Search Results (918)

Physical hazards are the most common source of health effects among waste recyclers, frequently leading to worker injuries. South Africa’s formal buy-back centres (BBCs) have emerged as key nodes in the recycling chain, yet the burden of non-fatal workplace injuries among BBC recyclers is not characterised. We conducted a cross-sectional study at ten BBCs in Johannesburg, enrolling 160 waste recyclers (median age 32 years; 55.6% female). A structured, interviewer-led questionnaire captured workers’ characteristics and self-reported injuries in the past six months. Robust Poisson regression was fitted to determine associations with frequent workplace injury. Overall, 69.4% of participants reported at least one injury. Cuts and lacerations (67.6%) and sprains or muscle strains (39.6%) predominated. Each additional year of age raised the risk of frequent workplace injury by 1% (adjusted relative risk [aRR] 1.01; 95% CI 1.00–1.02), each extra hour worked per day by 22% (aRR 1.22; 95% CI 1.04–1.42), and presence of hearing or vision problems by 45% (aRR 1.45; 95% CI 1.14–1.83). Targeted interventions—such as work hour regulation, sensory-friendly accommodations, and comprehensive, fit-focused PPE programs—are needed to reduce injury risk in this vulnerable workforce. Full article

Background: Work-Related Quality of Life (WRQoL) is an essential aspect of the sustainability of the healthcare workforce, intimately connected to employee well-being, job fulfillment, and the standard of patient care. This research sought to evaluate WRQoL among healthcare employees in Greek public hospitals, concentrating on the influence of demographic and work-related factors in a healthcare system affected by prolonged economic and public health crises. Methods: A cross-sectional study was conducted with 1022 staff members from 23 hospitals in the 1st Health Region of Attica, utilizing the validated Work-Related Quality of Life Scale (WRQoL). Data were analyzed using non-parametric tests, including Chi-square and Linear-by-Linear Association analyses. Results: The findings showed that 44.3% of employees experienced low WRQoL, with the lowest ratings found among younger workers, those on temporary contracts, and individuals working in pediatric hospitals. Holding a leadership position, being over 40 years old, and having a permanent job were linked to notably greater well-being and job satisfaction. A significant portion of participants viewed the working conditions and autonomy as insufficient, particularly in demanding institutional environments. Conclusions: These results emphasize the necessity for focused policy measures to enhance working conditions, guarantee job stability, and reinforce organizational support structures. Tackling structural shortcomings in the healthcare system is crucial for protecting workforce stability and the standard of public health services. Full article

Medicaid enrollees often face barriers to care due to inconsistent clinician participation. This study investigates how primary care clinicians’ engagement with Medicaid evolved from 2016 to 2019, focusing on those already serving Medicaid patients at baseline. Using longitudinal data from the Transformed Medicaid Statistical Information System Analytic Files (TAFs), we analyzed changes in the number of unique Medicaid enrollees served annually by 220,665 clinicians across 40 states. We defined major increases or decreases as changes exceeding 90% of baseline enrollee volume and examined associations with clinician, practice, and state-level characteristics. The results show that while about 60% of clinicians maintained stable enrollee volumes, nearly 20% experienced substantial increases or decreases. Higher baseline enrollee volume and affiliation with community health centers were associated with greater stability, while rural practice settings were linked to higher odds of major decreases. These findings underscore the dynamic nature of Medicaid participation and highlight the need for policies that support consistent clinician engagement. As Medicaid programs face potential funding cuts and eligibility changes, tracking participation trends and reinforcing stable provider networks will be critical to safeguarding access to care. Full article

As newborn screening (NBS) programs deal with growing complexities, including adding new disorders to their screening panels, adopting new technologies/screening methods, and workforce shortages, there is a greater need for continuous quality improvement (CQI) to ensure the NBS system is meeting its primary goal of identifying infants with NBS disorders in a timely fashion. In 2019, the Health Resources and Services Administration’s (HRSA) Maternal and Child Health Bureau (MCHB) awarded funding to the Association of Public Health Laboratories’ (APHL) Newborn Screening Technical assistance and Evaluation Program (NewSTEPs) to address CQI in the NBS system through a collaborative, data-driven process. From 2019–2024, NewSTEPs funded 36 quality improvement (QI) projects from a variety of state NBS programs and research centers across the U.S., to address timeliness, detection of out-of-range results, communication of results, and/or confirmation of diagnosis. Thirty-three QI teams completed their projects, and 85% achieved their specified goal outlined in their aim statement. Despite limitations, the QI Projects Collaborative provided NBS programs with funding and resources to begin and sustain quality improvement initiatives. This model of a technical assistance and central resource center for CQI was effective in achieving quality improvements within the national NBS system. Full article

