Search Results (210)

The healthcare needs of refugees and people seeking asylum are often broad and complex, with a higher burden of communicable diseases. There are limited data describing migrants’ experiences of accessing healthcare in Ireland. This cross-sectional study describes the experiences of migrants accessing healthcare services through an Irish Infectious Diseases clinic. Individuals attending the infectious diseases services in our hospital who had migrated to Ireland were included. Data were collected via a questionnaire, focusing on factors that may limit access to care, including communication, accessibility, cost, and stigmatisation. Seventy-six patients participated in this study. N = 20 (26%) of patients reported a commuting time of more than two hours to attend our clinic. N = 11 (15%) had experienced being unable to access healthcare in Ireland due to cost. Trust in healthcare providers was high (88%), and patient-reported satisfaction with communication was high (>90%). Persons living in direct provision services were more likely to report issues around privacy and less likely to have registered with a general practitioner. Accessibility and privacy were among the biggest challenges faced by migrants attending infectious diseases services at our centre, while communication and trust in healthcare providers were identified as areas of strength. Considering the burden of infectious diseases in migrant populations, and the challenges that certain migrant populations face in accessing healthcare, it is important to identify potential barriers to accessing care in order to ensure equitable, effective care. This study seeks to identify and describe the challenges that migrants face when accessing care through an Irish infectious diseases clinic. The results can help inform service provision and allocation of resources at a local level, while also identifying an area for further research regarding the barriers to accessing care faced by migrant communities in Ireland. Full article

Continuous technological, ecological, and digital transformations reshape urban mobility systems. While sustainable mobility has become a dominant keyword, there are many different approaches and policies to help achieve lasting and properly functioning change. This study applies a comprehensive qualitative policy analysis to influential and leading sustainable mobility approaches (i.a. Mobility Justice, Avoid–Shift–Improve, spatial models like the 15-Minute City and Superblocks, governance frameworks such as SUMPs, and tools ranging from economic incentives to service architectures like MaaS and others). Each was assessed across structural barriers, psychological resistance, governance constraints, and affective dimensions. The results show that, although these approaches provide clear normative direction, measurable impacts, and scalable applicability, their implementation is often undermined by fragmentation, Policy Layering, limited intermodality, weak Future-Readiness, and insufficient participatory engagement. Particularly, the lack of sequencing and pacing mechanisms leads to policy silos and societal resistance. The analysis highlights that the main challenge is not the absence of solutions but the absence of a unifying paradigm. To address this gap, the paper introduces CalmMobility, a conceptual framework that integrates existing strengths while emphasizing comprehensiveness, pacing–sequencing–inclusion, and Future-Readiness. CalmMobility offers adaptive and co-created pathways for mobility transitions, grounded in education, open innovation, and a calm, deliberate approach. Rather than being driven by hasty or disruptive change, it seeks to align technological and spatial innovations with societal expectations, building trust, legitimacy, and long-term resilience of sustainable mobility. Full article

Organisations are increasingly adopting the Chain of Custody (CoC) standards in the mining industry to enhance the traceability of minerals. It ensures that the minerals they have received are from credible sources and accompanied by verifiable information. However, unlikeother industries such as timber, where the effectiveness and benefits of CoC standards are mainly explored, this study subtly shifts the focus towards identifying strategic opportunities and innovation areas within the CoC standards that could extend beyond traceability. Four CoC standards were selected, and their provisions examined. It was found that implementing these requirements could not only enhance transparency but also support broader sustainability goals across the entire value chain. The study also identifies several challenges that could act as barriers to the CoC system, and these are seen as opportunities for innovative approaches to enhance the effectiveness of the standards. These are labelled as transformative innovation areas, and while they do include blockchains and analytical proof of origin technologies, this study also seeks to advocate for solutions that are more pragmatic and scalable. By identifying opportunities and areas of innovation, the findings will help improve the practical implementation of the standards and suggest areas for future evaluations of effectiveness that could consider aspects beyond traceability, such as sustainability and transparency. Full article

