Search Results (541)

Background/Objectives: The COVID-19 pandemic caused pronounced disorder in healthcare delivery globally, including ophthalmology. Our study explores how ophthalmologists in Puerto Rico (PR) altered their practices during the pandemic, confronting obstacles such as resource shortages, evolving public health mandates, and unique socio-economic and geographic constraints. The study aims to enhance preparedness for future public health crises. Methods: We conducted descriptive analyses on four online surveys distributed at crucial time points of the pandemic (March 2020, May 2020, August 2020, August 2021) to all practicing ophthalmologists in PR (N ≈ 200), capturing data on closures, patient volume, personal protective equipment (PPE) access, telemedicine use, and financial relief. Results: Survey responses ranged from 41% (n = 81) to 56% (n = 111). By March 2020, 22% (24/111) of respondents closed their offices. By May 2020, 20% (19/93) of respondents maintained a closed office, while 89% (64/72) of open offices reported seeing less than 25% of their usual patient volume. Access to PPE was a challenge, with 59% (65/111) reporting difficulty obtaining N95 masks in March 2020. Telemedicine usage increased initially, peaking in May 2020 and declining in July 2020. By August 2021, all respondents were fully vaccinated and most practices returned to pre-pandemic levels. Overall, 86% (70/81) of respondents found the surveys to be useful for navigating practice changes during the pandemic. Conclusions: PR ophthalmologists showed adaptability during the COVID-19 pandemic to maintain care given limited resources. Guidelines from professional organizations and real time surveys play an important role in future crisis preparedness. Full article

This study examines whether regional infrastructure can predict economic resilience in European regions, focusing on resistance, recovery, and reorientation during the COVID-19 crisis. While infrastructure is widely recognized as a key factor influencing regional resilience, its explicit role has been underexplored in the European context. Using a comprehensive literature review and spatial econometric models applied to NUTS-2 level data from 2017 to 2024, we investigate the direct and spatial spillover effects of various infrastructure types—transportation, healthcare, tourism, education, and digital access—on regional resilience outcomes. We apply OLS and four spatial models (SEM, SLX, SDEM, SDM) under 29 spatial weighting matrices to account for spatial autocorrelation. Results show that motorway density, early school leaving, and healthcare infrastructure in neighbouring regions significantly affect resistance. For recovery, railway density and GDP per capita emerge as key predictors, with notable spatial spillovers. Reorientation is shaped by population structure, railway density, and tourism infrastructure, with both positive and negative spatial dynamics observed. The findings underscore the importance of infrastructure not only in isolation but also within regional systems, revealing complex interdependencies. We conclude that policymakers must consider spatial externalities and coordinate infrastructure investments to enhance regional economic resilience across interconnected Europe. Full article

COVID-19 vaccine hesitancy (VH), like attitudes towards other vaccines, is a critical global public health concern. Despite numerous studies covering psychological, sociodemographic, and other determinants of vaccine acceptance, resistance, and hesitance, few studies have reported these factors among students, particularly in politically unstable settings like Ukraine. This cross-sectional, descriptive, and quantitative study assesses hesitancy towards COVID-19 vaccines, utilizing the 5Cs Model. Among 936 respondents surveyed in 2023, 64% received at least one shot of the COVID-19 vaccine (acceptant), 11% were still considering getting vaccinated (hesitant), and 25% refused vaccination (resistant). Vaccination behavior is significantly associated with the 5Cs. Higher collective responsibility significantly increased acceptance and reduced resistance, while higher constraints lowered the chances of being either acceptant or resistant. Confidence protected against resistance. Complacency, counterintuitively, reduced odds of resistance, pointing to differences between passive hesitancy and active refusal. Male gender and sources of information and misinformation influenced confidence. Collective responsibility was positively associated with official sources and negatively with conspiracy beliefs. Complacency increased with official sources, while constraints and calculation were least explained by predictors. Practical barriers should be tackled through improved accessibility and fostering collective responsibility via targeted communication strategies. These findings provide actionable insights for policymakers, healthcare providers, and academic institutions to enhance vaccine uptake among university students, particularly in crisis settings. Full article

