Search Results (480)

Whilst there has been an increasing trend of women holding academic positions in European Higher Tertiary Institutions (HTIs), leadership positions are held predominantly by men. The study draws on radical feminism theory with which its methodology is aligned by investigating the perceptions of both genders. To that end, the study categorizes the impediments holding women back from breaking the glass ceiling into endogenous and exogenous factors. By doing so, the authors are in a better position to recommend the implementation of policies and procedures to address this inequality and navigate towards achieving sustainable gender equality. The research was conducted using an online survey questionnaire administered among all academic and administrative staff of universities in the Republic of Cyprus, the country with the highest glass ceiling in the EU. The authors found that the binary genders differ in their perceptions of what keeps women from breaking the glass ceiling and that this is attributable to exogenous factors, namely, (a) the walls created by male leaders, reinforcing a feeling of marginalization and mansplaining; and (b) family obligations enhancing women’s experiencing a lack of time and burnout. Furthermore, the exogenous factors and the extremely gendered higher echelons of HTIs underpin the endogenous factor of self-sabotage, making women feel they would rather avoid the toxic leadership environment with its lack of professional credit, a view supported by radical feminism theory. The authors suggest practical policy implications to rectify the gender imbalance in leadership in HTIs and suggest directions for future research. Full article

Objectives: Burkholderia cepacia complex (Bcc), a Gram-negative organism, is a well-recognized cause of hospital outbreaks, often linked to a contaminated shared source, such as multidose medications. In this study, we report an outbreak of Bcc infections in a tertiary care hospital, associated with the intrinsic contamination of a prepared solution used in interventional radiology (IR) procedures. Additionally, we provide a detailed explanation of the interventions implemented to control and interrupt the outbreak. Methods: Records from the infection control committee from 1 January 2023 to 31 October 2024 were screened to identify cases with Bcc growth in cultured blood, urine, or respiratory samples. Clinical and laboratory data were collected in March 2025. Bacterial identification was performed using conventional methods and MALDI-TOF (Bruker Daltonics, Bremen, Germany). Controls were matched to cases by ward, date of initial growth, and duration of hospitalization. Demographic and clinical data of these patients were systematically collected and analyzed. Microbiological cultures were obtained from environmental objects of concern and certain medications. Results: A total of 82 Burkholderia species were identified. We enrolled 77 cases and 77 matched controls. The source of contamination was identified in ready-to-use intravenous medications (remifentanil and magnesium preparations) in the IR department. These preparations were compounded in advance by the team and were used repeatedly. Although the outbreak originated from contaminated IV medications used in IR, secondary transmission likely affected 28 non-IR patients via fomites, shared environments, and possible lapses in isolation precautions. The mortality rate among the cases was 16.9%. Infection with Bcc was associated with prolonged intensive care unit stays (p = 0.018) and an extended overall hospitalization duration (p < 0.001); however, it was not associated with increased mortality. The enforcement of contact precautions and comprehensive environmental decontamination successfully reduced the incidence of the Bcc outbreak. No pathogens were detected in cultures obtained after the disinfection. Conclusions: The hospital transmission of Bcc is likely driven by cross-contamination, invasive medical procedures, and the administration of contaminated medications. Implementing stringent infection control measures such as staff retraining, updated policies on medication use, enhanced environmental decontamination, and strict adherence to isolation precautions has proven effective in curbing the spread of virulent and transmissible Bcc. Full article

This study focuses on the current service/care difficulties and challenges that social institutions in Hungary are facing during their daily operations; how they can react to them utilizing their internal resources, mechanisms, and capacities; and what concrete, tangible needs and demands are emerging in terms of methodological professional support, potential forms, interventions, and direction for professional development. A total of 24 general and 55 specific service and operational problems were identified and assessed in eight different service areas (family and child welfare services, family and child welfare centers, respite care for children, care for the homeless, addiction intervention, care for people with disabilities, care for psychiatric patients, specialized care for the elderly, and basic services for the elderly). The empirical base of the study uses a database of 201 online questionnaires completed by a professional target group working for social service providers in two counties (Győr-Moson-Sopron and Veszprém), representing 166 social service providers. The questionnaires were completed between November and December of 2022. The findings will be used to develop a professional support and development problem map. Social institutions face complex and serious service/care difficulties and challenges in their daily operations. Three distinctive basic problems clearly stand out in both severity and significance from the complex set of factors assessed. The biggest problem in the social care system is clearly the complex challenge of low wages, followed by the administrative burdens in the ranking of operational difficulties, and the third key factor was the psycho-mental workload of staff. Full article