Background/Objectives: Research raising concerns about the occupational health of signed language interpreters has proliferated in the past two decades. Recent studies examining interpreters’ various work settings find that Video Relay Service (VRS) work is linked to greater health risks than other interpreting settings. This study aimed to shed light on why VRS work appears to be particularly hazardous. Methods: This mixed-methods study reports data from an online survey of 345 American VRS interpreters. Participants were queried about a range of potentially stressful experiences with callers. Quantitative data regarding the types, frequency, patterns, and consequences of stressful calls were further informed by qualitative data reported by participants in free-response survey fields. Results: Incidents of VRS interpreters mediating calls regarding sexual activity, drug deals, and prostitution were reported with notable frequency, as was interpreters’ witnessing abuse of vulnerable individuals. Interpreters also were often the object of callers’ derisive sexual, physical, and racial comments. Yet the incidence of participants reporting these experiences to management or outside authorities was quite limited despite the potential legal jeopardy involved. When reports were made, most participants stated their companies took little or no action. We also examined how factors such as the tenure of VRS, hours worked per week, and work shift times were associated with such caller experiences. Conclusions: This study builds upon prior VRS health risk research by examining external factors, including caller behavior and employer policies, that may contribute to interpreter stress and burnout. Suggestions for remediation and workforce development, involving VRS companies, the Federal Communications Commission (FCC) and state legislation are offered. Full article

Background: Undergraduate nursing students (UNSs) often enter clinical training just as they are still mastering the emotional labor of the profession. In Nepal, where teaching hierarchies discourage upward dialogue and hospitals routinely struggle with overcrowding, supply shortages, and outward nurse migration, these learners confront a distinct, under-documented burden of psychological distress. Objective: This study examines how UNSs interpret, negotiate, and cope with the mental health challenges that arise at the intersection of cultural deference, resource scarcity, and migration-fueled uncertainty. Methods: A qualitative design employing reflexive thematic analysis (RTA), guided by the Reflexive Thematic Analysis Reporting Guidelines (RTARG), was used. Fifteen second-, third-, and fourth-year Bachelor of Science in Nursing students at a major urban tertiary institution in Nepal were purposively recruited via on-campus digital flyers and brief in-class announcements that directed students (by QR code) to a secure sign-up form. Participants then completed semi-structured interviews; audio files were transcribed verbatim and iteratively analyzed through an inductive, reflexive coding process to ensure methodological rigor. Results: Four themes portray a continuum from silenced struggle to systemic constraint. First, Shrouded Voices, Quiet Connections captures how students confide only in trusted peers, fearing that formal disclosure could be perceived as weakness or incompetence. Second, Performing Resilience: Masking Authentic Struggles describes the institutional narratives of “strong nurses” that drive students to suppress anxiety, adopting scripted positivity to satisfy assessment expectations. Third, Power, Hierarchy, and the Weight of Tradition reveals that strict authority gradients inhibit questions in classrooms and clinical placements, leaving stress unvoiced and unaddressed. Finally, Overshadowed by Systemic Realities shows how chronic understaffing, equipment shortages, and patient poverty compel students to prioritize patients’ hardships, normalizing self-neglect. Conclusions: Psychological distress among Nepalese UNSs is not an individual failing but a product of structural silence and resource poverty. Educators and policymakers must move beyond resilience-only rhetoric toward concrete reforms that dismantle punitive hierarchies, create confidential support avenues, and embed collaborative pedagogy. Institutional accountability—through regulated workloads, faculty-endorsed wellbeing forums, and systematic mentoring—can shift mental health care from a private struggle to a shared professional responsibility. Multi-site studies across low- and middle-income countries are now essential for testing such system-level interventions and building a globally resilient, compassionate nursing workforce. Full article

