Search Results (169)

Climate change is among the most significant challenges of the 21st century, with global warming, heat stress, floods, and drought occurring in various parts of the globe, including Africa. The impact of climate change on health is becoming increasingly substantial on the African continent due to weaknesses in economies, infrastructure, and healthcare systems. This review explores the relationship between climate change and emerging and re-emerging infectious diseases in Africa and highlights possible solutions. It was conducted by summarizing and synthesizing related information from relevant scientific publications. This review reveals that climate change significantly contributes to Africa’s emerging and re-emerging infectious diseases, including Ebola, Marburg, Lassa fever, dengue fever, malaria, and cholera. The impact of climate change on infectious diseases is variable across the continent, with countries in West and Central Africa experiencing more significant climate change-instigated disease burdens. Multisectoral cooperation between climate change actors, environmental health researchers, policy makers, and political leaders centered in the One Health approach is necessary to develop and implement resilient interventions for climate change-induced emerging and re-emerging infections and related health hazards. Full article

Background: Pathology is essential for cancer diagnosis, bridging clinical and surgical fields, and requires adequate infrastructure, technology, and skilled staff to meet standards of care. In Romania, healthcare underfunding limits pathology laboratories’ capacity to provide timely and accurate diagnoses, leading to delays that could negatively impact treatment and patient outcomes. Our study aimed to assess the status of publicly funded pathology laboratories in Romania and identify key areas for improvement. Methods: We analyzed public hospitals in Romania, excluding specialized and non-general care institutions, to evaluate pathology laboratories. A 10-item survey was distributed over 12 months via email, phone, administrative offices, and professional networks to pathologists working in these laboratories, regardless of their hierarchical position. A total of 154 pathology services were represented. The questionnaire assessed technical capabilities, diagnostic techniques, automation, staffing, infrastructure, and satisfaction with funding and resources. Responses were gathered with both predefined and open-text fields to capture comprehensive insights. Results: The findings revealed that many pathology laboratories faced significant challenges, including a lack of automation, limited integration of modern technologies, and barriers to digitalization. Despite these issues, pathologists reported higher-than-expected levels of satisfaction with their laboratories. Conclusions: A comprehensive understanding of existing practices is necessary to drive the modernization of pathology services, establish national standards, and improve collaboration both within and across specialties. Without such foundational insight, efforts to enhance the integration and effectiveness of pathology services are likely to remain constrained. Full article

The coronavirus disease of 2019 (COVID-19) presented hospitals not only with significant clinical challenges but also with organizational obstacles, forcing hospitals to adapt their operations to ensure continuity of care. This study aims to explore the challenges that Nebraska hospitals encountered during COVID-19. To achieve this goal, the study draws on data collected through semi-structured interviews with the Chief Executive Officers (CEOs) and Chief Nurse Officers (CNOs) of eight hospitals in the state of Nebraska. These incident commanders held pivotal decision-making positions in their associated hospitals during the COVID-19 pandemic and its surge times. Data were analyzed using inductive thematic analysis, revealing nine key themes related to the challenges faced by hospital leaders. The main challenges included difficulties with hospital operational procedures, issues related to physical layout design, concerns over insufficient capacity to meet patient demand, disruptions in the supply chain affecting essential resources, challenges in managing hospital staff effectively, barriers in communication within and across departments, infrastructure deficiencies that impacted functionality, financial constraints, and complexities in organizational management. These themes are accompanied by their respective sub-themes and supporting quotes from interview transcripts within this paper. The insights from this study can inform healthcare leaders to develop more efficient operational frameworks to navigate public health crises. Full article

