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The systematic review aimed to systematize the empirical literature on the psychological impact of disability on the siblings of persons with disabilities, to inform research and provide clinical recommendations. Two research questions addressed the review: (1) What are the main psychological constructs investigated in siblings of persons with disability ? (2) What is the main role of each psychological construct in siblings of persons with disability experience ? The electronic search was conducted in 7 databases and the PRISMA diagram was used. The inclusion criteria were: Papers published in English and in peer-reviewed journals; papers published between January 2014 and June 2024; qualitative, quantitative, and mixed studies; and papers on the psychological impact of disabilities and/or chronic illnesses on the experience of siblings of persons with disabilities. The standardized Mixed Method Appraisal Tool protocol was used to appraise the methodological quality of the studies. To summarize the findings, a narrative approach was adopted. A total of 60 studies have been reviewed. According to the methodological quality appraisal of studies, most of them reported a high ( n  = 45) and medium ( n  = 15) quality. They involved 10,146 participants. Findings revealed that sibling relationships, sibling-focused parentification, and emotional/behavioral adjustment are the main psychological constructs investigated by existing literature. Few studies focused on siblings’ well-being. Studies exploring more than a psychological construct were included as a hybrid. Only one study examined the siblings’ psychological experience during the COVID-19 pandemic. The quality of the sibling relationship ranged from good to poor; the caregiver is the main role played by siblings of persons with disabilities; anxiety, depression, and aggressive behaviors are the main emotional/behavioral symptoms revealed. Most studies ( n  = 39) recruited participants with brothers or sisters with mental disorders. The findings of this systematic review may play a role in the clinical field, as they might help to design gender- and age-specific intervention programs.

Background Ethical problems in everyday healthcare work emerge for many reasons and constitute threats to ethical values. If these threats are not managed appropriately, there is a risk that the patient may be inflicted with moral harm or injury, while healthcare professionals are at risk of feeling moral distress. Therefore, it is essential to support the learning and development of ethical competencies among healthcare professionals and students. The aim of this study was to explore the available literature regarding ethics education that promotes ethical competence learning for healthcare professionals and students undergoing training in healthcare professions. Methods In this integrative systematic review, literature was searched within the PubMed, CINAHL, and PsycInfo databases using the search terms ‘health personnel’, ‘students’, ‘ethics’, ‘moral’, ‘simulation’, and ‘teaching’. In total, 40 articles were selected for review. These articles included professionals from various healthcare professions and students who trained in these professions as subjects. The articles described participation in various forms of ethics education. Data were extracted and synthesised using thematic analysis. Results The review identified the need for support to make ethical competence learning possible, which in the long run was considered to promote the ability to manage ethical problems. Ethical competence learning was found to be helpful to healthcare professionals and students in drawing attention to ethical problems that they were not previously aware of. Dealing with ethical problems is primarily about reasoning about what is right and in the patient’s best interests, along with making decisions about what needs to be done in a specific situation. Conclusions The review identified different designs and course content for ethics education to support ethical competence learning. The findings could be used to develop healthcare professionals’ and students’ readiness and capabilities to recognise as well as to respond appropriately to ethically problematic work situations.

Background Comprehensive geriatric assessment (CGA) addresses the bio-psycho-social needs of older adults through multidimensional assessments and management. Synthesising evidence on quantitative health outcomes and implementation barriers and facilitators would inform practice and policy on CGA for community-dwelling older adults. Methods We systematically searched four medical and social sciences electronic databases for quantitative, qualitative, and mixed methods studies published from 1 January 2000 to 31 October 2020. Due to heterogeneity of articles, we narratively reviewed the synthesis of evidence on health outcomes and implementation barriers and facilitators. Results We screened 14,151 titles and abstracts and 203 full text articles, and included 43 selected articles. Study designs included controlled intervention studies ( n  = 31), pre-post studies without controls ( n  = 4), case-control ( n  = 1), qualitative methods ( n  = 3), and mixed methods ( n  = 4). A majority of articles studied populations aged ≥75 years ( n  = 18, 42%). CGAs were most frequently conducted in the home ( n  = 25, 58%) and primary care settings ( n  = 8, 19%). CGAs were conducted by nurses in most studies ( n  = 22, 51%). There was evidence of improved functional status (5 of 19 RCTs, 2 of 3 pre-post), frailty and fall outcomes (3 of 6 RCTs, 1 of 1 pre-post), mental health outcomes (3 of 6 RCTs, 2 of 2 pre-post), self-rated health (1 of 6 RCTs, 1 of 1 pre-post), and quality of life (4 of 17 RCTs, 3 of 3 pre-post). Barriers to implementation of CGAs involved a lack of partnership alignment and feedback, poor acceptance of preventive work, and challenges faced by providers in operationalising and optimising CGAs. The perceived benefits of CGA that served to facilitate its implementation included the use of highly skilled staff to provide holistic assessments and patient education, and the resultant improvements in care coordination and convenience to the patients, particularly where home-based assessments and management were performed. Conclusion There is mixed evidence on the quantitative health outcomes of CGA on community-dwelling older adults. While there is perceived positive value from CGA when carried out by highly skilled staff, barriers such as bringing providers into a partnership, greater acceptance of preventive care, and operational issues could impede its implementation.

