Search Results (17)

Background: Sex work is one of the oldest trades in the world. It is the practice of sexual activity in exchange for money or material goods. It has traditionally been carried out by women, although in recent years, there has been an increase in the number of male sex workers. Sex workers have been recognized as a population at high risk of contracting and transmitting sexually transmitted infections and human immunodeficiency virus and have had limited access to multiple services, including health care. Objective: The aim was to identify the epidemiological profile and risk factors of a population of sex workers in the province of Granada, southern Spain. Methods: An analytical cross-sectional study was conducted by reviewing the medical records at a specific sexually transmitted infection center in Spain. Results: A total of 157 sex workers’ records were analyzed, most of whom were women, who mainly identified as heterosexual, with a mean age of 28.52 years and a high percentage of foreign nationality. Some sexual behaviors associated with the acquisition of sexually transmitted infections were also analyzed. Conclusions: The results revealed a deficient coverage of the health needs of a highly vulnerable and stigmatized social group, highlighting the need for interventions to prevent risky habits, as well as to promote behaviors aimed at achieving better sexual health. Full article

In Japan, where the shortage of care workers poses a challenge to the sustainability of the long-term care system, foreign care workers play a crucial role. This study aimed to identify the needs and challenges of Vietnamese Technical Intern Training candidates, the largest group of foreign care workers, to facilitate program reforms and a more efficient recruitment process. A semi-structured interview survey was conducted with 27 candidates in Vietnam. Interview items included reasons for choosing the training program in Japan, the desired length of stay, expectations, and career advancement after returning home. Descriptive statistics and K-means clustering were used to analyze the data. Survey results showed that all participants independently decided to pursue care worker training in Japan; 44% had considered other countries; most wanted to stay in Japan for as long as possible; and 37% wanted to live in Japan permanently. The K-means method revealed three clusters: a Japanophile cluster (preferred Japan for its landscape, culture, and national character); a word-of-mouth cluster (influenced by personal referrals); and an intellectual cluster (influenced by Japan’s economic development and care levels). Our findings indicate that support for obtaining qualifications, Japanese language skills, and caregiving skills are important to secure the stability of foreign care workers. It is necessary to tailor recruitment, training, and support for each cluster. Full article

Japan is experiencing significant demographic shifts due to an aging and declining population. In 1993, the Japanese Government introduced the Technical Intern Training Program (TITP) to accept foreign national workers. While the number of technical intern trainees under this program has constantly increased, many of them face challenges in their daily lives, such as stress, health insecurities and limited access to healthcare. Therefore, we conducted a cross-sectional study to assess the mental well-being of technical intern trainees, focusing on psychological distress and its related factors. This study included 304 technical intern trainees from 12 prefectures in Japan, and was conducted from August 2021 to October 2021. We used self-administered questionnaires in the participants’ native languages to assess their sociodemographic conditions, health-related conditions such as health insecurities and healthcare-seeking behaviors, and psychological distress. The K6 Kessler Psychological Distress Scale was applied to evaluate the levels of psychological distress. Among the participants, 26.3% had moderate psychological distress and 2.3% had severe psychological distress. In addition, about 15% of the participants reported health insecurities and did not see a doctor despite wanting to. The multivariate model of logistic regression revealed significant associations between psychological distress and female gender (AOR 2.62, 95% CI 1.12–6.12), nationality other than Vietnamese (AOR 4.85, 95% CI 2.60–9.07), tough financial conditions (AOR 2.23, 95% CI 1.18–4.19), experiencing health insecurity (AOR 2.21, 95% CI 1.04–4.66) and the health behavior of refraining from seeking medical care (AOR 3.06, 95% CI 1.49–6.30). The top reasons for refraining from seeking medical care were the participants’ limited knowledge about the healthcare system in Japan and their worries about medical bills. These findings highlight the necessity to extend mental health support services, including counseling services, and share information about Japan’s healthcare system to supply medical services to the targeted technical intern trainee population. Full article

