Background: Cybersecurity is increasingly becoming a prominent concern among healthcare providers in adopting digital technologies for improving the quality of care delivered to patients. The recent reports on cyber attacks, such as ransomware and WannaCry, have brought to life the destructive nature of such attacks upon healthcare. In complement to cyberattacks, which have been targeted against the vulnerabilities of information technology (IT) infrastructures, a new form of cyber attack aims to exploit human vulnerabilities; such attacks are categorised as social engineering attacks. Following an increase in the frequency and ingenuity of attacks launched against hospitals and clinical environments with the intention of causing service disruption, there is a strong need to study the level of awareness programmes and training activities offered to the staff by healthcare organisations. Objective: The objective of this systematic review is to identify commonly encountered factors that cybersecurity postures of a healthcare organisation, resulting from the ignorance of cyber threat to healthcare. The systematic review aims to consolidate the current literature being reported upon human behaviour resulting in security gaps that mitigate the cyber defence strategy adopted by healthcare organisations. Additionally, the paper also reviews the organisational risk assessment methodology implemented and the policies being adopted to strengthen cybersecurity. Methods: The topic of cybersecurity within healthcare and the clinical environment has attracted the interest of several researchers, resulting in a broad range of literature. The inclusion criteria for the articles in the review stem from the scope of the five research questions identified. To this end, we conducted seven search queries across three repositories, namely (i) PubMed^®/MED-LINE; (ii) Cumulative Index to Nursing and Allied Health Literature (CINAHL); and (iii) Web of Science (WoS), using key words related to cybersecurity awareness, training, organisation risk assessment methodologies, policies and recommendations adopted as counter measures within health care. These were restricted to around the last 12 years. Results: A total of 70 articles were selected to be included in the review, which addresses the complexity of cybersecurity measures adopted within the healthcare and clinical environments. The articles included in the review highlight the evolving nature of cybersecurity threats stemming from exploiting IT infrastructures to more advanced attacks launched with the intent of exploiting human vulnerability. A steady increase in the literature on the threat of phishing attacks evidences the growing threat of social engineering attacks. As a countermeasure, through the review, we identified articles that provide methodologies resulting from case studies to promote cybersecurity awareness among stakeholders. The articles included highlight the need to adopt cyber hygiene practices among healthcare professionals while accessing social media platforms, which forms an ideal test bed for the attackers to gain insight into the life of healthcare professionals. Additionally, the review also includes articles that present strategies adopted by healthcare organisations in countering the impact of social engineering attacks. The evaluation of the cybersecurity risk assessment of an organisation is another key area of study reported in the literature that recommends the organisation of European and international standards in countering social engineering attacks. Lastly, the review includes articles reporting on national case studies with an overview of the economic and societal impact of service disruptions encountered due to cyberattacks. Discussion: One of the limitations of the review is the subjective ranking of the authors associated to the relevance of literature to each of the research questions identified. We also acknowledge the limited amount of literature that focuses on human factors of cybersecurity in health care in general; therefore, the search queries were formulated using well-established cybersecurity related topics categorised according to the threats, risk assessment and organisational strategies reported in the literature.

Background: Cyber threats are increasing across all business sectors, with health care being a prominent domain. In response to the ever-increasing threats, health care organizations (HOs) are enhancing the technical measures with the use of cybersecurity controls and other advanced solutions for further protection. Despite the need for technical controls, humans are evidently the weakest link in the cybersecurity posture of HOs. This suggests that addressing the human aspects of cybersecurity is a key step toward managing cyber-physical risks. In practice, HOs are required to apply general cybersecurity and data privacy guidelines that focus on human factors. However, there is limited literature on the methodologies and procedures that can assist in successfully mapping these guidelines to specific controls (interventions), including awareness activities and training programs, with a measurable impact on personnel. To this end, tools and structured methodologies for assisting higher management in selecting the minimum number of required controls that will be most effective on the health care workforce are highly desirable. Objective: This study aimed to introduce a cyber hygiene (CH) methodology that uses a unique survey-based risk assessment approach for raising the cybersecurity and data privacy awareness of different employee groups in HOs. The main objective was to identify the most effective strategy for managing cybersecurity and data privacy risks and recommend targeted human-centric controls that are tailored to organization-specific needs. Methods: The CH methodology relied on a cross-sectional, exploratory survey study followed by a proposed risk-based survey data analysis approach. First, survey data were collected from 4 different employee groups across 3 European HOs, covering 7 categories of cybersecurity and data privacy risks. Next, survey data were transcribed and fitted into a proposed risk-based approach matrix that translated risk levels to strategies for managing the risks. Results: A list of human-centric controls and implementation levels was created. These controls were associated with risk categories, mapped to risk strategies for managing the risks related to all employee groups. Our mapping empowered the computation and subsequent recommendation of subsets of human-centric controls to implement the identified strategy for managing the overall risk of the HOs. An indicative example demonstrated the application of the CH methodology in a simple scenario. Finally, by applying the CH methodology in the health care sector, we obtained results in the form of risk markings; identified strategies to manage the risks; and recommended controls for each of the 3 HOs, each employee group, and each risk category. Conclusions: The proposed CH methodology improves the CH perception and behavior of personnel in the health care sector and provides risk strategies together with a list of recommended human-centric controls for managing a wide range of cybersecurity and data privacy risks related to health care employees.

