Well-being Of Residents Research Articles

7.F. Scientific session: Living lab Cartesius: multidisciplinary cooperation for health monitoring of an ‘urban blue zone’

Abstract This workshop will be based on health monitoring in living lab Cartesius; a neighbourhood that is currently developed in the city of Utrecht, the Netherlands (Home - Cartesius Utrecht (cartesius-utrecht.nl). The design of this neighbourhood is inspired by the concept of the “blue zones” of Pes and Poulain, places in the world, that they argue are inhibited by the healthiest, longest-living populations because they integrate sustainability, climate adaptation and healthy living. In Cartesius citizens will for example be encouraged to move by inviting outer spaces, meet each other in the community areas and eat healthily nudged by the food options in the food court. An important element of these blue zones is the incorporation of green spaces in the neighbourhood. Examples are (community) parks/gardens, a green walking route around the neighbourhood, trees in the bike parking lots, green facades etc. The neighbourhood is designed to become a home to local species such as plants and animals as well as people. In addition, climate change adaptation is incorporated, the appartements are well insulated and contain solar panels and green and white roofs. Preventing heat stress is considered in the green design of the outdoor spaces and special drainage and water storage equipment throughout the neighbourhood. The municipality has been closely involved in this project from the start, they created the call for developers to create a healthy urban neighbourhood and after selecting the Cartesius project they have remained involved in its development. Of special interest to the municipality is community building (in new neighbourhoods) in order to strengthen social cohesion and prevent loneliness. We will conduct a research on this topic of which the results could permanently impact how new neighbourhoods in Utrecht will be approached. Designers, developers, research institutes, governments and the current inhabitants are now collectively working on a holistic monitoring programme in this neighbourhood to collect evidence for the effects of the “blue zone” interventions and design choices on behaviour, health and well-being of residents. This workshop will focus on various aspects of the Blue Zone Concept, the importance of green in urban living, the participatory role of local residents, the role of stakeholders and the relevance for local governance. First of all the participants will be informed about a unique healthy/green urban living concept based on the blue zones currently in development. The participants will get insights in the process of developing a new healthy neighbourhood where different challenges (e.g. climate adaptation, community building, healthy living environment) are experimented with stakeholders from the quadruple helix (private, government, science and societal stakeholders). Simultaneously, we want to allow room for ample time for audience interaction to share their experiences on similar multi transdisciplinary cooperations and monitoring strategies. Key messages • This session will provide room for knowledge exchange in the area of healthy urban living and transdisciplinary collaboration. • Specific focus on holistic monitoring of the effectiveness of health interventions in urban living areas and (international) policy implications. The concept of Cartesius The workshop will start with a presentation about the concept of the Cartesius neighbourhood. The incorporation of the elements of the Blue Zones will be discussed and images of both the current state of the development and artist impressions of the future finished neighbourhood will be presented. Room for (among other topics) discussion about the ‘translation’ of the blue zone concept to this urban area. This presetntation will be done by Marije Lammers (University Utrecht, postdoc and coordinator monitoring programme healthy urban living in Cartesius) Incorporating citizens in monitoring 300 appartements in Cartesius are already realized, in which +/- 600 citizens are currently living. In a time span of about 8 years the number of apartments will have increased to 3000, with about 6000 inhabitants. The current citizens are involved in designing the monitoring strategy and community building approach. In order to measure effectively whether the health interventions in Cartesius will impact the citizens’ health their involvement and cooperation is crucial. Room for (among other topics) discussion about involving citizens in monitoring and community building effectively. WHO Europe Healthy Cities This presentation will discuss how developments in the Cartesius neighbourhood are in line with WHO Europe Healthy Cities ambitions for bringing about change and achieving improved health, well-being and equitable and sustainable development in cities across the European Region and globally. Room for (among other topics) discussion about possibilities for international knowledge exchange and applications. This presentation will be by: Kira Fortune, Regional Advisor, Healthy Cities, Health Promotion and Well- being, World Health Organization