Highly contagious diseases, such as mumps, are a global concern as new epidemics continue to emerge, even in highly vaccinated populations. The risk of transmission and spread of these viruses is even higher for individuals who are more likely to be exposed, including healthcare workers (HCWs). In healthcare settings, both HCWs and patients are at risk of infection during the care process, potentially leading to nosocomial epidemic outbreaks. Mumps is often underestimated compared with measles and rubella, despite being milder and less likely to spread. In fact, the risk of complications following mumps infection is extremely high, especially if the disease occurs in adulthood. The measles–mumps–rubella (MMR) vaccine has been shown to be an excellent preventive measure. Unfortunately, the mumps component appears to be less effective in inducing immunity than those for measles and rubella (two-dose effectiveness of 85%, 95% and 97%, respectively). The main aim of our study was to investigate the prevalence of detectable mumps antibodies (serum IgG antibodies) in a cohort of Italian and foreign HCWs in relation to personal and occupational factors. We included in the study 468 subjects who underwent health surveillance at the Occupational Medicine Unit of the Tor Vergata Polyclinic in Rome during the period from January 2021 to March 2023. In our study, the proportion of HCWs found to be unprotected against mumps was very high (8.3%), and those found to be immune are below the WHO threshold for herd immunity (95%). From our data, it seems essential that all occupational health services carry out an accurate screening with a dose of anti-mumps antibodies to assess serological protection before starting a job, regardless of an individual’s vaccination history. This approach is proving to be beneficial, accurate, as it allows all serologically non-immune individuals to be vaccinated in the workplace, including those who would be protected by their vaccination history but have lost the antibody response. Full article

Background: Measles infection in the hospital setting is a major issue. Despite the availability of an effective vaccine, measles outbreaks continue to occur in some European countries. We aimed to evaluate the immunological status of medical students attending the Tor Vergata Polyclinic (PTV). Methods: Measles antibodies titers were assessed by venipuncture on a sample of 2717 medical students who underwent annual health surveillance visits from January 2021 to March 2023. Subjects showing serum IgG values above 1.0 S/CO were considered serologically protected. Personal data, country of origin, and main demographic characteristic were also collected. Results: 66.7% (1467 Italian and 346 foreign) of medical students showed protective IgG antibodies levels. Female students were serologically immune more frequently than males (68.6% vs. 63.3%; p < 0.01 at Chi2). The mean antibody titer was 1.72 S/CO, significantly higher in females than males (1.67 vs. 1.75, respectively; p < 0.05), and significantly related to age (p < 0.01). Albanian students, who were the largest foreign population in our study, showed a low serological protection rate (40/90: 44.4%). Conclusions: The proportion of serologically non-immune students is high, raising concerns about the possible risk of hospital transmission. Substantial differences in the rate of immunity have been found between subjects coming from different parts of Europe and the world. Pre-training assessment of all medical students and vaccination of susceptible individuals is highly recommended, particularly for those from low immunization rate countries. Full article

This article explores the impact of COVID-19 restrictions on foreign health workers in Italy. Focusing on caregivers in Lombardia, we explore what we call carer precarity, an emergent form of precarity resulting from pandemic restrictions exacerbating existing socio-legal vulnerabilities. The duality of the carer role—complete household and societal reliance in addition to simultaneous socio-legal marginalization—shapes their precarity. Utilizing data from 44 qualitative interviews with migrant care workers in live-in and daycare facilities that were conducted prior to and during the COVID-19 pandemic in Italy, we demonstrate how the migrant populations working in the care sector were particularly adversely affected due to their migratory status and working conditions. Migrants are excluded from or have differential access to a range of benefits or entitlements and are employed in undervalued work. Workers with live-in employment experienced tiered access to benefits plus the spatiality of restrictions, resulting in their near-complete confinement. Drawing on Gardner (2022) and Butler’s (2009) conceptualizations of precarity, we describe the emergence of a new form of pandemic-induced spatial precarity for migrant care workers at the nexus of gendered labor, limited mobility, and the spatiality of and a hierarchy of rights associated with migratory status. The findings have implications for healthcare policy and migration scholarship. Full article

This report provides an overview of the skilled migrant health workforce and their contribution to health systems in European countries, particularly in relation to the COVID-19 pandemic. Migrant workers at all skill levels have worked in key areas during the pandemic. Skilled migrant health workers, particularly medical practitioners and nurses, make up a significant portion of the frontline health workforce and are essential to keeping health systems in developed countries running. While skilled migrants often face fewer hard barriers (entry control policies: visa policy, work permit schemes, labour migration quotas), this workforce faces soft barriers (e.g., lack of recognition of foreign educational credentials and other restrictive or discriminatory measures) in accessing the host nation’s labour market, as evidenced during the COVID-19 pandemic. This article explores this phenomenon, focusing on Italy’s health sector and foreign health professionals’ dynamics. The report concludes by proffering some practical policy recommendations to promote the inclusion of migrant health professionals in the health and social care systems in the context of the COVID-19 pandemic. Full article