Background/Objectives: Access to health services is often limited due to socio-economic and organizational determinants of health systems, which lead to increased unmet healthcare needs. This study aimed to identify access barriers for the general population in Greece, including those that may have emerged following the COVID-19 pandemic. Methods: This was a cross-sectional survey of 1002 Greek citizens. A questionnaire regarding socio-demographics, healthcare utilization, and access to health services was used. Interviews took place between October and November 2022. Results: Of 837 participants who used health services in 2022, 82.6% had a medical consultation, 80.6% took diagnostic tests, and 63.6% visited a pharmacy for pharmaceuticals. Of those having a medical consultation, 33.1% did so at an NHS health unit, while 75% of the participants taking diagnostic tests visited a contracted private laboratory. Out of the 135 participants requiring hospitalization, 62% were hospitalized in a public hospital, while 85% of the participants requiring pharmaceuticals visited a private pharmacy. Access barriers in the past year were reported by 48% of the participants requiring a medical consultation, 34% of the participants requiring diagnostic tests, and 40% of the participants requiring hospitalization. The most common barriers were long waiting times and financial constraints. The main barrier to accessing pharmaceuticals was the availability and administration of the product. Conclusions: The identified healthcare access barriers highlight the vulnerabilities of the current health system in Greece, which were further exposed during the COVID-19 pandemic crisis. Addressing socioeconomic factors that are considered key access indicators should be the focus of future health policy initiatives. Full article

Background/Objectives: Emotional intelligence has emerged as a key factor in shaping nursing performance and care quality, yet its specific mechanisms and impact within the Greek public healthcare context remain underexplored. This study aimed to investigate the role of emotional intelligence in ethical behavior, crisis management, and the perceived quality of care among nurses working in Greek public hospitals. Methods: A cross-sectional survey was conducted among practicing nurses using validated instruments to assess emotional intelligence, ethical compliance, crisis management skills, and care quality. Data were analyzed using covariance-based structural equation modeling (CB SEM) to examine both direct and indirect relationships among variables. Results: The results indicated that emotional intelligence training had a strong and significant effect on nurses’ ethical behavior and their ability to manage critical situations. However, the direct effect of emotional intelligence on the perceived quality of care was not significant; instead, its influence was mediated through improvements in ethics and crisis management. Conclusions: These findings suggest that the benefits of emotional intelligence in nursing are most evident when integrated with supportive organizational practices and ongoing professional development. Overall, this study highlights the need for comprehensive emotional intelligence training and a supportive workplace culture to enhance ethical standards, resilience, and patient care quality in Greek healthcare settings. Full article

The global rise in urban-related health issues poses significant challenges to public health, particularly in cities facing socio-economic crises. In Lebanon, 70% of the population is experiencing financial hardship, and healthcare costs have surged by 172%, exacerbating the strain on medical services. Given these conditions, improving the quality and accessibility of green spaces offers a promising avenue for alleviating mental health issues in urban areas. This study investigates the psychological impact of nine urban public spaces in Beirut through a comprehensive survey methodology, involving 297 participants (locals and tourists) who rated these spaces using Likert-scale measures. The findings reveal location-specific barriers, with Saanayeh Park rated highest in quality and Martyr’s Square rated lowest. The analysis identifies facility quality as the most significant factor influencing space quality, contributing 73.6% to the overall assessment, while activity factors have a lesser impact. The study further highlights a moderate positive association (Spearman’s rho = 0.30) between public space quality and mental well-being in Beirut. This study employs a hybrid methodology combining Research for Design (RfD) and Research Through Designing (RTD). Empirical data informed spatial strategies, while iterative design served as a tool for generating context-specific knowledge. Design enhancements—such as sensory plantings, shading systems, and social nodes—aim to improve well-being through better public space quality. The proposed interventions support mental health, life satisfaction, climate resilience, and urban inclusivity. The findings offer actionable insights for cities facing public health and spatial equity challenges in crisis contexts. Full article