Physical activity promotion in Aged care: a participatory approach

Abstract Introduction Aged care facilities (ACF) constitute an increasingly important, yet challenging setting for health promotion - given it is a highly sedentary pseudo-total institution characterized by structured daily routines within a paradigm of care for residents perceived as fragile and vulnerable. A participatory approach with residents, significant others, staff, and management might be a promising pathway to address intrapersonal, sociocultural, organizational, environmental, and political determinants of physical activity in this specific context. We will present processes and results from a research project, funded by the German Ministry of Health (2019-2023), on physical activity promotion in ACFs. Methods Our co-creation approach involved residents, significant others, staff, and management from seven nursing homes in Southern Germany. Methods included 800hrs on-site observations, semi-structured interviews (n = 31), Photovoice (n = 27 participants, n = 169 photos), as well as future workshops (n = 14) for intervention co-development (n = 14) and co-evaluation workshops (n = 7). Data analysis used reflexive thematic analysis with MaxQDA20. Results Implemented interventions (n = 57) addressed individual, social, environmental, and organizational factors. Activity promotion was integrated into care concepts and mission statements, staff work descriptions, as well as informal internal routines. Of the interventions implemented, 33% were rated as more successful, 43% as successful, and 19% as less successful than anticipated. Conclusions Participation can initiate structural and cultural change towards physical activity. However, the analyses also emphasized the critical role of staff training, along with the involvement of significant others and external service providers, as essential components for achieving sustainable change. Key messages • Participatory approaches integrate physical activity into aged care, fostering cultural shifts for resident well-being. • Success requires staff training, engaging residents’ support networks, balancing empowerment with protection.

The Impact of Virtual Immersive Public Art on the Restorative Experience of Urban Residents

This study explores the role of virtual immersive public art in improving the psychological well-being of urban residents. The research is set in the context of urban environments, where virtual immersive public art has the potential to foster innovation, integrate technology, and organically blend into public spaces. The study evaluates the impact of such art on psychological restoration by focusing on three key dimensions: interactive themes, interactive mechanisms, and artistic characteristics. A questionnaire survey was conducted to collect participants’ real-life experiences and reactions to these art installations. The results show that virtual immersive public art significantly contributes to the restorative experience of urban residents, offering valuable insights into how these installations can promote mental health. Based on the findings, the study provides practical design recommendations for incorporating virtual immersive public art into future urban planning and design projects to enhance urban living conditions and support psychological recovery.

Having to ‘go beyond’: Staff perspectives on activity programs for older people living in nursing homes

Activity programs are run by many nursing homes (also known as residential aged care facilities or long-term care facilities) however little is known about how activities are chosen or how well they meet the needs of residents. The aim of this study was to learn more about activity programs currently offered to older people living in nursing homes in Victoria, Australia. Interviews were undertaken with 13 activities/lifestyle staff working across six nursing homes. Staff were asked about their role and training; how activities were chosen, run, and evaluated; and barriers to providing social participation opportunities for residents. Thematic analysis of interview transcripts revealed six main themes: the role of the activities staff is to make people happy and meet their needs; activities staff largely choose (group based) activities; evaluation of activity programs is mostly informal; activity programs are poorly resourced; staff are often required to ‘go beyond’; and catering to the unique needs of residents is challenging. Given the established importance of social interaction to physical and psychosocial health, it is essential that activity programs and staff are viewed as integral to resident wellbeing; that staff are trained and supported; and that programs are funded and resourced adequately to deliver programs that are person-centred and meet the needs and preferences of residents.

DETERMINANTS INFLUENCING MADEIRA ISLAND'S SUSTAINABLE DEVELOPMENT POLICIES AS AN ECO-TOURISM DESTINATION: AN EMPIRICAL STUDY

Objective: Based on the standards of Global Sustainable Tourism Council and the participants' experiences at destination, the current study aims to reflect and survey among visitors to Madeira Island about the primary challenges to be taken into consideration for the development of sustainable policies for the tourist destination. Method: 1136 valid questionnaires were collected and statistical treatment was carried out. In order to create value, replicate it in the economy, and improve the well-being of both residents and visitors to the Destination, all parties involved in the Sustainable Destination certification process. Results and Discussion: The findings hold significance for an enhanced comprehension of the phenomena intrinsic to the Madeira Eco-Tourist Destination. Research Implications: The practical implications of the research were to recommend ways in which political decision-makers and companies in the tourism sector can improve their performance in the process of certifying the Madeira Islands destination as an Eco-Tourism destination with sustainability concerns. The research is relevant to the enrichment of literature at the level of Portuguese-speaking academia, in the panorama of global and island studies, particularly in the development of socioeconomic policies for sustainable tourism. Originality/Value: This study contributes to the growing body of knowledge on the border between the management of tourism destination certification projects based on sustainability and tourism innovation/promotion and can contribute something new for both professionals and policy makers in the formulation environment. of sustainable development policies for destinations.