Background: Emotional safety is increasingly recognized as crucial for high-quality patient care, encompassing a patient’s sense of security, courteous treatment, being heard, and a peaceful environment. Purpose: The purpose of this study was to explore the perceptions of patients and providers (doctors and nurses) regarding emotional harm and safety in relation to hospitalized patients. Methods: We conducted a qualitative study in public-sector teaching hospitals in Peshawar, Pakistan. Data were collected after we obtained informed consent using individual interviews with 15 providers, namely, doctors (n = 7) and nurses (n = 8), and five focus group discussions (FGDs) with 25 hospitalized patients. Data from both the interviews and FGDs were analyzed using Braun and Clarke’s six-phase approach to thematic analysis. Results: The key themes revealed by the providers’ perspectives were factors contributing to emotional harm, staff-related factors, coping mechanisms and solutions, and the impact of prior experiences and involvement. The main themes that emerged from the patients’ perspectives were anxiety upon admission, the impact of communication, emotional stress due to treatment delays, systemic/bureaucratic challenges, financial burden, a lack of emotional support, and post-hospitalization concerns. The consistent perspectives shared by both patients and providers included the impact of systemic factors, communication issues, the role of staff attitude/behavior, financial concerns, and the influence of prior experiences. Conclusions: This study highlights the complex interplay of systemic, staff-related, and patient-specific factors. It suggests a need to improve communication, staff support, administrative processes, financial counseling, emotional support integration, and discharge planning to minimize harm and create a patient-centered environment. Full article

Background: In this work, we examine determinants of staff departure rates in the NHS, a critical issue for workforce stability and continuity of care. High turnover, particularly among clinical staff, undermines service delivery and incurs substantial replacement costs. Methods: Here, we analyse a unique dataset derived from Electronic Staff Records at Ashford and St. Peter’s NHS Foundation Trust, using a machine learning approach to move beyond traditional survey-based methods, to assess propensity to leave. Results: In addition to established predictors such as salary and length of service, we identify drivers of increased risks of staff exits, including the distance between home and workplace and, especially for medical staff, cost centre vacancy rates. Conclusions: These findings highlight the multifactorial nature of staff retention and suggest the potential of local administrative data to improve workforce planning, for example, through hyperlocal recruitment strategies. Whilst further work will be required to assess the generalisability of our findings beyond a single Trust, our analysis offers insights for NHS managers seeking to stabilise staffing levels and reduce attrition through targeted interventions beyond pay and tenure. Full article

Background: The longitudinal RisCoin study investigated risk factors for COVID-19 vaccination failure among healthcare workers (HCWs) and patients with inflammatory bowel disease (IBD) at a University Hospital in Germany. Since the hospital served as the study sponsor and employer of the HCW, we implemented a custom mobile application. We aimed to evaluate the implementation, adherence, benefits, and limitations of this study’s app. Methods: The app allowed secure data collection through questionnaires, disseminated serological results, and managed bidirectional communication. Access was double-pseudonymized and irreversibly anonymized six months after enrollment. Download frequency, login events, and questionnaire submissions between October 2021 and December 2022 were analyzed. Multivariable logistic regression identified factors associated with app adherence. Results: Of the 3979 participants with app access, 3622 (91%) used the app; out of these, 1016 (28%) were “adherent users” (≥12 submitted questionnaires). App adherence significantly increased with age. Among HCW, adherent users were more likely to be non-smokers (p < 0.001), working as administrators or nursing staff vs. physicians (p < 0.001), vaccinated against influenza (p < 0.001), and had not travelled abroad in the past year (p < 0.001). IBD patients exposed to SARS-CoV-2 (p = 0.0133) and those with adverse events following the second COVID-19 vaccination (p = 0.0171) were more likely adherent app users. Despite technical issues causing dropout or non-adherence, the app served as a secure solution for cohort management and longitudinal data collection. Discussion: App-based cohort management enabled continuous data acquisition and individualized care while providing flexibility and anonymity for the study team and participants. App usability, technical issues, and cohort characteristics need to be thoroughly considered prior to implementation to optimize usage and adherence in clinical research. Full article

