Heart failure (HF) is a chronic medical condition becoming increasingly prevalent around the world. This condition is linked to poor quality of life (QoL) due to the impact it has on patients functional status and mental health. There have been several advancements in the care and management of patients with HF with little change to self-care interventions resulting. Two self-care interventions which are recommended throughout clinical guidelines are sodium and fluid restriction. These are widely used and encouraged through patient education. Research, however, has questioned their validity and demonstrated a lack of evidence on improved outcomes. In order to determine whether changes to current practice is warranted, an integrative review has been completed. The aim is to assess whether these self-care interventions improve outcomes for patients with HF. From this review identified themes include a lack of robust data, the potential harm of interventions, and various outcomes extending beyond HF exacerbations and readmissions. There appears to be a lack of recent data on the impact of a fluid restriction as an independent variable. However, there are noted improvements in a variety of outcomes from both interventions outside of hospital readmissions which demonstrates they are valuable. Given these findings there is not enough evidence to remove restrictions but there are recommendations which can be made to modify current practice. These recommendations include liberalizing sodium and fluid restrictions and making restrictions more specific to the severity of HF for patients going forward.

This qualitative descriptive study explores Ukrainian refugee women’s settlement experiences and how they negotiate the social and health care services to support their mental health and well-being in Canada. Utilizing an intersectional lens data from the lived experience of 16 Ukrainian refugee women was thematically analyzed. Four prominent themes emerge from the women’s narratives of their migration and settlement journey -a) confluence of oppressions; b) multifaceted and interwoven paths to cultural integration and adaptation, c) convergence of identity in professional development; and d) navigating settlement. Research findings reveal the complexities of self-reconstruction and socialization as experienced by refugee women. We are of the opinion that hosting refugee women in a new country and providing hope for a new life mean offering them meaningful choices built on forms of affordable and accessible culturally appropriate health and social services and ensuring that their settlement and integration in their new country is successful.

Background: While numerous research has been conducted on the energy efficiency advantages of green buildings, there remains a limited exploration of their effects on individuals’ health conditions and dietary intake. Green building’s structure and design aim to reduce the impact on the surrounding environments while also helping to improve the quality of health of individuals who live within them.
Aim: The objective of this study was to examine the impact of green buildings on health outcomes and dietary intake.
Method: Using four databases (Agricola, EBSCO, PubMed, and Web of Science), search of literature was directed with the following keywords: green buildings, green homes, built environment, housing design, health outcomes, dietary patterns, dietary intake, eating behavior, food choices, and others. We reviewed 33 articles, and 19 met our inclusion criteria.
Results: The synthesis of literature revealed four overarching themes: the association between green buildings and respiratory diseases, mental health, dietary intake, and physical activity level. Our findings suggest an association between green buildings and the improvement of certain health conditions, including asthma, depression, and obesity.
Conclusion: The results emphasize the necessity for additional research to investigate the sustained impact of green buildings on residents’ health and dietary habits over an extended period. The implications of the findings are significant for policymakers, urban planners, and researchers, underscoring the potential of green building initiatives in promoting healthy living environments.

Background: Adolescents are vulnerable to psychological disorders due to rapid physical, cognitive, and psychosocial changes. Depression affects 20% of adolescents worldwide, making it a leading cause of disability. Schools are the ideal places for preventative strategies for school-aged children.
Aim: To provide a synthesis of effective school-based strategies to prevent depression in adolescents in Qatar.
Methods: The integrative review framework developed by Whittemore and Knafl was utilized to guide this review. The CINAHL, MEDLINE, and Academic Search Complete databases were systematically searched for peer-reviewed primary studies published between 2016 and 2022. Ten articles were included after considering inclusion and exclusion criteria. The quality of the included studies was assessed using the Mixed-Methods Appraisal Tool (MMAT). The Population Health Promotion Model guided the data analysis and presentation of results.
Results: The implementation of school-based strategies at individual and family levels is effective in preventing depression in adolescents. At the individual level, the focus is on creating a supportive environment and developing personal skills (social, behavioural regulation, emotional regulation, cognitive regulation, resilience, and coping). At the family level, the focus is on creating a supportive environment and developing personal skills (parental and social).
Conclusion: Prevention of depression in adolescents requires multidisciplinary school-based strategies that must focus on creating a supportive environment and developing the personal skills of students and their families. National and organizational policies should be developed in support of multidisciplinary school-based strategies to prevent depression in adolescents.

Objective: Evaluate how an AI-based virtual triage (VT) and care referral technology impacted live triage and care referral in an outpatient/ambulatory care network.
Methods:Analysis of a dataset of 8,088 outpatient online encounters assessed how VT influenced patient care seeking action/behavior.
Results:There were modest decreases in patients seeking outpatient care, including in-person or video face-to-face encounters (-12.5%), or engaging self-care (-8.2%). Patient engagement of virtual care through e-visits and telephone calls increased moderately (19.1%). One-third (35.0%) of patients changed care seeking likely as a result of VT care referral. Another third (32.3%) reported a pre-VT care intent aligned with the VT care recommendation, and a third (32.7%) did not change care sought when their pre-VT intent was not aligned. A total of 12.0% de-escalated acuity of care seeking as recommended by VT, most frequently from outpatient care to virtual care (6.5%) or self-care (4.3%). When VT recommended care de-escalation, 53.5% de-escalated care. In 21.2% care acuity was escalated, of whom 10.6% pursued virtual care and 7.5% pursued outpatient care instead of self-care, while 3.1% whose care intent was virtual care instead pursued outpatient care. When VT recommended care escalation, 96.2% escalated care. Overall, 26.7% of patients required no further action or involvement of clinical staff.
Conclusions: Virtual triage impacted patient care seeking action/behavior among almost half of patients whose pre-VT intent differed from the VT recommendation, with patients nearly twice as likely to follow recommendations to seek higher rather than lower levels of care acuity, while modestly reducing the number of face-to-face visits and increasing virtual care. Overall, a quarter of patients using VT were able to perform self-care without interacting with the healthcare team. Virtual triage has the potential to efficiently and effectively redirect patients to more appropriate levels of care.