established within adult mental health services, their youth-adapted counterparts commonly referred to as Discovery Colleges remain underexplored within youth mental health systems research. This narrative review synthesises emerging literature to examine the conceptual foundations, developmental adaptations, and potential system-level role of Discovery Colleges within youth mental health care. A narrative review approach was employed to synthesise emerging literature on Discovery Colleges and related recovery-oriented educational initiatives. Peer-reviewed publications, programme descriptions, and implementation reports were analysed to examine the defining principles, developmental relevance, organisational characteristics, and system-level implications of Discovery Colleges within youth mental health contexts. The synthesis identified four interrelated conceptual domains characterising Discovery Colleges: (1) recovery-oriented learning models and developmental adaptation; (2) mechanisms of engagement and participation; (3) organisational and professional implications; and (4) cross-sector positioning within youth mental health ecosystems. The findings suggest that Discovery Colleges can be conceptualised as developmentally responsive and recovery-oriented learning environments operating at the intersection of education, community support, and mental health care. The review further highlights important tensions relating to implementation, safeguarding, fidelity, sustainability, and cross-sector integration. Discovery Colleges may represent a promising recovery-oriented innovation within youth mental health systems by reframing mental health support as a collaborative, participatory, and educational process rather than solely a clinical intervention. However, the current evidence base remains limited and largely exploratory. Further empirical, developmental, and implementation-focused research is required to evaluate their effectiveness, sustainability, and long-term contribution to integrated youth mental health systems.

Publicly funded home care is pivotal in supporting ageing in place across high-income health systems. Home care delivery models vary in funding, governance, and service delivery. The scope, distribution, and comparability of evaluation evidence is limited. To map and characterise models of publicly funded home care for community-dwelling older adults across six high-income countries: Canada, England, Denmark, Sweden, Australia, and New Zealand, and to synthesise available evaluation evidence related to model characteristics, quality, patient and family satisfaction, integration with health and social care, and equity-relevant considerations. A scoping review was conducted in accordance with JBI methodology and reported following PRISMA-ScR guidelines. MEDLINE, Embase, and CINAHL were searched from 2005 onwards, alongside targeted grey literature searches. Data meeting the inclusion criteria were extracted and synthesised using qualitative content analysis. An equity lens was applied using the PROGRESS-Plus framework, and SAGER guidelines. Nineteen sources were included, comprising 14 peer-reviewed studies and five grey literature documents. Five models of publicly funded home care were identified: (1) provincially/territorially organized home care in Canada, where models vary by jurisdiction and level of integration; (2) the National Home Care Packages Program in Australia organized around consumer directed care; (3) the Universal Welfare Model managed municipally in Denmark and Sweden; (4) Cash for Care/Direct Payments in England; and (5) nationally framed Home and Community Support Services in New Zealand. Characteristics most common across models were public funding and professional as well as support services. Across models, evaluation evidence was unevenly distributed and largely descriptive, with relational aspects of care and workforce conditions prominent in reported experiences, and equity-relevant characteristics inconsistently reported. This scoping review charts the models of publicly funded home care across six high-income countries and identifies gaps in the evidence. The findings underscore the need for consistent and comparative evaluation of home care models as population ageing and policy attention to integrated people-centred care intensifies.