Intimate partner violence is recognized as one of the most common forms of violence against women. However, it remains under-reported in many countries. The text aims to present key factors affecting women’s willingness to report intimate partner violence in Bulgaria. We proceed from the idea that the factors that create conditions for the existence of this type of violence in a society are also a major obstacle for women to file official complaints. Considering the complexity of the phenomenon and the numerous aspects that influence whether a victim will seek help or not, we use the three analytical levels—micro, meso and macro—to identify the main barriers to reporting intimate partner violence. The data used in the article were collected through a nationally representative adult population survey on attitudes towards violence against women in Bulgaria, in-depth interviews and focus groups with experts from various institutions related to the problem, and a survey among women victims of violence. The analysis revealed the impact on reporting willingness of macro factors such as the legal framework for preventing and regulating violence against women, as well as the existence of widely accepted cultural norms that normalize milder types of violence. At the meso level, ineffective institutional responses and a lack of support from the closest environment appear to be deterrents to reporting violence. Along with individual characteristics (such as psychological, emotional, and economic reliance) indicated by earlier studies and validated in our research, the analysis identified some poorly studied factors that positively influence the reporting of violence, such as public support expressed through social media and civil protests. Full article

The current study aimed to explore the incidence and severity of the mental health difficulties of ethnically diverse students at University of London institutions. Student mental health is a growing concern in UK higher education, yet little research has explored how ethnically diverse students experience embedded university wellbeing services. Despite persistent inequalities, embedded university wellbeing services remain under researched for ethnic minority students in the UK. A sequential explanatory mixed-methods design was essential to illuminate the mechanisms underlying observed quantitative patterns amongst this group of students, with qualitative accounts providing depth and context to statistical trends. A sequential explanatory mixed-methods approach was employed, combining data from 203 ethnically diverse students at University of London institutions with data from open-text and semi-structured interviews. A mixed-methods design was critical in capturing both the absence of broad group differences and the specific barriers shaping ethnic minority student experiences. Results showed few ethnic differences in distress, help-seeking, or dropout. However, ethnic minority students reported greater in-group stigma and cultural barriers, which were negatively associated with help-seeking. Qualitative themes further illustrated the importance of the therapeutic relationship, concerns about privacy, perceptions of undeservingness, and time constraints. Findings highlight the importance of culturally responsive approaches to embedded university wellbeing services in higher education. Targeted outreach, ethnic matching of therapists, and a more diverse counselling workforce may improve engagement and reduce inequalities. Full article

Chemsex is a phenomenon involving the intentional use of psychoactive substances before or during sexual activity, especially among men who have sex with men (MSM). It is associated with various health risks, including substance dependence, risky sexual behaviors, and both mental and somatic disorders. Despite its growing prevalence and public health relevance, chemsex lacks a clear definition and is not recognized as a distinct diagnostic entity. This narrative review synthesizes clinical, epidemiological, and technological evidence on chemsex; argues for its classification as a form of mixed addiction; and preliminarily proposes diagnostic criteria for a potential entity in the International Classification of Diseases, 12th Revision (ICD-12). This paper highlights key psychotropic substances used in chemsex, patterns of use, and their neurobiological, psychological, and behavioral consequences. It explores the relationship between chemsex and compulsive sexual behavior disorder (CSBD), current diagnostic frameworks (ICD-10 and ICD-11), and challenges in clinical practice. Therapeutic strategies discussed include cognitive behavioral therapy (CBT), digital interventions, and emerging applications of artificial intelligence (AI) in prevention and treatment. Attention is also given to epidemiological trends, sociocultural influences, and barriers to seeking help. This review concludes by identifying research gaps and advocating for a more integrated, multidimensional approach to classifying and treating chemsex-related syndromes. Full article

