Search Results (764)

Heart failure (HF) is a major global health challenge, characterized by high morbidity, mortality, and frequent hospital readmissions. Despite the advent of guideline-directed medical therapies (GDMTs), the burden of HF continues to grow, necessitating a shift toward comprehensive, multidisciplinary care models. Heart Failure Disease Management Programs (HF-DMPs) have emerged as structured frameworks that integrate evidence-based medical therapy, patient education, telemonitoring, and support for social determinants of health to optimize outcomes and reduce healthcare costs. This review outlines the key components of HF-DMPs, including patient identification and risk stratification, pharmacologic optimization, team-based care, transitional follow-up, remote monitoring, performance metrics, and social support systems. Incorporating tools such as artificial intelligence, pharmacist-led titration, and community health worker support, HF-DMPs represent a scalable approach to improving care delivery. The success of these programs depends on tailored interventions, interdisciplinary collaboration, and health equity-driven strategies. Full article

Tuberculosis (TB) remains a leading cause of death in Bangladesh, disproportionately affecting low socio-economic status (SES) populations. This review, guided by the WHO Social Determinants of Health framework and Rockefeller-Lancet Planetary Health Report, examined how social, economic, and ecological factors link SES to TB burden. The first literature search identified 28 articles focused on SES-TB relationships in Bangladesh. A second search through snowballing and conceptual mapping yielded 55 more papers of diverse source types and disciplines. Low-SES groups face elevated TB risk due to smoking, biomass fuel use, malnutrition, limited education, stigma, financial barriers, and hazardous housing or workplaces. These factors delay care-seeking, worsen outcomes, and fuel transmission, especially among women. High-SES groups more often face comorbidities like diabetes, which increase TB risk. Broader contextual drivers include urbanisation, weak labour protections, cultural norms, and poor governance. Recommendations include housing and labour reform, gender parity in education, and integrating private providers into TB programmes. These align with the WHO End TB Strategy, UN SDGs and Planetary Health Quadruple Aims, which expand the traditional Triple Aim for health system design by integrating environmental sustainability alongside improved patient outcomes, population health, and cost efficiency. Future research should explore trust in frontline workers, reasons for consulting informal carers, links between makeshift housing and TB, and integrating ecological determinants into existing frameworks. Full article

Background: Chlamydia trachomatis is the most prevalent bacterial sexually transmitted infection (STI) globally, linked to severe complications such as pelvic inflammatory disease and infertility. In the Brazilian Amazon, socioeconomic vulnerability and the absence of screening policies exacerbate risks, particularly among female sex workers (FSWs). Objective: This study aimed to determine the seroprevalence of anti-C. trachomatis IgG antibodies among FSWs in five municipalities of Pará State, Brazilian Amazon, and identify epidemiological factors associated with infection. Methods: A retrospective cross-sectional study (2005–2007) included 348 FSWs recruited via convenience sampling. Sociodemographic and behavioral data were collected through questionnaires, and blood samples were analyzed by ELISA for anti-C. trachomatis IgG. Statistical analyses included Fisher’s exact tests, odds ratios (ORs), and 95% confidence intervals (CIs), using SPSS 21.0. Results: Overall seroprevalence was 93.9% (327/348; 95% CI: 83.1–90%). Significant associations included a household income of 1–3 minimum wages (98.4%; p = 0.0002), sexual partners from the same region (98.8%; p = 0.0421), and age >42 years (96.3%). Most reported inconsistent condom use (43.7%), multiple monthly partners (54.6%), and illicit drug use (53.4%). Discussion: The extremely high seroprevalence reflects chronic C. trachomatis exposure, driven by socioeconomic deprivation and limited healthcare access. Comparisons with global data underscore the urgent need for screening policies, absent in Brazil for FSWs, and highlight the vulnerability of this population. Conclusions: The findings reveal an alarming burden of C. trachomatis exposure among Amazonian FSWs. Integrated strategies, including routine screening, sexual health education, and inclusion of FSWs in priority health programs, are critical to reduce transmission and associated complications. Full article