ABSTRACTIntroductionTimely antenatal care (ANC) is a critical determinant of maternal and neonatal outcomes. In the UK, women from migrant and ethnic minority backgrounds are more likely to initiate ANC later, attend fewer appointments and experience poorer maternal and infant outcomes. This study aimed to describe barriers and facilitators to timely ANC access and uptake from the perspectives of migrant and ethnically diverse women who initiated care late.MethodsWe conducted a qualitative study using semi-structured interviews with 20 women from migrant and/or ethnically diverse backgrounds who initiated ANC late (>10 weeks’ gestation) in the East of England, UK. Women, recruited through purposive and snowball sampling, were interviewed between October 2024 and January 2025 in-person, online or by telephone. All interviews were transcribed and analysed using a framework approach.ResultsFour interconnected themes, comprising 12 subthemes, captured women’s perspectives: perceptions about ANC, perceived facilitators and barriers to timely access and uptake, information needs and preferences and strategies to improve ANC access and uptake. All women recognised the importance of ANC. However, many reported limited awareness of when and how to initiate care and found ANC pathways difficult to navigate, particularly those unfamiliar with the UK healthcare system. Key facilitators of access and uptake included awareness of the importance of ANC, supportive healthcare professionals, relational continuity and support from family and friends. Barriers included uncertainty about care pathways, long waiting times, rushed appointments and language and logistical challenges. Suggested strategies to improve ANC access included accessible information on ANC pathways, stronger community and peer support, greater opportunities for direct engagement with professionals and integration of digital technologies into ANC services.ConclusionsFindings highlight need for easy-to-navigate ANC pathways, with targeted community outreach and supported navigation, culturally responsive communication with effective interpretation services and greater relational continuity to improve equitable ANC access and uptake.

This study aimed to explore women’s perceptions of a gender-tailored diabetes education program and examine self-reported behavioral, psychosocial, and self-management changes following participation among women in underserved Saudi communities and identify barriers influencing sustained diabetes management. An exploratory sequential mixed-methods study was conducted from January to June 2024 in community health centers in Al-Leith and Adham, Makkah region. Semi-structured interviews were carried out with 20 women aged 18 to 65 years to explore experiences and perceptions. Findings informed a structured questionnaire administered to 136 program participants. Descriptive statistics were used to summarize behavioral changes and perceptions, and thematic analysis followed Braun and Clarke’s 6-phase framework. Participants reported positive changes in lifestyle and self-care behaviors. Approximately 70% reduced sugar intake, 65% increased physical activity, 72% improved hydration practices, and 68% performed regular glucose monitoring. Most respondents agreed that the advice was easily applicable (73.7%), addressed women-specific challenges (71%), and enhanced motivation (72.4%). Qualitative themes highlighted daily life changes, helpful program aspects, challenges, and recommendations. Barriers included time constraints (22%), family duties (20%), financial limitations (19%), and limited healthcare access (8%). Participants perceived the tailored diabetes education program as helpful in supporting healthier behaviors, self-management practices, and motivation in underserved Saudi settings. Addressing social expectations, time pressures, and access barriers through digital follow-up and community support could strengthen long-term outcomes and advance Vision 2030 preventive health goals. Because findings were based on self-reported cross-sectional data, causal relationships regarding program effectiveness cannot be established.

The lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) community represents a high-risk group for lung cancer given higher smoking rates. We evaluated implementation of a pilot patient navigation intervention for smoking cessation services combined with lung cancer screening (LCS) care for eligible LGBTQ+ adults. We completed a concurrent mixed-methods evaluation of the intervention to enhance adaptation and future scale. Forty-one LGBTQ+-identifying individuals who were eligible for LCS and currently smoking were enrolled, completed baseline surveys, and underwent the intervention for a 90-day period. Thirty-four participants completed post-intervention surveys and 15 were invited for semi-structured interviews. We conducted a thematic analysis of qualitative data, integrated with quantitative and qualitative survey data through joint displays, guided by the Health Equity Implementation Framework. We identified fourteen themes in three topical domains. Key themes related to Intervention Success included: flexible communication; iterative contact through a longitudinal relationship; improved confidence and comfort; multimodal and tailored elements. Themes related specifically to LGBTQ+ Care included: LGBTQ+-specific social challenges; the impact of historic discrimination; emphasis on non-judgmental care; and varied responses to LGBTQ+-specific tailoring. Themes related to Future Adaptations included: more education and information on the LGBTQ+-tailored approach; synergy with trusted primary care clinicians; upfront information on financial risks; community connection and peer support; and variable need for more intense support. LGBTQ+-tailored patient navigation is an acceptable and well-suited intervention to facilitate and integrate LCS care and smoking cessation. Further adaptation should include more education and incorporate components of community support.