Introduction: This prospective descriptive study explored the disparities in perceptions and experiences regarding healthcare services between providers and users during the COVID-19 pandemic, with a specific focus on the impact of the digital divide on access to and quality of care. The study revealed significant inconsistencies in the experiences of healthcare providers and patients, particularly regarding the effectiveness of digital health interventions. Methods: This study was a prospective descriptive analysis conducted to evaluate and compare the use of electronic healthcare services between healthcare employees (HΕs) (N = 290) and consumers (Cs) (N = 263) from December 2024 to May 2025, utilizing an electronic survey after the COVID-19 pandemic. To ensure the statistical validity of the sample size, a power analysis was performed using G*Power 3.1.9.2 software. A questionnaire was developed to evaluate the readiness of healthcare employees and consumers for electronic healthcare services. It was validated to ensure reliability within this population and comprised 49 questions. Results: The response rate of the participants was 89.19%, and the Cronbach’s alpha for the questionnaire was 0.738. The study revealed notable differences in perceptions regarding health-related information and digital health technologies across genders and age groups. Specifically, 28.8% of females and 27.3% of males considered it important to be well-informed about health issues (χ² = 8.83, df = 3, p = 0.032). Conclusions: This research contributes to filling a gap in comparative analyses of provider and user perspectives, offering a comprehensive view of how digital health was adopted and experienced during a global crisis. Practically, it provides an evidence base to guide future interventions aimed at fostering more equitable, resilient, and user-friendly digital healthcare systems. Full article

Background/Objective: Fentanyl plays a pivotal role in the opioid epidemic, defined by four waves of overdose deaths. To analyse fentanyl research trends, examining its links to mental health, pharmaceutical development, healthcare, diseases, and pathophysiology within the broader social and health context of the time. Methods: To understand the evolution of scientific publications on fentanyl and its relationship to the opioid crisis, a search using Web of Science Core Collection and PubMed was conducted. A total of 53,670 documents were retrieved related to opioid scientific production, among which 1423 articles (3%) focused specifically on fentanyl. The 21,546 MeSH terms identified in these documents were analysed by publication year and specific fields: Psychiatry and Psychology, Chemicals and Drugs, Healthcare, Diseases, and Phenomena and Processes. R-statistical/FactoMineR libraries were used for the correspondence analysis. Results: In the first overdose death wave, research focused on improving therapies and reducing side effects. The second wave emphasised detoxification methods with naltrexone, methadone, and behavioural therapies. The third wave addressed psychological treatments and HIV-syringe-sharing prevention. The fourth wave prioritised less addictive analogues and understanding consumer profiles to combat the epidemic. Conclusions: Fentanyl research has evolved alongside real-world challenges, reinforcing the connection between patients’ needs, healthcare professionals’ roles, illicit users, policymakers, and the research community’s contributions to addressing both therapeutic use and its broader societal impact. These findings highlight the necessity for an interdisciplinary approach to scientific research integrating prevention, treatment, education, legal reform, and social support, emphasising the need for public health policies and collaborative research to mitigate its impact. Full article

Physician burnout is a multifaceted syndrome characterized by emotional exhaustion, depersonalization and a diminished sense of personal accomplishment. It affects physicians at various stages of their medical training more prevalently than their peers in the general population. This article aims to explore the systemic challenges contributing to physician burnout and the role of individual resilience as a mitigating factor. The article highlights that burnout not only impacts physician well-being but also patient care, organizational performance and healthcare costs. Factors such as heavy workload, long hours and poor interpersonal relationships significantly contribute to burnout, while personal characteristics and coping mechanisms can influence its prevalence. By examining the interplay between systemic challenges and individual resilience, this article contributes to a deeper understanding of physician burnout. It offers insights into potential strategies for mitigation, highlighting the importance of both organizational and personal interventions in addressing this escalating crisis. Full article