Background/Objectives: This study aims to provide a comprehensive understanding of the current mental health workforce and the factors influencing its distribution within adult community mental health services in Western Australia’s North Metropolitan Health Service. Methods: Mental health workforce supply across North Metropolitan Statistical Area Level 2 (SA2-Australian Statistical Geography Standard) was estimated using the Geographically-adjusted Index of Relative Supply (GIRS) and categorised as low (0–3) or moderate-to-high (4–8) for analysis and testing associations with multiple covariates. Population, clinic, and individual-level data were analysed using principal component analysis and logistic regression to identify the factors associated with workforce distribution. Results: Of the 68 SA2s analysed, 25 SA2s (representing 45 suburbs) were identified as having a low workforce supply, defined by a GIRS score of ≤3. These areas were compared to those with a moderate-to-high supply (GIRS > 3) to assess the differences in service performance. A principal component analysis identified three key components within the data: service usage, health service providers, and service efficiency. A logistic regression analysis revealed that areas with a low workforce supply were significantly more likely to experience reduced service usage (OR = 3.3, p = 0.037, CI [0.09–0.92]), indicating fewer patient interactions and lower engagement with mental health services. In addition, these areas demonstrated a lower service efficiency as evidenced by longer wait times (OR = 3.7, p = 0.002, CI [1.62–8.50]), suggesting that workforce shortages directly impact timely access to health care. Conclusions: The findings revealed disparities in workforce supply across different urban locations, with low-supply areas facing tangible challenges in service accessibility and operational efficiency. These findings highlight the need for targeted mental health workforce planning. Developing and implementing best practice guidelines is essential to effectively manage service demands and reduce waitlists. Full article

Introduction: The organization of mental health care is undergoing a transformation from an institutionalized model to a community-centered model. Due to the critical specialist workforce shortage, insufficient funding, and the large number of children in crisis, its implementation presents a challenge. The aim of this study is to analyze the current situation regarding access to system-based care under contracts with the National Health Fund in various provinces in Poland. Materials and Methods: Based on an analysis of data, resources available to patients were assessed—specifically, information was obtained from the National Health Fund website entitled “NFZ Treatment Waiting Times.” From this, the waiting times for appointments in child and adolescent mental health care facilities, the availability of mental health care facilities under contracts with the National Health Fund in Poland, legal acts, and data from the Central Statistical Office were extracted. Then, an analysis of the current accessibility to child and adolescent mental health services was conducted. The inclusion criteria for data sources were as follows: accessibility—the data had to be openly available to researchers without restrictions; credibility—the data had to be verified by individual health care facilities; usefulness—the data had to accurately reflect the actual availability of services and the needs within the child and adolescent psychiatric care system. Results: There are significant differences and deviations from the average number of facilities and waiting times when comparing the 16 provinces. Notably, some of the analyzed facilities are already operating within the framework of Child and Adolescent Mental Health Centers, where the mean waiting period for inpatient care is 105 days, the mean waiting period for day-care units is 61 days, and the mean waiting period for outpatient clinics is 257 days. The number of facilities is increasing under the reform, with new level I reference centers being opened, which ensures prevention and early support is provided by a pedagogue, psychologist, and non-medical staff, providing enhanced accessibility to care without the need for a visit to a child and adolescent psychiatrist, of whom there are only 579 for the entire child population in Poland. This metric primarily refers to first-time appointments in public institutions, with notable disparities between urban and rural areas. Conclusions: The development of the reform offers hope for quicker access to mental health support for children and adolescents. With the consistent implementation of the reform and further support from non-governmental organizations, there is a high chance of building an effective community-based model with a short waiting time for help and reducing ineffective hospitalizations, among other things, in terms of costs. Full article

The integration of robotics into Structural Health Monitoring (SHM) is rapidly reshaping how infrastructure is assessed and maintained. This review critically examines the current landscape of robotic technologies applied in SHM, with a specific focus on their implementation within the Saudi Arabian construction sector. It explores recent advancements in robotic platforms, such as unmanned aerial vehicles (UAVs), wall-climbing robots, and AI-driven inspection systems, and assesses their roles in damage detection, vibration monitoring, and real-time diagnostics. In addition to outlining technological capabilities, this paper identifies major adoption challenges related to system readiness, regulatory gaps, workforce limitations, and environmental constraints. Drawing on comparative experiences in the healthcare, energy, and legal domains, this review extracts cross-sectoral insights that offer practical guidance for accelerating robotic integration in SHM. This paper concludes by outlining research gaps and actionable recommendations to support scholars, policymakers, and industry professionals in advancing robotics-based monitoring in complex infrastructure environments. Full article