In a European context, facing pressure to digitalize public administration, the integration of artificial intelligence (AI) at the local level remains a deeply uneven and empirically poorly understood process. This study investigates the degree of adoption of artificial intelligence (AI) in local public administrations in Germany, exploring territorial disparities and institutional factors influencing this transition. Based on a national sample of 347 municipalities, this research proposes a composite AI adoption index, built by integrating six relevant indicators (including the use of conversational bots and the automation of internal and decision-making processes). In the simulations, local administration profiles were differentiated according to factors such as IT staff (with a weight of 30%), the degree of urbanization (25%), and participation in digital networks (20%), reflecting significant structural variations between regions. The analysis model used is a multilevel one, which highlights the combined influences of local and regional factors. The results indicate a clear stratification of digital innovation capacity, with significant differences between eastern and western Germany, as well as between urban and rural environments. The study contributes to the specialized literature by developing a replicable analytical tool and provides public policy recommendations for reducing interregional digital divides. Full article

The preparedness of healthcare workers for disaster situations depends on their technical skills, disaster knowledge, and psychosocial strength, including teamwork and emotional regulation. This study aims to assess disaster preparedness among healthcare professionals in primary healthcare centers (PHCs) in Alqurayat, Saudi Arabia, with a specific focus on evaluating technical competencies, psychosocial readiness, and predictive modeling of preparedness levels. A mixed-methods approach was employed, incorporating structured questionnaires, semi-structured interviews, and observational data from disaster drills to evaluate the preparedness levels of 400 healthcare workers, including doctors, nurses, and administrative staff. The results showed that while knowledge (mean: 3.9) and skills (mean: 4.0) were generally moderate to high, notable gaps in overall preparedness remained. Importantly, 69.5% of participants reported enhanced readiness following simulation drills. Machine learning models, including Random Forest and Artificial Neural Networks, were used to predict preparedness outcomes based on psychosocial variables such as emotional intelligence, teamwork, and stress management. Sentiment analysis and topic modeling of qualitative responses revealed key themes including communication barriers, psychological safety, and the need for ongoing training. The findings highlight the importance of integrating both technical competencies and psychosocial resilience into disaster management programs. This study contributes an innovative framework for evaluating preparedness and offers practical insights for policymakers, disaster planners, and health training institutions aiming to strengthen the sustainability and responsiveness of primary healthcare systems. Full article

Long-acting (LA) antiretroviral therapies for human immunodeficiency virus (HIV), such as injectable formulations of cabotegravir and rilpivirine (CAB+RPV LA), are now available. Considering the limited data on the out-of-hospital administration of this combination, evaluating the implementation strategies needed is essential to support future clinical efforts. To gather data on barriers and facilitators of implementation for CAB+RPV LA in alternative outpatient facilities, this study used qualitative interviews informed by the Consolidated Framework for Implementation Research (CFIR), with 13 staff participating in the HOLA study (NCT06185452). Data analysis followed qualitative descriptive methods, assisted by Atlas.ti software version 22. The study adhered to the COREQ guidelines. Findings reveal five main factors to consider for implementation: operational and infrastructure adaptations, integrated management of human and organizational resources, need for coordination and follow-up, professional attitudes and work environment, and patient experience and patients’ needs perceived by professionals. This study emphasizes the comprehensive operational and infrastructure adaptations, adequate staff training, and supportive professional environment required for the successful implementation of CAB+RPV LA, while considering patients’ needs throughout the externalization process (trial registration number: NCT06643897). Full article