Background: This study aimed to assess patient satisfaction with the quality of healthcare services at selected public primary healthcare facilities in Almaty during the COVID-19 pandemic and to identify associated demographic and facility-related factors. Methods: A cross-sectional, quantitative study was conducted over a period of 6 months, from 30 June to 31 December 2021, through a web-based survey. An adapted questionnaire was employed to survey the respondents. In total, 1035 respondents participated in the study. To examine the relationship between demographic and facility characteristics and patient satisfaction, we utilized the proportional odds model for ordinal logistic regression. Results: A total of eight primary healthcare organizations from the public sector in Almaty participated in the survey. The analysis identified significant demographic predictors of patient satisfaction, such as marital status, social status, self-perceived health, and the use of online consultations. Among the facility-related factors, only the availability of a cross-ventilation system emerged as a significant predictor. Conclusions: This study provides evidence for the factors influencing patient satisfaction with primary healthcare services in Almaty during the COVID-19 pandemic. Both demographic characteristics and facility-level attributes were found to significantly affect satisfaction levels. These findings underscore the need for targeted structural and organizational improvements in primary healthcare settings, especially during public health emergencies. Addressing these gaps through infrastructural upgrades, enhanced preparedness, and the integration of patient-centered care models can help to bolster trust and resilience within Kazakhstan’s healthcare system. Full article

Public-Private Partnerships (PPPs) are essential for accelerating sustainable development as they combine public goals with private sector efficiency, leading to improved service delivery and less financial burden on governments. It is a project delivery model based on long-term contractual arrangements, where the private sector provides services, including engineering, construction, and operation of public infrastructure, taking financial risks. At the project development stage, the private sector carries out a financial risk assessment to ensure economic returns from a PPP investment and secure funding for the project. In this paper, we present a Bayesian Belief Network (BBN)-based model that can be used to assess financial risks, particularly the level of profitability in PPP projects. The proposed model was developed considering PPP projects in the healthcare sector and validated using data on PPP hospital projects in Turkiye. The findings demonstrate that the BBN model is useful for capturing the interdependencies between risks, resulting in different scenarios, and provides effective decision support for investors in PPP projects. This study contributes to the literature by offering a novel application of probabilistic risk assessment to provide a better understanding of interrelated risk factors that may result in different financial scenarios. The model can be used by the private sector to assess risk, estimate profitability, and develop risk mitigation strategies in PPP healthcare projects, which may increase project success, contributing to social, environmental, and economic sustainability. Full article

E-leadership has become particularly prominent in the public sector over the last five years. The urgent shift requires more remote work and management via information and communication technologies. In recognition of its ever-growing popularity, the objective of this article is to provide a systematic review of the existing literature on e-leadership within public sector organisations and identify key research approaches and outcomes. The analysis provides a framework of research on e-leadership in public sector entities, by focusing on various theoretical, methodological, empirical and contextual perspectives, specifically tailored to public sector organisations. The detailed framework, presented here, incorporates dimensions, approaches, clusters and findings of previous research (articles, published in the period 2013–2022), aiding a deeper understanding of the phenomenon and its practical implementation. The study complies with PRISMA 2020 requirements. As it shall be demonstrated, interest in the phenomenon surged during the pandemic, particularly within educational and management disciplines. The findings highlight a predominant focus on leadership within educational institutions, whilst areas such as healthcare and public governance remain under-researched. The most common theoretical approach adopted is associated with the transformational leadership theory and encompasses three main interpretations. Specifically, it evaluates e-leadership as a strategic approach, a leadership process and a leadership transformation. Qualitative methodology predominates in e-leadership research within the public sector, with quantitative and mixed-method approaches being less frequent. Addressing the challenges identified by previous research, such as competency and infrastructure deficiencies, is crucial for advancing knowledge of e-leadership in the public sector and improving sustainable performance. Full article

Snakebite envenoming remains a critical yet underrecognized public health issue, particularly in tropical and subtropical regions, with India bearing nearly half of the global burden of snakebite-related deaths. Despite its significant impact, underreporting, delayed medical intervention, and insufficiently trained healthcare professionals continue to exacerbate the problem. In response, the Government of India launched the National Action Plan for Prevention and Control of Snakebite Envenoming (NAPSE) in March 2024, aiming to halve snakebite-related deaths by 2030. Key challenges during the development and implementation of NAPSE included the limited multisectoral engagement initially, variations in state-level capacities, and logistical barriers in reaching remote populations. Lessons learned include the value of early stakeholder consultations, the importance of inter-ministerial collaboration, and the need for continuous community engagement. This comprehensive strategy emphasizes strengthening surveillance systems, enhancing anti-snake venom (ASV) distribution and quality, improving healthcare infrastructure, and promoting community awareness through a One Health approach. The plan also addresses critical challenges such as inadequate training at primary healthcare levels, inconsistent ASV supply, and inefficient emergency referral systems. By fostering multisectoral collaboration and targeted interventions, such as strengthening Regional Venom Centres and establishing Poison Information Centre, targeted training, and awareness campaigns, NAPSE aims to reduce mortality and disability associated with snakebite envenoming, aligning with global health objectives and setting an example for regional efforts in Southeast Asia. Full article