Background: Healthcare systems worldwide face growing challenges in anticipating and managing patient surges, particularly in times of public health crises, natural disasters, or seasonal peaks. The ability of healthcare organisations to forecast and respond to such demand fluctuations—referred to as organisational readiness for patient capacity surge—has become a critical determinant of service continuity and patient outcomes. Despite the urgency, there remains a lack of consolidated evidence on how healthcare authorities measure, evaluate, and operationalise this readiness. This systematic review aims to identify and synthesise existing literature that presents case studies, methodologies, and strategic frameworks used to evaluate organisational preparedness for patient surge capacity. It also explores resource allocation mechanisms, hospital capacity planning algorithms, and temporary facility strategies documented in healthcare settings. Methods: The review was conducted across two major scientific repositories, i.e., PubMed and Web of Science (WoS). A set of four structured search queries were formulated to capture the breadth of the topic, focusing on demand forecasting, hospital capacity planning, workforce models, and resource management within the context of healthcare surge demand. The search was limited to publications from the last 10 years (2014–2024) to ensure the inclusion of contemporary practices and technologies. Results: A total of 142 articles were selected for detailed analysis. The articles were categorised into six thematic groups: (i) empirical case studies on healthcare surge management; (ii) hospital resources and capacity scaling; (iii) ethical frameworks guiding surge response; (iv) IT-driven algorithms and forecasting tools; (v) policy evaluations and actionable lessons learned; and (vi) existing systematic reviews in related domains. Notably, several articles provided evidence-based frameworks and simulation models supporting predictive planning, while others highlighted real-world implementation of temporary care facilities and staff redeployment protocols. Conclusions: The review underscores the fragmented yet growing body of literature addressing the multidimensional nature of surge preparedness in healthcare. While algorithmic forecasting and capacity modelling are advancing, gaps remain in standardising metrics for organisational readiness and incorporating ethical considerations in surge planning. Limitations of this review include potential selection bias and the subjective categorisation of articles. Future research should aim to develop integrative frameworks that couple technical, operational, and ethical readiness for patient surge scenarios.

Escalating extreme wildfires, fueled by the confluence of climate change, land use patterns alterations, ignitions by humans, and flammable fuels accumulation, pose significant and increasingly destructive risks to critical infrastructure (CI). This study presents a comprehensive comparative analysis of wildfire impacts and the corresponding CI resilience strategies employed across the EU and the US. It examines the vulnerability of CIs to the devastating effects of wildfires and their inadvertent contribution to wildfire ignition and spread. The study evaluates the EU’s CER Directive and the US National Infrastructure Protection Plan and assesses European Commission wildfire resilience-related initiatives, including FIRELOGUE, FIRE-RES, SILVANUS, and TREEADS flagship projects. It synthesizes empirical evidence and extracts key lessons learned from major wildfire events in the EU (2017 Portuguese fires; 2018 Mati wildfire) and the US (2023 Lahaina disaster; 2025 Los Angeles fires), drawing insights regarding the effectiveness of various resilience measures and identifying areas for improvement. Persistent challenges impeding effective wildfire resilience are identified, including governance fragmentation, lack of standardization in risk assessment and mitigation protocols, and insufficient integration of scientific knowledge and data into policy formulation and implementation. It concludes with actionable recommendations aimed at fostering science-based, multi-stakeholder approaches to strengthen wildfire resilience at both policy and operational levels.

The escalating threat of climate-driven wildfires, land abandonment, wildland–urban interface expansion, and inadequate forest management poses an existential challenge to Mediterranean oak ecosystems, for which traditional fire suppression has proven insufficient. This paper presents a combination of integrated fire management (IFM) and closer-to-nature forest management (CTNFM) in a representative mixed Pyrenean oak (Quercus pyrenaica) forest at Quinta da França (QF), in Portugal. It is structured around three main objectives designed to evaluate this pioneer integrated approach: (1) to describe the integration of IFM and CTNFM within an agro-silvo-pastoral landscape; (2) to qualitatively assess its ecological, operational, and socio-economic outcomes; and (3) to quantitatively evaluate the effectiveness of two key nature-based solutions (NbSs), that is, prescribed burning and planned grazing, in reducing wildfire risk and enhancing forest resilience and biodiversity. By strategically combining proactive fuel reduction with biodiversity-oriented silviculture, the QF case provides a replicable model for managing analogous Mediterranean forested areas facing similar risks. This integrated approach supports forest multifunctionality, advancing both prevention and adaptation goals, and directly contributes to the ambitious targets set by the European Union’s New Forest and Biodiversity Strategies for 2030, marking a significant step towards a more sustainable and fire-resilient future for such Mediterranean landscapes.

Escalating extreme wildfires, fueled by the confluence of climate change, land use patterns alterations, and flammable fuels accumulation, pose significant and increasingly destructive risks to Critical Infrastructure (CI). This study presents a comprehensive comparative analysis of wildfires impacts, and the corresponding CI resilience strategies employed across the EU and the US. It examines the vulnerability of CIs to the devastating effects of wildfires and their inadvertently contribution to wildfire ignition and spread. The study evaluates EU's CER Directive and US National Infrastructure Protection Plan and assesses European Commission wildfire resilience related initiatives including FIRELOGUE, FIRE-RES, SILVANUS, and TREEADS flagship projects. It synthesizes empirical evidence and extracts key lessons learned from major wildfire events in the EU (2017 Portuguese fires; 2018 Mati wildfire) and the US (2023 Lahaina disaster; 2025 Los Angeles fires), drawing insights regarding the effectiveness of various resilience measures and identifying areas for improvement. Persistent challenges impeding effective wildfire resilience are identified, including governance fragmentation, lack of standardization in risk assessment and mitigation protocols, and insufficient integration of scientific knowledge and data into policy formulation and implementation. It concludes with actionable recommendations aimed at fostering science-based, multi-stakeholder approaches to strengthen wildfire resilience at both policy and operational levels.