Search Results (401)

Background: During the flu season, there is an increase in absenteeism due to illness, a drop in productivity, and a greater risk of the virus spreading among workers. Thus, the Italian Ministry of Health recommends vaccination for essential service workers. The University of Salerno, in collaboration with the local health authority of Salerno, offers free vaccination to its employees. Methods: A public health methodology for seasonal influenza vaccination in the workplace is presented—specifically in the university setting—with the aim of identifying individual, contextual, and organizational elements of the model that have promoted vaccination uptake. An ad hoc questionnaire was used (October–December 2025) to survey 399 academic employees, investigating seasonal influenza vaccination in the following aspects: recent personal experiences, motivations, vaccination experiences at university, sources of information, considerations regarding national and local vaccination campaigns, and level of vaccine confidence (VCI). Results: Seasonal influenza vaccination at the University is appreciated for its compatibility with working hours (66.1%), the availability of a platform that allows flexible booking (56.9%), the perception of safety in the environment (31.6%), the fact that the vaccine is free (17.4%), and the involvement of office/laboratory colleagues (5%). Participants appreciate the model and would apply it to other vaccinations at the University and in other institutional settings. A significant relationship (F = 7.24; df = 1; p < 0.05) exists between confidence in the vaccine and the sense of security experienced when receiving the vaccine in the workplace. Data analysis was performed using the IBM SPSS v.28 software. Conclusions: The model proposed can be applied to other institutional contexts, simplifying and facilitating access to vaccines by implementing vaccination campaigns tailored to specific work environments. Full article

Background: Functional abdominal pain disorders (FAPDs) are common in youth and are often associated with depressive symptoms, school absenteeism, somatic symptoms, and low quality of life. This study aims to evaluate the effects of a dance and yoga intervention on abdominal pain frequency and associated symptoms over 24 months. Methods: This study presents analyses from a randomized controlled trial including 121 girls aged 9–13 years who were diagnosed with FAPDs. The intervention consisted of twice-weekly group sessions over eight months, combining dance and yoga. The primary outcome, maximum abdominal pain at 8 months, was published in 2022. Abdominal pain, depressive symptoms, health-related quality of life, school absenteeism, and somatic symptoms were prespecified as secondary outcomes in this study’s protocol. In the present manuscript, abdominal pain is analyzed as abdominal pain frequency. These secondary outcomes were assessed at 4, 8, 12, and 24 months. Both intention-to-treat and supportive per-protocol analyses were performed. Results: The intention-to-treat analysis showed a reduction in abdominal pain frequency in the intervention group compared with controls, with a mean difference of −1.10 with respect to the 95% CI (days per week) (−2.03 to −0.16; p = 0.02) at 8 months and −1.34 (−2.28 to −0.40; p = 0.005) at 12 months. No significant group differences were observed in the other outcomes. Per-protocol analyses showed similar or greater positive effects of the intervention. Conclusion: An intervention with combined dance and yoga has the potential to contribute to reductions in abdominal pain frequency at 8 and 12 months post-baseline in girls with FAPDs. Full article

Background: Examining the relationship between burnout and absenteeism is important for understanding how chronic occupational stress translates into economic costs, reduced productivity, and deterioration in the health of nursing staff. The aim of this study was to evaluate absenteeism among nursing staff and its association with burnout from a gender perspective. Methods: A total of 154 nursing professionals with permanent contracts were included. An interview was conducted, which included the collection of sociodemographic data, characteristics related to their employment status, and the Maslach Burnout Inventory questionnaire in its Spanish-validated healthcare personnel version. The absenteeism rate was calculated using information from the hospital’s human resources department. The Mantel–Haenszel test was used to identify the association between burnout and absenteeism from a gender perspective. A p-value < 0.05 was considered statistically significant. Results: The prevalence of burnout was 70.1%; 52.6% reported absenteeism in 2024. The general nursing category was significantly associated with burnout (p = 0.039). Although no association was found between burnout and overall absenteeism, holding multiple jobs was identified as a determinant of partial absenteeism (p < 0.05). The hospital absenteeism rate was 4.8%. No statistically significant difference was found between burnout, gender, and absenteeism, with an adjusted odds ratio of 1.386 (95% CI: 0.75–2.65) after controlling for the effect of gender (χ²_MH = 0.672, df = 1, p = 0.412). Conclusions: Nursing staff present a critical level of burnout. No statistically significant difference was found between burnout, gender, and absenteeism, which could indicate that gender roles in the workforce may be changing in our population. Full article