Multimorbidity, defined as the co-occurrence of two or more chronic conditions in an individual, has emerged as a worldwide public health concern contributing to mortality and morbidity. This complex health phenomenon is becoming increasingly prevalent worldwide, particularly as populations continue to age. Despite the growing burden of multimorbidity, the development and implementation of interventions published by scholars are still in their early stages with significant variability in strategies and outcomes. The variability in strategy and outcome may result from factors such as lack of infrastructure, socioeconomic status and lifestyle factors. The review aims to synthesize interventions designed to manage and mitigate multimorbidity and explore a range of approaches, including pharmacological treatments, lifestyle modifications, care coordination models, and technological innovations. The scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist. It included 1,553,877 individuals with multimorbidity with no age restriction; in the studies that included gender difference, 463,339 male participants and 1,091,538 female participants were involved. Multimorbidity interventions were defined as strategies or programs designed to manage and improve the health and quality of life of individuals with multiple chronic conditions. Of the downloaded articles, those that met the inclusion criteria were published between 2012 and 2024. The final analysis included 100 articles from 3119 published articles, which resulted in 9 themes and 15 subthemes. Themes on the need for lifestyle and behavioural interventions, patient empowerment and engagement, multimorbidity management, health integration, pharmacotherapy optimization, community and policy interventions, healthcare system improvements, technology and digital health, as well as research and evidence-based practice interventions, emerged. The reviewed literature emphasizes the necessity of multidisciplinary approaches to effectively combat the growing public health challenge of multimorbidity. Full article

Public buildings are crucial to creating healthy and sustainable cities. These buildings promote social cohesion and enrich urban life by transforming existing facilities into hybrid models that integrate medical content. Historical developments highlight shifts in residential, economic, and healthcare infrastructure. The healthcare system aims to enhance public health while ensuring financial equity. Reforms in healthcare privatization, governed by public health and insurance policies, involve liberalizing service provision and are supported by the Ministry of Health and Finance. This study examines how public buildings can adapt to enhance health and social sustainability. Through case studies, it assesses architectural adaptability in analyzing spatial, economic, and social impacts. Diagrams illustrate spatial dynamics, while surveys compare efficiency, sustainability, and user experience. Statistical analysis highlights the role of spatial adaptability in fostering sustainable urban environments. The results, which express significant differences between means for different locations and citizens’ satisfaction, suggest that the hypothesis offers substantial results in every area. Besides commercial programs in commercial buildings, healthcare also gives satisfactory results. This study advocates for adaptive architecture as a key strategy, aligning with evolving societal and health demands. Hybridizing healthcare facilities and commercial spaces transforms shopping centers into sustainable models, enhancing social cohesion and economic viability. Full article

Background/Objectives: Human papillomavirus (HPV) is a leading cause of cervical cancer. Despite the proven effectiveness of vaccination programs, global coverage remains uneven, with significant disparities across regions due to various socioeconomic, cultural, and political factors. This study explores the primary barriers to HPV vaccination worldwide and proposes recommendations to improve access to screening and vaccination programs. Methods: A systematic literature review was conducted, analyzing studies published in the past ten years from databases such as PubMed, Scopus, and Embase, following the PRISMA methodology. Study selection involved multiple researchers, with discrepancies resolved through consultation. The quality of the included studies was assessed using CASP checklists. The protocol was registered on Open Science Framework (OSF). Results: Out of 2119 records, eight studies were included. The findings indicate that the main barriers to HPV vaccination include insufficient public awareness, cultural and religious resistance, financial constraints, and limited access in rural and underserved areas. Additionally, political factors, such as low prioritization of HPV vaccination and the absence of supportive policies, were identified as significant obstacles. Multidisciplinary and cross-cultural collaboration, along with the integration of HPV vaccination into existing health programs, was suggested as a strategic approach to improve vaccine uptake. Conclusions: Barriers to HPV vaccination, including limited awareness, inadequate healthcare infrastructure, and socioeconomic factors, vary across regions but must be addressed to improve global coverage. Targeted interventions such as health education, inclusive policies, and culturally sensitive campaigns can significantly boost vaccine uptake. Strengthening local health systems and fostering international collaboration are key strategies to overcoming these barriers and ensuring equitable access to HPV vaccination. Full article