The growing urgency of the climate crisis has heightened the importance of integrating sustainability into health education. Allied health professionals are well positioned to lead sustainable healthcare efforts, yet evidence suggests a persistent gap between student awareness and formal training. This study explored the perspectives, knowledge, and attitudes of Portuguese allied health students regarding sustainability. An online and anonymous cross-sectional survey was conducted among undergraduate and graduate students across multiple allied health disciplines. The questionnaire assessed general knowledge, perceptions of curricular integration, and attitudes toward sustainable clinical practice. A total of 247 (response rate of 8.23%) students participated, with the majority expressing high concern about climate change and strong support for environmentally responsible healthcare. However, the results revealed inconsistent awareness of healthcare’s environmental footprint and a limited exposure to structured sustainability education. Friedman tests indicated significant variability in students’ knowledge, perceived responsibility, and curricular experiences. Students identified priority themes for curricular inclusion—such as the environmental impact of the health system—and recognized their alignment with the UN Sustainable Development Goals (SDGs), particularly SDG 3 (Good Health) and SDG 13 (Climate Action). The findings highlight the need for the systematic, competency-based integration of sustainability into allied health curricula to support a climate-resilient and ecologically responsible future healthcare workforce. Full article

The management of public health projects in a BANI (brittle, anxious, non-linear, incomprehensible) environment, exemplified by the ongoing war in Ukraine, presents unprecedented challenges due to fragile systems, heightened uncertainty, and complex socio-political dynamics. This study proposes an AI-driven framework to enhance the resilience and effectiveness of public health interventions under such conditions. By integrating a coupled SEIR–Infodemic–Panicdemic Model with war-specific factors, we simulate the interplay of infectious disease spread, misinformation dissemination, and panic dynamics over 1500 days in a Ukrainian city (Kharkiv). The model incorporates time-varying parameters to account for population displacement, healthcare disruptions, and periodic war events, reflecting the evolving conflict context. Sensitivity and risk–opportunity analyses reveal that disease transmission, misinformation, and infrastructure damage significantly exacerbate epidemic peaks, while AI-enabled interventions, such as fact-checking, mental health support, and infrastructure recovery, offer substantial mitigation potential. Qualitative assessments identify technical, organisational, ethical, regulatory, and military risks, alongside opportunities for predictive analytics, automation, and equitable healthcare access. Quantitative simulations demonstrate that risks, like increased displacement, can amplify infectious peaks by up to 28.3%, whereas opportunities, like enhanced fact-checking, can reduce misinformation by 18.2%. These findings provide a roadmap for leveraging AI to navigate BANI environments, offering actionable insights for public health practitioners in Ukraine and other crisis settings. The study underscores AI’s transformative role in fostering adaptive, data-driven strategies to achieve sustainable health outcomes amidst volatility and uncertainty. Full article

The COVID-19 pandemic sparked changes globally, as leaders scrambled to protect wellbeing and safety. With many U.S. students sent away from their campuses, undergraduate students still grappled with the time-old question: “what will I do after college,” except during an unprecedented time in history rife with heightened career uncertainty. This qualitative study presents the results of a survey administered as part of a mind–body health project conducted in the wake of the pandemic, speaking directly to undergraduate college students’ health-related career aspirations. Two open-ended survey questions—(1) what is your intended career, and (2) how (if at all) has the COVID-19 pandemic changed your perspective about your future career—were administered with thematic analysis conducted. Qualitative analysis using hybrid data and theory-driven approaches revealed several themes around an increased desire to work within health-related fields, decreased desire to work in healthcare, non-medical to medical career shift, and additional undecidedness. Connecting theory to practice, Super’s Life-Space, Life-Span Career Theory and Krumboltz’s Social Learning Theory of Career Decision-Making guide practical implications and grander discussion around career development during periods of crisis. Full article