Low-cost urban heat environment sensing device with Android platform for digital twin

The proper monitoring of heat and meteorological variables is essential for the well-being of residents of metropolitan areas. It is challenging to configure spatial heat variations in complex urban environments, even though the temporal variation of urban heat flux has been measured at several designated monitoring stations. Neither the budget nor existing techniques for efficient urban heat monitoring are sufficient for a digital twin of the urban heat environment. As a result, we have developed a low-cost monitoring system that can be easily integrated into a portable pedestrian device, kickboard, or electric bike. With this system, citizens can collect information about urban heat, such as air temperature, surface temperature, relative humidity, barometric pressure, light intensity, and micro-geophysical features including topological aspects and mobile information (e.g., three-dimensional accelerations). Citizens can participate in daily scientific activities using these devices, which facilitate data acquisition and information exchange in urban digital twin environments.

Overtourism perception among residents in a rural proximity destination during the COVID-19-pandemic – The writing on the wall for a sustainability transition of tourism?

Abstract This contribution investigates overtourism perceptions among residents in a rural German destination during the COVID-19 pandemic. Using a qualitative approach, it examines the impact of these perceptions on residents’ quality of life and subjective well-being in the Allgäu. As international travel declined due to pandemic-induced travel restrictions, domestic tourism surged, potentially foreshadowing effects of a net-zero transformation in global tourism on rural proximity destinations. Semi-structured interviews with 12 residents reveal that most respondents perceived tourism levels as excessive, negatively impacting their subjective well-being. Changed spatio-temporal visitor behavior patterns, with tourists venturing into previously less frequented areas, often felt intrusive to locals. This shift in tourism dynamics from urban hotspots to rural destinations challenges the notion that overtourism disappeared during the pandemic. Notably, the contribution introduces subjective well-being as a reliable indicator for overtourism and explores a novel notion of overtourism resulting from the interrelationship between perception, subjective well-being, and attitudes. The findings suggest that increased proximity tourism, while reducing carbon footprints, may lead to perceived overtourism and declining tourism acceptance in substitute destinations. The study underscores the necessity for participatory destination management approaches that balance sustainability goals with resident well-being to facilitate a broader sustainability transition in tourism.

The directors of resident support program: a program evaluation of a resident well-being and support innovation

BackgroundMedical training can be a challenging time for residents both professionally and personally. Resident support programs must be able to address a range of potential experiences, be accessible and easy to navigate, and consider the unique context of residency. Rigorous evaluation of resident support programs is needed to determine whether these programs are meeting these goals.MethodsThe Directors of Resident Support (DRS) program, launched in January 2021 at the Cumming School of Medicine at the University of Calgary, is a near-peer support model consisting of three faculty physicians, trained in peer support, who receive contacts from residents needing support for any issue. DRS physicians provide empathetic listening, referral to existing resources, and peer support for residents. A multisource evaluation of the DRS program, including field notes, data collection forms, and surveys, was guided by the Donabedian framework.ResultsThere were 62 total contacts in the 2-year evaluation period which required a median 2 h to address (range 5 min to more than 40 h). The most common topic for contact was to discuss feedback or evaluation (n = 10, 24.4%) and the most common response was listening and support (n = 29, 70.7%). Residents also contacted DRS to discuss experiences of racism, physical assault, sexual harassment, and mental health crises. Residents (n = 13) rated a median score of 74 out of possible 100 for usefulness (interquartile range [IQR] 1-100, with higher scores suggesting greater usefulness). Free text survey responses suggested that residents felt validated by contact with the program though some residents felt that additional follow-up would have been helpful.ConclusionThe DRS program has been well-utilized by residents for a variety of issues. Postgraduate Medical Education offices seeking to create resident support programs may anticipate that about 3% of residents may use a similar program per year and that the typical interaction would last 2 h, with a wide range. Feedback suggested that similar programs should have a formal process for follow-up with residents to ensure their concern was addressed and that resident supporters should have diverse lived experiences.

Evaluation of a pathology resident wellness initiative: Initial establishment and subsequent expansion through a time of high stress, the COVID-19 pandemic.

