International Journal of Environmental Research and Public Health

Radiology services play a vital role in modern healthcare, yet disparities in access and concerns about occupational radiation exposure remain understudied in many countries, including Kazakhstan. This study evaluates national trends in diagnostic imaging services, workforce distribution, and radiation-related anxiety among medical personnel. We analyzed national diagnostic imaging infrastructure and workforce data from 2018–2024. Individual radiation exposure data (n = 177) were obtained from dosimetry records in Astana’s medical facilities. Additionally, a cross-sectional survey (n = 324) was conducted using the Spielberger–Hanin Anxiety Scale to assess radiation-related anxiety and associated factors. Between 2018 and 2024, the number of CT rooms in Kazakhstan more than doubled from 162 to 358 (+121%), while X-ray examinations declined from 20.6 to 14.6 million (−29.2%) and fluorography dropped by 67.7%. CT scans increased over threefold, from 491,738 to 1.6 million. Radiologists grew from 3529 to 4511 (+27.8%), and ultrasound doctors from 1396 to 2178 (+56.1%). Interventional physicians had the highest quarterly radiation dose (0.65 ± 0.58 mSv, p = 0.001). Among radiology professionals, 32% reported anxiety related to occupational exposure. Anxiety was significantly associated with not using aprons (58% vs. 27%, p < 0.001), lack of dosimeter use (27% vs. 12%, p = 0.001), and inadequate safety training (27% vs. 6%, p < 0.001). Spielberger–Hanin scores ≥ 45 indicated high levels of situational (58%) and personal (56%) anxiety in this group. Kazakhstan’s diagnostic radiology capacity has grown rapidly, especially in CT availability, yet regional disparities and occupational anxiety remain critical concerns. Targeted workforce distribution, improved protective practices, and enhanced radiation safety education are urgently needed.

Background: Type 2 diabetes mellitus (T2DM) presents a significant and escalating public health burden in Saudi Arabia, adversely affecting various dimensions of patients’ well-being. This study aimed to assess the multidimensional quality of life (QoL), also referred to as health-related quality of life (HRQoL) across financial, physical, psychological, and sexual domains among individuals with T2DM in Al Baha, Saudi Arabia, and to compare these outcomes with non-diabetic individuals. Methods: A cross-sectional analytical study was conducted between October 2023 and November 2024 using a structured, self-administered online questionnaire. A total of 948 adults participated, including 495 individuals diagnosed with T2DM and 453 non-diabetic controls. The instrument collected sociodemographic data, disease history, treatment modalities, comorbidities, and QoL indicators across four domains. Results: Diabetic participants demonstrated significantly lower scores in psychological, physical, and sexual QoL domains compared to non-diabetics (p < 0.05). Lower psychological QoL was independently associated with younger age and longer disease duration. Physical QoL was significantly influenced by gender, disease duration, and type of treatment, while sexual QoL was negatively impacted by lower educational attainment and presence of comorbidities. A higher financial burden was strongly correlated with reduced psychological and physical QoL (r = −0.569 and −0.469, respectively; p < 0.001). Conclusion: T2DM is associated with impaired QoL across multiple domains. Targeted, multidimensional interventions are needed to address the physical, psychological, sexual, and financial challenges faced by diabetic individuals in this region.

This study examines how Israel’s legal and institutional arrangements, including migration policies, health-insurance eligibility rules, and safety enforcement mechanisms, shape health risks for Thai migrant agricultural workers, and identifies policy levers to mitigate preventable harm. Using a legal policy analysis informed by syndemics and labor frameworks, we mapped laws, regulatory oversight, and enforcement chains, and synthesized evidence from worker surveys, affidavits, and civil society reports to link institutional structures with barriers experienced in workplaces and healthcare settings. The findings reveal that health inequalities stem from structural design rather than isolated failures, including exclusion from public insurance, dependence on employer-based plans, employer-tied visas, opaque injury-claim procedures, fragmented oversight, absence of occupational-health surveillance, limited language access, poor housing conditions, and weak inspections. These interlocking features reinforce one another, resulting in under-reporting, delayed medical attention, and cumulative physical and psychological harm. The study concludes that structural legal and administrative reforms—rather than individual adaptation—are required to address these inequities. Policy priorities include integrating migrant workers into public insurance or ensuring equivalent coverage, decoupling residency from single employers, guaranteeing multilingual access, establishing independent health monitoring, and enforcing safety, housing standards and other social determinants of health through transparent inspections, positive incentives and meaningful sanctions.

Wastewater monitoring is a well-established form of community-based public health surveillance technology that gained renewed attention during the COVID-19 pandemic as an early warning system for SARS-CoV-2 infection trends. For monitoring data to be effectively translated into public health action, however, communication strategies that address public risk perceptions and foster cooperation are essential. This study focuses on wastewater monitoring in the context of COVID-19 and provides an evidential basis for developing targeted public health messages by segmenting the population into risk perception profiles. A survey of 332 Colorado residents was analyzed using latent class analysis (LCA), revealing four profiles: the worrisome (48%), the practical (19%), the community-oriented (11%), and the minimally concerned (22%). LCA with covariate analysis showed that communal coping orientation, belief in misinformation, and attitudes and knowledge of wastewater monitoring, along with age, education, and political ideology, were associated with these profiles. Findings highlight how communication strategies for community-based public health surveillance can be tailored to different population subgroups.