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Robotic surgery in healthcare: current challenges, technological advances, and global implementation prospects.
No full textRobotic surgery has transformed the field of surgery, offering enhanced precision, minimal invasiveness, and improved patient outcomes. This narrative review explores the multifaceted aspects of robotic surgery, examining the challenges, recent advances, and future prospects for its integration into healthcare. Our comprehensive analysis of 48 studies reveals significant geographic disparities in robotic surgery research and implementation, with 68.8% of studies originating from high-income countries. Despite its potential, the widespread adoption of robotic surgery faces significant obstacles, including high costs, training requirements, limited accessibility, and ethical considerations. Financial constraints make it difficult for resource-limited healthcare facilities to afford these systems, whilst the absence of standardised training restricts the pool of proficient robotic surgeons. Furthermore, ethical and medico-legal concerns about liability and patient consent complicate its adoption. Advances in artificial intelligence (AI) and machine learning (ML) are enhancing robotic systems with real-time decision support and personalised surgical approaches. In addition, telemedicine and remote robotic surgery show promise for expanding access to underserved areas. Looking forward, the development of affordable, portable robotic systems and integration of data-driven analytics are key to addressing current challenges and optimising patient care. This review provides a globally minded analysis of implementation barriers and identifies critical needs for more inclusive research and culturally appropriate solutions for diverse healthcare contexts. A multi-stakeholder approach involving policymakers, healthcare providers, and technology companies is crucial for overcoming these barriers and realising robotic surgery's full potential. As solutions to cost, training, and accessibility emerge, robotic surgery is expected to become a fundamental component of healthcare, offering substantial improvements in patient outcomes and operational efficiency. [Abstract copyright: © 2025. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.
From Pressure to Potential: How SMEs Leverage Blockchain for Sustainability under Institutional, Paradoxical, and Resource Constraints
Get PDFBlockchain technology (BCT) has garnered significant attention as a catalyst for advancing sustainability in small and medium-sized enterprises (SMEs). However, extant research has often relied on single-theory perspectives or has emphasized either technological potential or compliance imperatives, thereby overlooking the complex and context-dependent nature of BCT adoption. This study develops an integrative conceptual framework that synthesizes institutional theory, paradox theory, and the resource-based(RBV) view to elucidate the dynamics underpinning BCT adoption for sustainability in SMEs. The framework posits that adoption is not solely driven by external institutional pressures such as regulatory, normative, and mimetic forces but is fundamentally facilitated by the internal paradoxical tensions SMEs face and their distinctive organizational resources and capabilities. By highlighting the coexistence of opportunity and risk including enhanced transparency, traceability, technical complexity, and environmental impacts this study reveals that SME blockchain adoption is best understood as a dynamic, non-linear, and context-sensitive process. The framework advances the literature by demonstrating how the ability to navigate institutional and paradoxical pressures is contingent upon firm-level learning orientation, adaptive capacity, and resource endowments
Artificial intelligence in Nigerian nursing education: Are future nurses prepared for the digital revolution in healthcare?
Get PDFAim/Objective
This study aims to assess the knowledge, exposure, and willingness of Nigerian nursing students to integrate artificial intelligence (AI) into healthcare, identifying gaps that may hinder its adoption.
Background
AI is revolutionizing healthcare through improved diagnostics, predictive analytics, and automated administrative processes. However, research on AI awareness and adoption among nursing students in low- and middle-income countries (LMICs), particularly in Nigeria, remains limited. Understanding the preparedness of future nurses for AI integration is crucial for optimizing healthcare delivery and education.
Design
A cross-sectional study design was employed to evaluate AI knowledge, exposure, and adoption readiness among nursing students in Nigeria.
Methods
The study involved 676 nursing students from five universities in Nigeria. A structured questionnaire was administered to assess sociodemographic characteristics, AI knowledge, exposure to AI facilities, and willingness to adopt AI technologies. Data were analyzed using descriptive and inferential statistics with Microsoft Excel and JASP 0.19. Associations were tested using ANOVA and Chi-square tests at a 95 % confidence interval (p < 0.05).
Results
Findings revealed that 98 % of students had low AI knowledge, with only 1.8 % demonstrating average knowledge and 0.15 % showing high knowledge. Despite this, 85.5 % were willing to take AI training, and 92.6 % believed AI could enhance healthcare workflow. However, concerns regarding inadequate infrastructure (43.5 %) and privacy issues (37.1 %) were prevalent. Significant associations were found between AI knowledge and location, self-perception, and willingness to train (p < 0.001).