Background/Objectives: Improving health outcomes for Indigenous people by strengthening the cultural safety of care is a vital challenge for the health sector. University Departments of Rural Health (UDRH), academic centres based in regional, rural, and remote (RRR) locations across Australia, are uniquely positioned to foster a culturally safe rural health workforce through training, education, and engagement with Indigenous communities. This narrative review examines the contributions of UDRHs to health workforce issues through analysis of their publications focused on Indigenous health. Methods: Research articles relating to workforce were identified from an established database of UDRH Indigenous health-related publications published 2010–2021. Results: Of 46 articles identified across the 12 years, 19 focused on developing the understanding and cultural safety skills of university students studying in a health field, including campus-based Indigenous health education and support for students undertaking rural clinical placements. Twelve articles investigated cultural safety skills and recruitment and retention of the rural health workforce. Fifteen articles focused on Indigenous people in the health workforce, examining clinical training and resources, and the enablers and barriers to retaining Indigenous students and workers. Conclusions: This analysis highlights the sustained efforts of UDRHs to improve Indigenous health through multiple areas within their influence, including curriculum design, health student training on campus, and rural placement opportunities to transform understanding of Indigenous strengths and disadvantages and rural health workforce development. A continuing effort is needed on ways UDRHs can support Indigenous health students during their studies and while on placement, how to improve cultural safety in the health workforce, and ways to better support Indigenous health professionals. Full article

Coyaima is a town in the department of Tolima, Colombia, that was prioritized in a pilot program under Colombia’s National Plan for the Control of the Taeniasis/Cysticercosis Complex, focusing on this neglected health issue. The project engaged local indigenous communities, promoting education and outreach within the One Health framework. The study included 444 randomly selected volunteers, who filled a Knowledge, Attitudes, and Practices (KAP) survey on the taeniasis/cysticercosis complex. The baseline study found no Taenia spp. eggs via microscopy on 383 stool samples examined, and no T. solium DNA was detected on human stool and soil samples by Copro-qPCR. However, seroprevalence was 8.5% for human cysticercosis and 14% for porcine cysticercosis, as detected by in-house ELISA testing for T. solium. Moreover, 57.9% of participants who provided a stool sample were positive for at least one parasite. Following the sampling and characterization activities, local health workers implemented mass treatment with Niclosamide, based on evidence of ongoing transmission, high porcine seroprevalence, poor basic sanitation, and the presence of free-roaming pigs reported in the KAP survey. These findings provide scientific evidence to apply national public health policies for controlling taeniasis/cysticercosis complex in Coyaima. Full article

Background: The consumption of ultra-processed foods (UPFs) represents an important public health challenge, especially among education workers, whose intense routine can negatively impact eating habits. This study aimed to analyze the factors associated with the regular consumption of UPF among employees of the Federal Network of Professional, Scientific and Technological Education (RFEPCT) in Brazil. Methods: This was a cross-sectional study, with a quantitative approach, carried out with 1563 education workers. Validated instruments on eating habits (PeNSE), mental health (DASS-21) and quality of life (WHOQOL-bref) were used. The regular consumption of UPF was defined as intake on ≥5 days in the last seven days. The association between the regular consumption of UPF and sociodemographic, occupational, behavioral, mental health and quality of life variables was assessed by Poisson regression with robust variance, generating adjusted prevalence ratios (PRadj) and respective 95% confidence intervals. Results: The regular consumption of UPF was associated mainly with female gender, a lower age group, Southeast and Midwest regions, dissatisfaction with sleep and the body, physical inactivity and poor sleep quality. In addition, the findings suggested a significant relationship between the worst stress scores and soft drinks (PRadj: 2.11; CI: 1.43–3.13), anxiety and soft drinks (PRadj: 1.83; CI: 1.24–2.70) and depression and industrialized/ultra-processed salty foods (PRadj: 2.43; CI: 1.82–3.26). The same was observed in the scores for the worst perception of quality of life, where there was a prevalence of up to 2.32 in the psychological domain and the consumption of industrialized/ultra-processed salty foods. Conclusions: The findings indicate that multiple interrelated factors—individual, psychosocial and occupational—are associated with the consumption of UPF among education workers. These results reinforce the importance of institutional policies that integrate actions to promote dietary health, mental health care and improved working conditions in the education sector. Full article