Recent studies have shown that the pathology workforce is at risk of decreased workplace well-being, which may lead to decreased job satisfaction, increased attrition, burnout, depression, anxiety, and suicidality, but there has been relatively little research on well-being initiatives designed for pathologists, pathology trainees, and laboratory professionals. Some studies have suggested that well-being initiatives may decrease burnout and increase workplace satisfaction and engagement. Here we describe the creation of a Pathology Wellness Committee in a large residency program. Interventions included emotional, social, and physical well-being interventions as well as system-based improvements. Additional initiatives were introduced in response to the increased stress, isolation, and social distancing guidelines during the height of the COVID-19 pandemic. The program's impact was measured by an annual House Staff Council Resident Wellness Survey over 4 years. The annual surveys showed improvements in workplace and residency program satisfaction and emotional well-being following system-based improvements and well-being initiatives. Physical and social well-being showed slight but not statistically significant decreases over the 4-year period. Results from the annual Accreditation Council for Graduate Medical Education Survey were also evaluated. We found that dedicated well-being initiatives in conjunction with system-based interventions may help improve overall well-being in pathology residents.

Process Groups for Supporting Resident Wellbeing: Factors Influencing Resident Wellness amid the COVID-19 Pandemic.

Background: Burnout is a well-recognized problem among resident physicians. The COVID-19 pandemic impacted the dynamics of the patient/resident relationship and introduced new stressors for medical trainees, such as new restrictions in the hospital, increased patient death, and uncertainty around safety. There is limited research on the implementation of group therapy for residents to address issues of wellbeing and burnout during the pandemic. Method: In response to perceived burnout amongst internal medicine residents, a university-based internal medicine residency program in the Northeast United States implemented process groups, a form of group therapy, in the curriculum. These sessions were held hourly once every five weeks for each cohort of twelve residents during the academic year. We sought to measure resident burnout and identify themes that impacted wellbeing to facilitate the intervention of process groups during the pandemic. In 2021 and 2022, internal medicine residents were invited to complete the Maslach Burnout Inventory (MBI) and answer two open-ended questions about the factors that most negatively and positively influenced their wellness. Results: Of the 134 participants, 82% had high emotional exhaustion or depersonalization. The most prevalent themes hindering wellness were negative personal interactions at work, most notably rude behavior by patients, unsupportive attendings, residency program expectations, and work intensity. Findings unique to the pandemic include social isolation from family, distress from poor outcomes, and fear of contracting or spreading the virus. The most prevalent themes for supporting wellness were personal life, camaraderie, professional satisfaction, and program structured support. Conclusions: Our findings suggest that programs can tailor structured support to improve wellness, despite the presence of significant stressors.

The impact of subjective intergenerational mobility on well-being: evidence from China

Although social mobility has been shown to be essential for subjective well-being, empirical evidence on the relationship between subjective intergenerational mobility and well-being in the developing world is relatively limited and needs to be more comprehensive and conclusive. The primary purpose of this research was to investigate the impact of subjective intergenerational mobility on the well-being of Chinese residents. Using data from the China Labor Force Dynamics Survey conducted from 2012 to 2016, the results revealed an upward trend in the subjective intergenerational mobility of Chinese residents. Specifically, subjective intergenerational elasticity increased from 0.264 in the 1950s to 0.390 in the 1980s. Subjective intergenerational mobility positively influences well-being. In particular, it exerts an indirect positive effect on the well-being of Chinese residents through the self-evaluation of health and social inequality. This study also proves that the subjective Great Gatsby Curve exists in China. The practical implications of this research are that the human capital of Chinese residents should be improved and that restrictive institutional systems should be discontinued to improve residents’ subjective social status.

A COVID question: the impact on our nursing home residents

COVID-19, a novel coronavirus which targets the respiratory system, has had a significant impact on Irish nursing homes. The virus was declared a global pandemic in March 2020, and as of 14th June the Health Protection Surveillance Centre has reported 258 clusters of cases in nursing homes, comprising 21% of all cases in Ireland and associated with 943 deaths. This pandemic is a source of many ethical dilemmas — an example being the ethical issues arising from enforced social isolation imposed on residents during lock-down. The cocooning of residents in nursing homes raises a question with no simple answer — does the risk this isolation poses to the wellbeing of elderly residents outweigh the benefits of such strict measures to protect them from COVID-19? The adverse effects of isolation, although relevant in any infectious outbreak, are compounded in this instance by the unprecedented scale of the coronavirus pandemic and the immense pressure on the healthcare system as it faces this new threat to health. Even in the chaos of a global pandemic, the ethical principles at the root of all healthcare decisions, namely non-maleficence, beneficence, autonomy, and justice remain pertinent.