Conclusions
The study highlights critical knowledge gaps in AI among Nigerian nursing students despite a high willingness for adoption. AI education should be integrated into nursing curricula, and infrastructure improvements are necessary to support AI implementation in healthcare. Addressing these gaps will better prepare nursing students for the evolving landscape of AI-driven healthcare
L1 Attrition vis-à-vis L2 Acquisition: Lexicon, Syntax-Pragmatics Interface, and Prosody in L1-English L2-Italian Late Bilinguals
Get PDFLate bilingual speakers immersed in a second language (L2) environment often experience the non-pathological attrition of their first language (L1), exhibiting selective and reversible changes in L1 processing and production. While attrition research has largely focused on long-term residents in anglophone countries, examining changes primarily within a single L1 domain, the present study employs a novel experimental design to investigate L1 attrition, alongside L2 acquisition, across three domains (i.e., the lexicon, syntax-pragmatics interface, and prosody) in two groups of L1-English L2-Italian late bilinguals: long-term residents in Italy vs. university students in the UK. A total of 112 participants completed online tasks assessing lexical retrieval, anaphora resolution, and sentence stress patterns in both languages. First, both bilingual groups showed comparable levels of semantic interference in lexical retrieval. Second, at the syntax-pragmatics interface, only residents in Italy showed signs of L1 attrition in real-time processing of anaphora, while resolution preferences were similar between groups; in the L2, both bilingual groups demonstrated target-like preferences, despite some slowdown in processing. Third, while both groups showed some evidence of target-like L2 prosody, with residents in Italy matching L1-Italian sentence stress patterns closely, prosodic attrition was only reported for residents in Italy in exploratory analyses. Overall, this study supports the notion of L1 attrition as a natural consequence of bilingualism-one that is domain-and experience-dependent, unfolds along a continuum, and involves a complex (and possibly inverse) relationship between L1 and L2 performance that warrants further investigation
The effect of physical activity on cardiorespiratory fitness and markers of cardiovascular disease risk during menopause: A systematic review and meta-analysis of randomised-controlled trials.
No full textPurpose
The menopause transition is associated with increased cardiovascular disease (CVD) risk. Cardiorespiratory fitness (CRF) is inversely associated with CVD risk in healthy populations. CRF thus represents a responsive target for physical activity (PA) interventions in menopausal populations. The aims were: (1) to investigate the impact of PA interventions on CRF and CVD risk factors, respectively, in perimenopausal and menopausal women, and (2) to examine the association between changes in CRF and CVD risk factors following PA interventions.
Methods
Five databases (PubMed, EMBASE, Web of Science, CENTRAL, SPORTDiscus) were searched from inception to December 2023 for randomised controlled trials of PA interventions in menopausal females with non-active controls. The primary outcome was CRF, presented as VO2max. The Cochrane Risk of Bias Tool was used to assess bias. Heterogeneity was observed using I2. Effect measures were presented as Mean Difference (MD) with 95% Confidence Interval (CI). Meta-regression was conducted to examine the relationship between changes in VO2max and reduction in CVD risk.
Results
Seventy-eight studies with 5332 participants were included in meta-analysis. For VO2max, there was a favourable effect of exercise versus control (3.51 mL/kg/min, 95% CI 2.75 to 4.27, 1968 participants, 30 trials). Considerable heterogeneity was observed. Meta-regression indicated a small, significant inverse association between changes in VO2max and changes in systolic blood pressure in sensitivity analysis.
Conclusions
All types of PA improved CRF. Moreover, improvements in CRF through PA intervention may be associated with concomitant reductions in systolic blood pressure, which is a major risk for CVD. Many outcomes had unexplained heterogeneity and unclear risk of bias due to lack of transparent reporting. Future research should investigate age and PA intensity as moderator variables. Future RCTs should focus on transparent reporting
Agritourism Marketing in Africa: Exploring Digital and Social Media Strategy
No full textThis edited volume takes a multi-faceted approach, giving readers insights into the role of digital and social media marketing in the agritourism industry in Africa. Each chapter provides some theoretical, policy and practical implications for policy makers, educational practitioners, students and business communities on how agritourism’s digital and social media marketing strategies could be of benefit to them. It considers macro, micro and firm-level analyses relating to how agritourism digital and social media marketing could be harnessed to fuel tourism corporate brands development in under-researched African contexts. Its empirical case studies provide scientific evidence-based approaches that inform understanding on the contribution of these antecedents to the realisation of tourism corporate brands development. The book balances theory and experimentation, providing a thorough explication of the tools and techniques of agritourism digital and social media marketing, marketing, corporate communications and corporate reputation management relevant to the tourism and agricultural organisations in the African continent in particular, and the globe at large. As we reach the point of no return in our destruction of the planet, we need to look at global solutions to ‘reverse the traditional thinking’ (by applying frugal transformative futuristic solutions) of putting economy before green ecological balance and instead look to new ways of changing our appetite for wealth to fit within the ecological cycles which naturally exist