The distribution of the health workforce affects the availability of health service delivery to the public. In practice, the demographic and geographic maldistribution of the health workforce is a long-standing national crisis. In this study, we present an approach based on Functional Principal Component Analysis (FPCA) of data to identify patterns in the availability of health workers across different regions of Kazakhstan in order to forecast their needs up to 2033. FPCA was applied to the data to reduce dimensionality and capture common patterns across regions. To evaluate the forecasting performance of the model, we employed rolling origin cross-validation with an expanding window. The resulting scores were forecasted one year ahead using Autoregressive Integrated Moving Average (ARIMA) and Long Short-Term Memory (LSTM) methods. LSTM showed higher accuracy compared to ARIMA. The use of the FPCA method allowed us to identify national and regional trends in the dynamics of the number of doctors. We identified regions with different growth rates, highlighting where the most and least intensive growth is taking place. Based on the FPSA, we have predicted the need for doctors in each region in the period up to 2033. Our results show that the FPCA can serve as a significant tool for analyzing the situation relating to human resources in healthcare and be used for an approximate assessment of future needs for medical personnel. Full article

Neglecting preventive healthcare policies has contributed to the global surge in chronic diseases, increased hospitalizations, declining quality of care, and escalating costs. Non-communicable diseases (NCDs)—notably cardiovascular conditions, diabetes, and cancer—consume over 80% of healthcare expenditure and account for more than 60% of global deaths, which are projected to exceed 75% by 2030. Poor diets, sedentary lifestyles, regulatory loopholes, and underfunded public health initiatives are driving this crisis. Compounding the issue are flawed policies, congressional lobbying, and conflicts of interest that prioritize costly, hospital-based, symptom-driven care over identifying and treating to eliminate root causes and disease prevention. Regulatory agencies are failing to deliver their intended functions. For instance, the U.S. Food and Drug Administration’s (FDA) broad oversight across drugs, devices, food, and supplements has resulted in inefficiencies, reduced transparency, and public safety risks. This broad mandate has allowed the release of unsafe drugs, food additives, and supplements, contributing to the rising childhood diseases, the burden of chronic illness, and over-medicalization. The author proposes separating oversight responsibilities: transferring authority over food, supplements, and OTC products to a new Food and Nutraceutical Agency (FNA), allowing the FDA to be restructured as the Drug and Device Agency (DDA), to refocus on pharmaceuticals and medical devices. While complete reform requires Congressional action, interim policy shifts are urgently needed to improve public health. Broader structural changes—including overhauling the Affordable Care Act, eliminating waste and fraud, redesigning regulatory and insurance systems, and eliminating intermediaries are essential to reducing costs, improving care, and transforming national and global health outcomes. The information provided herein can serve as a White Paper to help reform health agencies and healthcare systems for greater efficiency and lower costs in the USA and globally. Full article

Mental illness has emerged as a significant global health crisis, inflicting immense suffering and causing a notable decrease in productivity. Identifying mental health disorders at an early stage allows healthcare professionals to implement more targeted and impactful interventions, leading to a significant improvement in the overall well-being of the patient. Recent advances in Artificial Intelligence (AI) have opened new avenues for analyzing medical records and behavioral data of patients to assist mental health professionals in their decision-making processes. In this study performance of four Randomized Neural Networks (RandNNs) such as Board Learning System (BLS), Random Vector Functional Link Network (RVFLN), Kernelized RVFLN (KRVFLN), and Extreme Learning Machine (ELM) are explored for detecting the type of mental illness a user may have by analyzing the random text of the user posted on social media. To improve the performance of the RandNNs during handling the text documents with unbalanced class distributions, a hybrid feature selection (FS) technique named as TOPSIS-ModCHI is suggested in the preprocessing stage of the classification framework. The effectiveness of the suggested FS with all the four randomized networks is assessed over the publicly available Reddit Mental Health Dataset after experimenting on two benchmark multiclass unbalanced datasets. From the experimental results, it is inferred that detecting the mental illness using BLS with TOPSIS-ModCHI produces the highest precision value of 0.92, recall value of 0.66, f-measure value of 0.77, and Hamming loss value of 0.06 as compared to ELM, RVFLN, and KRVFLN with a minimum feature size of 900. Overall, utilizing BLS for mental health analysis can offer a promising avenue toward improved interventions and a better understanding of mental health issues, aiding in decision-making processes. Full article