Last defense in climate change: Assessing healthcare inequities in response to compound environmental risk in a megacity in Northern China

The compound risk of extreme heat and air pollution in the context of climate change has become an important challenge for megacities in Northern China. Severe spatial differences exist in healthcare facilities, which are the last defense to protect the health of residents. Understanding the match between compound risks and healthcare services is important for ensuring the basic well-being of residents. We selected 255 census units in Tianjin to comprehensively assess the healthcare services and risks of hazards, exposures, and social vulnerabilities in order to explore the match between risks and services. We quantified and graded environmental quality on a 5-point scale and investigated inequalities in risk-service relationships across different regions using correlation analysis, analysis of variance (ANOVA), and LISA. The results showed that: (1) the level of compound risk and the variability of risk increased with environmental degradation, main urban areas exhibited the highest level of risk, while suburban and district centralized construction areas demonstrated significant variability in risk; (2) the relationship was significantly imbalanced between healthcare services and risk in suburban and peripheral districts and counties, while the main urban areas and rural areas showed high and low levels of matching respectively; and (3) blue-green spaces could effectively alleviate the pressure on healthcare services in the main urban area and rural area. The results obtained in this study provide references for healthcare allocation strategies in areas with different degrees of environmental degradation, and we call for further planning of healthcare facilities in megacities to enhance their ability to adapt to climate change risks.

Interventions to Support Resident and Fellow Well-Being During the COVID-19 Pandemic: A Scoping Review.

Background The COVID-19 pandemic led to rapid and wide-scale changes in graduate medical education and impacted the well-being of frontline physicians, including residents and fellows. While institutions and programs implemented initiatives to support the unique needs of trainees during the pandemic, there remains a gap in the literature in examining the approaches used, the domains of well-being addressed, and the effectiveness of these efforts. Objective To review the literature on interventions designed to promote resident and fellow well-being during the COVID-19 pandemic. Methods The authors conducted a scoping review of the literature published between January 1, 2020, and November 30, 2023, in PubMed, Scopus, Embase, PsycINFO, CINAHL, and ERIC to identify interventions to promote the well-being of trainees during the COVID-19 pandemic. Results Eighteen articles met inclusion criteria, mainly studies conducted in the United States (14 of 18, 77.8%). Most interventions targeted psychological well-being (16 of 18, 88.9%), with only a few studies that included interventions in the physical or social domains. Interventions entailed redeployment, schedule modifications, communication strategies, and expanded mental health support. Most interventions were limited to a few weeks' duration in the first surge phase of the pandemic. Only 11 studies (61%) reported outcome measures, and only 2 (11%) used instruments with validity evidence. Most studies did not report sufficient data to evaluate study quality. Conclusions While longer-term outcome data were often lacking, studies described a range of interventions to support resident well-being. Future research should focus on the effectiveness of well-being interventions and include cohorts from more diverse clinical settings.

Burnout and Well-Being in Trainees: Findings From a National Survey of US Obstetrics and Gynecology Residents.

Background Despite national attention on resident well-being, challenges persist. Effective solutions require greater understanding of personal and program factors. Objective To explore burnout, resilience, self-reported mental health, and perceptions of the learning environment in a national sample of obstetrics and gynecology (OB/GYN) residents. Methods An observational cross-sectional survey of OB/GYN residents taking the January 2022 national in-training examination included an abbreviated 2-item Maslach Burnout Inventory, a short version of the Connor-Davidson Resilience Scale, and subjective experience of other factors. Kruskal-Wallis and chi-square tests explored differences in outcomes and associations between variables. Results Among 5761 residents taking the examination, 3741 (64.9%) participated, with 2425 of 3741 (64.8%) reporting burnout, 2138 (57.2%) depression, 2651 (70.9%) anxiety, and 147 (3.9%) suicidal ideation. Women fared worse than men in terms of burnout (2105 of 3147, 66.9% vs 281 of 496, 56.7%, P<.001), depression (1843 of 3147, 58.6% vs 256 of 496, 51.6%, P=.004), anxiety (2318 of 3147, 73.7% vs 294 of 496, 59.3%, P<.001), and resilience (5.9±2.1 vs 6.2±2.1, P=.006). More nonbinary residents considered leaving residency (17 of 49, 34.7% vs 676 of 3147, 21.5% [women] and 108 of 496, 21.8% [men], P=.008). Race-based differences were seen in depression, suicidal ideation, and thoughts of leaving residency. Increased binge drinking was reported with increasing postgraduate year. Among 614 residents reporting that well-being was not a priority in their program, 539 of 614 (87.8%) reported burnout, 469 of 614 (76.4%) depression, and 508 of 614 (82.7%) anxiety. Conclusions Residents report high rates of mental health concerns, and these are worse among women, gender nonconforming individuals, Black residents, and those who perceive well-being is not a priority in their training program.