Background The concept of rapid implementation has emerged in the literature recently, but without a precise definition. Further exploration is required to distinguish the concept’s unique meanings and significance from the perspective of implementation science. The study clarifies the concept of rapid implementation and identifies its attributes, antecedents, and consequences. We present a theoretical definition of rapid implementation to clarify its unique meaning and characteristics. Methods Rodgers evolutionary concept analysis method, combined with a systematic integrative review, were used to clarify the concept of rapid implementation. A comprehensive search of four databases, including EMBASE, MEDLINE, SCOPUS, and WEB OF SCIENCE was conducted, as well as relevant journals and reference lists of retrieved studies. After searching databases, 2442 papers were identified from 1963 to 2019; 24 articles were found to fit the inclusion criteria to capture data on rapid implementation from across healthcare settings in four countries. Data analysis was carried out using descriptive thematic analysis. Results The results locate the introduction of rapid implementation, informed by implementation science. Guidance for further conceptualisation to bridge the gap between research and practice and redefine rigour, adapting methods used (current approaches, procedures and frameworks), and challenging clinical trial design (efficacy-effectiveness-implementation pipeline) is provided. Conclusions It is possible that we are on the cusp of a paradigm shift within implementation brought about by the need for faster results into practice and policy. Researchers can benefit from a deeper understanding of the rapid implementation concept to guide future implementation of rapid actionable results in clinical practice.

Background “Active aging” is an inclusive term and has been defined from a variety of aspects in different domains throughout the literature. The aim of this review was to identify those aspects that play significant roles in building this concept using an ecological approach. Methods In this study, seven online databases, including JSTOR, Pub-Med, Web of Science, Google Scholar, ProQuest, EBSCO, and Scopus, were searched from 2002 to 2018 for both qualitative and quantitative articles published in English. Two reviewers independently found the related articles using the search terms “active aging” and “built environment” and included both “ageing” and “aging”. Results Of 1500 records which passed the screening stage, 92 were eligible for inclusion in the review. A total of 15 subthemes were derived: (1) personal characteristics, (2) behavioral attitude, (3) land use, (4) access, (5) physical form, (6) cityscape/city image, (7) public open spaces, (8) housing, (9) social environment, (10) cultural Environment, (11) economic environment, (12) good governance, (13) physical health, (14) mental health, and (15) social health. Ecological themes of active aging can be defined as the 5P model: person, processes, place, prime, and policymaking. Conclusions The results of this study can shed light on different aspects of active aging. Also, the results emphasized the significance of the multidimensional nature of active aging, micro (person), meso (process), and macro systems (place and policymaking), based on health (prime) environments. Moreover, the results were based on the relationships between the person and the environment at the individual, interpersonal, and environmental levels, which can be used to conduct future studies and develop policies on aging populations.

Digital platforms have facilitated the emergence of novel entrepreneurial opportunities that rely on a platform for market entry and access to resources. This systematic review synthesizes current knowledge on how platforms impact and shape \"platform-dependent entrepreneurship\" and how platform-dependent entrepreneurs (PDEs) respond to power asymmetries. The results of the review suggest that platforms lower barriers to entry but also lead to PDEs' dependence and precarity. Specifically, platform governance significantly impacts PDEs' behavior by shaping their market access, visibility, and opportunities through various mechanisms. In response, PDEs employ several strategies to preserve their autonomy, such as engaging in multi-homing, capitalizing on branding, and conducting activities outside of the platform. Thus, PDEs' entrepreneurial identity is co-constructed through the interplay of individual agencies and platform dynamics as they navigate tensions in the platform ecosystem. Based on this review, we present a research agenda for the future that has substantial implications for the theory and application of PDEs in the literature.