Background and Objectives: Hereditary angioedema (HAE) represents a specific form of life-threatening inborn errors of immunity. Current guidelines recommend regular assessment of the disease burden, disease control and quality of life. This study describes the profile of HAE patients in Slovakia, disease control, quality of life, states of anxiety and depression, and socioeconomic situation. Materials and Methods: We used a set of standardized questionnaires—AE-QoL, AECT, HADS and Socioeconomic Status Questionnaire, and a non-standardized questionnaire—to describe the characteristics of the population. Results: We collected data on 56.44% (57 out of 101) of HAE adult patients registered in Slovakia. Moderate to severe HAE was present in 61.40% of patients; 73.68% were on long-term prophylactic treatment; and 19.30% received rescue treatment due to an acute HAE attack during the last 4 weeks. Most patients achieved lower AE-QoL scores, indicating a good quality of life. The AECT score indicated well-controlled disease in 91.23% of patients. Anxiety and/or depression scores were higher than normal in 17.54% of patients. Patients with HAE earned less than the average population, but most of them were economically active with relatively low rates of presenteeism and absenteeism. Only a minority of patients used social system benefits. Patients were exclusively cared for by relatives. Conclusions: The QoL scores achieved in all three standardized questionnaires indicate a good quality of life of HAE patients in Slovakia, which is associated with a high and specialized standard of care. Anxiety and/or depression were present in 17.54% of patients. Direct patients costs and social care costs are low, but there is an indirect socioeconomic burden on patients and their families. Full article

Background: Disorders of the gut–brain interaction (DGBIs) constitute a group of functional conditions widely described in adults; however, some of these have not been included in pediatric Rome criteria, despite the fact that they may manifest during childhood. Early identification of these conditions is relevant due to their clinical/psychosocial impact as well as their effect on quality of life. The aim was to determine the prevalence and associated factors of some DGBIs described in adults according to the Rome IV criteria in pediatric population. Methods: An observational/prospective/cross-sectional study was conducted in toddlers, school-aged children, and adolescents from three Colombian cities. The adapted Questionnaire for Pediatric Gastrointestinal Symptoms Rome IV (QPGS-IV) using adult criteria was applied, along with quality-of-life scales and PROMIS for anxiety/depression. Descriptive uni/bivariate analyses were performed as well as a multivariate logistic regression model. Results: A total of 704 participants were included (13.7 ± 2.8 years old). The prevalence of DGBIs described in adults according to QPGS-IV was 5.8%, with proctalgia fugax being the most frequent. In the bivariate analysis, race, school/social absenteeism, depressive traits, and impaired quality of life were significantly associated. In the multivariate model depressive traits (OR = 4.08; 95%CI = 1.82–9.12; p = 0.001), school (OR = 2.51; 95%CI = 1.06–5.98; p = 0.036), and social absenteeism (OR = 4.04; 95%CI = 1.70–9.62; p = 0.002) were the factors independently associated. Conclusions: These adult DGBIs, according to the QPGS-IV, can occur in pediatric populations and are closely related to psycho-emotional and functional factors. These are mainly associated with depression and school/social absenteeism, supporting the need for a biopsychosocial approach and a revision of the pediatric diagnostic criteria. Full article

Public organizations in Peru have committed substantial resources to artificial intelligence over recent years, yet evidence on whether these investments produce measurable returns has remained scarce. This study evaluated the causal impact of AI adoption on administrative efficiency across 20 Peruvian national public organizations, using a quasi-experimental design combining Difference-in-Differences with Propensity Score Matching, complemented by XGBoost version 1.7.6, Random Forest, GPT-4, and SHAP explainability analysis. The sample comprised 428 civil servants across treatment and control organizations. Results showed significant efficiency gains as perceived by civil servants through validated Likert instruments: work absenteeism decreased by 9.4%, processing times by 8.7%, and administrative costs by 18.2%, all at p < 0.001 with Cohen’s d ranging from 0.55 to 0.90. The convergence between DiD and PSM estimates supports a causal reading of these effects. Four of five hypotheses were supported. AI delivered comparable efficiency gains regardless of institutional complexity, so H2 was not confirmed. Digital infrastructure significantly moderated AI effectiveness (H3: r = 0.198, p = 0.004). Higher resistance to change was significantly associated with lower efficiency outcomes (H5: r = −0.256, p < 0.001), reinforcing the role of proactive change management as a positive moderator of AI effectiveness. SHAP analysis revealed that training investment, specialized IT personnel, and resistance management together explained 51% of predictive importance, outweighing structural variables such as budget size or geographic location. These findings provide the first systematic causal evidence on AI efficiency in Peruvian public administration and offer actionable benchmarks for comparable middle-income public sectors. Full article