Unaccounted-for migrant workers (UMWs), who have left their employment placement and whose whereabouts are unknown, make up a vulnerable population in Taiwan. The children of UMWs have a particularly precarious status because they are undocumented/stateless, immigrant, and young. Living with this precarious status limits their children’s rights to survival and development. Moreover, services for female UMWs and their undocumented children are underdeveloped. This study explores the accessibility and availability of social services for UMWs and undocumented children, based on interviews with 12 stakeholders from multiple systems, including a local government, a child welfare placement center, a migrant worker detention center, a hospital, a regional religious center, and a foreign country office. Preliminary findings indicate the following: First, UMWs’ rights to healthcare are not preserved, and they experience greater prenatal risks because their illegal status excludes them from universal health coverage. Second, undocumented children’s rights to survival and development are concerning because these children can be placed in residential care without individualized care or environmental stimulation. Third, children’s rights to cultural identity and permanency are uncertain in that repatriation or adoption does not guarantee their future best interests. Full article

This study aimed to evaluate the factors related to the mental health of foreign care workers in Japan’s long-term care (LTC) facilities and compare their results with those of native care workers. We conducted a cross-sectional survey covering 80 LTC facilities across Japan between August and November 2021. The survey mainly included mental health, workload, reward, sense of coherence, loneliness, COVID-19-specific factors and sociodemographic variables. The results show that workload was a distinct feature associated with the mental health of foreign care workers (n = 172) when compared with those of native care workers (n = 154). In addition, we found that the relationship between cultural adaptation and mental health in a sample of foreign care workers was mediated by loneliness and sense of coherence (SOC). Finally, we found that reward, loneliness, SOC, and COVID-19-specific factors had significant impacts on the mental health of both foreign and native care workers. These findings highlight the importance of support measures from the workplace for foreign care workers. Workplace interventions that focus on workload, reward, and sense of coherence strategies are required to address mental health improvement and may still be of value in dealing with the continuing COVID-19 pandemic. Full article

Cultural diversity among patients and healthcare workers in the Portuguese healthcare organizations will increasingly challenge nurse managers to develop favorable nursing work environments and to improve culturally congruent care. Aim: This study aimed to identify nurse managers’ interventions that improve favorable nursing work environments in multicultural nursing teams and culturally congruent care for patients, based on Portuguese nurse leaders’ experience in international settings. Methods: A qualitative and exploratory study was conducted as the first stage of a sequential exploratory mixed study design. A convenience sample of Portuguese nurses with leadership experience of multicultural teams was recruited to participate in one focus group. Qualitative data were recorded and transcribed for content analysis. Text segments were organized into themes and categories with the support of the qualitative software IRaMuTeQ. Results: Nurse managers’ interventions, such as adapting the leadership style, thanking nurses for their work, adjusting the unit to attend to patients’ worship practices, and supporting foreign nurses in learning the local language, were categorized into three main themes and five categories—transcultural nursing leadership assumptions, capitalizing nurses, improving culturally congruent care, team problems and strategies, and improving effective communication. Conclusions: These findings corroborate international studies, advocate for capable nurse managers to lead in a globalized world, and are suitable to develop a transcultural nursing leadership questionnaire. Full article

Due to digital inequality, poor living, and health care conditions, marginalized people are the most vulnerable group to the COVID-19 pandemic. This study examined how digital information influences knowledge, practices, threat appraisals, and motivation behaviors of urban marginalized communities. It examined slum people’s digital competencies, their access to COVID-19 online information, and their trust in COVID-19 information provided by both online and offline media. A total of 453 slum people in Bangkok city, Thailand were surveyed, and multiple regression was performed to examine whether socio-demographic factors influence the access to online communication of slum people. We hypothesized that access to online information might affect marginalized people’s awareness of COVID-19 and resulted in greater levels of their practices and protective behaviors. The finding showed that slum people who had access to online information tended to have a better awareness of self-protection against COVID-19, while elderly, female, and foreign migrant workers faced a number of constraints in accessing COVID-19 online information. Such results are important considering the pandemic is compelling societies to turn toward digital technologies to confront the COVID-19 pandemic and address pandemic-related issues. We also discuss how to enhance the role of digital communication in helping urban marginalized communities during and after the pandemic. Full article