Background: Type 2 diabetes (T2D) is a major global health concern influenced by sociodemographic and lifestyle factors. This study compared T2D risk scores between commerce and industry sectors and assessed the associations of age, sex, education, physical activity, diet, and smoking with elevated risk. Methods: This cross-sectional study included 56,856 men and 12,872 women employed in the commerce (n = 27,448) and industry (n = 42,280) sectors across Spain. Anthropometric, clinical, and biochemical data were collected. Four validated T2D risk scores (QDscore, Finrisk, Canrisk, and TRAQ-D) were calculated. Multinomial logistic regression models estimated adjusted odds ratios (ORs) for high-risk categories by sociodemographic and lifestyle characteristics. Results: Women in the industrial sector had significantly higher age, BMI, waist circumference, and lipid levels than those in commerce; differences among men were less marked. Across all participants, higher T2D risk scores were independently associated with physical inactivity (OR up to 12.49), poor Mediterranean diet adherence (OR up to 6.62), industrial employment (OR up to 1.98), and older age. Male sex was strongly associated with high Canrisk scores (OR = 6.31; 95% CI: 5.12–7.51). Conclusions: Employment in the industrial sector, combined with sedentary behavior and poor dietary habits, is independently associated with higher predicted T2D risk. Workplace prevention strategies should prioritize multicomponent interventions targeting modifiable risk factors, especially in high-risk subgroups such as older, less-educated, and inactive workers. Full article

Certain industries will bear a disproportionate share of the burden of climate change. Climate change risk perceptions can impact workers’ mental health and well-being; increased climate change risk perceptions are also associated with more favourable adaptive attitudes. It is, therefore, important to understand whether climate risk perceptions differ across workers between industries. We conducted an online survey of British Columbians (16+) in 2021 using social media advertisements. Participants rated how likely they believed their industry (Natural Resources, Science, Art and Recreation, Education/Law/Government, Health, Management/Business, Manufacturing, Sales, Trades) would be affected by climate change (on a scale from “Very Unlikely” to “Very Likely”). Ordinal logistic regression examined the association between occupational category and perceived industry vulnerability, adjusting for socio-demographic factors. Among 877 participants, 66.1% of Natural Resources workers perceived it was very/somewhat likely that climate change would impact their industry; only those in Science (78.3%) and Art and Recreation (71.4%) occupations had higher percentages. In the adjusted model, compared to Natural Resources workers, respondents in other occupations, including those in Art and Recreation, Education/Law/Government, Management/Business, Manufacturing, Sales, and Trades, perceived significantly lower risk of climate change-related industry impacts. Industry-specific interventions are needed to increase awareness of and readiness for climate adaptation. Policymakers and industry leaders should prioritize sectoral differences when designing interventions to support climate resilience in the workforce. Full article

The paper analyses the relationship between human capital formation and income growth in Burkina Faso using data from household surveys conducted in 2009 and 2018. By combining estimates from multiple linear regressions of the impact of human capital variables on income with variance decomposition techniques, this paper quantifies the contribution of education, health, underemployment, and dietary diversity to income growth. It distinguishes between the shares related to the effects of increasing capital factor endowments and those related to the returns on these endowments. The results demonstrate that an increase in human capital endowment is a key factor in determining workers’ income growth. Furthermore, the impact of human capital on income growth is greater when the endowment and return effects of these factors are both positive and high. These results also indicate that a significant improvement in household income is more likely to be achieved by interventions focused on both increasing human capital endowments and improving human capital outcomes. Full article