Influenza poses a significant public health threat, causing millions of severe cases and hundreds of thousands of deaths annually. Vaccination remains the most effective measure to reduce transmission, complications, and the strain on healthcare systems. Despite its importance, vaccination uptake remains suboptimal among college students, a key population for infectious disease transmission and a target group for public health interventions. The primary objective of this study was to examine the psychological and contextual determinants of influenza vaccination among college students in Israel, utilizing the Theory of Planned Behavior (TPB) as the guiding framework. A cross-sectional online survey was conducted among 591 students at Ashkelon Academic College between April and May 2023. The questionnaire included validated items assessing attitudes toward vaccination, subjective norms, perceived behavioral control, and vaccination history. Hierarchical logistic regression was used to assess the predictive power of these variables in explaining actual vaccination behavior. The results indicated that prior vaccination was the strongest predictor of current influenza vaccine uptake (OR = 38.7, p < 0.001). Positive attitudes (e.g., belief in vaccine protection), strong social influences (e.g., parental vaccination behavior and trust in healthcare professionals), and high perceived behavioral control (e.g., accessibility and convenience) were all significantly associated with increased vaccination likelihood. The final model explained 68% of the variance in vaccination behavior (Nagelkerke R² = 0.68, p < 0.001). These findings affirm the TPB as a robust framework for understanding vaccination behavior and underscore the importance of habitual vaccination, public trust, and systemic accessibility. The study contributes to the field by illustrating how national healthcare infrastructure interacts with individual-level beliefs to shape preventive health actions. Practical applications include the development of targeted interventions to promote first-time vaccination, address vaccine safety concerns, and leverage trusted social networks. Future research should investigate how digital communication, policy variation, and sociocultural context influence the components of the TPB across diverse populations. Full article

Population aging is an irreversible global trend, with China experiencing an aging trajectory far exceeding that of most low- and middle-income and high-income countries. Emerging evidence highlights the urban built environment (BE) as a critical determinant of older adults’ travel behavior (TB), exerting a greater effect than commuter populations. However, findings on BE-TB associations remain inconsistent. This study systematically reviewed 46 studies from 1666 articles retrieved from Web of Science and China National Knowledge Infrastructure databases, applying CiteSpace 6.4.R1 for keyword co-occurrence and temporal clustering analysis. This review synthesizes research trends, theoretical frameworks, key determinants, and methodological approaches by integrating knowledge from multiple fields such as urban planning, transportation engineering, public health, and social policy. It provides a comprehensive perspective on how the BE influences the TBs of the aging population. This article can contribute to improving the quality of life for older adults, promoting intergenerational harmony, reducing healthcare costs, fostering economic development, and encouraging green transportation. By identifying critical gaps and future research directions, our findings offer insights to inform strategies for promoting healthy aging and sustainable urban development. Full article

The growing concern over the transmission of pathogens, particularly in high-risk environments such as healthcare facilities and public spaces, necessitates the development of effective and sustainable antimicrobial solutions. Traditional coatings often rely on metals, which despite their efficacy, pose significant environmental and economic challenges. This study explores the potential of bio-based alkyd resins, supplemented with natural antimicrobial bioadditives, as an eco-friendly alternative to traditional antibacterial and antiviral coatings. Specifically, alkyd formulations incorporating thymol and soft resins extracted from hops were evaluated for antimicrobial and antiviral efficacy, following ISO standards (ISO 22196:2007 and ISO 21702:2019, respectively). The coating formulations showed significant activity against Gram-negative (Escherichia coli) and Gram-positive (Staphylococcus aureus), and Influenza A (H3N2) virus, proving their potential for mitigating pathogen spread. These bio-based coatings not only reduce reliance on harmful chemicals but also align with circular economy principles by repurposing industrial by-products. This innovative approach represents a significant step toward greener antimicrobial technologies, with broad applications in healthcare, public infrastructure, and beyond, especially considering the rising zoonotic disease outbreaks. Full article