Disparities in primary care access among Medicaid enrollees may be driven by differences in provider acceptance of Medicaid, yet the extent to which primary care provider (PCP) panels reflect the racial and ethnic diversity of local Medicaid populations is unknown. Objectives: To quantify the alignment between the racial/ethnic composition of PCP Medicaid panels and the underlying Medicaid population in their service areas. Methods: We conducted a cross-sectional analysis of 2019 Transformed Medicaid Statistical Information System Analytic Files from 44 states focusing on non-Hispanic White (NHW), non-Hispanic Black (NHB), and Hispanic enrollees. We calculated a panel representation ratio (PRR) for each PCP (physicians, nurse practitioners, and physician associates) as the proportion of a racial/ethnic group in their panel divided by that group’s proportion in the county Medicaid population. PRRs > 1 indicate overrepresentation; PRRs < 1, underrepresentation. Analyses were stratified by provider specialty, rurality, and Health Professional Shortage Area (HPSA) status. Results: The study sample included 372,320 PCPs from the following professions: nurse practitioners (NPs) and physician associates (PAs), along with physicians from the following specialties: family physicians (FPs), internal medicine physicians (IM), obstetrician gynecologists (ObGyn), and pediatricians (Peds). In the full sample, PRR was 1.28 for NHW enrollees, but less than one for NHB (0.98) and Hispanic (0.82) enrollees. Across provider specialties and professions, NHW enrollees were overrepresented in both rural and urban areas. In rural areas, NHB enrollees were overrepresented, but Hispanic enrollees remained underrepresented regardless of Health Professional Shortage Area (HPSA) status. In urban areas, both NHB and Hispanic enrollees were underrepresented in provider panels. Conclusions: Medicaid PCP panels do not reflect the racial/ethnic diversity of local Medicaid populations, particularly for NHB and Hispanic enrollees in urban settings. Efforts to improve equitable access to primary care must address these disparities in provider panel composition. Full article

Background/Objectives: Empathy is a core competency in nursing, contributing to patient care quality and professional resilience. This study investigated empathy levels among Greek undergraduate nursing students at the University of Peloponnese and examined the personal and educational factors that contribute to empathic development. Methods: A cross-sectional survey was conducted with 144 students from all academic years using the Jefferson Scale of Physician Empathy—Health Professions (JSPE-HP) and the SF-12 Health Survey. Data were analyzed using ANOVA and stepwise multiple linear regression. Results: Mean empathy scores were relatively high (M = 110.31, SD = 10.52). Empathy increased significantly with academic progression (p < 0.001), and higher scores were associated with parental status (p = 0.030) and better mental health (p = 0.044). Conversely, students with a chronically ill close contact reported lower empathy (p = 0.018). Regression analysis identified having children and exposure to chronic illness as significant predictors. Conclusions: Educational progression, life experience, and well-being are key contributors to empathy development. These insights support strategies to enhance empathy through curriculum design, student support, and wellness programs. Integrating empathy training into management policy can foster professional growth, reduce burnout, and improve patient care and workforce sustainability. Full article

Background: Pakistan reported its first case of COVID-19 in February 2020 and joined other countries in activating a national emergency response following the declaration of the COVID-19 pandemic by the World Health Organization (WHO). Playing a vital role in the early phase of the country’s response was the National Stop Transmission of Polio (NSTOP) program, a highly trained cadre of polio workers who ordinarily support polio eradication efforts in the country. Methods: We developed a reporting tool using Microsoft Excel that tracked the activities of NSTOP officers to support the COVID-19 response. All NSTOP officers submitted their activity reports fortnightly using this reporting tool. Each provincial NSTOP officer reviewed and compiled their respective officers’ reports and sent them to the federal NSTOP Team. We present a summary of the reports for the period from 1 March 2020 to 31 July 2020. Results: A total of 71 officers of the NSTOP program supported various aspects of Pakistan’s COVID-19 response, including coordination, detection and response activities, surveillance, quarantine/isolation management, training and orientation sessions for healthcare personnel, data analysis, community engagement, and risk communication. They successfully investigated 32,729 suspected COVID-19 cases, of which about one-third were confirmed cases, and facilitated the collection and dispatch of >57,000 samples from these cases. Conclusions: This report details NSTOP contributions to the early phase of the COVID-19 response in Pakistan, demonstrating the value of polio investments beyond eradicating the disease to encompass having a workforce that is ready to respond to emergent disease threats and outbreaks. Such a workforce could also play a role in strengthening the capacity of existing immunization systems to help improve routine vaccination coverage in resource-limited settings. Full article