(1) Background: Help-seeking behavior is a key way to maintain health and seek effective treatment, and it also helps to improve patients’ self-management ability. This study aimed to investigate the facilitating and hindering factors of help-seeking behaviors among patients with chronic diseases concerning their health issues. (2) Methods: Based on the Capability, Opportunity, and Motivation-Behavior (COM-B) model, 18 patients with chronic diseases in a tertiary hospital in Zhengzhou City, Henan Province, were selected for semi-structured in-depth interviews between July and November 2024 using a descriptive qualitative research approach. The collected data were analyzed using directed content analysis. (3) Results: A total of 18 interviews were conducted, and two themes and six sub-themes were extracted. The factors that promote health help-seeking behavior in patients with chronic diseases include ability (self-health monitoring ability, sufficient communication preparation ability), opportunity (health support in social bonds, effective support of medical staff), and motivation (good illness identity, past successful experience of health seeking help). Barriers include ability (symptom attribution bias, difficulty in identifying health information), opportunity (heavier financial burden, poor sense of gain in interactions), and motivation (fear and avoidance, stigma of illness). (4) Conclusions: There are some hindering factors and obvious contributing factors regarding health help-seeking behavior among patients with chronic diseases. Medical staff should prioritize guiding patients to seek help for health problems. The COM-B model can be applied to develop targeted intervention strategies for improving help-seeking behavior. This approach is beneficial for enhancing patients’ health management capabilities by promoting proactive health help-seeking practices. Full article

The 1.5-degree lifestyles aim to reduce household carbon footprints across six areas (food, housing, mobility, consumer goods, leisure, and services), as identified by IGES, relying on public efforts. This study seeks to understand Japanese university students’ perceptions of 1.5-degree lifestyles, their preferred actions for implementation at the individual, family, and community levels, and the top three enablers and barriers they face. Using a questionnaire based on the KIDA (knowledge, interest, desire, action) framework, which aligns with IGES’s six sectors, data from 244 responses collected via snowball sampling were analyzed. Results reveal low awareness of 1.5-degree lifestyles among Japanese university students, along with a moderate desire to learn more. Gender differences were significant, with females showing higher awareness, desire, and action compared to males. Three common barriers identified include challenges with work–life balance, economic concerns, and gaps between knowledge and action. Recommendations emphasize increasing youth awareness and encouraging action on 1.5-degree lifestyles through early environmental education, youth-focused communication (such as social media), and securing strong political support to help address practical challenges. Full article

AI-powered full-site web generation tools promise to democratize website creation for novice users. However, their actual usability and accessibility for novice users remain insufficiently studied. This study examines interaction barriers faced by novice users when using Wix ADI to complete three tasks: Task 1 (onboarding), Task 2 (template customization), and Task 3 (product page creation). Twelve participants with no web design background were recruited to perform these tasks while their behavior was recorded via screen capture and eye-tracking (Tobii Glasses 2), supplemented by post-task interviews. Task completion rates declined significantly in Task 2 (66.67%) and 3 (33.33%). Help-seeking behaviors increased significantly, particularly during template customization and product page creation. Eye-tracking data indicated elevated cognitive load in later tasks, with fixation count and saccade count peaking in Task 2 and pupil diameter peaking in Task 3. Qualitative feedback identified core challenges such as interface ambiguity, limited transparency in AI control, and disrupted task logic. These findings reveal a gap between AI tool affordances and novice user needs, underscoring the importance of interface clarity, editable transparency, and adaptive guidance. As full-site generators increasingly target general users, lowering barriers for novice audiences is essential for equitable access to web creation. Full article