Background/Objectives: Healthcare worker (HCW) sickness absenteeism can disrupt healthcare service delivery and increase workload pressures, yet evidence from Kuwait remains limited. This study examined patterns of sick leave episodes and duration among HCWs in Kuwait and identified associated predictors. Methods: We conducted a nationwide retrospective analysis of sick leave utilization using Ministry of Health (MOH) administrative records for 2022, including 51,204 HCWs across all MOH healthcare facilities. Outcomes were sick leave episodes and sick leave duration. Independent variables included age, gender, nationality, place of residence, profession, managerial position, and influenza vaccination status. Zero-inflated negative binomial regression models were used to estimate adjusted incidence rate ratios (IRRs) with 95% confidence intervals (CIs). Results: In 2022, 196,840 sick leave episodes and 295,206 sick leave days were recorded, with 53% of HCWs experiencing at least one episode. Upper respiratory tract infection (URTI)-related sick leave exhibited seasonal variation, with higher proportions during winter months. Younger age, female sex, Kuwaiti nationality, non-managerial position, and medical technician professions were associated with higher sick leave episodes and duration, while physicians, dentists, and pharmacists had lower sick leave utilization compared with nurses. Influenza vaccination was associated with fewer sick leave episodes and shorter duration. Conclusions: Sick leave patterns among HCWs in Kuwait show noticeable seasonal, demographic, and occupational variation. Targeted preventive strategies and workforce policies may help reduce sick leave burden. Full article

Endometriosis and PCOS are both leading causes of female infertility, each affecting approximately 10% of reproductive-aged women worldwide. Both conditions markedly impair quality of life by affecting physical health, emotional well-being, mental health, and social functioning, and they impose a substantial economic burden through surgical treatments, assisted reproductive technologies, and work absenteeism. Insulin resistance (IR) plays a key role in the pathogenesis of both disorders by promoting chronic low-grade inflammation and disrupting sex hormone homeostasis. Consequently, interventions targeting metabolic dysfunction and inflammatory processes may improve clinical outcomes. In this context, the kynurenine system—the primary metabolic pathway of tryptophan degradation—has emerged as a potential mechanistic link between inflammation, metabolic disturbances, and reproductive disorders. Chronic inflammation and psychological stress can enhance kynurenine pathway activation, leading to immune dysregulation, oxidative stress, altered neuroendocrine signaling, and impaired ovarian function. Dysregulated kynurenine metabolism has also been associated with IR and mood disturbances, which are common features of endometriosis and PCOS. Physical activity (PA) is widely recognized for its anti-inflammatory, metabolic, and stress-reducing effects. Emerging evidence suggests that PA may also modulate the kynurenine system by shifting tryptophan metabolism toward neuroprotective pathways. Various exercise modalities—including aerobic, resistance, and mind–body exercises—have shown beneficial effects; however, well-designed long-term studies are still needed. The aim of this review is to synthesize and critically evaluate the published literature on the effects of PA on IR, inflammation, kynurenine metabolism, and reproductive health in women with endometriosis and PCOS. Full article

This paper analyzes factors affecting school absenteeism due to an injury or illness among the US school student population between 6 and 15 years of age. The number of missed school days displays overdispersion and is modeled using the Finite Mixture Roy (FMR) model for count variables. The married/single parent family status (treatment) is potentially endogenous to the dependent variable (missed days). The Roy structure controls observed heterogeneity due to the mother’s marital status. Finite mixtures are intended to control unobserved heterogeneity due to healthy and unhealthy children in the sample. This approach facilitates identification of latent subpopulations in which treatment and marginal effects are relatively homogeneous. The model also incorporates two application-driven extensions. First, probabilities of the latent components are modeled as functions of regressors. Secondly, the mother’s income affects treatment nonparametrically. The FMR model is estimated with two latent components in each state, corresponding to healthy and unhealthy students. The results indicate that maternal marital status decreases annual missed school days by approximately 13 percent for a randomly drawn child; however, this increases absenteeism by about 14 percent among families that self-select into two-parent households, which is evidence of adverse selection. Full article