Background: As global populations age, the demand for effective and compassionate geriatric care has intensified. Humanized nursing emphasizes empathy and person-centered care, while community-based nursing builds on local resources and networks to support health and well-being. Together, these approaches offer promising strategies for improving care for older adults. This integrative review explores the evolution, clinical contributions, and implementation barriers of these models. Methods: A comprehensive literature search was performed using PubMed, CINAHL, Scopus, and Web of Science, targeting peer-reviewed studies, including qualitative and quantitative studies published between 2010 and 2025, that involved adults aged 60 years and older. Inclusion criteria emphasized humanized and community-based nursing interventions while excluding non-nursing and pediatric-focused studies. Quality appraisal was performed using CASP and JBI checklists, and data were thematically synthesized. Results: Evidence indicates that these care models significantly improve functional independence and psychosocial well-being and reduce hospital readmissions. For instance, community-based care in Taiwan improved activities of daily living in dementia patients by 15%, while U.S.-based programs reduced depressive symptoms by 30% among Latino older adults. Interdisciplinary, nurse-led interventions in South Korea and Puerto Rico showed a 22% reduction in readmissions and an 85% increase in care access. Despite these benefits, numerous barriers hinder widespread implementation, including workforce shortages, inadequate funding, fragmented healthcare systems, cultural resistance, digital literacy challenges, and policy constraints, particularly in low-resource settings such as the Philippines and Nepal. Conclusions: These findings underscore the transformative potential of humanized and community-based nursing while highlighting the need for targeted strategies such as task-shifting, inclusive technologies, and policy reform to advance equitable, sustainable geriatric care globally. Full article

By 2040, more than 80 million Americans will be aged ≥65, yet contemporary senior living communities still operate on a hospitality-first model developed for healthier cohorts three decades ago. This commentary argues that the next generation of senior living must pivot from hotel-style amenities to person-centric health platforms that proactively coordinate medical, functional, and social support. We outline four mutually reinforcing pillars. (1) Data infrastructure that stitches together clinical, functional, and social determinants of health enables continuous risk stratification and early intervention. (2) Ambient and conversational artificial-intelligence tools can extend sparse caregiving workforces while preserving resident autonomy. (3) Value-based contractual arrangements—for example, Medicare Advantage special-needs plans embedded within senior living sites—can realign financial incentives toward prevention rather than occupancy. (4) Targeted policy levers, including low-income housing tax credits for the “forgotten middle” and outcomes-based regulatory frameworks, can catalyze adoption at scale. Ultimately, re-architecting senior living around integrated technology, value-based financing and supportive regulation can transform these communities into preventive-care hubs that delay nursing home entry, improve quality of life, and reduce total cost of care. Full article

Workplace health and safety issues have long plagued the construction industry. While safety efforts have traditionally focused on physical risks, increasing attention is being paid to mental health and work-related stressors, which can negatively affect both productivity and safety. In Saudi Arabia, the construction sector presents a unique context because of its highly diverse, multinational workforce. Workers of different nationalities often operate on the same job site, leading to potential communication barriers, cultural misunderstandings, and inconsistent safety practices, all of which may amplify stress and safety risks. This research aims to investigate the influence of work-related stressors on construction workers’ safety in Saudi Arabia and identify which stressors most significantly contribute to the risk of injury. A structured questionnaire was distributed to 349 construction workers across 16 job sites in Saudi Arabia. The survey measures ten key stressors identified in the literature, including job site demand, job control, job certainty, skill demand, social support, harassment and discrimination, conflict with supervisors, interpersonal conflict, and job satisfaction. Data were analyzed using logistic regression and Pearson correlation to examine relationships between stressors and self-reported injuries. The findings indicated that work-related stressors significantly predict workplace injury. While the first regression model showed a modest effect size, it was statistically significant. The second model identified job site demand and job satisfaction as the most influential predictors of injury risk. Work-related stressors, particularly high job demands and low job satisfaction, substantially increase the likelihood of injury among construction workers. These findings emphasize the importance of incorporating psychosocial risk management into construction safety practices in Saudi Arabia. Future studies should adopt longitudinal designs to explore causal relationships over time and include qualitative methods such as interviews to gain a deeper understanding. Additionally, factors such as nationality, organizational policies, and management style should be investigated to better understand their moderating effects on the stress–injury relationship. Full article