A preliminary examination of perfectionistic self-presentation and doping in athletes
Get PDFPerfectionism has been linked to doping in sport. However, research to date has focused on trait perfectionism, and has neglected other, possibly relevant aspects of perfectionism. One such aspect is perfectionistic self-presentation – the interpersonal expression of perfectionism. Therefore, the aim of the present research note was to provide a first exploratory examination of whether perfectionistic self-presentation is related to doping in sport. To do so, we recruited two samples of athletes (total N = 362) who responded to measures of perfectionistic self-presentation (perfectionistic self-promotion, nondisplay of imperfection, nondisclosure of imperfection), positive attitudes towards doping (Sample 1), and doping willingness (Sample 2). Results of bivariate correlational analyses, showed that nondisclosure of imperfection was positively correlated with positive attitudes towards doping, and perfectionistic self-promotion and nondisplay of imperfection were positively correlated with doping willingness. When controlling for the overlap between perfectionistic self-presentation dimensions, in regression analyses, only nondisclosure of imperfection emerged as a positive predictor of positive attitudes towards doping (Sample 1). The findings provide tentative evidence that perfectionistic self-presentation may be associated with doping, at least at the bivariate level, and in doing so, highlights the need for future doping research to consider other aspects of perfectionism
Expanded descriptions of autistic repetitive behaviours: a Constructivist Grounded Theory review exploring the perspectives of autistic young people and other stakeholders
Get PDFRestrictive and repetitive behaviour are part of autistic identity. However, in clinical decision making, there are too few representative examples, qualitative descriptors, and personal meanings of rituals and routines in particular. This systematic review sought descriptions of repetitive behaviours from autistic young people, their families, and professionals. Constructivist Grounded Theory analysis illustrated the unsuitability of diagnostic criteria alone in defining autistic behaviours. Repetitive behaviours were meaningful when described by autistic people. They provided coping strategies and a window of time when a person felt at ease in their world, with fewer cognitive, social, and sensory demands. The visibility, excess, and inflexibility of repetitive behaviours demonstrated an autistic person’s responsiveness to demanding contexts. A definition of autistic repetitive behaviours is presented.
Keywords: autism, rituals, routines, repetitive behaviours, qualitative, lived experienc
Adaptive production strategy in vertical farm digital twins with Q-learning algorithms
Get PDFUrban food production can contribute to sustainable development goals by reducing land use and shortening transportation distances. Despite its advantages, the implementation of digital twin (DT) technology for urban food systems has received less investigation compared to manufacturing. This article examines the influence of DT technology on adaptive decision-making in urban food production, focusing on the “Grow It York” case study. Utilising mixed integer linear programming (MILP) and Q-learning models, this study explores how DT data enhances production decisions regarding service level and resource utilisation under demand fluctuations. The findings highlight that the Q-learning model achieves up to demand fulfillment compared to for the MILP model, demonstrating a significant improvement in operational efficiency. Additionally, electricity usage per fulfilled demand is reduced by approximately , advocating for broader DT application to the synergy between economic resilience and environmental sustainability. Future research directions include scaling DT implementation to manage complex supply chains, including advancing real-time data integration and incorporating sustainability considerations at supply chain level
The lasting impact of COVID-19 on forensic mental health: A review of shifts in patient profiles, service delivery, and legal considerations
Get PDFThe COVID-19 pandemic has had a profound and lasting impact on forensic mental health, reshaping patient profiles, disrupting service delivery, and introducing new legal and ethical challenges. This narrative review examines the long-term implications of the pandemic on forensic psychiatric populations, mental health service provision, and the justice system. Evidence suggests that rates of severe mental illness, including psychosis, depression, and anxiety, have increased among forensic patients, exacerbated by isolation, stress, and reduced access to care. Additionally, substance use disorders, and co-occurring psychiatric conditions have become more prevalent, complicating treatment and rehabilitation efforts. The pandemic also accelerated the adoption of telepsychiatry in forensic settings, improving accessibility but raising concerns about the reliability of remote assessments for competency evaluations and risk assessments. Inpatient and prison-based forensic psychiatric services experienced staff shortages, increased patient aggression, and limited access to therapeutic programs, further straining the system. Court closures and legal case backlogs delayed forensic evaluations, raising human rights concerns for detained individuals. Ethical dilemmas emerged regarding involuntary hospitalization, treatment prioritization, and resource allocation. As the forensic mental health field transitions into a post-pandemic landscape, key lessons include the need for hybrid forensic assessment models, strengthened forensic infrastructure, and better integration of legal and clinical perspectives. Future research should focus on developing resilient forensic mental health policies and ensuring equitable access to care while maintaining legal and ethical standards