Background: Despite strong guideline recommendations, participation in cardiac rehabilitation (CR) among patients with chronic heart failure (CHF) remains low due to logistical, geographical, and psychosocial barriers. Telerehabilitation may help overcome these limitations by offering remote, structured exercise programs supported by digital technologies. Objective: The TELEREHAB-HF study aims to evaluate the efficacy of an 8-week, home-based cardiac telerehabilitation program compared to standard in-person rehabilitation in patients with CHF. Methods: This is a prospective, controlled cohort study involving 220 adult patients with CHF (NYHA class I–III) clinically stable and on optimized therapy. Participants are assigned to either a telerehabilitation group (remote CR via a digital platform with wearable sensors and real-time physiotherapist supervision) or a standard in-person rehabilitation group. The primary outcome is the change in peak oxygen uptake (VO₂max) at 8 weeks. Secondary outcomes include quality of life, functional performance, biochemical and echocardiographic parameters, and cognitive function, assessed at baseline and at 4, 8, 16, and 24 weeks. Expected Results: We hypothesize that telerehabilitation will be non-inferior to standard CR in improving functional capacity and secondary outcomes, with additional benefits in accessibility and adherence. Data from remote monitoring may also support a translational “rehabilomics” approach to exploring exercise-induced biomarker changes. Conclusions: This study seeks to assess the clinical effectiveness, safety, and feasibility of a home-based telerehabilitation model for CHF, with the goal of informing future strategies for broader implementation and personalized rehabilitation. Trial Registration: ClinicalTrials.gov Identifier: NCT07023536 Full article

Suicide is a leading cause of death among construction workers, particularly younger and lower-skilled employees. Barriers such as stigma, low mental health literacy, and traditional masculine norms hinder help-seeking in this male-dominated sector. Few mental health interventions are tailored to this context. This study developed a co-designed, theory-informed training to improve mental health literacy, reduce stigma, and increase help-seeking among construction workers in Ireland. Using the Medical Research Council’s framework, the training was developed with the Theory of Planned Behavior (TPB), Behavior Change Techniques, and extensive stakeholder co-design. Two systematic reviews, a broad literature review, and focus groups with industry managers informed the content and structure. The training will be pilot-tested using validated measures: the Literacy of Suicide Scale (LOSS), the Stigma of Suicide Scale (SOSS), and the General Help-Seeking Questionnaire (GHSQ), the results of which will be the subject of a separate study. CAIRDE is a promising, evidence-based training that addresses key mental health barriers in Irish construction. Embedding the TPB within a co-design methodology has resulted in the development of a training program that is underpinned by theoretical fidelity and cultural relevance and provides a framework for other male-dominated industries to draw upon. Future work should address remaining challenges related to stigma and help-seeking, and explore broader implementation through integration into mandatory safety training. Full article

Public stigma toward psychological help-seeking is a critical barrier to mental health service utilization, particularly among university students in culturally conservative and academically demanding disciplines such as law. In China, where Confucian values emphasize social conformity and face preservation, law students may internalize societal narratives that associate mental illness with personal weakness, deterring them from accessing psychological services. This study translated and examined the psychometric properties of the Stigma Scale for Receiving Psychological Help (SSRPH) among Chinese law students. A total of 1257 undergraduate law students from five universities in China participated in the study. Exploratory factor analysis (EFA) was conducted on a randomly selected subsample (n = 628) to examine the scale’s factor structure, followed by confirmatory factor analysis (CFA) on a second subsample (n = 629). Results supported a unidimensional factor structure with strong internal consistency (α = 0.82). CFA yielded a good model fit (CFI = 0.97, TLI = 0.95). Significant negative correlations with help-seeking attitudes (r = −0.37, p < 0.001) supported discriminant validity. While further validation is warranted, the Chinese SSRPH appears suitable for assessing perceived public stigma in legal education contexts and may inform future research and program design in stigma reduction and mental health promotion. Full article