Background/Objectives: Low back pain (LBP) is a leading cause of disability and work absenteeism worldwide. Lumbar facet joint degeneration is a common source of chronic LBP, and when conservative treatment fails, interventional procedures may be indicated. Cryodenervation is a minimally invasive option that remains less extensively studied. This study aims to evaluate clinical outcomes, cost–utility, and return-to-work rates following lumbar facet joint cryodenervation. Methods: A retrospective study included 42 professionally active patients treated with lumbar facet joint cryoablation between 2020 and 2022 at a tertiary neurosurgical center. All patients had facet-mediated LBP confirmed by a positive diagnostic medial branch block. Pain (VAS), disability (ODI), and work status were assessed before and after treatment. ODI scores were converted to SF-6D utilities to estimate quality-adjusted life years (QALYs). Cost data were obtained from institutional records. Results: Mean ODI improved from 48.5 ± 12.8 to 36.6 ± 17.8, and mean VAS from 7.0 ± 1.7 to 3.8 ± 2.0. Mean SF-6D increased from 0.53 to 0.59, corresponding to a gain of 0.0103 QALYs over four months (annualized 0.0309). The mean procedure cost was 1905 PLN, resulting in approximately 185,000 PLN per QALY, which is within the national cost-effectiveness threshold. Overall, 58.5% of patients returned to work, with the highest rate in those aged 30–39 years (83.3%). Conclusions: Lumbar facet cryoablation provides meaningful pain relief and functional improvement at a favorable cost-effectiveness profile. Younger patients show higher return-to-work rates. Larger prospective studies are required to confirm these findings. Full article

Background/Objectives: The second victim phenomenon is increasingly recognized as a significant issue affecting nurses involved in adverse events resulting from clinical decisions or interventions. Although patients and families, considered the first victims, are directly impacted, nurses often undergo challenges as second victims. With the growing awareness of these effects, this study aimed to map recent evidence on the second victim phenomenon among nurses in Western countries. Methodology: A Scoping Review was conducted following the Joanna Briggs Institute methodology in September 2024 and updated in November 2025. Eligibility criteria were defined using the PCC (Population, Concept, Context) framework. Searches were performed in PubMed, CINAHL, SciELO, and Scopus. Two independent reviewers carried out study selection, data extraction, and synthesis. Rayyan^® supported screening, performed in two phases: title/abstract review and full-text analysis. Data extraction was conducted in Excel^®, and data were analyzed using descriptive statistics and categorized into thematic areas. The review followed PRISMA-ScR guidelines and was registered in the Open Science Framework. Results: Of the 111 articles retrieved, 39 met the inclusion criteria. Evidence shows that although several support programs exist for nurses as second victims, they are often perceived as inadequate or inconsistently implemented. Second victim experience is associated with physical (e.g., sleep disturbances), emotional (e.g., fear), and psychological (e.g., distress) symptoms, with consequences such as absenteeism, professional dissatisfaction, loss of meaning in life, and even suicide. Conclusion: Findings highlight the need for more comprehensive, accessible, and consistently implemented support strategies to meet the complex needs of nurses affected by the second victim phenomenon. Full article

Sick leave in physically demanding warehouse logistics poses persistent challenges for employee well-being, operational performance, and sustainable work participation. This study investigates how warehouse employees and supervisors understand drivers of absence and presence, and which workplace resources are perceived as most important for sustaining work happiness and attendance. Using an explanatory sequential mixed-methods design, phase 1 comprised in-depth interviews with warehouse leaders and focus groups with employees (N = 20). Qualitative findings highlight physical strain and sustained pace demands, but also emphasized psychosocial drivers such as emotional exhaustion, limited recognition, insufficient relational support, and a “push-through” culture that normalized strain and hindered recovery. At the same time, collegial support, humor, and everyday recognition were described as critical resources for coping and maintaining presence. Building on these insights, we used a cross-sectional survey (N = 99) to assess work happiness and perceived negative workplace conditions. Exploratory factor analysis identified four work happiness dimensions—supervisor support and recognition; self-development, meaning and autonomy; interpersonal relationships; and collaboration to achieve goals and four dimensions of negative workplace conditions: structural alienation, work-related exhaustion, adverse social climate, and work intensity. Multiple regression analyses showed that interpersonal relationships were the most consistent protective resource, negatively associated with exhaustion, adverse social climate, and work intensity, while supervisor support and recognition primarily reduced structural alienation. Overall, the findings suggest that social relationships constitute a central resource for sustainable well-being and attendance in physically demanding work, offering actionable implications for HRM. Full article