Organisations have provided health and safety (H&S) control measures for construction activities, but the literature suggests that implementing these measures in the construction industry remains a challenge. This study aims to explore the factors impeding the implementation of H&S control measures (barriers). The study followed a qualitative research approach using interview form as a data collection tool designed to collect qualitative data on the factors impeding the implementation of H&S control measures. Purposive sampling method was adopted. The content analysis method was used to analyse the collected data. The findings reveal that the implementation of H&S control measures is affected by different barriers. The study uncovered eight main barriers (lack of management support and commitment, implementation costs, lack of training and education, language and cultural differences, time pressure, prioritisation of production over H&S issues, lack of worker involvement and participation and lack of communication) to the implementation of H&S control measures. Respondents were mainly from H&S background; it would be interesting to explore the perceptions of site managers, engineers, designers, supervisors and field workers through the use of a quantitative approach involving a larger sample. By identifying and understanding these barriers to the implementation of H&S control measures, construction organisations could be in a better position to control construction hazards. This paper adds value to construction organisations and professionals’ understanding of barriers to the implementation of H&S control measures on construction sites. The study also recommends measures to remove barriers or facilitate better implementation of H&S control measures on construction sites. Full article

Infectious disease outbreaks amplify the influence of stressors on psychological conditions. The purpose of this study was to analyze the disturbing influence of COVID-19 outbreak-related information and the influence of trust on the Serbian healthcare system and COVID-19 preventive measures on anxiety and depression. An anonymous online questionnaire assessing the demographic information, disturbance level and causes, and levels of anxiety and depression has been distributed to the participants, divided into student and non-student groups. The non-student group was further divided into healthcare, military, and education workers. Anxiety and depression levels, as well as the level of decreased trust in COVID-19-related preventive measures, were higher among students compared to non-students (p = 0.011). Higher anxiety and depression levels, and higher influence of the COVID-19 outbreak on those levels, were observed in education and healthcare workers, compared to military personnel. Medical doctors reported a higher level of trust in the healthcare system compared to nurses (p = 0.023). Trust in the healthcare system increased more frequently compared to the pre-vaccination period among medical doctors, compared to nurses (p = 0.040). Higher anxiety and depression and lower public trust levels in students and workers in education and the healthcare sector indicate a need to focus on these important society members during public health emergencies. Full article

Background: The aim of this scoping review is to analyze the health status of Roma and Sinti in Europe, highlighting the issues faced by children and women. In addition, we want to examine the access of these groups to health care services and to identify possible interventions to increase their use. Methods: Our research was conducted on Pubmed, Google Scholar, and the Trip Database. We selected articles written in English, Spanish, and Italian published since 2015. Results: Studies have shown that the health status of Roma and Sinti populations is generally worse than that of the rest of the population. Limited access to care is due to several specific factors, such as beliefs, traditions, and the lack of awareness of widespread direct and indirect discrimination against these groups by healthcare professionals. The studies reviewed have shown how mistrust can be broken down through multi-centered interventions linked to information, education, and communication through mediators able to interact with these populations, as well as through appropriate training of the health workers in charge. Conclusions: The health of the Roma and Sinti populations is commonly worse than that of the rest of the population. This is particularly true for the large proportion of people confined to suburban camps. However, the available evidence signals the low quality of life they experience and the need for interventions involving the communities and the establishment of ad hoc orientation or initial care contact points in the segregated areas. This could lead to an improvement in the integration of this population into the National Health Systems’ activities. Full article