Background/Objectives: Mobile healthcare units (MHUs) comprise flexible, ambulatory healthcare teams that deliver community care services, particularly in underserved or remote areas. In Greece, MHUs were pivotal in epidemiological surveillance during the COVID-19 pandemic and are now evolving into a sustainable and integrated service for much-needed community-based healthcare. To support this expanded role, targeted, competency-based training is essential; however, this can pose challenges, especially in coordinating synchronous learning across geographically dispersed teams and in ensuring engagement using an online format. Methods: A nationwide, online training program was developed to improve the knowledge of the personnel members of the Hellenic National Public Health Organization’s MHUs. This program was structured focusing on four core themes: (i) prevention–health promotion; (ii) provision of care; (iii) social welfare and solidarity initiatives; and (iv) digital health skill enhancement. The program was implemented by the University of Crete’s Center for Training and Lifelong Learning from 16 January to 24 February 2025. A multidisciplinary team of 64 experts delivered 250 h of live and on-demand educational content, including health screenings, vaccination protocols, biomarker monitoring, chronic disease management, treatment adherence, organ donation awareness, counseling on social violence, and eHealth applications. Knowledge acquisition was assessed through a pre- and post-training multiple-choice test related to the core themes. Trainees’ and trainers’ qualitative feedback was evaluated using a 0–10 numerical rating scale (Likert-type). Results: A total of 873 MHU members participated in the study, including both healthcare professionals and administrative staff. The attendance rate was consistently above 90% on a daily basis. The average assessment score increased from 52.8% (pre-training) to 69.8% (post-training), indicating 17% knowledge acquisition. The paired t-test analysis demonstrated that this improvement was statistically significant (t = −8.52, p < 0.001), confirming the program’s effectiveness in enhancing knowledge. As part of the evaluation of qualitative feedback, the program was positively evaluated, with 75–80% of trainees rating key components such as content, structure, and trainer effectiveness as “Very Good” or “Excellent.” In addition, using a 0–10 scale, trainers rated the program relative to organization (9.4/10), content (8.8), and trainee engagement (8.9), confirming the program’s strength and scalability in primary care education. Conclusions: This initiative highlights the effectiveness of a structured, online training program in enhancing MHU knowledge, ensuring standardized, high-quality education that supports current primary healthcare needs. Future studies evaluating whether the increase in knowledge acquisition may also result in an improvement in the personnel’s competencies, and clinical practice will further contribute to assessing whether additional training programs may be helpful. Full article

Achieving health equity for people with disabilities requires addressing the barriers that they face when accessing healthcare. Older adults with disabilities may experience compounded disparities, yet little research has explored their satisfaction with health facility personnel, including non-healthcare staff. This study examines differences in satisfaction with health facility personnel between younger (18–59 years) and older (60+) adults with disabilities in Chile. Data from the 2024 Disability and Citizenship (DISCA) survey were analysed using chi-square tests to examine differences between younger and older people with disabilities with regard to their satisfaction with health facility personnel. Ordered logistic regressions were employed to predict high satisfaction, given socioeconomic and health-related variables. Findings indicated that a higher percentage of older adults with disabilities reported high satisfaction with health facility personnel compared to younger adults. Ordered logistic regressions confirmed that older adults had greater odds of reporting high satisfaction with doctors (OR: 3.83), other health professionals (OR: 4.66), paramedical technicians (OR: 4.31), and administrative staff (OR: 3.13). These results suggest that age influences satisfaction levels among people with disabilities, potentially due to varying expectations, experiences, or interactions with health facility personnel. Understanding the underlying reasons for these age-related differences is essential to inform policies and practices that ensure equitable, person-centred care for people with disabilities across the life course. Full article