Sorghum-based porridges are a key component of breakfast meals in South African school feeding programmes. While these meals support learner nutrition and educational outcomes, their effectiveness depends on learner acceptance and the extent of plate waste. This study assessed acceptance and plate waste of two sorghum-based porridges—Mabele (100% sorghum) and Morvite (pre-cooked sorghum, 75–100% depending on flavour, with possible inclusion of soya, cow’s milk, and wheat/gluten)—compared with instant maize meal, Jungle Oats (100% wholegrain oats), within the Tiger Brands Foundation breakfast programme. Patterns of waste and underlying reasons were examined across five provinces. A mixed-methods approach was used in 25 primary schools across Gauteng, KwaZulu-Natal, Limpopo, North West, and Northern Cape. Quantitative data were collected through 10-day food waste diaries completed by Volunteer Food Handlers and analysed using descriptive statistics, ANOVA, and regression models. Qualitative data were obtained from 75 semi-structured staff interviews and 25 learner focus groups, analysed thematically using ATLAS.ti version 22. Overall, food waste was low, with “no food waste” reported in over half of the observations. Acceptance of sorghum-based products varied. Morvite was generally well accepted, whereas Mabele was frequently disliked in some provinces. Key drivers of waste included food dislike, poor preparation, bland flavour, and learner absenteeism, with serving conditions and a lack of utensils as secondary factors. Although waste was modest, variability in acceptance of sorghum-based porridges suggests the need to improve preparation quality, flavour, and serving conditions to enhance programme effectiveness. Full article

Digital transformation poses significant challenges to employee well-being, particularly in public administration, where hierarchical structures, increasing digitalization pressures, and high mental health-related absenteeism underscore the need to understand individual and job demands and resources. This study explores these aspects from the perspectives of employees and supervisors in public administration. Between September 2023 and February 2024, semi-structured interviews were conducted with eight employees and eleven supervisors from public administration organizations in Northern Germany and analyzed using deductive–inductive qualitative content analysis based on the Job Demands-Resources model. Identified individual resources included technical affinity, error tolerance, and willingness to learn, while key job resources involved early and transparent communication, attentive leadership, technical support, and counseling services, with most job resources linked to leadership behavior and work organization. Reported job demands comprised insufficient participation, inadequate planning, and lengthy procedures, whereas personal demands included fears and concerns about upcoming changes and negative attitudes toward transformation. The variation in perceived demands and resources highlights the individuality of the employees’ experiences. The findings provide initial insights into factors influencing psychological well-being at work during digital transformation, emphasizing the importance of participatory communication, employee involvement, leadership awareness of stressors, and competence development. Future research should employ longitudinal and interventional designs to improve causal understanding and generalizability. Full article

Background: Leakage is a major concern for individuals living with a stoma and may negatively impact quality of life (QoL). A digital leakage notification system (DLNS) recently launched in the UK provides timely notifications to users via their smartphone when faeces is detected underneath the baseplate. This provides predictability and enables users to take proactive measures to help avoid leakages outside the baseplate. Methods: A single-arm, observational, longitudinal study of the DLNS, including its associated support service, has been initiated to follow 300 users for a year in the UK to evaluate long-term health benefits of the DLNS and its implications for healthcare resource utilisation in a real-world setting. The DLNS is prescribed by healthcare professionals (HCPs), and all users were invited to participate in the study. Study participants complete questionnaires capturing data on QoL (using the Ostomy Leak Impact tool), number of leakages outside the baseplate, utilisation of ostomy products, interactions with HCPs, and work productivity (using the Work Productivity and Activity Impairment questionnaire) at baseline and then every third month for one year. Data from the planned interim analysis of the first 100 participants who had been in the study for 6 months is presented. Results: Use of the DLNS for 6 months together with the associated support service was associated with a 51% reduction in leakage episodes outside the baseplate (p < 0.001) and great improvements in QoL (p < 0.001). Use of the DLNS reduced the number of unplanned baseplate changes due to worry about leakage by 47% (p < 0.001) and overall was associated with a reduction in the number of baseplates used by 14% (p = 0.002). Total time spent with HCPs related to stoma care was reduced by 65% after 6 months compared with baseline (p < 0.001). Work absenteeism and presenteeism improved significantly with the use of the DLNS. Conclusions: The interim results of this prospective, longitudinal study provided first insights into the long-term benefits of the DLNS in a real-world setting. ClinicalTrials.gov ID: NCT06554015. Full article