Association between public and private greenspace availability and electricity consumption

Natural environment including greenspace has been suggested to be beneficial for health and well-being of urban residents. Several mechanisms have been proposed, including mitigation of environmental stressors, such as air pollution, and thermal stress. However, the role of greenspace on reducing electricity consumption in the urban environments has not yet been reported using these mechanisms. The present study used the annual electricity consumption of Yazd city dwellers in the period (2016–2019) and examined its association with different greenspace indicators at their residential addresses. Different private and public greenspace indicators were defined, including private garden access and area, distance to the nearest park (regional and local), percentage of land covered with urban greenspace and residential surrounding greenness (by normalized difference vegetation index [NDVI]) at different buffer size around residential addresses. Different demographic, urban design and contextual variables were included as the covariates in the models. An inverse association was found between the increase of greenspace in a private garden and the amount of electricity consumption in all the included buildings. One-unit increase in NDVI was significantly associated with 2046.5 kWh/y lower electricity consumption (95 % CI: 1151.79: 2941.21). An increase of 1 m2 in the area of a private garden was associated to 1.2 kWh/y lower energy consumption. A stronger association was also found between the private garden area and lower electricity consumption in contemporary urban texture compared to two other urban texture (contemporary urban texture: β: −1.97, 95 % CI: −2.39 to −1.54, old urban texture: β: −1.21, 95 % CI: −1.97 to −0.46, and historical urban texture: β: −0.25, 95 % CI: −1 to 0.49). The results of this study can strengthen previous theories about eco-friendly cities and sustainable cities. Promoting availability and access to greenspace can help urban sustainability through lower energy consumption.

COVID-19 and Its Influence on Prevalence of Dementia and Agitation in Australian Residential Aged Care: A Comparative Study

Agitation is one of the most common and persistent behavioral and psychological symptoms among persons with dementia (PWD) in residential aged care facilities (RACFs). While most studies have explored the general impact of COVID-19 on the mental health and well-being of aged care residents, there has been limited research on the pandemic’s impact on agitation in dementia within RACFs. This knowledge is crucial to ensuring that RACFs are better equipped to handle future public health emergencies. Therefore, this retrospective cohort study investigates the impact of the pandemic on agitation incidents within 40 Australian RACFs. Using Python, we extracted agitation symptoms from nursing notes and compared the frequency and percentage of symptom occurrence pre-pandemic versus during-pandemic. Chi-square tests examined any significant change in the prevalence of dementia and agitation in dementia between the comparative groups and periods. Dementia prevalence dropped significantly during the second year of the pandemic, with a concurrent increase in early-onset dementia cases. Overall, agitation symptoms decreased by 20.1%, but six symptoms significantly increased: resisting (28.98%), wandering (11.78%), restlessness (3.19%), complaining (10.1%), arguing (2.36%), and outbursts (1.74%). Conversely, pacing decreased by 15.88% and speaking loudly decreased by 10.9%. Over half of the care recipients with dementia experienced agitation symptoms 2–5 times each year, increasing from 50.56% in 2019 to 58.28% in 2021. Despite the co-occurrence of symptoms such as falls, confusion, and weakness, there was no evidence to suggest that these comorbidities were specific to COVID-19; rather, they appeared to be prevalent even before the pandemic. Persons with agitation in dementia had a significantly higher death rate during the COVID-19 pandemic than otherwise.