Taiwan is expected to reach super-aged status by 2026, leading to an increased demand for elderly caregiving services. Low local unemployment and a dwindling working-age population mean the island’s care system relies heavily on female foreign domestic workers (FDWs) from Southeast Asian neighbors such as Vietnam to satisfy labor shortages. Although suggested by anecdotal evidence, limited research has been conducted on the link between the shortfall in FDW qualifications, training, preparedness, and expertise and their employment stressors. Therefore, this study aims to assist FDWs by evaluating their stressors and helping them better understand health care delivery by (1) administering the Modified Caregiver Strain Index (MCSI) revised 2003 questionnaire, (2) performing semi-structured in-depth one-on-one interviews, (3) classifying interview results according to thematic analysis, and (4) using these themes to devise and deliver a 12-week multilingual health education teach-back program. Our results indicate that Vietnamese FDWs face specific challenges, including language barriers, homesickness, intensive physical and psychological work demands, stress adaptation, and occupational exposures. Despite yielding no significant improvements in caregiving strain, our intervention, conducted at the height of the COVID-19 pandemic, pinpoints and classifies areas of grave concern and proposes recommendations that can assist long-term care (LTC) stakeholders in understanding and overcoming their respective challenges, thereby improving the quality of elderly care. Full article

Discharge against medical advice (DAMA) and readmissions are important issues worldwide and can lead to adverse clinical outcomes, financial burden, and exposure of healthcare workers to unintended medical disputes. This study aimed to identify factors that affect readmissions within 48 h after DAMA. This retrospective study utilized the medical records of patients who visited an emergency medical center in Korea for treatment and were readmitted during a 10-year period. Factors predicting readmission after being DAMA were identified using logistic regression analysis. The total number of patients who were DAMA during the study period was 5445, of which 351 were readmitted to the emergency department within 48 h (6.4%). Factors influencing readmission included medical aid (odds ratio (OR) = 2.02, 95% confidence interval (CI): 1.46–2.83) and foreign worker insurance (OR = 2.07, 95% CI: 1.04–4.09) as their health insurance, as well as presenting for readmission by car (OR = 1.41, 95% CI: 1.08–1.82). Healthcare workers should treat patients who are DAMA and those who are likely to return with a more careful and preventative management strategy so that potential clinical, legal, and economic impacts of DAMA can be mitigated. Full article

Bronchoscopy is an aerosol-generating procedure and involves a high risk of transmission of SARS-CoV-2 to health care workers. There are very few indications for performing bronchoscopy in a patient with confirmed COVID-19. These include atelectasis, foreign body aspiration, and suspected superinfection in immunocompromised patients. Proper use of standard personal protective equipment is mandatory to reduce the risk of transmission to health care workers. In this article, we describe a case of acute lung collapse in a 16-year-old boy with cerebral palsy who was infected with COVID-19. This patient responded to therapeutic bronchoscopy and had complete resolution of lung collapse within 24 h of the procedure. Full article

The occupational hazards of health workers (HWs) in standard work environments have been well defined in both the developed and developing world during routine working conditions. Less defined are the hazards to HWs during pandemics, epidemics, natural disasters, wars, conflicts, and other crises. How do crises affect the infrastructure of medical systems? What are the distinct needs of the patient population during crises? What are the peculiarities of the Crisis Health Worker (CHW)? What are the known CHWs’ occupational risks? What are the protective factors? By means of a PubMed search, we synthesized the most relevant publications to try to answer these questions. Failures of healthcare infrastructure and institutions include CHW shortages, insufficient medical supplies, medications, transportation, poorly paid health workers, security concerns, and the absence of firm guidance in health policy. Healthcare needs affecting the patient population and CHWs include crisis-induced injury and illness, hazardous exposures, communicable diseases, mental healthcare, and continuity of care for pre-crisis medical conditions. CHWs’ occupational hazards include supply deficiencies, infectious disease transmission, long working hours, staff shortages, financial reimbursements, mental fatigue, physical exhaustion, and inconsistent access to clean water, electricity, and Internet. CHWs suffer from injuries and illnesses that range from immediate, debilitating injuries to chronic, unforeseen effects like mental fatigue, physical exhaustion, anxiety, burnout, and even post-traumatic stress syndrome (PTSD). Protective factors include personal traits such as adaptability and resilience as well as skills learned through structured education and training. Success will be achieved by constructively collaborating with local authorities, local health workers, national military, foreign military, and aid organizations. Full article