Background Due to medical advancements the number of children living with life-limiting and life-threatening conditions is rising, meaning more children and their families will require palliative and end-of-life care in the future. While ‘home’ is often the preferred place of end-of-life care, the evidence around best practice for decision-making about place of end-of-life care remains inadequate. Aim To synthesise evidence on the factors influencing decision-making regarding place of end-of-life care for children with life-limiting and life-threatening conditions. Design A systematic integrative literature review. The review protocol was registered in Prospero: CRD42023406800. Data sources CINAHL, MEDLINE, EMBASE, PsycINFO, and Maternal and Infant Health were searched for studies published between 2013 and 2024. Any empirical, peer-reviewed journal articles published in English that included data pertaining to decision-making about place of end-of-life care for children (≤ 18 years) with life-limiting or life-threatening conditions were considered. Quality appraisal was conducted using the Mixed Methods Appraisal Tool. Results Eleven eligible studies were included. Using an iterative process of constant data comparison, four themes were identified, highlighting that (i) consideration of the child, (ii) availability and suitability of end-of-life care services, (iii) parents’ capacity and control in providing care, and (iv) family and sibling well-being were factors influencing decision-making about place of end-of-life care. Conclusion There are a complex range of factors surrounding decision-making regarding place of end-of-life care for children with life-limiting and life-threatening conditions. Studies focused primarily on parents’ perspectives. Further research is needed to identify how to best support decisions about place of end-of-life care for families of children with life-limiting and life-threatening conditions.

Supporting the decision-making process for the production of a 3D-printed hand exoskeleton within the Industry 4.0 and Industry 5.0 paradigms brings new concepts of manufacturing procedures for 3D-printed medical devices, including hand exoskeletons for clinical applications. The article focuses on current developments in the design and manufacturing of hand exoskeletons and their future directions from the point of view of implementation within the Industry 4.0 and Industry 5.0 paradigms and applications in practice. Despite numerous publications on the subject of hand exoskeletons, many have not yet entered production and clinical application. The results of research on hand exoskeletons to date indicate that they achieve good therapeutic effects not only in terms of motor control, but also in a broader context: ensuring independence and preventing secondary motor changes. This makes interdisciplinary research on hand exoskeletons a key study influencing the future lives of patients with hand function deficits and the further work of physiotherapists. The main aim of this article is to check in what direction hand exoskeletons can be developed from a modern economic perspective and how decision support systems can accelerate these processes based on a literature review, expert opinions, and a case study.

This paper aims at characterizing the Autonomous Vehicles (AVs) research field in the areas of management and business in its bibliometric context; identifying strategies, practices and management tools specified in the scope of the investigated publications; summarizing existing evidence, pointing to gaps within this study area. Methodologically, the research is characterized as qualitative and descriptive, drawn by a bibliometric review on the databases; ISI Web of Science, Scopus and Science Direct, followed by a systematic integrative bibliographic review. All the titles and abstracts of the identified articles were analyzed allowing for a research refinement, adopting the exclusion criteria for; a) duplicates; b) not obtained references; and c) misaligned references. The main results pointed out that, in the near future AVs will certainly be inserted in our society, however the way in which this innovation might be established is still surrounded by uncertainties, impacting directly on governments' lack of planning for such arrival (Guerra, 2016). The absence of work related to the business area can be a driving factor, considering that business models plays an extremely important role in the events that precede the AVs' advancement (Yun et al., 2016). Nevertheless, among the analyzed papers, a studies' trend is highlighted, especially in European countries (e. g. U.K. and Germany), related to AVs' business model of \"car-sharing\" (Zakharenko, 2016; Geldmacher, 2016); presenting such as a great substitute for traditional transportation models (cars, taxis and buses) (Enoch, 2015). In this way, it was observed a study gap related to business models and platforms, radical and responsible innovation theories, in order to minimize the risks, impacts and uncertainties of the eminent arrival of AVs and provide the necessary tools to guide governmental and organizational spheres.

This systematic integrative review evaluates the effectiveness of SGLT2 inhibitors in relation to improving glycaemic control, reducing cardiovascular events, and preserving renal function based on the latest published evidence. Search for publications referenced in PubMed, from January 2020 to January 2025, was conducted; 48 abstracts were reviewed, and 27 full-text articles were included for analysis—systematic reviews, meta-analyses, narrative reviews and comparative effectiveness studies. SGLT2 inhibitors are effective in reducing glucose levels, but the magnitude of reduction varies compared to other classes of antidiabetics. A noticeable reduction in the risk of major cardiovascular events, cardiovascular and all-cause mortality was reported, particularly compared to DPP-4 inhibitors and placebo. SGLT2 inhibitors demonstrated the most pronounced and consistent benefits in reducing hospitalisation for heart failure among all other evaluated classes. However, outcomes like myocardial infarction and stroke results were inconsistent. Renal outcomes consistently favoured SGLT2 inhibitors in reducing the risk of acute kidney injury, slowing chronic kidney disease and lowering the risk of end-stage kidney disease. SGLT2 inhibitors provide consistent glucose-lowering, cardiovascular and renal benefits. However, heterogeneity in study designs, patient populations, and treatment durations does not allow drawing definitive conclusions and highlights the need for future research focused on conducting well-designed trials with standardised methodology.