ABSTRACT Human emotions toward animals, perception of animal minds, and moral concern play crucial roles in shaping public support for wildlife management initiatives. This study uses Moral Typecasting Theory to explore how these psychological factors influence attitudes toward controlling two non-native species, feral cats (Felis catus) and European hedgehogs (Erinaceus europaeus), in the context of New Zealand’s Predator Free 2050 initiative. A sample of 395 New Zealand residents completed a survey assessing their emotional responses, perceptions of animal minds, and support for mitigation strategies concerning these species. Using latent profile analysis, we identified three distinct psychological segments for each animal – Advocates, Detractors, and Indifferents – characterized by varying levels of emotional engagement, perception of animal mind, resulting moral concern, and support for control measures. Advocates expressed strong positive emotions, high attribution of animal “experience” and moral concern, along with low support for lethal control; Detractors exhibited strong negative emotions, high attribution of animal “agency” associated with a lower attribution of moral concern, high perceived threat, and strong support for control; and Indifferents held moderate views across all dimensions. These profiles were significantly associated with demographic factors such as age, location, residency duration, and pet ownership. Our findings underscore the value of psychological segmentation in designing targeted communication and policy strategies to foster broader public engagement with conservation goals. We argue that tailoring interventions to the emotional and cognitive dispositions of different segments can enhance the legitimacy, effectiveness, and social sustainability of wildlife management initiatives.

The COVID-19 pandemic highlighted the critical importance of protective behaviours-such as mask-wearing, hand hygiene, and physical distancing-in managing public health crises. Understanding the factors that influence these behaviours is essential for improving preparedness and response in future health crises. This umbrella review aimed to synthesize evidence on determinants of protective behaviours during pandemics and to provide recommendations for policy and practice. Following PRISMA 2020 guidelines, we conducted an umbrella review of peer-reviewed literature reviews and meta-analyses published up to June 2025. Searches in Epistemonikos, MEDLINE, and Scopus targeted reviews on "protective behaviours" and "COVID-19", including other infectious diseases. Eligibility criteria followed the Population-Concept-Context framework: general population, multifactorial determinants of protective behaviours, and pandemic contexts. Data extraction was performed in a table that included review characteristics, behavioural domains (general compliance, medical interventions, open dialogue promotion, information handling, hygiene, physical distancing, and other behaviours), and factor valence. We conducted a narrative synthesis organizing factors by sociodemographic, personal, and social-environmental categories, with valence classification based on consistency of findings across reviews. Quality appraisal used the Joanna Briggs Institute checklist. From 86 records identified, 11 met inclusion criteria, covering COVID-19 and other diseases (e.g., H1N1, SARS, MERS, Ebola). Quality scores averaged 8.8/10. Protective behaviours were influenced by three categories of factors: (1) sociodemographic (age, gender, education, socio-economic status) (2), personal (perceptions, beliefs, trust in authorities and science, political orientation) and (3) social/environmental (access to protective materials, social norms, community support, health education and communication, policies). Enabling factors included trust in credible sources, perceived effectiveness of measures, and multimodal communication. Barriers comprised misinformation, conspiracy beliefs, and resource inaccessibility. Some factors (e.g., age, gender, education) showed inconsistent effects across behaviours. Findings underscore the need for culturally sensitive messaging, transparent communication, and targeted interventions for vulnerable populations. This umbrella review identifies multi-level determinants of protective behaviours to inform pandemic preparedness. It highlights the need for transparent communication through trusted channels, culturally adapted messaging, equitable access to protective resources, and targeted interventions for low-engagement groups. Integrating these determinants early may enhance population-level adherence. PROSPERO registration number: CRD42023467236.