Background: Violence against healthcare professionals is a growing public health concern. In Spain, the National Observatory of Aggressions recorded 16,866 cases in 2024, marking a 103.06% increase since 2017. This phenomenon has intensified in recent years, with serious repercussions for both the physical and psychological well-being of healthcare workers, as well as for the quality of care provided. Objectives: This descriptive study examines the knowledge, perceptions, and experiences of workplace aggression among undergraduate students at the University School of Nursing of the Nuestra Señora de Candelaria University Hospital. Materials and Methods: A self-administered ad hoc questionnaire was distributed to 266 students across all academic years to assess their knowledge and to explore their perceptions and experiences of aggression witnessed or experienced during clinical placements. This study was guided by the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Results: The findings revealed significant educational gaps among students regarding how to manage aggressive situations, as well as high levels of concern and an aggression exposure rate exceeding 30%. A statistically significant association was also observed in relation to the academic year. Conclusions: This study provides a foundation for the development of specific training programmes tailored to the needs identified and for enhancing occupational safety in healthcare settings. Full article

Introduction: Racial and ethnic disparities in end-of-life (EOL) cancer care persist, leading to lower rates of advance care planning (ACP), reduced access to palliative care, and poorer patient outcomes for minority populations. While previous research has documented these inequities, less is known about the specific interventions developed to address them, necessitating a comprehensive review of existing strategies aimed at improving EOL care for racial and ethnic populations. The objective of this scoping review is to examine the extent and characteristics of interventions and their outcomes designed to address racial and ethnic disparities in EOL cancer care in the United States. Methods: A comprehensive search of EOL cancer care interventions for minority populations was conducted in Ovid MEDLINE, CINAHL with Full Text (EBSCOhost), and Scopus (Elsevier) in September 2024. Two independent reviewers screened titles, abstracts, and full texts following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, with inclusion limited to studies conducted in the US and published in English. Results: Of 3104 screened studies, 10 met the inclusion criteria. Participants enrolled were only from Latino (n = 6 studies) or Black (n = 4 studies) populations. We identified four types of interventions, including communication skills for patients, caregivers, researchers, and clinicians (n = 2), education programs for patients (n = 1), navigation and support programs for patients and caregivers (n = 3), and training programs for health workers and community leaders (n = 4). The most effective interventions were those that addressed linguistic barriers, integrated cultural values, and involved trusted community figures. Faith-based models were particularly successful among African American patients, while bilingual navigation and family-centered ACP interventions had the greatest impact in Latino populations. Conclusions: This review highlights (1) the importance of culturally tailored interventions for specific minority populations and (2) the limited number of such interventions, which primarily target only the largest minority groups. Full article

Background/Objective: Shift work has been increasingly associated with adverse metabolic outcomes, including insulin resistance (IR), a key contributor to cardiometabolic diseases. However, few large-scale studies have explored the association between shift work and validated IR indices across sociodemographic and lifestyle variables, stratified by sex. To investigate the relationship between shift work and four surrogate markers of insulin resistance—TyG índex, TyG-BMI, METS-IR (Metabolic score for insulin resistance), and SPISE-IR (Single-Point insulin Sensitivity estimator)—in a large Spanish working population and to assess how sociodemographic and behavioral factors modify these associations. Methods: This cross-sectional study included 53,053 employed adults (31,753 men and 21,300 women) across various regions and labor sectors in Spain. Participants were classified as shift or non-shift workers based on their work schedules. Data were collected during routine occupational health assessments and included anthropometric, clinical, biochemical, and behavioral variables. IR indices were calculated using standard formulas. Statistical analyses included t-tests, chi-square tests, and multivariable logistic regression, with stratification by sex. Results: Shift workers exhibited significantly higher levels of TyG, TyG-BMI, and METS-IR, and lower SPISE values compared to non-shift workers (all p < 0.001). These differences persisted after stratification by sex, age, education, and lifestyle factors. Logistic regression analyses confirmed that shift work independently predicted high IR risk across all indices, with adjusted ORs ranging from 1.49 to 1.89. Physical inactivity, low adherence to the Mediterranean diet, and alcohol consumption were the strongest modifiable predictors. Men exhibited a higher burden of IR than women across all indices. Conclusions: Shift work is independently associated with elevated insulin resistance in both men and women. These findings emphasize the importance of workplace health interventions targeting physical activity, diet, and substance use, particularly in populations engaged in non-standard work schedules. Full article