Background/Objectives: Healthcare workers (HCW) have increased the risk of occupational stress injuries and adverse mental health outcomes, which were exacerbated during the COVID-19 pandemic. Understanding HCW psychological distress patterns and help-seeking behaviors can inform responsive resource development that may mitigate negative outcomes in future crises. This paper provides insights on monthly trends in HCW distress and support utilization at a large Canadian hospital over a 14-month period. Methods: As part of a hospital-wide wellness initiative during COVID-19, the STEADY program emailed monthly confidential wellness assessments to hospital staff from April 2020 to May 2021. The assessments included screens for burnout, anxiety, depression and posttraumatic stress, types of support accessed, and demographic information. Repeated cross-sectional data were summarized as monthly proportions and examined alongside longitudinal COVID-19 data. Results: A total of 2498 wellness assessments were submitted (M = ~168 monthly, range: 17–945). Overall, 67% of assessments had at least one positive screen for distress. Average positive screens were 44% for anxiety, 29% for depression, 31% for posttraumatic stress, and 53% for burnout. Despite high distress, most respondents used informal supports (e.g., family/friends), highlighting limited formal support use. Conclusions: HCWs experienced sustained high levels of psychological distress during the COVID-19 pandemic, with burnout remaining a predominant and persistent concern. The limited use of formal support services may indicate barriers to accessing these types of supports. Our findings underscore the need for accessible and acceptable mental health supports for HCW during prolonged crises. Full article

This study investigates how demographic characteristics, severity of intimate partner violence (IPV), social support, gender equality awareness, and demographic factors (e.g., living with children at home) influence help-seeking behaviors among 2527 IPV-experienced women in Beijing, Shanghai, Guangzhou, and Shenzhen. Drawing on the help-seeking model and conservation of resource theory, the study distinguishes between formal (e.g., police, legal aid) and informal (e.g., family, friends) help-seeking. Logistic regression results reveal that greater violence severity, stronger perceived social support, and higher gender equality awareness significantly increase both formal and informal help-seeking. Notably, living with children is associated with a higher likelihood of seeking formal help, possibly due to increased concerns for children’s safety and the desire to change the abusive environment. While help-seeking behavior is on the rise overall, particularly among women with strong support networks and progressive gender attitudes, structural and cultural barriers remain. The findings underscore the need to improve public education, reduce stigma, and enhance accessibility of support systems. This study contributes to the growing literature on IPV in China and provides evidence for refining policy interventions and service delivery. Full article

Introduction: Visual impairment impacts millions of people around the world, with the vast majority of problems being treatable. Disadvantaged communities are unable to utilize the same resources to treat these problems due to a lack of knowledge or resources, in addition to the presence of barriers preventing access. The objective of this paper is to assess eye health awareness and evaluate the barriers for individuals from disadvantaged communities in order to inform future interventions and increase access to care. Methods: This is a pilot study utilizing an online anonymous questionnaire designed to assess the demographics, eye health awareness, and access to eye care of community-based patients. A comprehensive literature review was also conducted using PubMed, Scopus, and Google Scholar to evaluate barriers to eye care and methods to improve community health outcomes. The primary goal was to improve understanding of eye health awareness and access in order to inform future strategies that can help in improving eye health awareness and service availability. Results: The results indicated that 61.2% of respondents believed that eye exams are very important, and only 7.7% of participants believed that regular eye exams are not important. The majority of participants (75%) agree that regular eye exams help prevent serious eye conditions and 84.5% believe that eye health can affect quality of life. 35.6% of participants reported they had their eyes checked by a healthcare professional within the last year, while 21.2% reported never having an eye exam. Although the majority of participants found access to eye care services in their community somewhat or very easy, 8.6% and 9.5% of participants found access difficult and very difficult, respectively. Even though 45.6% of participants reported not facing any barriers regarding access to eye care, the cost of services, long waiting times, and lack of nearby eye care providers were often cited as barriers from the remainder of the participants. Moving forward, local interventions such as mobile eye clinics, public health workshops, and telehealth are viable options to obtain an understanding of the community’s health status in addition to creating opportunities to educate and provide health screenings. Conclusion: The results indicate that although there is awareness of the importance of eye health for the majority of participants, there is still a sizable minority who have insufficient understanding. Barriers to healthcare such as cost, waiting times, and proximity to providers are common problems that are preventing many from seeking eye care. Future interventions should be created to increase access and literacy amongst the community through telehealth, mobile eye clinics, and public health workshops. Additional efforts should be taken by healthcare stakeholders to enhance care delivery, implement policies, and improve awareness. Full article