Associations between workplace social capital, well-being, and work engagement in medical residents: a multicenter cross-sectional study

BackgroundWorkplace social capital (WSC), a social resource available within work or occupational environments, has been identified as an important factor for employees’ health in fields other than medical education. However, little is known about whether WSC is associated with well-being and work engagement among medical residents. The aim of this study was to examine the relationships between WSC, well-being, and work engagement specifically among medical residents.MethodsThis cross-sectional study was conducted at 32 hospitals in Japan, assessing WSC with the Japanese medical resident version of the Workplace Social Capital (JMR-WSC) scale. Well-being and work engagement were measured as the primary and secondary outcomes using the Subjective Well-Being Scale and the Japanese version of the Utrecht Work Engagement Scale.ResultsWe analyzed data from 276 residents. Adjusting for possible confounders, the JMR-WSC Scale scores were associated with well-being in a dose-dependent manner (adjusted mean difference 6.55, 95% CI 4.96–8.15 for the WSC highest score quartile, compared with the lowest score quartile). The WSC Scale scores demonstrated a dose-dependent association with work engagement (adjusted mean difference 15.12, 95% CI 11.66–18.57 for the WSC highest score quartile, compared with the lowest score quartile).ConclusionsThis study showed that WSC was linked to enhanced well-being and work engagement among residents. Our findings offer insights for developing interventions to prevent resident burnout and create an environment conducive to residents’ well-being and engagement.

The effect of dwelling size on the mental health and quality of life of female caregivers living in informal tiny homes in Hong Kong

BackgroundAlthough the adverse impact of substandard informal housing has been widely documented, most studies concentrated on developing societies, thereby leaving informal housing in developed regions underexplored. This study examines Hong Kong, where limited dwelling size is a distinctive feature that characterises informal housing, to explore the impact of housing informality on mental health, with a particular focus on dwelling size. It centers on subdivided units (SDUs), which are tiny compartments partitioned from a large domestic quarter, to understand how housing informality and housing size affect the mental well-being of female caregivers, who typically bear the brunt of the housework.MethodsIn partnership with nongovernment organisations in three SDU-abundant districts, this mixed-methods study conducted a survey on 413 female caregivers aged 18—65 and qualitative research combining ethnographic observations and in-depth interviews on 36 families living in SDUs in Hong Kong between 2021 and 2023. The mental health outcomes and health-related quality of life (HRQoL) of the participants were assessed by using the Depression, Anxiety, and Stress Scale-21 and a EuroQol-5 Dimension-5 Level questionnaire.ResultsDepression, anxiety and stress were prevalent across the female caregivers living in SDUs (12.4%), as well as a significantly lower HRQoL compared with that of the general population (0.882 vs. 0.919). Findings showed that a total floor area smaller than 13.0 m2 was associated with increased likelihood of experiencing anxiety and depression and reduced HRQoL. Cramped living space adversely affected the caregivers’ well-being through the 1) physical, 2) relational and 3) personal aspects of home experiences. Negative experiences at home can cause housework burnout, exacerbate family conflicts and lead to feelings of repression and low self-efficacy.ConclusionsThis study contributes to the understanding of the consequences of housing informality in diverse geographical contexts and illuminates the effect of dwelling size by identifying the mechanisms through which housing size can affect the mental well-being of residents, which may vary depending on their family status. The findings yield important policy implications, including the need to establish a minimum space standard for subdivided residential dwellings and ensure equitable access to community spaces for deprived families.

Exploring the impacts of urbanization on vegetation growth from the perspective of urban expansion patterns and maturity: A case study on 40 large cities in China

Rapid urbanization replaces vegetation with build-up land, which threatens green spaces and the well-being of residents. In this study, the urban expansion patterns (UEPs) of build-up land from 2000 to 2020 were identified for 40 typical large cities in China, and their urban maturity (UM) was quantified. The different UEPs and UM types were used to analyze the comprehensive impacts of different types of cities on vegetation growth at different urbanization expansion intensity gradients. Finally, the relationship between different driving forces and the urban ecological effects was explored. The results showed that mature cities and the infilling cities experienced vegetation loss while other UEPs and UM levels resulted in increased vegetation growth. In particular, laggard cities and looser UEPs were able to effectively offset the direct vegetation loss caused by urbanization. The UM level had a high driving effect on the urban ecological offset. In the future, the scale and speed of urbanization can be optimized to reasonable levels and the urban ecological restoration should be strengthened to meet the needs of ecological security. This study contributes to explore the effectiveness of the urbanization process and land management.