Higher-education institutions are increasingly embracing digital transformation to meet the evolving expectations of students, academics, and administrators. The smart campus paradigm offers a strategic framework for this shift, yet most existing assessment models originate from high-income contexts and remain largely untested in the Global South, where infrastructural and technological conditions differ substantially. This study addresses this gap by evaluating the contextual relevance of a comprehensive smart campus assessment framework at the Papua New Guinea University of Technology (PNGUoT). A questionnaire survey of 278 participants—students and staff—was conducted using a 5-point Likert scale to assess the perceived importance of performance indicators across four key dimensions: Smart Economy, Smart Society, Smart Environment, and Smart Governance. A hybrid methodology combining the Best–Worst Method (BWM) and Public Opinion (PO) data was used to prioritise framework components. The research hypothesises that contextual factors predominantly influence the framework’s relevance in developing countries and asks: To what extent is the smart campus assessment framework relevant and adaptable in the Global South? The study aims to measure the framework’s relevance and identify contextual influences shaping its application. The findings confirm its overall applicability while revealing significant variations in stakeholder priorities, emphasising the need for context-sensitive and adaptable assessment tools. This research contributes to the refinement of smart campus frameworks and supports more inclusive and responsive digital transformation strategies in developing country higher education institutions. Full article

Increasing the use of healthcare facilities has resulted in the growing production of biomedical waste, which poses health risks to users, health professionals, and the environment. The aim of this research is to study the correlation between governance in Togo’s public health facilities and the quality of biomedical waste management within these facilities. Methods: This was a cross-sectional, descriptive, and analytical study conducted from September to December 2024. It involved 264 public health facilities of all types in all health regions of Togo. Health facilities were selected using the simple random selection technique. Healthcare providers were selected using the reasoned choice technique. The statistical tests used were the chi-square test and logistic regression, which enabled proportions to be compared and confounding factors to be eliminated, respectively. Results: Multivariate analysis revealed a statistically significant association between the organization and training component of governance and the quality of biomedical waste management (BMWM) in health facilities (OR = 3.79; 95% CI [1.79–8.03]; p < 0.001). This relationship suggests that health facilities with functional infection prevention and control (ICP) or BMWM committees, trained staff at all levels (nursing, technical, and administrative), and dedicated waste management personnel are more likely to implement compliant waste management practices. Analyses of the data also revealed that, among the criteria for assessing the quality of biomedical waste management (BMWM), the most significant were sorting (OR = 1.482; 95% CI [1.286; 1.708]), quantification (OR = 2.026; 95% CI [1.491; 2.753]), transportation (OR = 1.403; 95% CI [1.187; 1.66]), and disposal infrastructure (OR = 1.604; 95% CI [1.298; 1.982]). The application of this grid shows that 17.8% of the health facilities surveyed had a score equal to or above 80% on all the criteria used to assess the quality of biomedical waste management, and they were therefore managing waste in an “acceptable” manner. The study highlights key findings in biomedical waste management practices, providing actionable insights for improving public health safety. Full article

Regular physical activity (PA) is crucial for health, yet many individuals face barriers to engage in an active lifestyle. This study aimed to identify and analyze the barriers preventing university staff from participating in PA. A cross-sectional quantitative approach was utilized, distributing surveys to a diverse sample of 238 university staff aged 19 to 77 years, with an average age of 40. The survey was designed to identify the barriers that individuals face in adhering to physical PA and collected data on various internal and external factors influencing PA participation. Younger participants reported significantly higher scores for lack of energy and motivation compared to older age groups. Additionally, female participants experienced greater internal and external barriers than their male counterparts. Furthermore, university employees experienced significantly higher internal barriers, namely a lack of energy and lack of motivation. The primary barrier to PA participation among university staff was a lack of time. This study highlights the need for supportive environments that address these obstacles to promote PA participation. The findings offer valuable insights for university administrations and policymakers, emphasizing the importance of targeted interventions and supportive policies to enhance the health and activity levels of university staff. Full article

This study explores the attitudes of university administrative staff toward disability and their perceptions of the potential for inclusive environments in higher education institutions across Georgia. Using the Attitudes to Disability Scale (ADS), a cross-sectional survey was conducted with 63 staff members from a Tbilisi-based and a regional university. The findings reveal generally positive attitudes, especially among younger and female staff, but expose persistent hierarchies in disability perception—particularly skepticism toward intellectual and psychosocial impairments. While the participants expressed support for inclusion, their recommendations for occupational roles reflected narrow and often custodial views of employability. Urban–rural and tenure-based divides further underscored structural and cultural barriers to full inclusion. This study concludes with actionable recommendations for inclusive training, policy reform, and participatory approaches to shift Georgian universities toward genuine inclusion. Full article