Background: Cochlear implants (CIs) have become a widely used intervention for Deaf and hard-of-hearing (DHH) children, particularly for developing spoken language. However, parental decision-making regarding CIs is influenced by a range of factors, including socio-economic status, healthcare accessibility, cultural beliefs, and societal attitudes. While extensive research on parental perceptions of CIs exists in high-income countries (HICs), there is limited research on these perspectives in low- and middle-income countries (LMICs), like South Africa, where disparities in healthcare access significantly impact CI uptake. Objectives: This study aimed to explore the views and perceptions of South African parents regarding CIs for their DHH children, with a specific focus on how financial, cultural, and informational barriers influence decision-making. Methods: A mixed-methods approach was used, combining Q-methodology for quantitative data and thematic analysis for qualitative insights. Nine parents of DHH children participated. The Q-set survey ranked parental attitudes toward CI risks, benefits, and accessibility, while semi-structured interviews provided deeper insights into decision-making processes. Factor analysis grouped participants into clusters based on their perceptions, and qualitative data were analysed using a thematic framework approach. Results: Findings revealed two distinct parental clusters: (a) Cluster 1 parents viewed CIs as essential for speech development and strongly supported implantation, and (b) Cluster 2 parents recognized CI benefits but emphasized that outcomes vary based on individual circumstances. Three overarching themes emerged from thematic analysis: (1) financial barriers restricting CI access, (2) parental reliance on medical professionals for decision-making, and (3) persistent stigma and cultural beliefs influencing CI perceptions. Conclusions: This study highlights critical barriers to CI access in South Africa, including socio-economic inequities, limited healthcare infrastructure, and persistent stigma. While parents largely recognized the benefits of CIs, their decisions were shaped by financial constraints and concerns about Deaf identity and societal acceptance. This study calls for the expansion of publicly funded CI programmes, the development of culturally tailored parental counselling protocols, and targeted public awareness campaigns to reduce stigma surrounding hearing restoration devices. These interventions can help mitigate financial and cultural barriers to CI adoption in South Africa. Full article

Background: Children with disabilities, particularly in low- and middle-income countries (LMICs), face heightened risks of vaccine-preventable diseases due to a range of systemic and social barriers. Although immunization is a fundamental human right and a proven public health intervention, this vulnerable group is often overlooked in policy and practice. Understanding the factors compromising vaccine equity for these children is critical to reducing zero-dose prevalence and improving health outcomes. Methods: This scoping review examined peer-reviewed, gray literature from 2010 to 2024. Searches were conducted in PubMed, Google Scholar, and relevant organizational reports (WHO, UNICEF). Studies addressing children with disabilities and focusing on immunization barriers, interventions, or lessons learned were selected. English-language publications were screened in title/abstract and full-text stages. Key data extracted included population, barriers, and immunization outcomes. Since this review focused on articles in English, this is a key limitation. Results were synthesized thematically to identify recurring patterns and to guide improved interventions and policies. Results: Twelve articles met the inclusion criteria. Key barriers identified were inadequate healthcare infrastructure, insufficient provider training, limited follow-up services in rural regions, societal stigma, and pervasive misconceptions around both disability and vaccines. Factors such as maternal education, logistical support for caregivers, and using low-sensory, inclusive vaccination settings were consistently linked with better outcomes. Effective strategies included mobile vaccination units, tailored interventions (e.g., distraction or sedation techniques), school-based immunization programs, and robust community engagement to address stigma. Lessons learned underscored the importance of flexible, individualized care plans and empowering families through transparent communication. Conclusions: Children with disabilities continue to experience significant gaps in immunization coverage, driven by intersecting barriers at the individual, health system, and societal levels. Scaling tailored interventions, inclusive policies, strengthened infrastructure, and ongoing research can help ensure these children receive equitable access to life-saving vaccinations. Full article